Mandatory Health Insurance part 3

[Irvine511]

I'll further extrapolate out and predict that you won't make this argument when overturning statutes, ballot referendums and state constitutions concerning same-sex marriage is on the Supreme Court's docket.

Because minority rights and health care are the same thing? Because the people of California voted to take away the health insurance of red heads?

Oh, wait, this is all just point scoring and my side vs. your side for the right. Feel free to continue to feel under siege.

You know, Israelis have universal health care.

 

[financeguy]

TBH, free entry to A&E, whatever about what happens later after a condition is diagnosed, just seems like a basic hallmark of a decent and civilised society. To call it socialism is just absurd. Charging for A&E is something only the privateer brigade, the "privatise everything" wingnuts, would think is a good idea. Didn't work in the 80s, doesn't make sense now either. Even Thatcher didn't go near the NHS.

As for Steve1998, he is obviously trolling or being ironic.

 

[martha]

I'll further extrapolate out and predict that you won't make this argument when overturning statutes, ballot referendums and state constitutions concerning same-sex marriage is on the Supreme Court's docket.

Dude, fucking chill.

purpleoscar seemed to be complaining that the Supreme Court (I refuse to use that hideous acronym) was legislating. I was pointing out that the law that was upheld had been legislated. That's all.

 

[INDY500]

Sorry, strawman argument. There are plenty of employed young people who choose not to buy health insurance because they are "healthy," but they can't afford to pay their medical bills if they have a catastrophic injury or illness like cancer.

1) The employed, "young and healthy" need the option of catastrophic, high deductible insurance. If they don't buy that then they are gambling in a manner no different than not buying insurance on their house or saving for retirement. If one chooses to act irresponsibly with their money I lose a certain deal of economic compassion for them.

2) This law now forces the employed, "young and healthy" to buy comprehensive insurance (which actuarially and in reality most won't need) or pay the tax. Obamacare enforces community rating on the "young and healthy" which means their premium is the same as a 55 yo with diabetes, hypertension and a history of heart attacks. In the name of fairness of course.
I wonder at what point the "young and healthy" will realize they are the revenue patsies in this scheme?

 

[maycocksean]

1) The employed "young and healthy" need the option of catastrophic, high deductible insurance. If they don't buy that then they are gambling in a manner no different than not buying insurance on their house or saving for retirement. If one chooses to act irresponsibly with their money I lose a certain deal of economic compassion for them.

So you're arguing that these people should be denied care then. Because that's the only way the housing/saving for retirement analogy works. They should have not been so short sighted as not to purchase catastrophic care so they should be turned away at the ER door no?

2) This law now forces them to buy comprehensive insurance or pay the tax. I wonder at what point the "young and healthy" will realize they are the revenue patsies in this scheme?

Prior to this law the tax came in the form of higher healthcare costs to cover the costs of those who show up in the emergency room and can't pay. I suppose I understand, given your distaste for the government, why you would prefer to keep those costs being passed on in the private sector rather than via a government tax, but lets not pretend that we haven't been paying for the uninsured all along.

 

[Danny Boy]

1) The employed "young and healthy" need the option of catastrophic, high deductible insurance. If they don't buy that then they are gambling in a manner no different than not buying insurance on their house or saving for retirement. If one chooses to act irresponsibly with their money I lose a certain deal of economic compassion for them.

2) This law now forces the employed "young and healty" to buy comprehensive insurance (which actuarially and in reality most won't need) or pay the tax. I wonder at what point the "young and healthy" will realize they are the revenue patsies in this scheme?

Of course they are the revenue source. No health insurance plan works if only old sick people are paying premiums. And someday, those young healthy people will be old and sick.

I suppose you would like to get rid of social security as well.

 

[INDY500]

So you're arguing that these people should be denied care then. Because that's the only way the housing/saving for retirement analogy works. They should have not been so short sighted as not to purchase catastrophic care so they should be turned away at the ER door no?

I didn't say denied care or asked to pay up front. I said not resolved of responsibility in the same way someone leaving a restaurant or gas station without paying isn't granted immunity because "they don't want to pay."
And I'm talking about bills that, in most cases, that total less then 6 months income. The same way someone failing to pay their income tax isn't forgiven.

