His Gambling Problem, We Pay
http://www.sltrib.com/home/5028000-155/casino-industry-dont-dump-gambling-disorders
(Edited for f-bomb masking. The board is PG; please mask your swears. Thanks.)
Quote: BellaingProbably no more than 10% of people gamble at all ...
Ummm... According to the attached link, 80 percent of Americans gamble at least once per year.
Gambling By Americans, 2014
The article discusses reasons why we gamble as much as we do.
Quote: odiousgambitI didn't know this. One of the reasons my g.d. health insurance payment is so high is it covers gambling disorder treatments. WTF?
http://www.sltrib.com/home/5028000-155/casino-industry-dont-dump-gambling-disorders
You are legally required to buy substance abuse coverage so it might just be an outgrowth of that?
Quote: AZDuffmanYou are legally required to buy substance abuse coverage so it might just be an outgrowth of that?
you are also automatically enrolled for mental health coverage in O-care, so, more of an expansion of that idea I think
why wouldn't it be covered? I think you should be able to elect what you want covered. For example, I do not want or need to be covered for getting pregnant, but I am with O-care. And I may need the Gambling Problem coverage, ha ha ha, but I would like to elect not having it, thank you very much.
Quote: odiousgambitI think you should be able to elect what you want covered
I totally agree. I would drop maternity, mental health. and substance abuse coverage if I could. One reform I would like to see is get all the health insurers to standardize what coverage is and means. Then you could shop.
Back to topic, is it a "gambling" problem people have or a "losing" problem? If you play poker daily but are net ahead, no problem. If you play once a week and lose your paycheck, problem. I do not think it is gambling so much as the person will find some self-destructive behavior.
Quote: odiousgambityou are also automatically enrolled for mental health coverage in O-care, so, more of an expansion of that idea I think
why wouldn't it be covered? I think you should be able to elect what you want covered. For example, I do not want or need to be covered for getting pregnant, but I am with O-care. And I may need the Gambling Problem coverage, ha ha ha, but I would like to elect not having it, thank you very much.
Cable and satellite tv are no different.
Thankfully the only difference is that the Fed isn't forcing me to buy cable or satellite.
My point? There are many, many items that we end up paying for and that we don't get a direct benefit for them. The insurance stuff is small potatoes compared to other items out there that we pay to spread the risk, or the cost. If only paying for the things that you directly use is your thing, then at least start with the big ticket items. Sheesh........
Quote: odiousgambitI didn't know this. One of the reasons my g.d. health insurance payment is so high is it covers gambling disorder treatments. WTF?
http://www.sltrib.com/home/5028000-155/casino-industry-dont-dump-gambling-disorders
This is part of what having pools is all about. I don't like paying for viagra, prostrate cancer treatment, substance abuse, lots of other stuff that doesn't pertain to me, but that's how it works. My car insurance went up 20 % in one half-year just now, and is going up again. In August. I'm told it's because so many people made hurricane claims. Did I? No. Do I have a choice? No. Sucks.
Pretty sure, lifetime so far, I am a contributor on all types of insurance, not a beneficiary. My blessing. But who knows what tomorrow will bring, for anyone.
Part of what you benefit from in a pool is negotiated rates that are well below no - insurance charges. I daresay that's the major advantage for most people. For example, I just started a drug that costs me 73/month to take. (Haven't had any reason to take drugs before, so just learning about the market; lucky me, again.)
That seemed incredibly high until I priced it without insurance (didn't think my company had approved my prescription ), just walking up and filling it. The cheapest quote was 280 for 30 days, and most over 300; no generic equivalent due to patent protection. That difference alone is about what I'm paying for my monthly premium. So whaddya know; thanks, insurance!
Its similar to government entities giving incentives to employers and over burdening the Single Family Homeowners. Employers can threaten to pack up and leave town, homeowners are a captive market without organized clout.Quote: beachbumbabsPart of what you benefit from in a pool is negotiated rates that are well below no - insurance charges. I daresay that's the major advantage for most people.
There is no cost saving in the price at which the pharmacy pays for the drug or any cost saving in dispensing it. There simply is an agreement to "soak the uninsured" to make up for all the concessions won by pool members.
Quote: odiousgambitI didn't know this. One of the reasons my g.d. health insurance payment is so high is it covers gambling disorder treatments. WTF?
http://www.sltrib.com/home/5028000-155/casino-industry-dont-dump-gambling-disorders
I feel the same way about drug addiction and smoking addiction. But while we are at it how about not insuring fat people since we are more likely to have a heart attack.
Quote: odiousgambityou are also automatically enrolled for mental health coverage in O-care, so, more of an expansion of that idea I think
why wouldn't it be covered? I think you should be able to elect what you want covered. For example, I do not want or need to be covered for getting pregnant, but I am with O-care. And I may need the Gambling Problem coverage, ha ha ha, but I would like to elect not having it, thank you very much.
