Obamacare...health care for everybody, really?

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Obamacare

Poll ended at Thu Oct 03, 2013 7:07 pm

Obamacare is just fine; let's fund it and let it run already
1
9%
Obamacare is a step in the right direction; fund it and fix it later
6
55%
Obamacare is a disaster; fund it and watch it implode
0
No votes
Obamacare is a disaster: defund it and fight it with everything possible
1
9%
Obamacare has a couple of good ideas. Scrap the program, take those ideas and start over
3
27%
 
Total votes: 11

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dianaiad
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Obamacare...health care for everybody, really?

Post #1

Post by dianaiad »

Some of you know that I have a problem; I haven't been all that shy. Frankly, it makes me mad as all get out.

Oh, not because I HAVE this condition, though frankly, I feel like I would have had better chances of winning the lottery.

I have Multiple Myeloma, stage II, 'high risk.'
It's an odd duck; cancer of the bone marrow. What makes it 'high risk,' is a chromosomal abnormality that doesn't mean good news for survival.

Now I'm actually blessed with great insurance, paid by my husband's retirement; Kaiser Permanente. Because of that, I had a doctor who saw that I was slightly anemic and sent me for some 'further tests.' Those 'further tests' ended up being a LOT of tests (including a bone marrow biopsy, which I recommend to the Spanish Inquisition, or the CIA...perhaps especially the CIA, since nobody could object to the government 'taking care of the prisoner's health') The verdict was, yup, I got this thing; 75% of my bone marrow was cancerous plasma cells.

The REALLY odd thing is that most people who have this don't find out until they have broken bones, kidney failure, dementia, liver failure....it's a nasty disease. Me? My bones are fine and so are my kidneys and liver.

No cracks about my mental capacity, please. ;)

I'm in GREAT health...except for the dying of cancer part.

This Friday I'm going in for a bone marrow transplant. I'll be in the City of Hope for two to three weeks, while they destroy my immune system and then 'reset' it, in hopes that this will put me into a good, long term remission. There's a really good chance that it will work, despite the 'high risk' thing, because they caught it before it did any damage to my bones and organs. It has been borne upon me that this is EXTREMELY rare, that someone with as an aggressive form of this condition as mine is gets caught this early. OK, I'll take that.

After all, this disease mostly affects African American men over 65. I am about as lily white a redheaded blue eyed female as you can find. Why in the world would they even LOOK for something like this?

Now, why this longwinded introduction, she asks?
I'll tell you.

In the normal course of events (pre-Obamacare) I would get the transplant, have the rest of the stem cells (that were collected from me last week) frozen and kept in reserve for another one...which I'm almost guaranteed to need, and if that doesn't work, I'd do a third, using donor cells from one of my sisters. I hope. Neither my age nor my life condition would affect this, because, well, I have Kaiser and I would transfer that to a 'Senior Advantage' Kaiser membership next August. All done. Good thing, because I'm going to be taking extremely expensive medication (as in, $2000 per pill) for the rest of my life.

If I had NOT had good insurance, the City of Hope and the pharmaceutical companies that make the novel drugs for this have all sorts of programs: once you have Multiple Myeloma, you get the care. All you have to do is get to a facility that specializes in it.


I have been told, however, and I have since confirmed this, that if Obamacare gets through as written, this will no longer be true. For one thing, there will be no possibility of a donor transplant, (which is the only hope for an outright cure) the most effective medication won't be available , and it's highly possible that I won't be offered even the second transplant using my OWN stem cells. My prognosis, thanks to Obamacare, will go from a possible ten to fifteen years down to two or three....because the decisions for my health care won't be mine or my doctor's. They will be made by committees according to guidelines, which will include the idea that no matter what, people over 70 won't get that sort of treatment.

It doesn't matter what my doctor says, or what my insurance company now pays for; the government will regulate this.

I'm OK now. Things are getting paid for.

But what about next year, when Obamacare takes me over?

Now me, I'm an example, and of course this is hitting home hard for me....but I'm hardly unique. I have been talking to a great many MM patients from all over the world, and the ones from 'universal health care' nations, like Canada, Australia and Great Britain do not do well. They are sicker and die sooner, and many of them don't even know that there are novel agents that can treat them; because THEIR healthcare won't provide them.

Those of you who know me know that I don't LIKE Obamacare. Now you know why.

So.....here's the topic for debate (and I'll participate for the next three days...). If you wanted to fix health care in this nation, how would YOU do it? Obviously Obamacare isn't going to work.

