Obamacare - What to do

[GrowinDad]

So I read through the thread on 2016 which started out about Obamacare and went into infinite other things.

My opinion on Obamacare is that we're better off with it than without it but it's still a shitty bill. I read a ton of what I'd describe as paranoia on that thread and don't think it is anything to fear. I personally support a single-payer system and something more akin to our Canadian and European friends. I say that even though it would likely have a negative impact on me personally, as I'm one of those fairly high income people with good employer-based insurance. I try to view all issues from a macro viewpoint of what is best for society rather than for me personally.

On Obamacare, he was determined to pass something for legacy sake. He knew that in the current (or 4 yr ago) environment, he'd never get anything through unless he got pharma and the insurance companies on board - so yes, just more cutthroat capitalism rather than a care-oriented approach. And then he refused to look into the malpractice lititgation issues that are very real for providers today because he wasn't going to fuck with the trial lawyers. Point being, I have my views on what should be done but I also try to be objective.

With no offense intended to anyone, what pisses me off is how the opposers never seem to have any suggestions. Being against something without any recommendations isn't of much value. So thus the point of this post. I'm curious what ya'll think should be done.

Today, insurance is tied to employment and employers have no mandate to offer or defray costs. Do you believe any full time employer should be forced to have a health care program reasonably priced and subsidized by the employer? Should there be regulations on what that insurance offers? Should insurance be tied to employment.

A huge cost today is people who don't have or can't afford insurance using the emergency room. I made a career change a year ago and looked into buying a policy. What I found is that all that exists out there are policies to protect you if something major happens - cancer, run over by a bus, etc. There's a huge deductible. What it does not cover AT ALL for the most part is the ability for someone to do what I did yesterday - take their sick kid to the doctor. So..... in today's world if you buy a policy for the worst-case scenario, you still will likely use the emergency room and lack primary care to take care of things before they are too bad.

The reason why I support a socialized healthcare system where people can buy supplemental insurance to improve choices is because it allows everyone to go to the doctor and get taken care of. It doesn't force employers to pay for it, which in turn makes burgers cost too much. It admits that all human beings deserve basic dignity and health.

I suport single payer because it would cut huge amounts of administartive costs that make life horrendous for practitioners. I have a good friend who is a GP and trying to comply with each insurance company's rules, chase them down for payment, answer their stupid questions, etc adds a huge distarction and amount of cost to the business.

I'm happy to go on and on with my opinions but I am curious what the naysayers to Obamacare or socialized medicine believe should be done. I will say up front that if you try to claim the market solves all woes or that we shouldn't give a shit about anyone but ourselves, then you're fundamentally ignoring the issue. I'm curious what reforms you support to make healthcare more accessible to the majority of people who don't have it - the WORKING poor.

 

[ChesusRice]

So I read through the thread on 2016 which started out about Obamacare and went into infinitie other things.

My opinion on Obamacare is that we're better off with it than without it but it's still a shitty bill. I read a ton of what I'd describe as paranoia on that thread and don't think it is anything to fear. I personally support a sngle-payer system and something more akin to our Canadian and European friends. I say that even though it woudl likely have a negative impact on me personally, as I'm one of those fairly high income people with good employer-based insurance. I try to view all issues frmoa macro viewpoint of what is best for society rather than for me personally.

On Obamacare, he was determined to pass something for legacy sake. He knew that in the current (or 4 yr ago) environment, he'd never get anything through unless he got pharma and the insurance companies on board - so yes, just more cutthroat capitalism rather than a care-oriented approach. And then he refused to look into the malpractice lititgation issues that are very real for providers today because he wasn't going to fuck with the trial lawyers. Point being, I have my views on what should be done but I also try to be objective.

With no offense intended to anyone, what pisses me off is how the opposers never seem to have any suggestions. Being against something without any recommendations isn't of much value. So thus the point of this post. I'm curious what ya'll think should be done.