By the way, the individual mandate at one time pushed by some Republicans as a response to Hillarycare, it was a mandate to buy high deductible insurance or post a bond that health care providers could use for reimbursement. An altogether different animal than the Obamacare mandate.

Prior to this law the tax came in the form of higher healthcare costs to cover the costs of those who show up in the emergency room and can't pay. I suppose I understand, given your distaste for the government, why you would prefer to keep those costs being passed on in the private sector rather than via a government tax, but lets not pretend that we haven't been paying for the uninsured all along.

I haven't been, it's called cost-shifting. Another form of cost-shifting is when Medicare or Medicaid cuts back on reimbursement rates and that loss of revenue is then passed on to private payers. Expect more of that one in the future.

 

[Danny Boy]

I didn't say denied care or asked to pay up front. I said not resolved of responsibility in the same way someone leaving a restaurant or gas station without paying isn't granted immunity because "they don't want to pay."
And I'm talking about bills that, in most cases, that total less then 6 months income. The same way someone failing to pay their income tax isn't forgiven.

They do get billed, and their accounts even get handed over to collection agencies, but a lot of it never gets paid and the cost gets passed on to the insured. Unreimbursed care has only been going up and up since the economy has been in the shitter.

 

[maycocksean]

I didn't say denied care or asked to pay up front. I said not resolved of responsibility in the same way someone leaving a restaurant or gas station without paying isn't granted immunity because "they don't want to pay."
And I'm talking about bills that, in most cases, that total less then 6 months income. The same way someone failing to pay their income tax isn't forgiven.

The situations you are describing are again, not analogous. When you go to a restaurant or a gas station is not even potentially a life-threatening situation. If you can't afford to go out to eat, eat at home. As for gas, if you're driving off without paying that is intentional theft in a way that going to the ER with chest pains is not. Likewise with tax evasion.

As for less than six months income, for some of us a hospital bill totaling one months income would be a serious problem. Now when you start talking about bills less than a hundred bucks, well, yeah most people who "can't afford it" aren't really trying. But we both know even routine health cares costs aren't even remotely that cheap.

I haven't been, it's called cost-shifting. Another form of cost-shifting is when Medicare or Medicaid cuts back on reimbursement rates and that loss of revenue is then passed on to private payers. Expect more of that one in the future.

How is the cost shifting here? Who was paying the costs of the uninsured before? Who is paying the cost now?

And a word on these "young and healthy" that don't want to buy insurance. Typical of youth (with no offense intended to youthful posters here) to assume that they are invincible, that "it will never happen to them" and so decline to buy insurance. Isn't that the height of irresponsibility?

 

[Irvine511]

5 years ago I was in a weird, freakish accident while I was out being young and healthy (swimming laps). I also had, and continue to have, a relatively high paying job (but no benefits) which afforded me the ability to buy private insurance on my own. If the accident had happened 1-2 years earlier, I only had catastrophic coverage. And there was a period when I had no insurance. A week in the ICU even with health insurance cost me over $2k, and the "real" cost was $17k. Therapy and a permanent injury plus medication that I must now take (flawless health history beforehand), has cost me at least $40k over the past 5 years. AND I PAY $250 A MONTH ON PRIVATE INSURANCE. I can afford it because im a childless homo with a liberal arts degree (horror) who works an urban elite snob evil media job that nets me significantly more than $40k a year ... What do other people do? Like people in red states with high unemployment and far, far higher health risks (like unwanted pregnancy and smoking)?

 

[Diemen]

Oh wait, getting government MORE involved, not less, is the raison d'être of Obamacare.

That sounds more like the rallying cry of those who oppose it, and not the actual raison d'être of providing affordable health care to people who previously could not afford it.

 

[Moonlit_Angel]

If, as the argument goes, this new mandate, err, tax is only going to affect the 1% to 2% of "freeloaders" who can afford insurance but refuse to pay then why not, just like any other business, allow hospitals to collect on unpaid bills rather than cost-shifting that loss to those that do pay?

Why can the government collect a tax on these people but hospitals can't sue them for unpaid bills? Why not just cut out the middleman, government?

Oh wait, getting government MORE involved, not less, is the raison d'être of Obamacare.