Remember: the object is to make certain that:
1. Those who need health care GET it...the best available, not just the least expensive.
2. The decisions regarding health care should be made by the patient and the doctor, not by some faceless bureaucrat looking at cost/benefit charts.
3. Nobody has to go bankrupt because of health care expenses.
4. Healthcare is delivered efficiently, with no long waiting times.
5. Health professionals get paid enough to justify the student loans, and have autonomy.
6. So do patients, in their ability to choose who provides them health care.


Obamacare does NONE of the above, btw.

Go.

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micatala
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Post #181

Post by micatala »

bluethread wrote:
micatala wrote:
WinePusher wrote: Fire insurance companies don't cover people who have preexisting fires. Car insurance companies don't cover people who have preexisting crashes. What makes you think that health insurance companies are financially capable of covering people with preexisting medical problems?
You realize this is an argument for the ACA, right?

We require everyone to buy car insurance partly for this precise reason. The ACA includes the individual mandate partly for this very reason. Leaving aside the problem that health insurance is not really like car or fire insurance for a number of reasons, even granting your analogy, the implication is we should require people to have insurance, or have the government cover everybody. The alternative would be to simply accept that some people will have to live with catastrophic losses. I will point out that the catastrophic losses from health issues will often be significantly more than people would suffer from a car accident or a house fire.
No, the law does no require comprehensive insurance, but liability insurance. That means I am required to carry a certain amount of insurance to cover the damage my car might do to you or your belongings. I can lose my car and have no way of buying another one. So, the analogy requires me to have insurance to cover the cost of medical expenses for things I do to you, but I need not have insurance against me losing my health and having no way of getting it back.

That is a fair point. The nature of the requirement is different. On the other hand, the point about having to have the insurance ahead of time is still valid.

If we did not require everyone to buy insurance, then the risk would be spread over a smaller pool, and those who did buy insurance would end up subsidizing the costs for some of the damage caused by those with no insurance.
" . . . the line separating good and evil passes, not through states, nor between classes, nor between political parties either, but right through every human heart . . . ." Alexander Solzhenitsyn

WinePusher

Post #182

Post by WinePusher »

WinePusher wrote:As I've previously said it is not possible to force insurance companies to take on unlimited liabilities.
micatala wrote:I would agree with this, but this is somewhat of a red herring. No one is saying insurance companies have to accept "unlimited" liabilities.
By forcing insurance companies to cover people with pre existing condition you are essentially forcing them to take on unlimited liabilities. A person with a pre existing condition is a liability for an insurance company. If you have pre existing car accidents you'll notice that it will be much more difficult for you to get car insurance. If you have bad credit you'll notice that it will be difficult for you to get loans. Insurance companies are no different, it simply is impossible to force them to take on and cover people with pre existing medical conditions.
WinePusher wrote:I'm sorry to break it to you, but an individual with a preexisting condition is considered a liability. That does not mean they should not get treatment for their medical conditions, but it does mean that they should pay for their medical costs using other means than traditional insurance. Republicans have proposed creating state run high risk insurance pools that I support, and this program would be much more effective than the failure that is Obamacare.
micatala wrote:well, this might be worth discussing. This would shift the costs of high risk people, people, with pre-existing conditions, whatever, to the tax payer. If you are willing to do this, why not just go all the way and cover everybody with a single-payer system?
Yes, you're absolutely correct. I have no problem with state governments running high risk pools for people with pre existing conditions. But ideally, what I want is for healthcare prices to come down drastically so that we can begin moving away from a system of third party payments and towards a system of out of pocket payments. A single payer system would not achieve this goal. Also, a single payer system would require federal government oversight, and this is something I am ideologically against.
WinePusher wrote:Fire insurance companies don't cover people who have preexisting fires. Car insurance companies don't cover people who have preexisting crashes. What makes you think that health insurance companies are financially capable of covering people with preexisting medical problems?
micatala wrote:You realize this is an argument for the ACA, right?

We require everyone to buy car insurance partly for this precise reason.
No, we don't require everyone to buy car insurance. We only require people who drive to buy car insurance. If you don't drive then you aren't forced to buy car insurance. What Obamacare does is essentially force everybody to buy car insurance regardless of whether or not they drive. This is something I oppose.
micatala wrote:What we DO know is that countries with single-payer systems all have much lower costs than we do.
Still, I think a market oriented healthcare system is far better than a government run single payer system. I'm sorry, but the government simply has a horrible track record when it comes to managing things even as basic as a simple website. Why would I want to give them full jurisdiction over the healthcare industry given their horrible track record?