Today, insurance is tied to employment and employers have no mandate to offer or defray costs. Do you believe any full time employer should have a health care program reasonably priced and subsidized by the employer? Should there be regulations on what that insurance offers? Should insuirance be tied to employment.

A huge cost today is people who don't have or can't afford insurance using the emergency room. I made a career change a year ago and looked into buying a policy. What I found is that all that exists out there are policies to protect you if something major happens - cancer, run over by a bus, etc. There's a huge deductible. What it does not cover AT ALL for the most part is the ability for someone to do what I did yesterday - take their sick kid to the doctor. So..... in today's workld if you buy a policy for the worst-case scenario, you still will likely use the emergency room and lack primary care to take care of thigns before they are too bad.

The reason why I support a socialized healthcare system where people can bu supplimental insurance to improve choices is because it allows everyone to go to the doctor and get taken care of. It doesn't force employers to pay for it, which in turn makes burgers cost too much. It admits that all human being deserve basic dignity and health.

I suport single payer because it would cut huge amounts of administartive costs that make life horrendous and practitioners. I have a good friend who is a GP and trying to comply with each insurance company's rules, chase them down for payment, answer their stupid questions, etc adds a huge distarction and amount of cost to the business.

I'm happy to go on and on with my opinions but I am curious what the naysayers to Obamacare or socialized medicine belive should be done. I will say up front that if you try to claim the market solves all woes or that we shouldn't give a shit about anyone but ourselves, then you're fundamentally ignoring the issue. I'm curious what reforms you support to make healthcare more accessible to the majority of people who don't have it - the WORKING poor.

Obamacare is a republican idea what they worry about it is middle class will like it and give credit to a Democratic president

 

[merkzilla]

I followed it a little bit.

Keeping things simple, my personal insurance is 50% higher now and my family members are now paying upwards of $500 a month to cover just 2 people since the regulations went through. Is my insurance *any better,* fuck if I know. I've only used it twice for the 4-5 years I've had it. My plan isn't "Cadillac" plan or anything special, its literally just enough to reduce the cost of a visit if I ever need one.

So far, without obamacare even going into effect this is my personal experience.

My opinion though is that making healthcare affordable could be done by capping law suits, thereby lowering malpractice insurance which in turn would lower healthcare. If memory serves, malpractice insurance is over 1/3 the cost of practice.

 

[merkzilla]

Obamacare is a republican idea what they worry about it is middle class will like it and give credit to a Democratic president

George Bush tried to introduce the same kind of Bill, so I agree that there is partisanship involved (political penis envy). I do hesitate to say the middle class will like it, since they are the ones shouldering the burden.

 

[ChesusRice]

I followed it a little bit.

Keeping things simple, my personal insurance is 50% higher now and my family members are now paying upwards of $500 a month to cover just 2 people since the regulations went through. Is my insurance *any better,* fuck if I know. I've only used it twice for the 4-5 years I've had it. My plan isn't "Cadillac" plan or anything special, its literally just enough to reduce the cost of a visit if I ever need one.

So far, without obamacare even going into effect this is my personal experience.

My opinion though is that making healthcare affordable could be done by capping law suits, thereby lowering malpractice insurance which in turn would lower healthcare. If memory serves, malpractice insurance is over 1/3 the cost of practice.

Did what you said Texas. Insurance rates went up same pace as every other state. With the added bonus of an influx of shitty doctOrs from other states

 

[merkzilla]

Did what you said Texas. Insurance rates went up same pace as every other state. With the added bonus of an influx of shitty doctOrs from other states

If we based things on Texas... Dear god...

As far as I'm aware, the context of Texas capping it was to give incentive for physicians to move their practices to Texas. In that context, I'm not surprised that they didn't pass the savings along to the end consumers. Chances are too, that the hospitals themselves may be using that newfound slush-fund to cover their own "losses".

 

[GrowinDad]

I support malpractice reform but it is not the end all. I found different views on line so I will go with Wikipedia.