I don't know if you've ever been in a situation where you're struggling to pay your rent, let alone anything else, but these people aren't paying these hospital bills not because they "refuse" to, but because THEY LITERALLY CANNOT PAY THEM. Not when they're trying to keep a roof over their heads and food in their bellies, and they figure the little money they do have should probably go to that first and foremost, so they're not sitting there, y'know, homeless and hungry.

I think the biggest issue related to health care should be more with looking into why the hell every single hospital-related procedure or whatever costs so much. My dad, when he was sick, could not get properly treated at the hospitals closest to us, because they were small town ones and didn't have the sort of equipment and such he needed to get treated. So he had to take an ambulance to another hospital nearly 2 hours away (my mom would take him when she could, but that required taking time off at her part time job she had, at a retail store, which was easier said than done, and it also required the mercy of our older van not dying out on us, which happened too often, unfortunately). And paying for the ambulance service is fine, but when you add that cost (which was a pretty big one, if I recall rightly) into the treatments and the time spent in the hospital, which was a couple months, plus all the pills my dad had to take for this and that (most of which were probably really unnecessary, in my opinion, and didn't help much, if at all, anyway), plus the costs for my mom if she managed to get a moment free to travel to the city two hours away to see my dad and talk with the doctors about what was going on, it adds up very, very quickly.

And when you're relying on a part-time job to keep yourself and your family in an apartment, and possibly having to use some of that money for cab service to get to that job if your car dies on you (and cab services add up, too, if you use those on a regular basis), or to make sure your family can eat, sorry, hospital bills aren't going to be at the top of your list of things to pay off right away. Even if you want to pay them, after you use up all your money for the other important necessities, you don't have enough to do it anyway.

And if you do absolutely need to get them paid, then sometimes you may have to turn to that "evil government aid" that is known as Medicare/Medicaid to help you out.

 

[MrsSpringsteen]

We don't need to hear about the reality of human lives Moonlit Angel-stereotypes will suffice

 

[anitram]

1) The employed, "young and healthy" need the option of catastrophic, high deductible insurance. If they don't buy that then they are gambling in a manner no different than not buying insurance on their house or saving for retirement. If one chooses to act irresponsibly with their money I lose a certain deal of economic compassion for them.

I am assuming that you take the same view of women who become pregnant while uninsured (seemingly statistics seem to indicate that this totals 13% of all pregnant women on an annual basis in the US - Promoting Pregnancy Wellness : American Pregnancy Association).

Now let's look at costs a bit, all from Cost of Baby Delivery - Consumer Information and Prices Paid - CostHelper.com, which cites various sources.

- Vaginal delivery without complications $9,000-$17,000
- C-section delivery without complications $14,000-$25,000
- Bill received by healthy baby upon discharge $1,500-$4,000

On top of that let's add:

- An average of $130/visit during the pregnancy, and the average number of visits during a healthy pregnancy is 14, totaling almost $2,000

And this does NOT include costs spent on high-risk pregnancies (ie. women who develop gestational diabetes, fibroids, early ruptures, etc) nor does it include costs incurred by babies who need to spend time in the NICU - this is where they really ding you and you can easily be looking at $100K/case.

Seems that if you take a pro-life view and want all of these wonderful bundles of joy to be born, then you'd have a vested interest in, you know, providing coverage for these women so that they don't instead opt for the much cheaper option of abortion, which by the way, the Guttmacher Institute estimates to be an affordable $468 on average in the USA.

 

[Danny Boy]

Obviously these women were deprived of an abstinence only sex education curriculum.

 

[Steved1998]

1) The employed, "young and healthy" need the option of catastrophic, high deductible insurance. If they don't buy that then they are gambling in a manner no different than not buying insurance on their house or saving for retirement. If one chooses to act irresponsibly with their money I lose a certain deal of economic compassion for them.

2) This law now forces the employed, "young and healthy" to buy comprehensive insurance (which actuarially and in reality most won't need) or pay the tax. Obamacare enforces community rating on the "young and healthy" which means their premium is the same as a 55 yo with diabetes, hypertension and a history of heart attacks. In the name of fairness of course.
I wonder at what point the "young and healthy" will realize they are the revenue patsies in this scheme?

