Forum Index » Chaff » Who is signing up for ObamaCare (aka ACA) on Tuesday?


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Richard May
(richardmay)

Locale: Costa Rica
Re: Assumptions on 10/03/2013 10:04:06 MDT Print View

I'm just trying to understand the problem. I've lived in Costa Rica since I was in my teens so I haven't been exposed the issue.

So, the government has played the role of a de-facto Public Insurance Company. I should think the ACA mandate is right up the conservatives' alley by putting the burden of insurance squarely on the shoulders of the population and taking it out of government hands. But hey, it's politics not people right?

From personal experience (living in Costa Rica) I can say that having public health care (not insurance) existing concomitant with private health care works. The competition keeps the private rates reasonable, prevention high and doctors wealthy.

My wife and I opted to use the private system when we had a baby. She has panic attacks so there was a psychologist and a psychiatrist on our team throughout the pregnancy. We had expenses like vitamins, and medicines to help with the side effects of having a baby, monthly visits to the OBGYN (with ultrasounds at every visit), the psychiatrist and weekly ones to the psychologist. There were no panic attacks (thanks to the psych team and hormonal changes). Our son was born by c-section (pre-programmed to avoid an attack) with a team of three doctors including the neo-natal, two nurses and an overnight stay.

All our baby related expenses from the first positive test and pregger clothes to walking out of the hospital was close to $8500. We didn't have private insurance so we had to pay for the whole thing out of pocket.

Yeah. I'm a proponent of public options too.

Katharina ....
(Kat_P) - MLife

Locale: Pacific Coast
Re: Re: Assumptions on 10/03/2013 10:09:41 MDT Print View

"
All our baby related expenses from the first positive test and pregger clothes to walking out of the hospital was close to $8500. We didn't have private insurance so we had to pay for the whole thing out of pocket."


That seems like a great deal.

Richard May
(richardmay)

Locale: Costa Rica
Re: Re: Re: Assumptions on 10/03/2013 12:39:18 MDT Print View

It sure is. Especially compared to $45000 it can cost in the States.

In fact, we got a better deal since the hospital was running a 'special' for births and we got a discount on the hospital fees (all the hardware, doctors are separate). They do it every year between January and April to get all the holiday parents. It seems an unusual number of babies are made around the year end holidays for some reason. :P

But this is a bit of hijack. I still think the mandate is a viable option. It certainly beats doing nothing.

Fred Thorp
(BFThorp) - F
The shortfall on 10/03/2013 13:53:22 MDT Print View

@ Jennifer

Fred, I'm not sure what "shortfall" you are talking about. I also have no idea what you mean by another layer of government. You do know this is private insurance we are buying, right? And you keep talking about young people getting screwed...how is that exactly?

The shortfall is the cost of services/product not covered by insurance or the consumer. Joe walks into the ER, complains of a headache and has no insurance. They x-ray his lungs, scan his grey matter, give him some advil and turn him loose. This is the shortfall I'm referring to, if Joe can't pay his bill. Regardless...
the government has now decided they will force Joe to get insurance or fine him, and no matter what his condition, he will be eligible for insurance. If the insurance co. wants to play, they will have to insure Joe, no matter what the statistical loss. If Joe is young, he will statistically pay more into the system than he will receive in greater proportion than someone older. Look it up. If he elects to opt out, the system will be short 1 more contributor. I don't necessarily think the young will be screwed any more than anyone else. If this all passes your smell test for more efficient and improved health care, I guess I'll just have to scratch my head. If you think the Supreme Court is OK with the government forcing the purchase of contracts, I'll be silent.

Layer might be the wrong word, maybe additional government employees and departments would be more accurate. Do you think all these employees that were hired to implement this program were transferred from the Department of Agriculture? It has to be monitored and the compliance on this deal is a nightmare for businesses that fall under the blanket. You think that businesses with low margins will just soak it up? I really have to sit back and laugh at some of this legislation and wonder if they could really be this stupid.

d k
(dkramalc) - MLife
Re: The shortfall on 10/03/2013 14:03:19 MDT Print View

Okay, Fred, please tell us your preferred solution to the healthcare situation. I am assuming (perhaps incorrectly, let me know if I'm wrong) that you probably don't think the existing situation is perfect.

What I'm most interested in is what happens with Joe, who can't afford to pay medical bills, in your ideal scenario? Especially if Joe is like the person who Jennifer described above, with a long hospitalization and rehab needs? Does he get denied medical care, or if not, who pays the bills?

Richard May
(richardmay)

Locale: Costa Rica
Re: The shortfall on 10/03/2013 14:32:47 MDT Print View

@Fred: If Joe is young, he will statistically pay more into the system than he will receive in greater proportion than someone older.