Malpractice has both direct and indirect costs, including "defensive medicine." According to the American Medical Association, defensive medicine increases health systems costs by between $84 and $151 billion each year. Studies place the direct and indirect costs of malpractice between 5% and 10% of total U.S. medical costs, as described below:[SUP][27][/SUP]

"About 10 percent of the cost of medical services is linked to malpractice lawsuits and more intensive diagnostic testing due to defensive medicine, according to a January 2006 report prepared by PricewaterhouseCoopers LLP for the insurers’ group America’s Health Insurance Plans. The figures were taken from a March 2003 study by the U.S. Department of Health and Human Services that estimated the direct cost of medical malpractice was 2 percent of the nation’s health-care spending and said defensive medical practices accounted for 5 percent to 9 percent of the overall expense."
​

According to the Trial lawyers:

Malpractice a Tiny Percentage of Health Care Costs
One of the principal myths surrounding medical malpractice is its effect on overall health care costs. Medical malpractice is actually a tiny percentage of health care costs, in part because medical malpractice claims are far less frequent than many people believe.
In 2004, the CBO calculated malpractice costs amounted to “less than 2 percent of overall health care spending. Thus, even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small.”[SUP] i [/SUP]
Five years later, the CBO revisited the issue of medical negligence costs. This time, they attempted to account for the indirect costs of medical negligence, mainly the idea that doctors order extra tests to avoid liability. Again, the CBO found that tort reform would only save 0.5 percent of all health care costs.[SUP]ii[/SUP]

 

[PurpleBuz]

my health insurance rates keep going up, year after year, despite the fact that I have minimal catastrophic insurance. While there have been a few good things with obama care such as pre existing conditions, Overall it just seems that I'm being forced to pay for others .... Despite what that dumb smooth talking lier says.

 

[st0wandgrow]

Personally, I think Obamacare sucks. It was a half-assed compromise which makes matters worse for the average American.

There is really no middle ground with this topic. We either decide as a society that health care coverage should be a right and move forward with a single payer system, or we keep things as is where only the folks with the financial means to purchase health care coverage have it.

I support a single payer system. It's what is most cost effective for us all, and every American will have at least basic coverage.

 

[tumorhead]

Something isn't right when people with health insurance go bankrupt over medical illness.

Majority of bankruptcy is due to medical expenses while 75% of those bankruptcy filers had health insurance.

http://www.pnhp.org/new_bankruptcy_study/Bankruptcy-2009.pdf

Obama care gives patients more power over insurance companies.

One potential "savings" for government I never see mentioned is the effect of making insurance companies keep their "loser" patients rather than kicking them off to medicaid.

 

[GrowinDad]

I heard a professor who studies healthcare speak once. A major topic was people who claim medicare, VA, etc are inefficient and more costly. He had to correct people pointing out that teh insurance companies have a great deal. They insure all the normally healthy people, whon granted can get ill. But generally speaking the government gets the elderly who tend to cost a lot before dying (not trying to sound heartless, just being honest), the severely handicapped, injured vets, etc. He said when he did the analysis those folks were generally more cost effective than the insurers if there was a level playing field.

So there was tons of vitriole about Obamacare on that other thread. I am honestly very curious what you folks think we should do about healthcare. My initial criticism was one that I find the conservatives bitch alot, are against anything Obama comes up with, and offer no solutions of their own. So please, prove me wrong! What do you think should be done to reform our healthcare system????

 

[ginwilly]

I would like to purchase prescription drugs made in Canada at a fraction of the cost. I'd like to be able to group together with other like-minded people and buy insurance or drugs from the lowest bidder no matter what state they reside in. I'd like for trained emergency personnel to be allowed to turn away non-emergent drug seeking repeat customers. I would like to be able to tailor my plan to my needs. I don't need birth control, don't want to pay for it. I would like to see certificate of need as a thing of the past allowing competition to move in right across the street if they want. I would like to see medical courts just like we have juvenile, divorce, traffic etc. It would streamline the process and from experience, I don't see 90% of my patients after they settle their case. This shouldn't take 5 years of going through the motions of pretending to need care while we pretend to try to help with both knowing as soon as the case is settled we'll never see each other again.

