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Lyan Jordan
(redmonk)

Locale: Greater Yellowstone Ecosystem
Tea Party Haters on 10/25/2013 16:42:42 MDT Print View

Anyone who leaves the house is one accident away from needing medical treatments.

In some cases a car can fly through the side of a house, or an earthquake can move the house, or a fire... I guess home isn't safe either.

There are two types of people, people that have need for a functioning health care system, and people that will have need for a functional health care system.

Katharina ....
(Kat_P) - MLife

Locale: Pacific Coast
Re: Re: Re: Re: Re: Re: Re: Re: fantastical on 10/25/2013 17:14:30 MDT Print View

I bet Jerry and Ken H. would be happy to only have one party.

Edited by Kat_P on 10/25/2013 17:34:13 MDT.

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: Re: Re: Re: Re: Re: Re: Re: Re: fantastical on 10/25/2013 17:32:52 MDT Print View

Which Ken?

No, I think diversity is better, though at times It's frustrating things don't happen faster.

And, like I've said, the one party we have that has the real power is the big money party. They're laughing at us for arguing. Laughing all the way to the bank.

David Olsen
(oware)

Locale: Steptoe Butte
Sue on 10/25/2013 17:37:53 MDT Print View

Sue 2 a Tea

Edited by oware on 10/25/2013 17:47:12 MDT.

Fred Thorp
(BFThorp) - F
Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: fantastical on 10/25/2013 17:52:42 MDT Print View

Sorry but I think you misunderstood. It's not about forcing the purchase (although that's probably next), it's about someone willing to pay for a contract that they will unlikely (statistically speaking) benefit from. Young people who typically are little or no expense to the insurer, provide cash flow for those not so healthy. I get it. Getting enough of this group to sign up, is the problem. Don't be surprised when this group's rates are subsidized to make it more attractive to sign up, with tax money of course.

Katharina ....
(Kat_P) - MLife

Locale: Pacific Coast
Guts on 10/25/2013 18:18:13 MDT Print View

http://daily.represent.us/news-anchor-completely-loses-it-on-camera-because-of-everything-thats-wrong-with-america/

Dean F.
(acrosome) - MLife

Locale: Back in the Front Range
Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: fantastical on 10/25/2013 18:19:26 MDT Print View

If it were any other contract that might be a cogent argument. But it isn't. They do benefit- they get insurance coverage in case they get sick. Statistically (since you used that word) even some of the "young invincibles" will get sick. And if they aren't insured we end up paying for their healthcare when they get sick. If they would be willing to die without treatment if they got sick I would buy that argument, but no one is. Will they end up paying more into the insurance program than they get out? Most of them, yes, clearly. But most of everyone else does, too, even the sicker older people. That's... insurance. On average EVERYONE pays more into their healthcare plans than they get out of them. Otherwise it wouldn't be profitable for the insurers, would it? And, presuming that the young invincibles end up keeping some form of health insurance for the rest of their lives then eventually they would no longer be young nor invincible and would recoup some of that benefit. I mean, you can't expect people to only buy insurance once they get sick- that defeats the purpose of insurance! If everyone did that then premiums would be so high that that would really just be fee-for-service medical care. That's a society with NO healthcare insurance.

As I alluded, the personal liberty argument cuts both ways on that one. So I think it's a wash. Null. Means nothing, either way.

The "young invincibles" per se aren't subsidized- the poor are. But that is sort of the same thing, really. The non-poor invincibles can afford the insurance and will probably buy it (because it is better than paying for nothing, if they pay the penalty). The poor ones will get the subsidy. This is all designed to get as many of them to sign up as we can.

But it isn't JUST about the invincibles.

And ultimately yes I forsee everyone's premiums coming down. I admit, it may take a while, but barring horrid circumstances like a premium spiral they will come down. They must, for the reasons I mentioned regarding preventive care, etc. Frankly, even if premiums go up a bit you're at least getting better services for it, since the scam "hollow policies" are now illegal, all preventive services lack co-pays, etc. So that's probably a wash financially. (Indeed, it almost has to be, mathematically.)

EDIT-- I guess I should ask a basic moral question, Fred. Would you be willing to let the uninsured die from lack of medical treatment if they couldn't pay out of pocket? In essence, turn them out of the ER into the street?

Edited by acrosome on 10/25/2013 18:54:31 MDT.