Exactly! Force the kids to buy insurance, but not me! I'm a responsible adult and am very careful in my daily affairs. I should be able to be able to buy insurance whenever I need it. This mandate is only for the stupid kids and the unhealthy who don't deserve to be insured! The Republicans run Congress. With great power comes great responsibility! Now they have to step up and undo this. They have the responsibility of making sure these fools and illegals don't run up my premiums!

 

[Steved1998]

Of course they are the revenue source. No health insurance plan works if only old sick people are paying premiums. And someday, those young healthy people will be old and sick.

I suppose you would like to get rid of social security as well.

Yes. Privatize it. It's a ponzi scheme as it is. Let me invest it in the free market because that will return my money 20 fold!

 

[mobvok]

I typed something, but then deleted it because your use of exclamation points is setting off Poe's Law alarm bells.

 

[Steved1998]

I typed something, but then deleted it because your use of exclamation points is setting off Poe's Law alarm bells.

I don't know what that is, but it sounds Marxist

 

[INDY500]

- Vaginal delivery without complications $9,000-$17,000
- C-section delivery without complications $14,000-$25,000
- Bill received by healthy baby upon discharge $1,500-$4,000

On top of that let's add:

- An average of $130/visit during the pregnancy, and the average number of visits during a healthy pregnancy is 14, totaling almost $2,000

You realize there was a time not too long ago when families of very modest means had 7, 8 or more children and somehow paid their bills without government assistance. So how did it get so expensive? I'll give you 3 big reasons: lawsuits, 3rd party payers and technology.

Has Obamacare addressed any of these drivers of increased costs? It purposely avoids tort reform. “Tort reform is not in the bill because the people who wrote it did not want to take on the trial lawyers. And, that is the plain and simple truth.” Howard Dean 2009. ObGyn is one of the highest by the way leading to the closing of maternity wards in many hospitals and a shortage of such doctors.

The more engaged a consumer is in the market the more incentive there is for the market to drive down the price -- is the heath care consumer more or less engaged in the market by Obamacare.

8% of babies born in this country are to parents here illegally. Somebody (that would be us) is paying for that. I can't even ask with a straight face if Obamacare addresses that issue so I won't.

And this does NOT include costs spent on high-risk pregnancies (ie. women who develop gestational diabetes, fibroids, early ruptures, etc) nor does it include costs incurred by babies who need to spend time in the NICU - this is where they really ding you and you can easily be looking at $100K/case.

Caring for infants such as these, the elderly and other terrible diseases add to the total cost of health care and the fact that we do more of it than other countries is a reason we spend so much more on health care per capita. And that's I good thing I'd argue. We'll see if the Obamacare rationing board shares that view soon enough I guess.

 

[Steved1998]

You realize there was a time not too long ago when families of very modest means had 7, 8 or more children and somehow paid their bills without government assistance. So how did it get so expensive? I'll give you 3 big reasons: lawsuits, 3rd party payers and technology.

Has Obamacare addressed any of these drivers of increased costs? It purposely avoids tort reform. “Tort reform is not in the bill because the people who wrote it did not want to take on the trial lawyers. And, that is the plain and simple truth.” Howard Dean 2009. ObGyn is one of the highest by the way leading to the closing of maternity wards in many hospitals and a shortage of such doctors.

The more engaged a consumer is in the market the more incentive there is for the market to drive down the price -- is the heath care consumer more or less engaged in the market by Obamacare.

8% of babies born in this country are to parents here illegally. Somebody (that would be us) is paying for that. I can't even ask with a straight face if Obamacare addresses that issue so I won't.

Caring for infants such as these, the elderly and other terrible diseases add to the total cost of health care and the fact that we do more of it than other countries is a reason we spend so much more on health care per capita. And that's I good thing I'd argue. We'll see if the Obamacare rationing board shares that view soon enough I guess.

Well said!

The free market is completely fair. No one was ever dropped for preexisting conditions and it is absurd and unAmerican to suggest otherwise. I agree! You want to drive down costs, get rid of lawsuits(the work of the devil) and limit this scientific technology. MRI machines are basically sorcery, and people who are weak enough to get sick should use the power of prayer to get better. Thats how they did it in the olden days. If they don't, well thats so called liberal darwinism for you. As for the large families it was a sign of a healthy Christen sex life!