Just a few ideas that would have cost nothing yet saved billions.

I'd also like to see about 1/2 a trillion from the defense budget put into the VA system making them a free clinic for everyone.

 

[GrowinDad]

ginwilly, I agree with you by and large. I am not 100% convinced on the pick and choose what you want because I think the are some negatives that would come with that. Another huge flaw on Obamacare was that it didn't allow the gov to negotiate drug prices, which was part of how he got pharma on board.

 

[ChesusRice]

I would like to purchase prescription drugs made in Canada at a fraction of the cost.
Blame Bush and the Republicans for that
I'd like to be able to group together with other like-minded people and buy insurance or drugs from the lowest bidder no matter what state they reside in.
State Insurance exchanges also talk to your states insurance comissioner
I'd like for trained emergency personnel to be allowed to turn away non-emergent drug seeking repeat customers.
They make em wait for hours, but they still need to be looked at
I would like to be able to tailor my plan to my needs.
Nothing stopping you now
I don't need birth control, don't want to pay for it.
Too bad. We dont want to pay for your hemmorroids either. Deal with it
I would like to see certificate of need as a thing of the past allowing competition to move in right across the street if they want. I would like to see medical courts just like we have juvenile, divorce, traffic etc. It would streamline the process and from experience, I don't see 90% of my patients after they settle their case. This shouldn't take 5 years of going through the motions of pretending to need care while we pretend to try to help with both knowing as soon as the case is settled we'll never see each other again.

Death panels?

Just a few ideas that would have cost nothing yet saved billions.

I'd also like to see about 1/2 a trillion from the defense budget put into the VA system making them a free clinic for everyone.

Well enough said

 

[ginwilly]

Cheezus I know posting on a forum was your make a wish so I'll go easy.

Your Bush derangement is leaking again. Your first red was waaaaaaaaaaaaay before Bush. Don't know or care if it was blue or red at the time, doesn't matter, it's stooopid.

2nd red statement has nothing to do with buying across state lines, or being able to group together people from all walks of life.

3rd red statement shows a complete lack of understanding of what happens when people make 100's of "emergency" trips a year and have to be seen. Let's let the professionals who are trained in emergent care decide what constitutes an emergency.

4th red statement contradicts your 5th doesn't it?

6th red... um .. seriously, wtf? These people are tying courts now, let's dedicate a medical branch of the judicial system with judges and lawyers who specialize in medical laws. Not sure how you made the jump to death panels*.

I still suspect you are either 15, a level account or a witch.

* end of life committee, let's call it right.

 

[ChesusRice]

Buying across state lines is insurance company euphinism for
let us buy the best and cheapest state goverment and then sell shitty plans with no rights out of that state.

Ever wonder why your credit card companys are all located in Maryland and Souyth Dakota

Now as to state insurance commisioners
Yes they totally control the health insurance regulations in their respective states

how do I know this?
My wife has to underwrite health insurance policys for everyone of the 50 states as they all have different laws and different minimal coverage requirements

And no EMT is now or ever will be qualified enough to know if someone has or doesnt have a underlying medical ailment that needs to be treated

 

[ginwilly]

Buying across state lines is insurance company euphinism for
let us buy the best and cheapest state goverment and then sell shitty plans with no rights out of that state.

Ever wonder why your credit card companys are all located in Maryland and Souyth Dakota

Ever wonder what would happen to competition if we were only allowed to use credit cards issued from our own state.

Now as to state insurance commisioners
Yes they totally control the health insurance regulations in their respective states

how do I know this?
My wife has to underwrite health insurance policys for everyone of the 50 states as they all have different laws and different minimal coverage requirements

These are government regulations. You don't honestly believe the insurance companies made this rule do you? Yes each state has different regulations, imposed by each state's government. You realize Obamacare covers all 50 states right? Why can't Aetna? Why can't I buy Aetna South Dakota if it's cheaper?