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Post #183

Post by johnmarc »

WinePusher wrote:

No, we don't require everyone to buy car insurance. We only require people who drive to buy car insurance. If you don't drive then you aren't forced to buy car insurance. What Obamacare does is essentially force everybody to buy car insurance regardless of whether or not they drive. This is something I oppose.
Cute! This is one of the strangest things I have ever seen posted here. You can't choose to (or not to) get ulcerative colitis at eighteen and remain uninsurable the rest of your life.

No, we don't require everyone to buy health insurance. We only require people who are alive to buy health insurance. If you aren't alive then you aren't forced to buy health insurance. What Obamacare does is essentially force everybody to buy health insurance regardless of whether or not they are living. This is something I oppose. :confused2:

What exactly is the correlation here? You can choose to drive irresponsibly. You can't choose to live and you can't choose to be cancer free. Driving is a choice (almost) but health conditions are not.
WinePusher wrote:

Still, I think a market oriented healthcare system is far better than a government run single payer system. I'm sorry, but the government simply has a horrible track record when it comes to managing things even as basic as a simple website. Why would I want to give them full jurisdiction over the healthcare industry given their horrible track record?


Notice that the conservative side of this argument rarely uses the word, 'Medicare' There is an excellent reason for this. Medicare takes people with pre-existing conditions. If the pool is large enough it can be a practical and sustainable way to include everyone. Medicare is a government program that works---and Winepusher should know that.

Note: Winepusher has me on 'ignore' so just carry on this conversation as if I am not here. (shouldn't I be getting a trophy or something?)
Why posit intention when ignorance will suffice?

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Post #184

Post by johnmarc »

[Replying to post 182 by WinePusher]


This in today's newspaper written (partly) by the Governor of the State of Washington:

"The Affordable Care Act has been successful in our states because our political and community leaders grasped the importance of expanding healthcare coverage and have avoided the temptation to use health-care reform as a political football.

In Washington, the Legislature authorized Medicaid expansion with overwhelmingly bipartisan votes in the House and senate this summer because legislators understood that it could help create more than 10.000 jobs, save more than $300 million for the state in the first 18 months. and, most important, provide several hundred thousand uninsured Washingtonians with health coverage.

In Kentucky, two independent studies showed that the Bluegrass State couldn't afford not to expand Medicaid. Expansion offered huge savings in the state budget and is expected to create 17,000 jobs.

In Connecticut, more than 50 percent of enrollment in the state exchange, Access Health CT, is for private health insurance. The Connecticut exchange has a customer satisfaction level of 96.5 percent. according to a survey of users in October, with more than 82 percent of enrollees either "extremely likely" or "very likely" to recommend the exchange to a colleague or friend.

In our states, elected leaders have decided to put people, not politics, first."
Why posit intention when ignorance will suffice?

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Post #185

Post by bluethread »

micatala wrote:
If we did not require everyone to buy insurance, then the risk would be spread over a smaller pool, and those who did buy insurance would end up subsidizing the costs for some of the damage caused by those with no insurance.
The insurance industry is not damaged by those who have no insurance, as long as it is permitted to take preexisting conditions into account. Government subsidized medical care does transfer costs, but so do all social welfare programs. People who get EBT even though there is no requirement for them to have ever paid any taxes. Women on WIC just need to have a child, no contribution required. Cell phones are handed out by the government without regard to any personal contribution too the program. Mandatory subsidization of those who do not contribute is a product of social welfare, not the marketplace. Should we require everyone to have food and phone insurance?

That said, not everyone is being required to have health insurance. Those who refuse to work, the ultimate freeloaders, are give benefits without having to buy insurance. This is what is driving up healthcare costs. The transfer costs of Medicare/Medicaid increases demand which inflates the costs out of the reach of the working poor. We then attempt to solve the problem by requiring those working poor to buy insurance that they can not afford.

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Post #186

Post by bluethread »

johnmarc wrote: Medicare takes people with pre-existing conditions. If the pool is large enough it can be a practical and sustainable way to include everyone. Medicare is a government program that works---and Winepusher should know that.
Medicare is bankrupting the country. It is not based on a large pool of participants. It is dependent on a large pool of payers. It just transfers the costs from those who are not paying for the services they receive to those who pay for services they do not receive.

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bluethread
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Post #187

Post by bluethread »

johnmarc wrote: [Replying to post 182 by WinePusher]


This in today's newspaper written (partly) by the Governor of the State of Washington:

"The Affordable Care Act has been successful in our states because our political and community leaders grasped the importance of expanding healthcare coverage and have avoided the temptation to use health-care reform as a political football.

