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GOP Senate Healthcare Bill Collapses...
victor809 Offline
#51 Posted:
Joined: 10-14-2011
Posts: 23,866
Come on macs... cost structure for a Dr check up is significantly lower than an er visit... a strong argument could be made that a reduction in ER visits can easily make up for an increase in Drs office checkups.

I'm not even arguing for Obamacare. I'm just trying to tell you that the healthcare market is not as simple as a 3 minute Prager video wants you to believe.
MACS Offline
#52 Posted:
Joined: 02-26-2004
Posts: 79,601
frankj1 wrote:
they used to go to the ER for runny noses when not covered cuz they had no primary care physician...and we'd pay.
Many ER's actually started to show a profit when treating actual emergencies.


Because they charge more, more people are going... and once again, the gov't pays with taxpayer money, and doesn't care that the doctor charges $3500 for a 5 minute visit and a prescription for antibiotics.
victor809 Offline
#53 Posted:
Joined: 10-14-2011
Posts: 23,866
Is that actually happening or is that what you imagine is happening?
teedubbya Offline
#54 Posted:
Joined: 08-14-2003
Posts: 95,637
No it isn't.
Speyside Offline
#55 Posted:
Joined: 03-16-2015
Posts: 13,106
So now the Republicans want to vote on repeal. Can you hear the careers going down the drain?
MACS Offline
#56 Posted:
Joined: 02-26-2004
Posts: 79,601
Speyside wrote:
So now the Republicans want to vote on repeal. Can you hear the careers going down the drain?


That's what a lot of folks want. They want it repealed, and not replaced.
DrafterX Offline
#57 Posted:
Joined: 10-18-2005
Posts: 98,512
Think
So, I should send more peoples to the ER..?? Huh
frankj1 Offline
#58 Posted:
Joined: 02-08-2007
Posts: 44,211
MACS wrote:
That's what a lot of folks want. They want it repealed, and not replaced.

but they voted for the guy saying better coverage for less money
DrafterX Offline
#59 Posted:
Joined: 10-18-2005
Posts: 98,512
they just wanted Obama stuff un-done... Mellow
victor809 Offline
#60 Posted:
Joined: 10-14-2011
Posts: 23,866
Shhh... don't pay attention to what people did Frank. Just what they say.
delta1 Offline
#61 Posted:
Joined: 11-23-2011
Posts: 28,755
The healthcare INSURANCE system was broken before Obamacare. After the ACA, the healthcare INSURANCE system is still broken, and slowly getting worse, for a multitude of reasons but primarily because the party in power refuses to promote the exchanges, enforce the mandate and skip paying subsidies.

The interesting thing is that although the American people were conditioned to believe that the ACA/Obamacare program was a catastrophe that would destroy America, it actually provided 20 million MORE Americans with decent health insurance, with minimum levels of benefits and where those with pre-existing conditions couldn't be denied coverage.

Even though many Americans still deplore Obamacare, they love the health insurance they got as a result of the ACA, and will not give it up willingly, even if the GOP says it sucks so it should be repealed. It aint gonna be repealed...we'll eventually get around to tinkering with the problems with the state exchanges, pressure will be put on the market to promote the purchase of insurance without a mandate, in the form of subsidies or penalties for buying insurance after an accident, employer based health insurance will not be required...and other potential fixes...
DrafterX Offline
#62 Posted:
Joined: 10-18-2005
Posts: 98,512
let it happen at the state level... Mellow
teedubbya Offline
#63 Posted:
Joined: 08-14-2003
Posts: 95,637
except for removing the whole state line thing that causes all the problems

Sarcasm
DrafterX Offline
#64 Posted:
Joined: 10-18-2005
Posts: 98,512
just give everybody what they had 10 years ago and call it good... Mellow
teedubbya Offline
#65 Posted:
Joined: 08-14-2003
Posts: 95,637
I'd be back to never being able to change jobs due to a preexisting condition but I suppose that's ok.
MACS Offline
#66 Posted:
Joined: 02-26-2004
Posts: 79,601
Taking on people with pre-existing conditions is like telling auto insurance companies they have to insure the guy that's been in 12 accidents. You're asking them to board a sinking ship. What business in their right mind would do that? It raises rates for everyone else.