And no EMT is now or ever will be qualified enough to know if someone has or doesnt have a underlying medical ailment that needs to be treated

I'd put my life in the hands of a paramedic under an emergency situation way before a general practitioner. I was actually talking about doctors and mid-levels though. You know, the people who care for people in the ER. EMTs are not in this discussion. I don't think ward clerks should have that power either in case your stupidity takes you to this conclusion next.

You continue to expose your ignorance of Obamacare and the medical field in general yet you keep trying. I admire that.

I know you claim to have read Obamacare before, how many pages is it up to now?

 

[ChesusRice]

I'd put my life in the hands of a paramedic under an emergency situation way before a general practitioner. I was actually talking about doctors and mid-levels though.

I'd like for trained emergency personnel to be allowed to turn away non-emergent drug seeking repeat customers.

You continue to expose your ignorance of Obamacare and the medical field in general yet you keep trying. I admire that.

I know you claim to have read Obamacare before, how many pages is it up to now?

Yes you are so smart


Usury Laws

Many states have a usury law which limits the interest rate that a company may charge.
Most of these laws capped interest rates at 18%. However, some states, such as South Dakota, do not have a usury law, allowing in-state businesses to charge as much interest as they want.
Congress has the power to regulate interstate commerce, which includes regulating nationally chartered banks which do business in more than one state. In the Supreme Court case Marquette v. First Omaha Service Corp. in 1978 the Court ruled that nationally chartered banks do not have to follow state law in which they do business, but only the law of the state in which the company is incorporated. Because state usury laws were not uniform this rendered all of them irrelevant as credit card companies picked up and moved to the states that allowed them to charge the highest interest rates.
After the 1978 ruling only national banks were exempt. If you banked with a bank which only did business in your state you were protected by your state's law. But a federal law now exempts state banks as well.

 

[ChesusRice]

Insurance is currently regulated by states. California, for instance, says all insurers have to cover treatments for lead poisoning, while other states let insurers decide whether to cover lead poisoning, and leaves lead poisoning coverage -- or its absence -- as a surprise for customers who find that they have lead poisoning. Here's a list (pdf) of which states mandate which treatments.

The result of this is that an Alabama plan can't be sold in, say, Oregon, because the Alabama plan doesn't conform to Oregon's regulations. A lot of liberals want that to change: It makes more sense, they say, for insurance to be regulated by the federal government. That way the product is standard across all the states.

Conservatives want the opposite: They want insurers to be able to cluster in one state, follow that state's regulations and sell the product to everyone in the country. In practice, that means we will have a single national insurance standard. But that standard will be decided by South Dakota. Or, if South Dakota doesn't give the insurers the freedom they want, it'll be decided by Wyoming. Or whoever.

This is exactly what happened in the credit card industry, which is regulated in accordance with conservative wishes. In 1980, Bill Janklow, the governor of South Dakota, made a deal with Citibank: If Citibank would move its credit card business to South Dakota, the governor would literally let Citibank write South Dakota's credit card regulations. You can read Janklow's recollections of the pact here.

 

[ginwilly]

Dude, just stop with the copy and paste and think logically for a sec. Whatever state you live in, that's the state your health insurance is based. If you travel to another state, they will take your insurance. You do not have to buy a policy within that state.

If that state takes your insurance, or your state will cover someone from another state, why then can't we simply purchase a cheaper policy from that state? Your state will cover someone from that state, but not allow you the same policy. Let's change this.

If you are clinging to the idea that emergency professionals can't recognize emergencies or don't recognize the most heinous repeat offenders then you have a seriously low opinion of healthcare workers. Either that or your faith in government officials borders on hero-worship. You are a govangelical.

Don't forget, we don't have to take your insurance if we don't want to so if all insurance was based on shitty non-coverage it wouldn't last. Unless of course you guys make even more stupid rules to combat this by forcing companies to accept all insurance.

How many pages is Obamacare up to now?