Fred, Ok I see what the shortfall is you are referring to. So it's actually the old people with expensive needs and won't pay their share into the system before they die that cause the inefficiency. The young, even if expensive now will pay their share later in life.

If that's what you are referring to then it's a temporary problem and we'll just have to bit the bullet till the inefficiency solves itself and people are in the system from birth.

You could also think of them as your parents or grandparents.

Jennifer Mitol
(Jenmitol) - M

Locale: In my dreams....
Re: Re: The shortfall on 10/03/2013 14:37:52 MDT Print View

And Fred, does that mean you never buy insurance? No car insurance, no homeowners insurance, etc? Any disability insurance? Life insurance? Guess what? By far most of us will never, ever recoup the money we pay into those policies. I have been driving for 30 years and have never been in an accident and never filed a claim. $100/ month x 30 years is a ton of money...

The one thing we know about health care is that every single one of us will need it at some point. ALL of us. Some a lot, some a little...but accidents and diseases and strokes and heart attacks happen. Then what are we supposed to do?

What I really don't understand about your comments, Fred, is why you think people aren't being screwed now and why this is any worse. You are already paying for the uninsured, the guy who walks into the ER with a headache, etc. Why not at least be more pragmatic about how we cover these people...maybe if Joe had a primary care doctor and a halfway decent insurance plan, he'd go see his MD for his headache instead of the WAY more expensive ER, then he wouldn't always get the lung scan and the CT scan of his brain, etc.

I'm not the biggest fan of the ACA, but at least it's a step in the right direction, and we need to start walking. We have the most inefficient and unfair health care system in the developed world and it doesn't need to be that way.

Jennifer Mitol
(Jenmitol) - M

Locale: In my dreams....
Insurance fairness... on 10/03/2013 14:46:47 MDT Print View

Here's another patient who broke my heart:

60-ish year old guy, janitor or something at Fed Ex. Widower, no kids. Never been sick, never missed a day of work in his life and had been working since he was a teenager, more than 20 some years at fed ex. Soon he started having some funny leg pains...turns out he had a nasty vascular problem that meant he had virtually no blood flow in his legs. So he took some sick time and had a bypass graft of his legs. Well, that started to get infected, then the graft wasn't really working very well...

They did another surgery. Then another. Pretty soon it was apparent that he was going to lose his legs. Fed Ex said thanks for all your years of service, but you are out of sick time and out of FMLA. We're going to have to let you go.

So here was this older man, crying in my clinic. He had no more job, was about to lose his legs; his insurance left with the job, and who was going to insure him now? How was he going to pay his mortgage? His heating bill? How was he going to pay for the amputations, the subsequent rehab, and the prosthetics?

Are we really the kind of people who tell this guy thanks but no thanks? Really??!!!!!

Doug I.
(idester) - MLife

Locale: MidAtlantic
Re: Re: Assumptions on 10/03/2013 14:54:58 MDT Print View

"I should think the ACA mandate is right up the conservatives' alley by putting the burden of insurance squarely on the shoulders of the population and taking it out of government hands. But hey, it's politics not people right?"

That's, perhaps, one of the grandest ironies in the whole debate. One of the biggest issues in the current legislation, the mandate, originated in conservative circles, was advanced in Republican bills years ago and supported by many of the same Republicans who now, suddenly, think it's unAmerican.

Politics, yeah, which is another word for ignorance in my dictionary.

just Justin Whitson
(ArcturusBear)
Re: Re: Re: Who is signing up for ObamaCare (aka ACA) on Tuesday? on 10/03/2013 22:03:52 MDT Print View

I think the real issue of health care in this country are the hugely over inflated prices of everything "medical".

Why, because we live in a country where greed and strong materialism is not just common, but fostered and lauded.

Wim Depondt
(wim_depondt) - F - MLife

Locale: The low countries
non issue on 10/04/2013 05:46:47 MDT Print View

"Anyone? Checked out the exchanges yet? Excited?"

Nope, but then, I live in Western Europe. Universal health care coverage - including national systems with US-style 'individual mandates' - is not an issue on this side of the pont (thank god, so debate energy can be used for the real (for the US probably next) challenge regarding health care: the cost control).

But I am excited whether the (outcome of the) current stalemate will have a fundamental & lasting impact on the political landscape in the US.

Kronos Master of Fate
(kthompson) - MLife

Locale: Behind the Redwood Curtain
Re: The shortfall on 10/04/2013 06:17:08 MDT Print View

My country has failed me.


For profit medical anything. That's the root problem.


Money, money, money. Destroyer of souls.

We should be helping one another, all of us.

Ian Destroyer of Forums
(IDBLOOM) - MLife

Locale: PNW
Re: non issue on 10/04/2013 06:44:19 MDT Print View

'But I am excited whether the (outcome of the) current stalemate will have a fundamental & lasting impact on the political landscape in the US."