If what you guys say is true, and all these folks were just going to the emergency room, and they were getting covered at our expense there... why the outrage? They're still covered if it gets repealed, right? They'll just go to the emergency room, like before... so what's the big deal?

Or maybe you're just talking out your ass.
DrafterX Offline
#67 Posted:
Joined: 10-18-2005
Posts: 98,512
I think there's a code for that... Mellow
teedubbya Offline
#68 Posted:
Joined: 08-14-2003
Posts: 95,637
MACS wrote:
Taking on people with pre-existing conditions is like telling auto insurance companies they have to insure the guy that's been in 12 accidents. You're asking them to board a sinking ship. What business in their right mind would do that? It raises rates for everyone else.

If what you guys say is true, and all these folks were just going to the emergency room, and they were getting covered at our expense there... why the outrage? They're still covered if it gets repealed, right? They'll just go to the emergency room, like before... so what's the big deal?

Or maybe you're just talking out your ass.



Its not that simple Mr Trump LOL

But I do know a little about health care delivery systems, payment and insurance from the inside and outside. It's one thing I do know.

As for the preexisting condition at least you are honest about it. You are cool with it.

One of the companies I worked for wanted to exclude preventative care and restrict prenatal care because statistically folks would likely change insurance before any benefit (savings) were recognized so why would we pay for another insurance companies savings LOL

wicked business
DrafterX Offline
#69 Posted:
Joined: 10-18-2005
Posts: 98,512
well, if you'd quit drinking with your antibiotics your hep just might go away.... Shame on you
teedubbya Offline
#70 Posted:
Joined: 08-14-2003
Posts: 95,637
DrafterX wrote:
well, if you'd quit drinking with your antibiotics your hep just might go away.... Shame on you



but there is pee everywhere


by the way with DNA testing there is a legal argument for preexisting conditions prior to birth thus never eligible for insurance.
DrafterX Offline
#71 Posted:
Joined: 10-18-2005
Posts: 98,512
but they can still go to da methadone clinic tho right..?? Huh
teedubbya Offline
#72 Posted:
Joined: 08-14-2003
Posts: 95,637
yea and they can still vote in the mexican elections
DrafterX Offline
#73 Posted:
Joined: 10-18-2005
Posts: 98,512
well hell.... what else do they need..?? Huh
teedubbya Offline
#74 Posted:
Joined: 08-14-2003
Posts: 95,637
chalupas?
DrMaddVibe Offline
#75 Posted:
Joined: 10-21-2000
Posts: 55,311







NOBODY




EXPECTS




THE





SPANISH






INQUISITION!!!!!






Frying pan
MACS Offline
#76 Posted:
Joined: 02-26-2004
Posts: 79,601
I understand it isn't that simple, Tim.

I am vehemently against government mandated, and/or government provided health insurance. The excuse that some people go bankrupt because of catastrophic illnesses is not valid to me. Yes, it happens, and I do feel bad for the people it happens to (in most cases).

It is not our governments responsibility to ensure that does not happen. And I would add that it doesn't happen to enough people to make a mandate that everyone buy it or get penalized. Think about what the ACA did... it mandated that you purchase something. No way out of it.

If you don't want to buy home insurance - rent. If you don't want to buy car insurance - take the bus/uber/cab. If you don't want to buy health insurance... too bad, you have to or we fine you. That is wrong, wrong, wrong on so many levels.

Before, people were able to shop for what they wanted/needed.... the ACA has mandates on what your insurance must cover. That's wrong, too.

Can anyone argue that prices, premiums, and copays have not gone up, for most people?
teedubbya Offline
#77 Posted:
Joined: 08-14-2003
Posts: 95,637
There were winners and losers for sure. Some went up more than they would have others didn't.

I agree with you on much of what you say however. The pre-existing thing bothers me though. We do need a way to not penalize someone who develops a condition especially not of their own doing. My dad could not change jobs because of my brothers condition and I couldn't now because of my heart.

I hate the individual mandate and the whole concept of it. It was one avenue for dealing with the pre-existing issue. You need healthy in the pool to spread the risk of the unhealthy and can not allow folks to come in when they are sick.