I agree but if we can choose exactly what we want then I think premiums would be even higher.
Quote: IbeatyouracesWhen is the human race going to figure out that insurance of any type is a scam? You are going to lose this bet and spend way more money on it than you'll ever get out of it.
except that some will make out like a bandit, except that making out like one in this case means bad health
I feel an examination of what insurance is all about leans toward catastrophic coverage, otherwise you get screwed due to the profit motive - and profit is not a dirty word if that is the system we want
but I find others disagree totally, my wife included
If life/home/auto insurance were a Vegas slot machine, it would be shot-down for insufficiently low rate of return.
Quote: gordonm888Most insurance (auto, home, life) returns no more than 41% of the premiums to people that have claims. (I have no idea what the return is for health insurance, though.)
If life/home/auto insurance were a Vegas slot machine, it would be shot-down for insufficiently low rate of return.
By law, health insurance products must return 80% of premiums in claim payments for Individual and Small Group products (employers <50), Large group products and Medicare products must return 85% of premiums in claim payments.
Quote: rsactuaryBy law, health insurance products must return 80% of premiums in claim payments for Individual and Small Group products (employers <50), Large group products and Medicare products must return 85% of premiums in claim payments.
So as I said. It's a scam perpetrated by the insurance companies and the government. I'll exclude the middle man and stick to paying cash for medical bills.
And before anyone asks, if I can't afford it, I don't get it and suffer through it.
Quote: beachbumbabsThat seemed incredibly high until I priced it without insurance (didn't think my company had approved my prescription ), just walking up and filling it. The cheapest quote was 280 for 30 days, and most over 300; no generic equivalent due to patent protection. That difference alone is about what I'm paying for my monthly premium. So whaddya know; thanks, insurance!
for people that don't have insurance, (and even for those that do), you might want to check:
https://www.goodrx.com/
I've gotten things for about $25 that had a $300+ retail price.
I'd buy that for a dollar.
Quote: Hullabaloofor people that don't have insurance, (and even for those that do), you might want to check:
https://www.goodrx.com/
I've gotten things for about $25 that had a $300+ retail price.
Thanks, but that's where I comparison shopped to mention the quote. I like them, too.
Quote: beachbumbabsThey're the best argument out there for single-payer systems.
The single payer system we have out there right now is Medicare. Would you be up for paying your current insurance premiums to Medicare directly and becoming covered entirely by that system?
Would that solution work for everyone...those that want single payer can opt into Medicare early in exchange for a premium payment in addition to Medicare Taxes and those that want to stay in the private insurance world would figure it out in the private insurance marketplace and pay Medicare Tax for coverage after age 65?
Medicare infrastructure is already set up, so it would seem like the easiest way to address both sides of the debate and perhaps find common ground.
Portability of private insurance coverage, competition across state lines as well as some requirement for private insurers to enroll their pro-rata share of "pre-exisiting" condition patients would need to be kept/put in place in the private insurance marketplace as this shift cannot just dump all "undesirable" insureds on to Medicare System.
I don't know...it's a thought. Bottom line is I don't think you have the public political consensus out there to put a single payer system in place that everyone has to be a part of...it is still looked at as not the American Way, regardless of whether you personally think the "American Way" has any merit.
Quote: ParadigmThe single payer system we have out there right now is Medicare. ... Medicare infrastructure is already set up, so it would seem like the easiest way to address both sides of the debate and perhaps find common ground.
Clearly different folks feel differently about medical insurance. However, Medicare uses two different (statutorily required -- probably by the Bureau of Redundancy Bureau) methods by which it annually reports its administrative overhead, according to Physicians for a National Health Program, here:
Medicare Administrative Costs
Reports to the Medicare Boards of Trustees indicate Medicare’s administrative expenditures are 1 percent of total Medicare spending. The other calculation is in the National Health Expenditure Accounts (NHEA), and that calculation of Medicare administrative overhead indicates the figure is 6 percent. The link explains the differences between how the two figures are calculated.
But, at 6 percent administrative overhead, Medicare beats any and all private insurance programs hands down. Seems to me it's a no-brainer to hook into Medicare if someone ever gets the opportunity. No, it doesn't cover everything, but folks can still purchase supplemental insurance, and Medicare has a smooth-working partnership with other insurance (at least in my experience).
