Obamacare... Comments? Concerns?

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KrazyNick
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Postby KrazyNick » Sat Jul 13, 2013 6:46 pm

DoingHomework wrote:So given a choice you would rather not have insurance. So the rest of us would pay if you got hit by a truck, wrecked your bike, or got a catastrophic disease?

Maybe you just don't like that medical science says those supplements are a ripoff or worse...potentially deadly in some cases.


And tell me if you got sick would you rather come to a retail store and buy a natural supplement with no known side effects or interactions or go to a hospital wait in the waiting room with other sick people finally get to the doctor, they run a few tests just to give you a prescription you have to go fill and you get all these horrible side effects that are worst than the issue you came in for.

I've seen these supplements change people's lives over the past years, never seen a potential deadly interaction.
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MemberSince99
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Postby MemberSince99 » Sun Jul 14, 2013 7:13 am

I agree Nick.

This law did nothing to solve the fundamental problems - astronomical costs, it simply mandates that you will have insurance or you will pay for not having it and still not have it. Poorly conceived atrocity of a law that's just going to further erode this company.

I personally had hopes for it in the beginning, but seeing the utter disaster that Obama's "leadership" has been to this country, my only hope is he can't do any more damage before he's out of office.

Robrus1
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Postby Robrus1 » Sun Jul 14, 2013 10:35 am

I don't think the government should make you pay for it if you don't want to, however, let's say you don't have health insurance, get in a car wreck, and don't have the money to pay for medical treatment. You should be denied medical treatment and they should just leave you in the nearest parking lot/sidewalk next to your wreck. I mean if you're willing to take the chance...
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DoingHomework
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Postby DoingHomework » Sun Jul 14, 2013 3:19 pm

Robrus1 wrote:I don't think the government should make you pay for it if you don't want to, however, let's say you don't have health insurance, get in a car wreck, and don't have the money to pay for medical treatment. You should be denied medical treatment and they should just leave you in the nearest parking lot/sidewalk next to your wreck. I mean if you're willing to take the chance...


But that will never happen. What could happen, although I doubt we'd ever do this either, would be to make not paying medical expense a crime. If we lock people up until they can pay their debts by earning money doing prison labor at 10 cents an hour, then you would see people more willing to pay.

In principle I agree that the government should not tell people what o do. In practice no one can avoid the health care system and many people are stupid enough to think they can. I think in practice we need laws to protect the rest of us from paying for those peoples' stupidity.

DoingHomework
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Postby DoingHomework » Sun Jul 14, 2013 3:26 pm

KrazyNick wrote:And tell me if you got sick would you rather come to a retail store and buy a natural supplement with no known side effects or interactions or go to a hospital wait in the waiting room with other sick people finally get to the doctor, they run a few tests just to give you a prescription you have to go fill and you get all these horrible side effects that are worst than the issue you came in for.

I've seen these supplements change people's lives over the past years, never seen a potential deadly interaction.


If I got sick I would not take supplements any more than I would take prescription meds. I eat right, exercise, don't smoke, and generally try to stay healthy. But when something goes wrong I will rely on science rather than a store clerk to try to fix me.

I tend to think natural cures ARE effective in many cases, don't get me wrong. But you don't need to buy supplements. People need to eat right and exercise. Those things are free.

And the list of deadly supplements is long - fen-fen, ephedra, BD, steroids, etc. Plus, since they are unregulated the quality control varies from excellent to extremely poor. I want nothing to do with them.

DoingHomework
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Postby DoingHomework » Sun Jul 14, 2013 3:33 pm

KrazyNick wrote:Natural supplements aren't a ripoff. You obviously have no clue what you are talking about. If I get in a wreck I will pay my own emergency bills, not rely on taxpayers to do it. But some people don't take care of their selves and eat McDonald's for every meal with no exercise and wonder why they have to visit the doctor 4 times a year.


I agree with you about McDonalds. The typical American high-fat, high-sugar diet kills. It also costs all of us billions in diabetes care, heart disease, and so forth. I think someone who takes a bunch of supplements is certainly better off than someone who frequents fast food.