Fred Thorp
(BFThorp) - F
Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: fantastical on 10/25/2013 18:56:02 MDT Print View

Sorry Dean but I'm not talking civil liberties, contract law, or specific instances. It's simple math. Odds are, this needed group of contributors will pay far more (more now than in the past BTW) in premiums than they will recover. Not a good bet statistically speaking, and I don't see them lining up with check books in hand. So do you force it or subsidize it, to make this thing work?

ETA the moral question has been asked and answered. County hospital is supported by local property taxes. Maybe we should check back in five years and see where things are. I'm guessing you'll owe me a steak dinner. Care to wager?

Edited by BFThorp on 10/25/2013 19:35:25 MDT.

Dean F.
(acrosome) - MLife

Locale: Back in the Front Range
How many times must I tell you that it is subsidized? on 10/25/2013 19:16:21 MDT Print View

@ "Sorry Dean but I'm not talking civil liberties, contract law, or specific instances."

OK, I'll call BS on that one. You have in fact "talked" all of those.

@ "So do you force it or subsidize it, to make this thing work?"

Fred, are you even reading my posts? It is subsidized, for the poor. Just like Medicare and Medicaid. As I've said several times. Also, I *think* the plan is to slowly increase the penalty over time until basically everyone is strongarmed into buying insurance. The goal is to eventually get to the point that everyone has health insurance. Any other questions?

You claim simple math. Show it to me. Because right now I'll call you out and say that you are trying to invent your own facts, again. This math is anything but simple.

Yes, of course the previously uninsured will pay more for their premiums. Previously they were uninsured- they paid nothing. Error: Divide by Zero. Duh.

OTOH if you are trying to claim that the average premiums for everyone in the young invincible demographic will go up then I'll yet again call you out on trying to make up your own facts. I mean- that boggles logic. How does having more of them participate result in higher premiums? At worst it results in stasis, since presumably the risk is uniform across the demographic. And, in the end, we won't know for a few years how it will level out. The WORST thing that could happen is if none of the invincibles participated- that would result in a premium spiral, as has happened in smaller isolated markets.

"OMG everyone's premiums will go up!" is yet another of those many fearmongering lies that FactCheck and PolitiFact have debunked (to the best that anyone can tell at this early point). Follow your own advice- look it up. There actually are valid criticisms you could come up with- inflated promises by the Obama administration, etc.

And, in the interests of finding common ground with you, what is your position on letting the poor die untreated as I asked earlier? Are you willing to do so? Because if you are not (and as a compassionate human being I doubt that you are), then the logical result is either COBRA or some sort of universal insurance scheme.

So, then, do you prefer COBRA?

Edited by acrosome on 10/25/2013 19:58:22 MDT.

Fred Thorp
(BFThorp) - F
Re: How many times must I tell you that it is subsidized? on 10/25/2013 19:47:03 MDT Print View

OTOH if you are trying to claim that the average premiums for everyone in the young invincible demographic will go up then I'll yet again call you out on trying to make up your own facts. I mean- that boggles logic.

Not at all. Let me explain it for you. Let's assume services don't decline and we have a single insurer. If the insured youngsters are supporting the elderly, so to speak, and we add high risk- pre existing individuals to the pool, it's going to statistically increase the payout, which will cause the premiums to adjust upwards.

Eta Again your assumption of participation IMO, at least initially will be inadequate.

Edited by BFThorp on 10/25/2013 19:52:59 MDT.

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: Guts on 10/25/2013 20:10:47 MDT Print View

Nice video Kat - Stick your head out the window and yell "I'm as mad as hell and I'm not going to take it anymore"

He's got it right about the problem - we have a bought government, have to get the money out of politics

I don't agree with his solution - Obama has to come out and make a speech, create a bank that lends money to companies at 2%

Unreasonable to put all the blame on Obama. His guest identified the same problem but said congress has to be part of the solution, not just Obama.

Regardless of any speech, anything he proposed would be fillibustered by the Tea Party because he proposed it.

This is a real "catch 22" - if politicians threaten to take money out of politics they'll be primaried and then they won't be able to do anything, the new guy will have to support the money in politics system

Maybe if enough people talked about it a lot and everyone became aware of it a solution would happen

Another thing, the problem with the economy isn't that companies can't borrow money. Money is cheap now because of all the stimulus by the Federal Reserve. Creating a special bank that loans money at 2% won't make that much of a difference.

Doesn't Dylan Radigan have a MSNBC show that's pretty liberal? He was blaming Republicans and Democrats about equally, except maybe a little more at Obama.