As far as I know, the only state with a (near) universal health insurance requirement is Massachusetts, the plan used as a general pattern for the Affordable Health Care Act. So, how is it doing? Well, according to the AMA study below, about 94% of non-elderly residents had health insurance in 2013 (most recent data at time of publication). Insured adults were surveyed on these areas: Service availability, freedom to choose a doctor or other health practitioner, quality of care provided to them, locations of their medical providers, and overall ability to gain access to specialist care. Almost two-thirds of those surveyed reported satisfaction as "excellent" or "very good" in the various categories. Between 8% and 12% reported "fair" to "poor" satisfaction with their health care programs. Here's the link to the report:
Consumer Satisfaction with Health Insurance Coverage in Massachusetts
My strong belief is health care in America would be far better if it had a plan more like that in Massachusetts than what it currently has or what congress is now considering. But, I'm no doctor, so what do I know? Someone else may look at all this differently.
Quote: Paradigm
I don't know...it's a thought. Bottom line is I don't think you have the public political consensus out there to put a single payer system in place that everyone has to be a part of...it is still looked at as not the American Way, regardless of whether you personally think the "American Way" has any merit.
"Some 58 percent of respondents support replacing ObamaCare with a universal healthcare system, while 37 percent oppose that plan."
http://thehill.com/blogs/blog-briefing-room/news/279991-poll-majority-of-americans-support-federally-funded-healthcare
This in spite of relentless propaganda telling us how it's good to pay twice as much as other countries for inferior coverage, for everyone but the well off.
If pols and media were even remotely honest on the subject, I'm sure it would shift even more. A lot of people still think Canadians have to wait 5 years to get an emergency appendectomy.
obviously the people of every other country prefer their systems to ours, because they are not insane, so it's reasonable to assume we would too once we had it.
Quote: LuckyPhowMy strong belief is health care in America would be far better if it had a plan more like that in Massachusetts than what it currently has or what congress is now considering. But, I'm no doctor, so what do I know? Someone else may look at all this differently.
The problem is there is a large section of the American population that doesn't share a willingness to be part of a universal/single payer health insurance plan. To get anything accomplished for the long term on health care you are going to have to provide a way for those that want a non-private insurance plan a "single payer" type option and those that want to keep the private insurance plans that they have had in the past. Forcing everyone on to a universal health care plan isn't the answer...and I say this as someone that is not opposed to a health care coverage mandate, I just want choices on how to fulfill the mandate obligation.
I get that many, maybe as much as 50% of the population, feel the current system is bad due to the profit motive. But that perspective is also not shared by a significant section of the population. Forcing either side on to the other sides idea of the best way to address their personal health care needs is not a sustainable answer. One side will win an election and repeal what is in place, then the other side will do the same when they win an election...why not provide a system that allows the individual to chose what system they want to participate in and just require that they participate in one of the systems?
My guess is you will pay more being on the private side of the equation and likely get better care. But the Medicare side will provide decent basic coverage for those that chose that option. It will be a two tiered system just like Medicare is today...some only have Medicare (A, B & maybe D) and others pay more for Medicare+Supplemental Medicare Private insurance. You will normally have a two tiered system with a universal/single payer plan anyway...those that have means will buy more/better than basic health care coverage offered under the basic plan.
Quote: Rigondeaux"Some 58 percent of respondents support replacing ObamaCare with a universal healthcare system, while 37 percent oppose that plan."
http://thehill.com/blogs/blog-briefing-room/news/279991-poll-majority-of-americans-support-federally-funded-healthcare
This in spite of relentless propaganda telling us how it's good to pay twice as much as other countries for inferior coverage, for everyone but the well off.
If pols and media were even remotely honest on the subject, I'm sure it would shift even more. A lot of people still think Canadians have to wait 5 years to get an emergency appendectomy.
obviously the people of every other country prefer their systems to ours, because they are not insane, so it's reasonable to assume we would too once we had it.
Well the recent election, as opposed to a "poll" says it isn't quite that big a discrepancy in favor of universal/Obamacare...you can jump up and down about how bad Trump is for this and that, but he got a lot of votes based on "Repeal & Replace"...I am choosing to look as the 49/51% popular vote for the two Presidential Candidates as a closer approximation of the country's views on healthcare than the sample poll you cited. Polls haven't worked out very well in predicting the real outcome of things recently.
Quote: ParadigmYou will normally have a two tiered system with a universal/single payer plan anyway...those that have means will buy more/better than basic health care coverage offered under the basic plan.
In the late 1990's I advised universities in Australia (not about health issues), so things might have changed since then. Australia then had universal health insurance, but folks could also purchase supplemental insurance. Of the folks with whom I worked most closely, the grad student and the professional staffer each had supplemental insurance. The Department Chair only subscribed to the basic universal health insurance. Go figure.
Unfortunately, your comment that many do not favor universal insurance as a mandate "forced" upon them is probably correct. I haven't checked, but I betcha that was also the case in Massachusetts prior to implementation of its mandatory health insurance requirement.
I have a pretty conservative aussie friend and, like almost everybody, he thinks our system is insane and wouldn't switch for anything. He pays an income tax for heath care. A bit more since he is well off.