But there is no need for either. Just eat a diet of mostly fruits and vegetables, exercise at least 4 times a week, keep your weight down, and most people will be fine.

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Postby MemberSince99 » Mon Jul 15, 2013 6:50 am

So now you want to bring back debtor's prisons?

And hell yes they will let you die, are you kidding me? I haven't gone to the doctor in years even though I have insurance (and according to King Barry, that should immediately solve ALL of my problems with health care....) but when I did, even when I came into the emergency room with my head ripped open because some guy's truck brakes failed and he plowed into me at high speed and knocked my car off the road and totalled it, they made me sign forms swearing I would pay them before they would even touch me. It wasn't like they treated me first then worried about it, nope, it was clear that payment was top priority. They are not going to help you if you can't pay beyond the bare minimum of making sure you'll live then getting you the hell out of there.

Having insurance is far from a cure for all the issues in this system. I agree, in general it's a good idea, but it's still possible to go bankrupt, and even be DECLINED payment from your insurance company simply because the bean counters decide it's better for their bottom line that you die. Think I'm kidding? The insurance company I had a few years back did that to a little girl and it made it into the national news. The bad publicity caused them to finally relent and agree to pay but she had already died by then. Saved them some money so that's what really counts. It's so naive to think that just forcing people to carry insurance is going to magically make things all better, but in King Barry's alternate universe, we get new credit cards to make payments on the current cards we have, and that's fixing our debt problem (raising the debt ceiling to pay our debts) so what can we expect.

I know you didn't want to make it political and it's not it's just not a policy that fixes the issues to be honest it's just going to cost us more money (like everything Barry does).

DoingHomework
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Postby DoingHomework » Mon Jul 15, 2013 8:34 am

MemberSince99 wrote:So now you want to bring back debtor's prisons?

Is that really such a bad idea? Defaulting on debt is a form of theft. We already lock people up for that.

MemberSince99 wrote:It's so naive to think that just forcing people to carry insurance is going to magically make things all better

Yes it is. But it is a first step. Plus, the PPACA fixes other problems. It requires all insurance companies cover preexisting conditions for example. In general it is going to keep the bean counters from having the power to make some of those bad decisions.

It has all the attributes of a good law - everyone hates a part of it. I certainly don't think it is perfect. It's not the law I would have wanted. But I think it will make things better in a few years after thekinks are worked out.

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Postby Sevenfeet » Mon Jul 15, 2013 12:00 pm

I take it from the conversation that most, if not all of you either don't work in health care or any of the related fields that provide or support health care in this country. I have worked in health care IT for 20+ years, including payer insurance so I have some experience and perspective on the subject.

Some background...we've all heard that the US has the best health care system in the world. But in reality, if you measure the US versus many first world western nations, we're not leading (and in some cases, significantly behind) in a variety of industry metrics. We do have the best trained health care workers, facilities and technology. The problem for many Americans is access, either due to economic or logistical issues. People who do not engage the health care system, especially early on will be sicker and therefore, use more expensive resources of the health care system later on.

Our health care delivery system is unique in the world for its complexity. The system is largely based on private sector insurance, which grew out of post WWII American business. Because of the piecemeal approach, it's never been able to cover the majority of the entirety of the US population. As a result, we got federal mandated health care for the poor...Medicaid. Run by the states themselves, the idea was to guarantee access to the system for the most economically disadvantaged. At the same time, Medicare for senior citizens was created. Both are mostly single payer systems (i.e., the government pays the health care providers for service rendered), but states run Medicaid while the feds run Medicare. On top of that you have the Veterans Administration system which is also single payer federally based but everyone agrees has serious problems, mainly to initial access because of red tape. Once you get access, it's supposed to be pretty good.

So in one lifespan, you could be on Medicaid at one point, payer insurance from an employer and Medicare at the end of life (or the VA system)...all with their own databases, support infrastructures, payer networks, everything. Does this sound efficient? Most of the rest of the world would say no. Virtually all other 1st world nations (and many third world ones) have single payer systems, which is just another term for government paid healthcare. There's lots of consternation in this country over the very topic, some of which has been said earlier in this thread. Yet Medicare seems to have high approval ratings for the seniors who use it, which is basically just what the rest of the world is doing, limited by age.