Katharina ....
(Kat_P) - MLife

Locale: Pacific Coast
Re: Re: Guts on 10/25/2013 20:16:07 MDT Print View

Goodness Jerry, he did not put all the blame on Obama. He just said Obama ought to do something about it. In my opinion you are too preoccupied in defending Obama that you miss a whole lot all over the place, like wearing blinders. It's actually exhausting.

Katharina ....
(Kat_P) - MLife

Locale: Pacific Coast
Guts on 10/25/2013 20:17:33 MDT Print View

You really ought to watch it again and not get stuck the moment he dares say that Obama, as the President should do or say......
And yes, he is a liberal that says the man in charge owes us to speak up. How could you disagree with that?
I see my exercise in futility here. You are right Jerry, Obama is awesome, does no wrong, not even as far as the NSA or the drug war, or letting down Palestinians. And the drones. And on and on. Ok, you win. Your relentless pursuit is chasing out anyone that dares say otherwise is working.

Edited by Kat_P on 10/25/2013 20:24:28 MDT.

Dean F.
(acrosome) - MLife

Locale: Back in the Front Range
Re: Re: How many times must I tell you that it is subsidized? on 10/25/2013 20:18:54 MDT Print View

@ "Let's assume services don't decline and we have a single insurer."

A heck of an assumption- it's not a single insurer. The insurance companies are now (finally) being forced to compete. And I'm still not sure where your worry about declining services originates. But, to continue...

@ "If the insured youngsters are supporting the elderly, so to speak, and we add high risk- pre existing individuals to the pool, it's going to statistically increase the payout, which will cause the premiums to adjust upwards."

One could easily argue that adding in the healthy people balances the cost of the previously-uninsured ill people. (Really, you totally ignored the benefit of adding in those healthy people, there, and just talked about adding sick people. Many people are healthy but poor and would buy insurance if they could afford to- which they now can.) Also, those previously-uninsured ill people will now be getting preventive care thus lowering urgent care needs. Which will lower costs and thence presumably premiums. Plus, you and I will no longer be paying for those urgent care needs, which is a nice benefit in itself.

See why I said it's not simple? There are all sorts of second- and third-order effects at play.

@ "Eta Again your assumption of participation IMO, at least initially will be inadequate."

OK, I'll display my ignorance. What does "Eta" mean? Clearly I'm no longer up to date on the state of the art in interwebs abbreviations or something.

And I guess that's OK. As I said, we all get to have our opinions. I happen to disagree, and think that participation will be adequate. However, I will readily admit that it might take quite a while to realize these costs savings I'm talking about- especially since the federal website has crapped out and delayed everything. Yes, the more reliable evaluations (CBO, Rand, KFF) say that we have already seen modest decreases in premiums just from the competition, but really it's too early to hang your hat on that. Before we see the full extent of cost savings we have to allow time for the sick people who previously used to go to ERs for urgent care all of the time to get a bit better once they have insurance and can get preventive care. It will take a while to catch up. Will those savings offset costs? Again, I suspect so since I know just how costly urgent care can be, and how effective prevention can be. Plus, there should be few "loafers" if enough people sign up, which as I said I suspect will happen eventually. Maybe not this year, but eventually. You disagree- so be it.

Whew! Ok- we have boiled this down into simple issues that we can merely reasonably diasgree on. I'm happy. Are you?

But do you prefer COBRA? Or do you want to let the poor die when they take ill?

:)

Edited by acrosome on 10/25/2013 20:24:30 MDT.

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: Re: How many times must I tell you that it is subsidized? on 10/25/2013 20:22:53 MDT Print View

I hate to make an argument supporting Fred's position, but

They say that to make this work, younger (healthier) people have to participate

That means they will pay more now, and when they get older or sicker they'll get it back

It seems like if the system was actuarially based, the rates for young people would be enough less so it paid for the number of people that get sick in that age group, with no excess. Older people would pay more to pay for the number of people that get sick in that age group. The younger people wouldn't be required to make it financially viable for older people.

You would need to get healthy people in each age group to sign up. In a year they stayed healthy, they'de pay more than if they had no insurance, but statistically, they will get sick eventually, and then they'll be covered so it will average out. That's how insurance works.

On the other hand, younger people pay into Social Security and it isn't until they get old that it makes financial sense, so maybe that's okay for health care, but we should be up front about it.

It would be better if health care was just paid for with a Social Security like tax, but that wasn't politically possible.