He fell down the stairs and broke his arm in a bunch of places. Went to the nearest hospital. Got x-rays, follow ups, even catscans IIRC. Didn't pay a dime. Didn't wait. No paper work. He spends zero seconds per year sweating over different plans, or worrying what will happen if he has a medical emergency.
Instead of that, we hand money over to ceos and shareholders for no reason.
My wife spent 1 night in the hospital for a minor issue and it cost us $3k. With "good" insurance.
But, it's like a lot of things. our country has become too deeply corrupt for something like that to even really be an option. Even if Bernie DID win, it's not like anyone would cooperate with him.
Ce la vie.
At least we have trillion dollar programs for obsolete weapons the pentagon doesn't want.
Quote: ParadigmWell the recent election, as opposed to a "poll" says it isn't quite that big a discrepancy in favor of universal/Obamacare...you can jump up and down about how bad Trump is for this and that, but he got a lot of votes based on "Repeal & Replace"...I am choosing to look as the 49/51% popular vote for the two Presidential Candidates as a closer approximation of the country's views on healthcare than the sample poll you cited. Polls haven't worked out very well in predicting the real outcome of things recently.
At the risk of further derailment of this thread (though the conversation is central to the OP's argument), I think the question has been hopelessly obscured by decades of anti-public option advertising by private insurers, and partisan politics.
The fact is that Medicare controls costs best, and returns best value both in extremely low administrative costs (including no shareholders, which I think is sometimes not included in private care admin costs; not sure) and in having huge blocks of patients for which to negotiate low rates (very like Walmart). It's just a fact that stands alone, with many years of records to prove it.
The proposals which push marketplace expansion across state lines are lobby - driven by companies wanting access to a larger client base. It's possible that would lead to somewhat lower premiums through competition, but ultimately the user is paying shareholders and billionaire CEO's a hefty premium.
They can't match the value Medicare provides just because of these additional burdens on the annual budget. But they can lobby and bribe Congress (another budget inflator) and advertise using scare tactics and slanted persuasion (another budget inflator) in order to protect their profit margin. I don't believe it's in the public's best interests to continue to sustain this model.
I do think there's a place for a layered plan over Medicare. Insure everyone, not just the over-65's, at that base level. Make it mandatory, and remove the cap on fica payments. Include fica payments in public assistance calculations as well as paycheck deductions.
Allow supplemental insurers to sell gap insurance, long-term care, pharmacy and medical device coverage, whatever perks they can develop. But the days of big private insurers screwing people on base coverage need to be over.
Quote: beachbumbabsI do think there's a place for a layered plan over Medicare. Insure everyone, not just the over-65's, at that base level. Make it mandatory, and remove the cap on fica payments. Include fica payments in public assistance calculations as well as paycheck deductions.
So make everyone earning more than $118.5K per year (of earned income) foot the increased bill for a single payer plan that 49% of voters in November didn't want...seriously Babs, do ya see how flawed that comment is and why it will never come to pass. Why didn't you say increase everyone's Medicare Tax, even the poor, that opts into the "Medicare at Any Age" coverage by 3%? You can't pass off the "super efficient/no waste" costs of increasing Medicare to those that opt in on to others that don't want it and opt for a private insurance plan. This single payer plan isn't free for those that opt for it...what's next, free college education for all ("wait, I heard about that recently as well").
Plus if the service levels and costs of the super efficient high quality Medicare plan are so great, it will push private insurance out of business through competitive forces...why don't I believe that will happen?
Quote: beachbumbabsAllow supplemental insurers to sell gap insurance, long-term care, pharmacy and medical device coverage, whatever perks they can develop. But the days of big private insurers screwing people on base coverage need to be over.
You can't have your cake and eat it too...either put the government in charge of your plan (and not my plan) and run with it. Don't think the government also gets to tell private insurance companies what they can and can't sell as health insurance to everyone else. If I am getting screwed by my private insurance plan, I'll take care of it...I don't need a Nanny Country to handle that for me...heck, if they screw me bad enough, I'll opt into the Medicare for All program. See how this is going to work?
But, you can't have the wealthier half the population opt out because "nanny state." It would be an unmitigated disaster (see Robocop), just like our healthcare system is.
Meanwhile, every country that treats healthcare the way we treat police, fire, military, roads, etc. has a vastly superior system and like 91% of the population would never dream of switching with us.
It's a mute point because the people in a position to fix it are all bought off.
Quote: RigondeauxI guess you could look at any other service.
This is the fundamental difference between each side...half of the population looks at health services like "any other service" the government should provide, the other half doesn't think healthcare is a service the government should provide. I am not saying right or wrong, but this is where the divide exists and anyone making progress in this area needs to find common ground between these two philosophies.