I think the GOP has imploded to a point that I don't see them challenging the DNC too much for the next 5-10 years. I won't be surprised to see them lose the House of representatives.

This is unfortunate not because I'm a fan of the GOP but because I tend to despise my elected officials less when there is a balance of power between the Dems and the Republicans.

As far as ACA goes, it will all depend on our economy. If ACA doesn't kill jobs and the economy returns then this will go down in history as a complete success. If the economy tanks, then the GOP and the Dems will spend the next 100 years arguing (still) about free markets and entitlement programs.

Fred Thorp
(BFThorp) - F
No insurance. on 10/04/2013 19:58:03 MDT Print View

@jennifer

"And Fred, does that mean you never buy insurance? No car insurance, no homeowners insurance, etc? Any disability insurance? Life insurance? "
I am not mandated to buy car, homeowners, life, or disability insurance.

"By far most of us will never, ever recoup the money we pay into those policies. I have been driving for 30 years and have never been in an accident and never filed a claim. $100/ month x 30 years is a ton of money..."
We will never recover all of the premiums and their earnings (100%). If that were the case, no company could afford to offer the service. Shifting the financial burden of a possible catastrophic event to an entity with deeper pockets, is something I'm willing to do at times.

BTW I agree with most of your comments. That this is a step in the right direction, not so much. Adding more government has never made anything more efficient.

Edited by BFThorp on 10/04/2013 20:24:16 MDT.

Doug I.
(idester) - MLife

Locale: MidAtlantic
Re: No insurance. on 10/04/2013 20:45:35 MDT Print View

"I am not mandated to buy car, homeowners, life, or disability insurance."

Not sure that's really true. I believe the vast majority of states require you to have auto insurance - not your choice. And no bank I know of will give you a loan for a house unless you insure it, so it's de facto mandatory unless you outright own your house or buy one with cash.

Life and disability, yeah, that's not mandated as far as I know.

Doug I.
(idester) - MLife

Locale: MidAtlantic
Re: Re: non issue on 10/04/2013 20:50:26 MDT Print View

"I won't be surprised to see them lose the House of representatives. "

I'd be very surprised. The House districts have been so gerrymandered that I believe it's quite unlikely the repubs will lose the house any time soon.

I do think they might lose more Senate seats over the latest silliness, and that the crazy faction, which seems to be calling most of the shots, will ensure (with ideologically driven, short term thinking) that they don't get the White House in the near future.

BUT, if they let the country default on its (our) debts, and nothing terrible happens, all bets are off.

d k
(dkramalc) - MLife
Re: No insurance. on 10/04/2013 22:16:39 MDT Print View

Still waiting for the answers to my questions. I hear you saying that you don't like the ACA, but I would like to know what you think we should have instead, and what you think should happen when someone who can't afford to pay their medical bills needs treatment - should they receive treatment? if so, who pays?

Daniel Pittman
(pitsy) - M

Locale: Central Texas
Re: Who is signing up for ObamaCare (aka ACA) on Tuesday? on 10/05/2013 00:35:32 MDT Print View

Here's some information to add fuel to the fiery debate. I have not fact-checked anything this dude says, but his statistics are interesting.
Copy and paste; me no HTML

https://www.youtube.com/watch?v=qSjGouBmo0M

Edited by pitsy on 10/05/2013 00:36:42 MDT.

Wim Depondt
(wim_depondt) - F - MLife

Locale: The low countries
RE: health care cost on 10/05/2013 02:37:04 MDT Print View

Although not presented in a an academic style (hence the 4+ million views), he is dead on. And yes, ironically, US households spent way more on health care compared to GDP than any other OECD-country.

Virtually all nations with universal health care coverage will negotiate in some way with and regulate the health care industry. E.g. Belgium (my home country): the price of medication is - after consultation - eventually fixed by the federal government or doctors are generally not allowed to prescribe a specific (expensive) brand of medication (but must prescribe the generic name). I can give hundreds of examples.

But I suppose intervening in free market mechanisms - whether working efficient or not - in the US is easier said than done, especially in the current (ideologic) political stalemate.

So, one is allowed to fuel this debate? Roger that: http://www.aljazeera.com/indepth/opinion/2013/10/a-government-shutdown-a-social-breakdown-201310491015764779.html (p.s. I wonder if the author likes hiking - would generate superb camp shore debates :-))

Wim (BA social work & LLM, specialized in social law)

Fred Thorp
(BFThorp) - F
Solutions on 10/05/2013 03:12:15 MDT Print View

First. It's not a federal government issue. Second. We have a safety net in place (at least in my state), albeit very inefficient in spots and with obvious holes. Why not tackle that before turning the entire system upside down... at the state level.

Healthcare "costs" are another issue.