In Washington, the Legislature authorized Medicaid expansion with overwhelmingly bipartisan votes in the House and senate this summer because legislators understood that it could help create more than 10.000 jobs, save more than $300 million for the state in the first 18 months. and, most important, provide several hundred thousand uninsured Washingtonians with health coverage.

In Kentucky, two independent studies showed that the Bluegrass State couldn't afford not to expand Medicaid. Expansion offered huge savings in the state budget and is expected to create 17,000 jobs.

In Connecticut, more than 50 percent of enrollment in the state exchange, Access Health CT, is for private health insurance. The Connecticut exchange has a customer satisfaction level of 96.5 percent. according to a survey of users in October, with more than 82 percent of enrollees either "extremely likely" or "very likely" to recommend the exchange to a colleague or friend.

In our states, elected leaders have decided to put people, not politics, first."
Good, then as Romney stated, leave it a state issue. If it is a good thing, those states with it will succeed and those without it will fail.

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johnmarc
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Post #188

Post by johnmarc »

bluethread wrote:
johnmarc wrote: Medicare takes people with pre-existing conditions. If the pool is large enough it can be a practical and sustainable way to include everyone. Medicare is a government program that works---and Winepusher should know that.
Medicare is bankrupting the country. It is not based on a large pool of participants. It is dependent on a large pool of payers. It just transfers the costs from those who are not paying for the services they receive to those who pay for services they do not receive.

Correct me if I am wrong, but I think that I have been paying into Medicare my entire tax paying life. (2012 rate 1.45%) The pool is every taxpayer in the United States. That is a huge pool and it subsidizes premiums that I now pay.

Medicare members DO pay for the services they receive in that they have been paying their entire working life. The pool of payers that you describe BECOME the folks receiving the services.

For my family, both Social Security and Medicare are not a hand out from anyone. They are payments and services that I have purchased over time.
Why posit intention when ignorance will suffice?

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johnmarc
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Post #189

Post by johnmarc »

bluethread wrote:

Good, then as Romney stated, leave it a state issue. If it is a good thing, those states with it will succeed and those without it will fail.

As I understand it. Texas has an uninsured rate of 25%. There are folks who care about things like that. ER visits from the uninsured ARE the services that folks get that others pay for. That is a better correlation than your Medicare example.
Why posit intention when ignorance will suffice?

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bluethread
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Post #190

Post by bluethread »

johnmarc wrote:
bluethread wrote:
Medicare is bankrupting the country. It is not based on a large pool of participants. It is dependent on a large pool of payers. It just transfers the costs from those who are not paying for the services they receive to those who pay for services they do not receive.

Correct me if I am wrong, but I think that I have been paying into Medicare my entire tax paying life. (2012 rate 1.45%) The pool is every taxpayer in the United States. That is a huge pool and it subsidizes premiums that I now pay.


No, the payer pool is every employed taxpayer. Those who are not employed are not paying into the system.
Medicare members DO pay for the services they receive in that they have been paying their entire working life. The pool of payers that you describe BECOME the folks receiving the services.

For my family, both Social Security and Medicare are not a hand out from anyone. They are payments and services that I have purchased over time.
No, the only people who receive services that are paid for from monies withheld from their checks are those on Medicare/Medicaid and working. This is a system made famous by Charles Ponzi paying early investors using the investments of later investors, ie Bernie Madoff. What you are counting on is called an unfunded liability. That is illegal for the insurance and banking industry. However, since it is the government, the rules don't apply. In short, there is no money in the "Medicare Trust Fund" and no assurance, apart from general riots, that "the government" will pay medical expenses in the future.
bluethread wrote:

Good, then as Romney stated, leave it a state issue. If it is a good thing, those states with it will succeed and those without it will fail.


As I understand it. Texas has an uninsured rate of 25%. There are folks who care about things like that. ER visits from the uninsured ARE the services that folks get that others pay for. That is a better correlation than your Medicare example.
People who can pay do pay. Those who can't pay and are on Medicaid are covered by Medicaid. The working poor, who are not on Medicaid, are subsidized by Medicaid or file for bankruptcy. So, the people being demonized as freeloaders are the working poor.

The ACA only helps them by requiring the working poor to pay not only the hospital, but also an insurance company and beg the government for a subsidy, rather than the subsidy going directly to the hospital. Oh ya, they can also stop working and go on full Medicaid. So, at best, the ACA is requiring the working poor to help finance the insurance industry, front the Medicaid subsidy to the hospital and beg for a refund, or give up and quite working. How is this good for the working poor?

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