The argument that all these other countries "are doing single payer/national health care and their citizens love it...so why wouldn't we love it too" simply doesn't hold water. The majority of Americans believe their country has a superior economic system to any other in the world...evidently a lot of the world feels that way as well. Why the heck else do so many folks want to immigrate here. When this country starts having net exodus of the population to the rest of the world, you can talk about how other countries in the world have a better system.
Quote: RigondeauxBut, you can't have the wealthier half the population opt out because "nanny state." It would be an unmitigated disaster (see Robocop), just like our healthcare system is.
I didn't say the wealthier population opts out...I said you can't ask the wealthy to pay the entire cost for the single payer system via Babs suggestion of "uncapping FICA tax" to pay for it. Besides, why would wealthy people be more prone to opt out of the single payer system. The proponents jump up and down and say how great the service with be with so little of the funds going to administration. Sounds like if this were true, wealthy people would be smart to opt in, why in the world would anyone opt out if the premise were true? By the way, I would like to opt out.
Quote: RigondeauxIt's a mute point because the people in a position to fix it are all bought off
Some folks, a lot actually, that use the current private insurance system don't want it changed. They aren't bought off, they just don't see anything that needs fixing. You can say they are wrong, fine...but they all get a vote on what gets changed in the system, just like you. And we lived under 3+ years of Obamacare and 49% just voted against it. No "Bernie would have won" tangents to deflect the Election Results...Trump still got 49% of popular vote and a vote for Trump was a vote against Obamacare...that was a pretty clear message.
I'll have to leave it there...both sides need to recognize the validity of the other sides angst and find a solution that serves both. The progressives want a new single payer system, give it to them and those that opt in to that system bear the costs. Those that want to maintain their private health insurance/healthcare, give it to them and let them fight it out in the marketplace with who to buy insurance from across state lines. Why does this need to be a binary decision? Everyone has an option to get coverage and that is the dream, right...more people with health insurance coverage. Why are some so bent on making the decision regarding the type of coverage?
Quote: ParadigmThis is the fundamental difference between each side...half of the population looks at health services like "any other service" the government should provide, the other half doesn't think healthcare is a service the government should provide. I am not saying right or wrong, but this is where the divide exists and anyone making progress in this area needs to find common ground between these two philosophies.
I think this is true of gun control, and some other issues. But not this one.
Firstly, this Trump thing is wrong. He won because he ran against a hated, repugnant, openly corrupt piece of trash, who ran an almost impossibly incompetent campaign. It doesn't prove much about any particular policy. Nor would Bernie's victory, (or the victory of any competent, non-hated Dem), in itself, have proven much.
Secondly, rejection of obamacare ain't rejection of anything but obamacare. Everyone agrees that it sucks. Trump even suggested at times that he would go for something more like universal care.
This is a naked power struggle. I post some variation of this every time. Do an image search for "heath care cost per capita" and you will find dozens of charts like this.
I acknowledge that there are some ideological extremists who oppose most any government program no matter what. But they are as crazy as commies and represent a small number of people.
We have a horrible, inefficient, life shattering health care system and it is designed to be that way by people who take bribes.
Quote:The argument that all these other countries "are doing single payer/national health care and their citizens love it...so why wouldn't we love it too" simply doesn't hold water. The majority of Americans believe their country has a superior economic system to any other in the world...evidently a lot of the world feels that way as well. Why the heck else do so many folks want to immigrate here. When this country starts having net exodus of the population to the rest of the world, you can talk about how other countries in the world have a better system.
You certainly know this is a poor point.
First off, it's not like only the French have and like universal healthcare. Every wealthy country, and some poorer ones do. Asians, latins, and all the whites. And they all strongly prefer it. In other words, everybody who actually has experienced it, likes it, no matter their cultural background.
And 58% to 39% want it here, in spite of massive misinformation campaigns. How many of that 39% do you think know that Brits spend way less on healthcare than we do?
Second, like all of those countries, we have a mixed economy. It's not our economic system that is at issue. Australia is hardly a Stalinist state.
Third, most people like and stay in all those other countries too. And immigrate to them. It really proves nothing about health care, or gun laws, TV programming, popular shoe styles, or speed limits.
Quote:I didn't say the wealthier population opts out...I said you can't ask the wealthy to pay the entire cost for the single payer system via Babs suggestion of "uncapping FICA tax" to pay for it. Besides, why would wealthy people be more prone to opt out of the single payer system. The proponents jump up and down and say how great the service with be with so little of the funds going to administration. Sounds like if this were true, wealthy people would be smart to opt in, why in the world would anyone opt out if the premise were true? By the way, I would like to opt out.
Well, I think you overestimate human nature. The sort of person who winds up rich, and certainly in DC, often just doesn't want a steak. The want to eat a steak while someone else eats from the garbage. It's not just about material gain, it's about having as wide a disparity in wealth and power as possible.
obviously, the wealthy would have to pay a big share of the costs, just like with the military or fire department. The money has to come from somewhere, and they have it all now.
