For those that are working...

[michstfr]

...get ready to be dumped into a health care exchange pool once Obamacare (God forbid) goes into effect in 2014 (conveniently after the 2012 elections).

Employers, you know those greedy people who actually EMPLOY people in this country, by a nearly 1 in 3 ratio announced via a survey that they will DUMP their health care plans for their employees once Obamacare goes into effect. The number rises to about 1/2 of all employers for those who truly understand the new law.

Because as we know those who voted for it did not read it so why should we right?

But remember the President's mantra, "If you like your current plan this law will not impact you." What he was talking about was the government was not going to force people out of their current plan. Technically correct however the problem is what if THEY HAVE NO CHOICE because their employers will no longer be offering the same coverage because of his law??? OOOOOPS.

Health care for me but not for thee

 

[Merge]

Not buying that report at all.

So employers will drop people to pay the fine which is cheaper than insurance and yet they continue to offer healthcare without a fine?

Companies will stop offering healthcare when employees are no longer looking for it as a benefit. 98% of companies with over 50 employees who face no penalties currently have healthcare plans.

Now, there may be lower income workers who can qualify for tax credits to purchase coverage through the exchanges... that might make sense for the company and the employee. It will happen to some people but it won't be near 30%.

In Massachusetts when their healthcare reform mandate went through with a similar (but less) penalty, the percentage of people covered by their employers healthcare plan went up.
This post was edited on 6/7 3:24 PM by Merge

 

[michstfr]

Your contributions to the political discussions are both informative and highly enlightening.

I could not come up with better arguments if I made them up myself, actually....well forget that.

 

[SPK145]

Originally posted by Merge:
Companies will stop offering healthcare when employees are no longer looking for it as a benefit.
This post was edited on 6/7 3:24 PM by Merge

Add in "or when it becomes taxable to the employee or not deductible for the company."

 

[Merge]

Part of me would welcome companies dropping health coverage. It would lead to what I would consider the better option of a single payer system.

I just don't see why 30% of employers would drop coverage. Assuming by 2014 that the employment numbers look much better, employers will still need to offer competitive benefits.

They can fill out whatever box they want on a survey. They have biased opinions on the subject, but when it comes down to competition for valuable employees... they are not going to let another company gain that competitive advantage.

What happened in Massachusetts kind of proves that point.

 

[SPK145]

Originally posted by Merge:
Part of me would welcome companies dropping health coverage. It would lead to what I would consider the better option of a single payer system.

Part of me would welcome companies dropping health coverage too. I would rather this be a personal responsibility and each person would choose the plan that works best for their respective situation.

I'm certainly not for a single-payer system, government is terribly inept and inefficient.

In order for either to work though, you need to be made whole; companies would have to increase your salary by the amount they are now paying for your insurance. You think companies would do that? I'm not thinking they would, certainly not dollar for dollar.

 

[Merge]

I think we have proven that personal responsibility doesn't fly so well in America, and we are not going to start turning people away at the hospital either. No situation is perfect.

Ideally for me we would move away from employer sponsored coverage. I don't think employers would open up that money to the employees directly so most people would have a very hard if not impossible time paying for coverage for a family.

Single payer is the way to move the burden away from employers and at the same time make sure everyone has coverage. Not perfect, but I do believe it would be better than our current system.

 

[HALL85]

We should actually move to having only catastrophic coverage. It makes no sense that every part of your healthcare experience has to be covered by insurance. There is so much fraud and abuse that occurs regarding normal preventative or doctor visits that if you make that pay as you go, you eliminate all of it. Also, why do we reimburse elective surgeries such as gastric bypass? Shouldn't that be 100% on the patient?? We are a country that enables people to not be responsible and there is also a sense of entitlement that health insurance should just cover everything. If we used the same analogy for your car, would you expect your car insurance to pay for gas and normal repairs???

 

[SPK145]

Originally posted by Merge:
Single payer is the way to move the burden away from employers and at the same time make sure everyone has coverage. Not perfect, but I do believe it would be better than our current system.

Hasn't it been proven that anything run by the government would be fraught with waste, inefficiency, and high cost? The government can't run anything right not to mention the Constitution gives the federal government no authority to do this.

Personal responsibility and the free market has made America what it is today only to be driven back down at every turn by elitist politicians of both parties.

 

[Merge]

Originally posted by HALL85:
We should actually move to having only catastrophic coverage. It makes no sense that every part of your healthcare experience has to be covered by insurance. There is so much fraud and abuse that occurs regarding normal preventative or doctor visits that if you make that pay as you go, you eliminate all of it. Also, why do we reimburse elective surgeries such as gastric bypass? Shouldn't that be 100% on the patient?? We are a country that enables people to not be responsible and there is also a sense of entitlement that health insurance should just cover everything. If we used the same analogy for your car, would you expect your car insurance to pay for gas and normal repairs???