I said up front the other way is to hit a reset button, give everyone an avenue in to the pool and allow movement within companies with some tie to a pool (overgeneralizing but there is a way). You wouldn't be forced in, but if you chose not to and got sick you are simply left to pay for it yourself or die if you can not. And we need to be hard core about it. The problem is America is a bunch of softies and we can't or won't do that.

I'm no fan of obama care. Never have been. It does have some good components to it though. My issue is the spaghetti manor in which it was developed and implemented combined with the special interests that bought favors. Its not comprehensive, is rag tag and not well thought out. And the individual mandate is unamerican at best.

There is and has been a bunch of shysters out there selling insurance with no value. It doesn't do much good to the pool to have folks insured with a no value plan. But obammy care went way overboard with it's minimums .



How about a catastrophic only plan (like an umbrella plan) that you can buy into one time and as long as you don't lapse you are ok. If you don't buy in or it lapses you are on your own even if that means death. If you chose to buy anything more than that thats on you or your employer.


I'm ok with that.
teedubbya Offline
#78 Posted:
Joined: 08-14-2003
Posts: 95,637
Or you could just let everyone buy in to Medicare and make it actuarial y sound rather than the disconnect between paid in and benefit we have now. But that would drive costs up for many too because even though folks think they pay in to it, in no way is premium tied to expenditure and it too is by definition an entitlement program.
DrMaddVibe Offline
#79 Posted:
Joined: 10-21-2000
Posts: 55,311
AtlasMD...check it out...


https://www.youtube.com/watch?v=ANSF43Rd7bQ
victor809 Offline
#80 Posted:
Joined: 10-14-2011
Posts: 23,866
teedubbya wrote:
You wouldn't be forced in, but if you chose not to and got sick you are simply left to pay for it yourself or die if you can not. And we need to be hard core about it. The problem is America is a bunch of softies and we can't or won't do that.


This is the key here that I was trying to emphasize.

Currently, we don't let people die.

Everyone gets the 20" tv, even if they chose not to buy a tv. This changes the economics of how a person makes a buying choice.

I don't care about a person's bankruptcy or death. But the bankruptcy screws up the costs for everyone else in the system, and the death is something the hospitals are unwilling to allow to happen, screwing up the costs for everyone else in the system.

Don't get me started on pre-existing conditions. While I agree that sucks to have one, I really really really don't agree with forcing a company to insure without allowing them to take that risk into account. It'd be like forcing casinos to hit on 19. It takes away a lot of the "risk" for the buyer of insurance. I understand why they had to sell off the healthy to the insurance companies to get them to accept that group. Something else needs to be done with pre-existing conditions (and as our genetic testing gets better, I agree with TW that pre-existing conditions are going to start getting identified prenatally) because to pretend we are working on an "insurance" type of model in that case is just fooling ourselves.
frankj1 Offline
#81 Posted:
Joined: 02-08-2007
Posts: 44,211
I'm just not OK with letting sick people die if they are too poor to afford life.
teedubbya Offline
#82 Posted:
Joined: 08-14-2003
Posts: 95,637
Let them have cake
MACS Offline
#83 Posted:
Joined: 02-26-2004
Posts: 79,601
frankj1 wrote:
I'm just not OK with letting sick people die if they are too poor to afford life.


Me neither. I just don't think forcing everyone else to bear the burden is right, or fair. Hypothetically speaking... having all of us in the insurance pool was supposed to lower prices. It didn't... because half the folks (if not more) were getting it paid for or subsidized by the rest of us.

When you rob from Peter to pay Paul, you'll always have Paul's support. What happens when Peter runs out of stuff to rob? Or when he just quits, and gets in line with Paul? Socialism, in all it's forms, is and always will be an abject failure.
victor809 Offline
#84 Posted:
Joined: 10-14-2011
Posts: 23,866
Come on macs.... this is possibly one of the most frustratingly naive comments.

You are not ok with sick people dying from an inability to afford care but you don't want the people who can afford to pay for it to have to pay for it?

You can't have it both ways. Either nut up and accept that poor people should die if they can't afford care or go join the socialist party and bernie sanders...
frankj1 Offline
#85 Posted:
Joined: 02-08-2007
Posts: 44,211
I wasn't making a political statement, just a personal one.