The fact that universal care is more efficient overall, a matter of fact, doesn't mean the wealthy should want it. They prefer an inefficient system, where they get the best of everything, profit of others' misery, and don't have to pay for the care of others.
Whether they get that system, or we get one that benefits everybody is just a matter of slugging it out. And they pretty much already won.
Quote:Some folks, a lot actually, that use the current private insurance system don't want it changed. They aren't bought off, they just don't see anything that needs fixing.
Really? I've just about never meet someone who likes our system. I was talking to a nurse the other day who told me her hospital charges $750 for an IV that costs the hospital $2. Why would anyone like that?
Hundreds of thousands are bankrupted by medical bills every year. And those costs, the courts, the divorces, the general misery are not factored into the costs in the chart above. And this could happen to almost any of us at any time. Why would anybody like that?
http://www.snopes.com/643000-bankruptcies-in-the-u-s-every-year-due-to-medical-bills/
Apart from wealthy people and CEos.
I do know people who oppose normal healthcare systems because they, for example, believe them to be much more expensive. Which is objectively false.
Quote: ParadigmI know, propaganda, lies and all that stuff...Medicare wins! It's the best, most efficient system out there...I'll stipulate to that and offer no counter argument or facts to that statement. That being said,, I would like to participate in a system other than Medicare/Single Payer Plan for my own "insane" reasons. So you do you and let me do me...how about that? I don't want to be in your pool of insureds, I want to be in a different pool...but still covered against shoving my health care costs on the local ER.
So make everyone earning more than $118.5K per year (of earned income) foot the increased bill for a single payer plan that 49% of voters in November didn't want...seriously Babs, do ya see how flawed that comment is and why it will never come to pass. Why didn't you say increase everyone's Medicare Tax, even the poor, that opts into the "Medicare at Any Age" coverage by 3%? You can't pass off the "super efficient/no waste" costs of increasing Medicare to those that opt in on to others that don't want it and opt for a private insurance plan. This single payer plan isn't free for those that opt for it...what's next, free college education for all ("wait, I heard about that recently as well").
Plus if the service levels and costs of the super efficient high quality Medicare plan are so great, it will push private insurance out of business through competitive forces...why don't I believe that will happen?
You can't have your cake and eat it too...either put the government in charge of your plan (and not my plan) and run with it. Don't think the government also gets to tell private insurance companies what they can and can't sell as health insurance to everyone else. If I am getting screwed by my private insurance plan, I'll take care of it...I don't need a Nanny Country to handle that for me...heck, if they screw me bad enough, I'll opt into the Medicare for All program. See how this is going to work?
Your number is incorrect : 49% of the country did not vote for Trump. 46.1% of those who voted did. Further, only 59.7 % of those eligible to vote did so, which means only 27.5% of the country voted for Trump. If you're going to use numbers to bludgeon me with your argument, they should be accurate.
I highly doubt that you can say with any accuracy that a vote for Trump was automatically a vote for private health care, either; they are not synonymous. There is at least some crossover among all 2016 candidates on either side of this debate. There are many single-issue voters whose issue was not healthcare, and higher priority issues for many others.
Healthcare barely made the top 5.
Your way has been tried. It doesn't work. We're in this mess because of privatized for - profit healthcare that has been unaffordable for many years. Basic healthcare should be like police and fire protection; spend more, get more if you like, but there has to be a base level that everyone supports. It has to be paid for.
You have a better idea on financing it, I'd love to hear it, but since you don't acknowledge the need for universal coverage, I doubt you've wasted a moment's thought on how we could pay for it.
I think one thing you can count on for sure is everybody in every country finds something they don't like about their health care system. I for one am very suspicious about claims that we should be 'more like Europe' no matter if it's about healthcare or if about something else. Europe is turning into a basket case.
Not to say I want to defend our system much. Mainly it's just that it is preposterously expensive; the care generally is very good. Half-ass attempts to get things under control lead to incidents of unconscionable billing - million dollar stays in the hospital and all that. I don't know that much about it, but my little exposures make me think that if you have something that for some reason isn't covered by insurance - you don't have insurance, or they don't take your insurance - then look out brother, how high is the moon?
Example: Previously I would pay thousands of dollars for a colonoscopy, and maybe it would have been newsworthy how much I was going to pay then, except my insurance at that time stepped in and said, in so many words, "no, although we aren't paying for this either due to deductible, you can't charge that much." It was still thousands. But how messed up is that kind of system to begin with?