The politics of the issue are framed in the polarization of the political process in general. In other worlds, if your political opponent comes up with an idea, you must trash it by default, regardless of how much of it you might agree with. This has made some interesting bedfellows and protest which, if looking from the outside in, is absolutely absurdist. If you joined the rest of the world in the single payer model, you would likely do away with the entire private insurance industry, sending all of those companies nationwide out of business, or at least just end up being government contractors. If the US had done single payer early on, say after WWII, this discussion would be academic. But Truman's poll numbers were horrible and the Eisenhower and Kennedy administrations were dealing with the Cold War mostly. By the time the Johnson administration came around, private insurance health care was firmly entrenched. The best that he could do was to fill in the gaps in the system (Medicaid, Medicare). But other gaps remained (like employers that didn't offer health care or the short term unemployed) and those gaps would only grow enormously in recent years. For context, Britain's Margaret Thatcher was a huge supporter of single payer universal health care and passed legislation guaranteeing it in the UK.

The Affordable Care Act (nee Obamacare) actually grew out of ideas from the Heritage Foundation...not exactly the beacon of liberal policy making. The idea was this: "Could you use the existing private insurance market to fill in the coverage gaps and make universal health care possible?" The idea was mandating that everyone join the insurance system run by the free market, not the government (like Medicaid/Medicare). Large companies who already provided insurance for employees could still do so. But the tax structure would subsidize everyone else and there would be a sliding scale of payment depending on the person's income, employment (or lack thereof), etc. The idea was adopted and implemented by Mitt Romney in Massachusetts and was largely successful.

But when President Obama proposed doing the same thing, Republicans who spent years working or implementing the idea all of a sudden washed their hands of it, largely because of who was trying to implement it on a nationwide scale. This is curious since it would be the final stake in the heart of ever having a single payer system in the US....which conservatives usually say they want. Why abandon your own idea if your political opponent wants to do it? That used to be called in political circles, a victory. Now a victory is considered to be a total repeal of the legislation, putting us back to the old system with it's growing gaps of millions of Americans and natural inefficiencies.

By far, the mandate that everyone join the system is the most unpopular of the plan. The people of the US has a history of distrusting government mandates, regardless of how benign they might be. But from an actuarial standpoint, it only works of everyone actually participates (healthy and sick people in the same system). Sick people get the care they need, but more important long term, healthy people engage the system early and stay healthy longer. The alternative is either single payer, or what we have now where people avoid care due to the costs and only show up when they are very sick, after cheaper therapies were available earlier.

Some say that you should have a "right" not to have insurance and not to engage the system. The problem is that health care isn't something like a car. You don't want to pay mandated car insurance? Don't own a car. But everyone has to visit the doctor or a hospital sooner or later and it's best if (like a car), you go in for routine maintenance. Since the likely hood that you will engage the health care system is about 100%, platitudes on independence don't make sense here. Since the system costs money to run, we have to figure out a way to make the system work for all without bankrupting the government or families. The rest of the world figured this out decades ago and nobody complains. Here, we seem to have a perverse wish to have the right to get sick on our own without a safety net, which only drives up the cost of heath care for everyone when said person shows up in an ER (the most expensive of all care) or waits too long to solve a medical issue that could have been treated less expensively and with a better outcome years earlier.
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DoingHomework
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Postby DoingHomework » Mon Jul 15, 2013 2:10 pm

Sevenfeet wrote:I take it from the conversation that most....


Excellent post Sevenfeet. You are 100% right on the facts. The whole issue has become completely politicized.

I have always had insurance, through my employer. I have also lived and worked in a couple of other countries. Nationalized health care works. Nearly every other industrialized country has it, it does not represent an unbearable tax burden, people do not die waiting for care, and most people are happy with the system. Americans are completely misled by the politicians. There are horror stories and disgruntled people in any system but overall, universal health care works and is a requisite of a modern civilized society. The US really needs to get with the program in this regard.



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