There must be an answer that allows for us to help those living outside of our enviable prosperity.
To my way of thinking, that is a requirement if we want to be the greatest society in history.

ymmv, I am aware.
MACS Offline
#86 Posted:
Joined: 02-26-2004
Posts: 79,601
victor809 wrote:
Come on macs.... this is possibly one of the most frustratingly naive comments.

You are not ok with sick people dying from an inability to afford care but you don't want the people who can afford to pay for it to have to pay for it?

You can't have it both ways. Either nut up and accept that poor people should die if they can't afford care or go join the socialist party and bernie sanders...


You read what I wrote, then you put it in YOUR words, not mine. You do it ALL the time. That is frustrating.

I said FORCED to pay. If the liberals in this world want to help everyone, they can do so willingly with their money, right? So we don't have to force anyone to pitch in... all these altruistic people will be happy to do it.

Oh, wait... then they'd have to use their own money.

I give to charity. I've donated to gofundme accounts. I've helped friends and family and expected nothing in return. I'm big on sharing... on MY terms. To people whom I feel deserve the help. I don't think we should ever be forced to do so.
delta1 Offline
#87 Posted:
Joined: 11-23-2011
Posts: 28,755
MACS...you are mandated by law to buy auto insurance in CA, right? That was a GOP idea, which I hated at the time. But guess what, the rates stabilized, more insurance companies are competing for business, coverage minimums work and rate increases are controlled. An example of a govt. mandate that worked...
victor809 Offline
#88 Posted:
Joined: 10-14-2011
Posts: 23,866
Macs. Then you live in a fantasy land if you think people will voluntarily give enough of their own income to help pay the poor people's medical needs. ... helping your friends and family doesn't do the devastatingly poor any good. None of us are ever going to be traveling in circles that would result in us paying their medical bills. What do you propose? Every poor person start a gofundme whenever they need a medical procedure? Are you suggesting charities? Because then you're gonna violate your Prager u course lesson on 3rd party payer.

At least I'm honest enough to say the biggest problem I see is cleaning the dead bodies off the street.

MACS Offline
#89 Posted:
Joined: 02-26-2004
Posts: 79,601
delta1 wrote:
MACS...you are mandated by law to buy auto insurance in CA, right? That was a GOP idea, which I hated at the time. But guess what, the rates stabilized, more insurance companies are competing for business, coverage minimums work and rate increases are controlled. An example of a govt. mandate that worked...


I can opt out of that, as I said. I can use the bus, uber, a cab, walk, ride a bike... We can't opt out of the ACA, or we get fined. Many people were paying the $600 fine because it was cheaper... and they still didn't have health care. So it helped some poor, but hurt a lot of others.

And I don't know about you, but even with USAA I think my auto insurance is too damn high. Especially here in CA, close to the border.

Victor... I realize it's fantasy land. Everyone is for it until it's their own money.
MACS Offline
#90 Posted:
Joined: 02-26-2004
Posts: 79,601
BTW - had a buddy in the Navy. We've been friends for 24 years. He is an alcoholic, lost his job, wife, kids, and dove into the bottle further. He was homeless.

I bought him a cell phone so he could text me. Let him stay with me, wash his clothes, eat my food, bought him clothes, back-packs, shoes, always had him for holidays... (couldn't/wouldn't let him stay permanently) and finally, when he was ready, got him in to a Christian based (free) rehab. He's been clean for a year and graduates the program Sunday.

I genuinely care about people. As I said, though... I don't believe you, who has readily admitted you do not, should be forced to provide for poor people. I can say, with complete conviction having spent time with a man who was homeless for a few years, 99% of the homeless population put themselves there through a series of poor choices over a number of years.