My latest colonoscopy was supposed to be covered completely by my insurance, no cost to me - preventative medicine under ACA. It turned out the anesthesiologist didn't take my insurance, although nobody said a thing to me at the time. I got billed $1200; my insurance paid $400* and the rest I was to pay. Maybe because I paid so much before, and that it took 3 months for them to ask for the difference, I went ahead and paid. Later, talking to someone better informed, I find out I should have negotiated with them! He says you use the fact you are willing to pay immediately, point out that they agreed to pay less no doubt with insurance they do take, and make an offer!
Now, I'll be damned if I think this is a good system. I think I got surprise-billed for the 'how high is the moon' initial negotiating stance that they take with the insurance company! And I am just supposed to know I don't have to pay that? What? Who can defend this kind of stuff? And believe me, not everyone is well suited to be a negotiator. It's just all wrong.
*Not a contradiction to 'didn't take my insurance'. Confusing enough for you? The $400 is what they would pay if they took my insurance. Since the anesthesiologist didn't take my insurance, my insurance company actually sent me a check for this $400! Can you believe it? I think this is why it took them 3 months to bill me.
Quote: odiousgambitI didn't know this. One of the reasons my g.d. health insurance payment is so high is it covers gambling disorder treatments. WTF?
http://www.sltrib.com/home/5028000-155/casino-industry-dont-dump-gambling-disorders
That is kind of messed up that you have to pay for gambling addiction treatments.
Quote: beachbumbabsYour number is incorrect : 49% of the country did not vote for Trump. 46.1% of those who voted did. Further, only 59.7 % of those eligible to vote did so, which means only 27.5% of the country voted for Trump. If you're going to use numbers to bludgeon me with your argument, they should be accurate.
OK 46.1% of votes were for Trump and 48.2% of votes were for Hillary...so, 46.1%/(46.1+48.2) = 48.9% of those that voted for Trump or Hillary, voted for Trump...I rounded to 49%, split hairs if you want.
Not sure why your "59.7% of eligible voters" is relevant...OK so 28.8% of the country voted for Hillary and 27.5% voted for Trump...who cares about diluting the numbers by the percent of eligible voters that actually voted. Are you really asserting that the 59.7% of the country that voted doesn't pretty accurately represent the current state of thinking by 100% of the public? That's conclusion is inaccurate.
Quote: beachbumbabsI highly doubt that you can say with any accuracy that a vote for Trump was automatically a vote for private health care
I think I can..."Repeal and Replace" was a pretty big part of the Republican platform in both Presidential and Congressional races...seems like the Republicans didn't pretty well across the board in November if memory serves me correctly.
Quote: beachbumbabsYou have a better idea on financing it, I'd love to hear it, but since you don't acknowledge the need for universal coverage, I doubt you've wasted a moment's thought on how we could pay for it.
I guess my suggestion of some type of "Medicare at Any Age" that you could opt into vs. private insurance is not an "acknowledgement" of a need for some universal basic healthcare coverage, OK, but I think it counts as acknowledgement.
How to pay for it...I think those that opt into Universal Care should pay for it. Everyone benefits from Police and Fire Protection and so it is paid for with everyone's taxes. Not everyone wants to use/benefit from a Universal Health Care/Single Payer health care system, so everyone shouldn't pay for it.
Besides as all the proponents have pointed out, the single payer system is going to be "so efficient" remember. Surely a re-direction of the current private insurance payments (or some other payment that the Opt Ins can afford) being made by those that opt into the new plan should more than pay for it, right?
Quote: beachbumbabsIf you're going to use numbers to bludgeon me with your argument
OK, I am done here...not interested in "bludgeoning". Your plan won't happen today because a lot of America doesn't want it...you can argue that fact with "polls", etc. I'll just stick to actual votes of 57%+ of eligible voters...those "polls" have been pretty bad in predicting actual outcomes recently.
Or you can argue about how it would be so efficient...the majority of America doesn't believe you.
Or you can argue about how the current system is a disaster, but it has worked just fine for me and I have paid for 100% of my own insurance costs and medical expenses for the last 22 years and a portion of my employees insurance for the last 20 years. It works fine for many others as well despite the claims to the contrary...why do you think Obamacare is hated by so many? And the votes say it is so stop disputing that.
The only hiccup coming with the implementation of Obamacare, which until this year, prohibited me from reimbursing any portion of my employees personal health insurance policy premium costs. Wait, I thought Obamacare only impacted Employers with 50 or more employees...I have one full time employee...broken government plan promises but I am sure the new and improved "Universal Plan" will be different. Can you tell me again how I opt out?
Quote: RigondeauxReally? I've just about never meet someone who likes our system. I was talking to a nurse the other day who told me her hospital charges $750 for an IV that costs the hospital $2. Why would anyone like that?
Hundreds of thousands are bankrupted by medical bills every year. And those costs, the courts, the divorces, the general misery are not factored into the costs in the chart above. And this could happen to almost any of us at any time. Why would anybody like that?