Dean F.
(acrosome) - MLife

Locale: Back in the Front Range
Re: Re: Re: How many times must I tell you that it is subsidized? on 10/25/2013 20:32:05 MDT Print View

"That's how insurance works."

Absolutely, that's how insurance works. And there are different ways to do insurance- one being actuarial as you mentioned. But if we do that they the people who are currently old get screwed terribly- they have probably already put quite a lot of money into the system their whole lives and now just when they start to get some value out (speaking as a population) we would hike their premiums up to truly ridiculous levels and they would be forced to continue paying at a massive loss. We're stuck with what we're stuck with, just like with Social Security. But at least a universal insurance coverage plan would be sustainable.

Yes, the people who were previously uninsured will pay more- previously they paid nothing. But will the premiums for all young healthy people who already had insurance go up due to the ACA? No. They wont. We are (probably) net adding healthy young people to the pool, since they are the ones who tend to forgo insurance. And, yes, the ACA needs them for it to work without raising premiums. I've said as much.

And I'm OK with that- in the long run it saves everyone money (my opinion). As a *population* are these young healthy people being screwed into paying in more than they will get? In the short term, as a population, yes. But not *individually*, since every individual gets value in the form of insurance coverage. And, as I said, some of them WILL get sick and need the coverage. Is it a crime that most will pay more into the system than they get out? No, clearly not- as you said "that's how insurance works." On average EVERYONE pays more in than they get out. Are they in particular getting screwed more than other people? Again, no, not if they maintain coverage for their lifetime, as you mentioned, and as is the plan.

As I quoted earlier: A dastardly plan that can only be described as... insurance.

Edited by acrosome on 10/25/2013 20:42:03 MDT.

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: Guts on 10/25/2013 20:38:11 MDT Print View

No Kat : )

The solution Dylan Ratigan proposed was that Obama push a plan to create a bank.

His guest disagreed and said that congress has to participate too, can't just be Obama.

I agree more with his guest on the solution, but agree with both on the identification of the problem.

Obama is not awesome. Well, maybe he is...

Actually, Obama hasn't accomplished a lot, but he's in an almost impossible situation in large part because the Tea Party refuses to go along with anything he proposes. If Obama was more clever, maybe he'de figure out a way to get them to cooperate. Then he'de be awesome.

Tom Kirchner
(ouzel) - MLife

Locale: Pacific Northwest/Sierra
Re: Re: Re: How many times must I tell you that it is subsidized? on 10/25/2013 20:40:44 MDT Print View

"It would be better if health care was just paid for with a Social Security like tax, but that wasn't politically possible."

It's been there for Seniors since the 60's. It's called Medicare. Why not just expand it to everyone and use a well tested system that works? Sure, you'd have to tinker with the premiums and payroll deductions for those still working, and really go after fraud, but by also eliminating all the overhead associated with private insurance companies, including their need to make a profit, I'll bet we could reduce costs and provide coverage for everyone. Every other developed country seems to be making a go of a single payer system for far less money than we spend with better outcomes for most patients. Why can't we? We stand alone in that regard, and I, for one, think it is a disgrace.

Excuse me while I change into my asbestos suit.

OK, I'm all suited up. Have at it, folks. ;0)

Dean F.
(acrosome) - MLife

Locale: Back in the Front Range
Re: Re: Re: Re: How many times must I tell you that it is subsidized? on 10/25/2013 20:47:13 MDT Print View

You don't need the suit. I'll just point out that single-payer isn't quite the norm that you think it is. A lot of countries just make insurance mandatory, not unlike the ultimate goal of the ACA. Germany, for instance. And then there are weird systems like New Zealand's. Etc.

The other issue, of course, is that no generation wants to be the one that goes through the teething pains that countries like the UK had. (Sort of like with fixing Social Security, or lowering the national debt.) The UK damned near DID have "death boards."

Edited by acrosome on 10/25/2013 20:50:59 MDT.

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: How many times must I tell you that it is subsidized? on 10/25/2013 20:51:13 MDT Print View

But then it would make financial sense for young healthy people to pay the penalty. If they get sick or old then they could get insurance.

Of course if someone can only sign up once a year, and they got sick in the middle of a year, they'de have to pay out of pocket until the next sign-up period. That could be difficult. And what would you do if they couldn't pay, kick them out onto the sidewalk? That's one of the problems we're trying to fix.

Maybe it should just be paid for by a social security like tax.

Maybe we have to see what participation rates are and then fix any problems that occur.