These illegal children should have no right to healthcare. As Newt said, "put them to work!" Newt 2011 When my forefathers who came here long ago, did they have healthcare? No! They worked for their money and didn't demand government handouts. They didn't get sick either! They didn't need healthcare and neither do these illegal kids. Jesus certainly didn't support caring for the sick and the needy. He said " teach a man to fish and he'll eat for a lifetime". These kids need to learn to fish for themselves and not rely on NObamacare. Why does this guy want to keep driving up costs? He's ruining the very fabric of America and is just going to turn us into another European socialist state!!!!

The elderly worked all their lives and now Obama wants to put them before death panels? To hell with that I say!! NObamacare is unconstitutional and had he not held Roberts' family hostage the court would have struck it down. I weep as my country keeps going down the toilet. Who will save us? Future President Rmoney, that's who! He would never let something like a mandate slide if he was in charge! We need to throw the usurper and chief out the door and send him packing back to Ken... I mean Hawaii this November.

 

[Salome]

8% of babies born in this country are to parents here illegally. Somebody (that would be us) is paying for that. I can't even ask with a straight face if Obamacare addresses that issue so I won't.

I can't even believe you suggest with a straight face that the PPACA is the place to address this issue
unless you find logic in the notion that the issue of illegal immigrants should be addressed in about a dozen different laws
in which case I think you just lack common sense
which would explain why you reckon the PPACA would be the place to (finally) attack the unbecoming lawsuit culture in the USA

 

[BVS]

You realize there was a time not too long ago when families of very modest means had 7, 8 or more children and somehow paid their bills without government assistance. So how did it get so expensive? I'll give you 3 big reasons: lawsuits, 3rd party payers and technology.

All free market issues

Has Obamacare addressed any of these drivers of increased costs? It purposely avoids tort reform. “Tort reform is not in the bill because the people who wrote it did not want to take on the trial lawyers. And, that is the plain and simple truth.” Howard Dean 2009. ObGyn is one of the highest by the way leading to the closing of maternity wards in many hospitals and a shortage of such doctors.

The Affordable Care Act is not the time or place for tort reform, you are smart enough to know this but you ignore every this every time someone brings it up to you. Tort reform would have to be a separate monster in order to work, ask your pal Laura Ingram.

The more engaged a consumer is in the market the more incentive there is for the market to drive down the price -- is the heath care consumer more or less engaged in the market by Obamacare.

Yet the free market that you have so devoutly praised has removed the consumer out of this process. When was the last time you allowed a patient to research and shop around the implant or the prescription that they will use?

8% of babies born in this country are to parents here illegally. Somebody (that would be us) is paying for that. I can't even ask with a straight face if Obamacare addresses that issue so I won't.

That number is misleading. The study that you grab that 8% from does not distinguish if the mother is illegal or not, it only reports if the baby had at least one parent that was illegal. Other statistics would show that it's usually the father.

Caring for infants such as these, the elderly and other terrible diseases add to the total cost of health care and the fact that we do more of it than other countries is a reason we spend so much more on health care per capita. And that's I good thing I'd argue. We'll see if the Obamacare rationing board shares that view soon enough I guess.

We are a collective society, when will those that oppose "Obamacare" finally see that and understand the costs of not caring for(paying) for these individuals?

 

[anitram]

You realize there was a time not too long ago when families of very modest means had 7, 8 or more children and somehow paid their bills without government assistance. So how did it get so expensive? I'll give you 3 big reasons: lawsuits, 3rd party payers and technology.

Really? People are not having 7 or 8 children because they are expensive, and they are expensive because of lawsuits, 3rd party payers and technology?

That's pretty hilarious.

Did the parents of those 7 or 8 children live in urban centres where houses cost $2 million? Did those 7 or 8 children have to pay 500 bucks for a year's tuition at college or $45,000? Did the father of those parents make a fair wage so that he could support his family or was he toiling at 2 minimum wage jobs, like his wife?

But I note that you didn't answer the question, so am I to assume that you'd rather not see pregnant women who can't afford to have the baby due to costs, whether that woman is an illegal immigrant or an unemployed or underemployed American if it means that you'd have socialized medicine? I'm not saying that stance is wrong, but let's at least be honest so that we know what we're talking about next time a pro-life conversation kicks up.