Alcoholics, dopers, criminals, or just people who are nuts. I feel bad for the nuts.
teedubbya Offline
#91 Posted:
Joined: 08-14-2003
Posts: 95,637
I know you were exaggerating with the 100% number since a huge number are due to mental illness not of their doing. But good on you.
delta1 Offline
#92 Posted:
Joined: 11-23-2011
Posts: 28,755
The health insurance business was not working for most Americans before Obamacare, unless they were fortunate enough to work for large companies or government entities. People working for small businesses or who were buying individual personal plans had to pay exorbitant premiums for junk insurance. Many basic health benefits were not covered. Annual deductibles and caps were outrageous. Premiums were going up at alarming rates, in some cases more than 100% per year. Profits were going up for the for-profit carriers faster than premiums.

Insurance companies could cherry pick who to sell policies to, and deny coverage to others. They would deny payment for stuff the insured thought was in the policy. Those with pre-existing conditions couldn't get insurance at all. That was the state of our free market health insurance system. Who wants to go back to those conditions?
MACS Offline
#93 Posted:
Joined: 02-26-2004
Posts: 79,601
teedubbya wrote:
I know you were exaggerating with the 100% number since a huge number are due to mental illness not of their doing. But good on you.


Not in my experience. Most of the nuts are people who've abused meth for far too long... that IS of their own doing. Very few just have mental issues. The overwhelming majority are drunks, dopers, and criminals whose families have had it with them.
teedubbya Offline
#94 Posted:
Joined: 08-14-2003
Posts: 95,637
While there are many of them there are also many where it's not their doing.
victor809 Offline
#95 Posted:
Joined: 10-14-2011
Posts: 23,866
Macs I don't question you're a generous guy. I'm actually surprised you had an associate who was homeless (Not for any reason than it's statistically improbable). The guy was lucky to know you. But most homeless don't have someone with resources in their circle of friends... usually because of their bad choices or crazy.

If you want to ensure consistent access to any life or death level medical services you simply are going to have to have some large bureaucratic entity... and the resources to fund it. That means taxes or the convoluted Obamacare system. That's just reality. You can't ensure sufficient funds for all those who need it, or even make sure you're setting up an accurate system of delivery without something like that.

People seem to miss that issue with a lot of our modern problems. They want the problem (whether it be homeless people pissing on the street... or poor people needing medical care... ) to just not be a problem. But they don't think there needs to be money used to solve the problem... or blood. Blood solves the problem too.
teedubbya Offline
#96 Posted:
Joined: 08-14-2003
Posts: 95,637
Very few would be an incorrect statement I beleive. But I get your point.
victor809 Offline
#97 Posted:
Joined: 10-14-2011
Posts: 23,866
I can say in SF a lot of the homeless seem crazy. But they also seem to have a very interesting sense self preservation. They do something nuts... but not if it gets them the attention of someone larger than them.

Some of this could very well be due to huge amounts of drug use... their brains seem busted.
delta1 Offline
#98 Posted:
Joined: 11-23-2011
Posts: 28,755
Health Insurance policies under Obamacare seek to help the drug abuse/mental health problem vicious cycle. Whether it starts with mental health problems that lead to drug abuse or vice versa, our society has recognized that we should be looking at that as a treatable illness and not the criminal justice problem it has become. It costs much more as a criminal justice problem...

The objective is to provide early, and less expensive, treatment, whether for drug abuse or mental problems, and hopefully make that person a productive member of society. Treating him early might keep that person from spinning down the drain, increasing costs of dealing with him as his problems become more severe. Many families turn their back because he/they can't afford health insurance and trying to pay for his medical bills would drag the rest of them down.
MACS Offline
#99 Posted:
Joined: 02-26-2004
Posts: 79,601
^^I don't argue that a lot of alcohol and drug abusers have underlying mental health issues. The problem is, their drug use leads to robbery, burglary, theft, and a multitude of other crimes against people. They deserve time for that.

We have many programs for them in the jail. RSAT - residential substance abuse treatment is very ineffective. Maybe works for 15-20% because most of them go right back to it. I had a guy tell me he was high again less than an hour after release. Guess where he is? Yep... back in custody.
delta1 Offline
#100 Posted:
Joined: 11-23-2011
Posts: 28,755
Nobody opts out of getting sick. Mental health and substance abuse is just a small slice of the population that has been helped by Obamacare...more than 20 million people have health insurance now compared to the number before...the percentage of Americans without health insurance, about 12%, is the lowest ever...the vast majority are low income WORKING Americans.
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