I like my private medical insurance that I pay for 100% and based on its coverage have zero chance of going bankrupt due to medical costs. You do you and I'll do me...how about that?
You know the hospital doesn't get paid $750 for that IV...that crappy, disastrous private insurance company empire tells them to take $15 in payment for it or they won't be part of their network and the hospital says "OK". I am good paying $15 for an IV that costs $2 when it comes with a trained nurse administering its implementation.
I didn't like the snarky tone in your response to me, so I responded in kind. Sorry; we're both better than that. I'd like to continue the conversation.
My personal situation (since you discuss yours, it seems relevant) is, that for 32 years, I've had the best private health care available, and have been able to afford it. My premiums in 1985 were 25/mo. They've gone up yearly to where now, in retirement, I'm paying 219/mo, with required co-pays of 25-35/visit. Certainly affordable, compared to most, but still a 9x increase.
I started topping out the fica deduction in 1998. I definitely enjoyed the 7.15% "raise" the end of every year, but I wouldn't have missed it, either. I can't imagine anyone who does top out really needs the money more than those uninsured who can't afford the early intervention visit that would keep them from becoming more seriously ill, or those who don't have catastrophic coverage that would prevent financial ruin.
But I got mine, as they say, and before i did, i had no health issues, so it's hard to appreciate what it's like to be without it.
Police and fire are paid for on a mil rate by property valuation nearly everywhere. Your property taxes don't top out; the more your property is worth, the more you pay for those services. I don't find that unfair, but perhaps you do, and we have philosophical differences rather than the same goal with different solutions.
I still don't see how opt in/opt out will provide universal coverage. I know when I was young and broke, I didn't have any, and wouldn't have voluntarily bought it without issues that required it. Several here in that boat have said the same. So how do you build a pool?
Current practices haven't curbed pricing through competition ; instead, they've skyrocketed. Doctors are making less than they used to, though nurses are making more; not sure what the labor cost curve looks like, but as a percentage I'm guessing flat or a little down. A lot of the increase has to be in technology. But administrative and shareholder costs are huge and unnecessary burdens.
Quote: ParadigmI like my private medical insurance that I pay for 100% and based on its coverage have zero chance of going bankrupt due to medical costs. You do you and I'll do me...how about that?
You know the hospital doesn't get paid $750 for that IV...that crappy, disastrous private insurance company empire tells them to take $15 in payment for it or they won't be part of their network and the hospital says "OK". I am good paying $15 for an IV that costs $2 when it comes with a trained nurse administering its implementation.
So presumably, you are either a well off single man, or a very well off family man. I agree, the system is ok for those people. Less efficient, but has it's perks. It's only objectively terrible for maybe 85% of the population.
Meanwhile, hundreds of thousands of less fortunate people go bankrupt, or die (yes the snopes article says the exact number is uncertain. Maybe it's only 572,000.) Apparently, this has no weight in your evaluations. Which is why it is a naked power struggle. "I kinda like this system and I'm have money" vs. "I don't want my life destroyed to cater to the whims of people with more money." And obviously, huge corporations.
Quote:My personal situation (since you discuss yours, it seems relevant) is, that for 32 years, I've had the best private health care available, and have been able to afford it. My premiums in 1985 were 25/mo. They've gone up yearly to where now, in retirement, I'm paying 219/mo, with required co-pays of 25-35/visit. Certainly affordable, compared to most, but still a 9x increase.
I started topping out the fica deduction in 1998. I definitely enjoyed the 7.15% "raise" the end of every year, but I wouldn't have missed it, either. I can't imagine anyone who does top out really needs the money more than those uninsured who can't afford the early intervention visit that would keep them from becoming more seriously ill, or those who don't have catastrophic coverage that would prevent financial ruin
Which raises another issue. I know this forum is populated by people who fill out tax returns for fun. But to most people, this stuff is a confusing, tedious chore with mostly guess work. Millions of hours of unpaid labor by people who don't know what they're doing.
vs. "I broke my arm, so I'm going to the hospital." Another massive inefficiency.
And yet another, touched upon at the end. We have no incentive for preventative care, down to feeding school kids decent food. People skip preventive care or neglect to go to the doctor early on, and problems become bigger, deadlier and more expensive.
Quote: NathanThat is kind of messed up that you have to pay for gambling addiction treatments.
Who do you think pays for bankruptcy courts? Who do you think gambling addicts steal money from? Who pays to manage the homeless population, and for divorce courts, or kids from broken homes who wind up in jail?
From a total selfish perspective, it probably makes more sense to pay to treat someone else's gambling addiction than to treat their cancer. The person with cancer is just going to go off somewhere and die.
Moreover, I don't understand what is surprising about mental health issues being covered by medical.