 

[ladyfreckles]

Slightly unrelated question here. I have house insurance. But I always wondered what it was supposed to cover. Just emergencies or does it actually cover things that break/get damaged because of poor build quality?

Really? People are not having 7 or 8 children because they are expensive, and they are expensive because of lawsuits, 3rd party payers and technology?

Did the parents of those 7 or 8 children live in urban centres where houses cost $2 million? Did those 7 or 8 children have to pay 500 bucks for a year's tuition at college or $45,000? Did the father of those parents make a fair wage so that he could support his family or was he toiling at 2 minimum wage jobs, like his wife?

This is an excellent point. The fact is that it was much cheaper to have kids a long time ago than it is now. I think free markets are better than the alternative however I don't believe in 100% free markets. Some regulation is required because we are humans and humans aren't all perfect/fair. A lot of these issues (things going way up in price) happened conveniently right after we stopped regulating banks.

 

[INDY500]

I can't even believe you suggest with a straight face that the PPACA is the place to address this issue
unless you find logic in the notion that the issue of illegal immigrants should be addressed in about a dozen different laws
in which case I think you just lack common sense
which would explain why you reckon the PPACA would be the place to (finally) attack the unbecoming lawsuit culture in the USA

It is relevant in that this administration has passed a law to now force millions of American "freeloaders" to engage in health care commerce but grants blank-check amnesty to the millions of non-Americans using our health care services for free.

 

[INDY500]

Really? People are not having 7 or 8 children because they are expensive, and they are expensive because of lawsuits, 3rd party payers and technology?

That's pretty hilarious.

Did the parents of those 7 or 8 children live in urban centres where houses cost $2 million? Did those 7 or 8 children have to pay 500 bucks for a year's tuition at college or $45,000? Did the father of those parents make a fair wage so that he could support his family or was he toiling at 2 minimum wage jobs, like his wife?

Nice debate tactic, make me defend an argument I never made while avoiding any empirical defense of your position.

But I note that you didn't answer the question, so am I to assume that you'd rather not see pregnant women who can't afford to have the baby due to costs, whether that woman is an illegal immigrant or an unemployed or underemployed American if it means that you'd have socialized medicine? I'm not saying that stance is wrong, but let's at least be honest so that we know what we're talking about next time a pro-life conversation kicks up.

I don't even understand the premise of your question. I want to actually reform health care to make it affordable enough for families to pay for the birth of a child and their subsequent health care needs through adolescence. I also want to return to an expectation that parents assume financial responsibility for their offspring. Old fashioned I know.

In case you haven't noticed, government can't afford to raise our children starting with pregnancy and continuing through college.

 

[BVS]

Nice debate tactic, make me defend an argument I never made while avoiding any empirical defense of your position.

Her point is pretty obvious and doesn't avoid anything. I'm sorry you missed it.

I don't even understand the premise of your question. I want to actually reform health care to make it affordable enough for families to pay for the birth of a child and their subsequent health care needs through adolescence. I also want to return to an expectation that parents assume financial responsibility for their offspring. Old fashioned I know.

In case you haven't noticed, government can't afford to raise our children starting with pregnancy and continuing through college.

Yet none of the solutions you have offered so far do any of this.

 

[Moonlit_Angel]

Is there a chance we can retire the word "freeloaders" from all economic discussion for a while?

Also:

I also want to return to an expectation that parents assume financial responsibility for their offspring. Old fashioned I know.

In case you haven't noticed, government can't afford to raise our children starting with pregnancy and continuing through college.

Neither can many parents. I love the idea of parents being able to provide everything for their children, that's wonderful. But even with the best of intentions, many still have a hard time doing that.

 

[Steved1998]

Is there a chance we can retire the word "freeloaders" from all economic discussion for a while?

Also:



Neither can many parents. I love the idea of parents being able to provide everything for their children, that's wonderful. But even with the best of intentions, many still have a hard time doing that.

Freeloaders describes these people perfectly. Why retire it? While we're at it, we should also reexamine all the freeloaders who are suckling at the government teat once they hit 65. I have to pay for their health insurance too? I think not. A day of reckoning is coming.


Kids get too much now a days because parents provide too much. We need to lower the age that you can start working down to at least 10, although I'd be happy at 13. When I was 11 I got a job off the books sweeping floors in a factory. It will teach them responsibility.