That may work, but what defines catastrophic? A few hundred dollars may be catastrophic to some people.

I would view a working single payer system not much different from what you are suggesting with higher copays for normal doctor visits or prescription drugs and less payment from the insurance plan.

Insurance companies would want to cover something like a gastric bypass if they believe that patient will use less care after the surgery which would save them money over time. Diabetes, hypertension, and high cholesterol have been eliminated or improved among many gastric bypass patients.

 

[Merge]

Originally posted by SPK145:

Originally posted by Merge:
Single payer is the way to move the burden away from employers and at the same time make sure everyone has coverage. Not perfect, but I do believe it would be better than our current system.

Hasn't it been proven that anything run by the government would be fraught with waste, inefficiency, and high cost? The government can't run anything right not to mention the Constitution gives the federal government no authority to do this.

Personal responsibility and the free market has made America what it is today only to be driven back down at every turn by elitist politicians of both parties.

I understand your argument but a free market for healthcare just doesn't work in my opinion, and thats why politicians step in to make sure coverages are adequate and people are not being taken advantage of.

Insurance companies make more money by denying coverage.

That statement alone is why the system just doesn't work in a free market.

 

[shu09]

Originally posted by HALL85:
We should actually move to having only catastrophic coverage. It makes no sense that every part of your healthcare experience has to be covered by insurance. There is so much fraud and abuse that occurs regarding normal preventative or doctor visits that if you make that pay as you go, you eliminate all of it. Also, why do we reimburse elective surgeries such as gastric bypass? Shouldn't that be 100% on the patient?? We are a country that enables people to not be responsible and there is also a sense of entitlement that health insurance should just cover everything. If we used the same analogy for your car, would you expect your car insurance to pay for gas and normal repairs???

All that would do is massively increase costs on individuals and discourage them from making regular doctor visits. That results in a population even more unhealthy than it already is.

Health insurance should cover everything in my opinion. Why should you have to pay hundreds of dollars for something like a simple test at a doctors office, hospital, etc? The price of medical care is ridiculous to begin with.

A few years ago while I was in school I went to the ER for a few stitches. The bill was well over $2,000 and if I wasn't covered on my parents' plan I'd have been screwed. Why should anyone have to pay that much for a simple procedure? I'm sure there are many more examples much worse than this out there.
This post was edited on 6/8 10:19 AM by shu09

 

[shu09]

I agree Merge. In my opinion, private insurance is one of the biggest scams out there. You pay them every month to protect you in case you get sick and then they may drop you if you do get sick. A simple question I always think about with health insurance is, why is it a for-profit industry? Why should people be making money off of other people's health. Just seems unethical to me.

 

[SPK145]

Originally posted by Merge:
I understand your argument but a free market for healthcare just doesn't work in my opinion, and thats why politicians step in to make sure coverages are adequate and people are not being taken advantage of.

Politicians shouldn't legislate stupidity.

Originally posted by Merge:
Insurance companies make more money by denying coverage.

In a truly free-market/personal responsibility society (which we haven't had in MANY years), insurance companies that do that will lose business. Because the payers and decision makers of insurance policies/premiums are not the users of the healthcare, this is currently very distorted.

 

[SPK145]

Originally posted by shu09:
A simple question I always think about with health insurance is, why is it a for-profit industry? Why should people be making money off of other people's health. Just seems unethical to me.

So being a doctor is unethical to you too? Should they work for free or minimal wages? When did you become a socialist, LOL?

 

[shu09]

A doctor provides actual care that can heal you. The insurance company is all about money.

 

[SPK145]

Originally posted by shu09:
A doctor provides actual care that can heal you. The insurance company is all about money.

Without money, nobody has health care. Why vilify private health insurance? Without it, where would we be? Doctors, hospitals, and other health providers would have to accept much less from the government single-payer system leading to little innovation. Like in Canada. Where does most of the medical innovation come from? And why is that?

 

[Merge]

We don't need a middle man taking 20% off the top having to answer to shareholders with the incentive to deny coverage when people are sick.

We would still have innovation.
Pharma has a profit motive and that is a good thing for them. They provide a valuable service. I don't agree with what Bernie Sanders is promoting with a prize for new drugs rather than a timeline for patent expiration. Although I think a patent buyout for successful drugs assuming it will save the federal government money in the long run, and provide companies with more cash to invest is a great idea.
This post was edited on 6/8 2:41 PM by Merge

 

[SPK145]

Originally posted by Merge:
We don't need a middle man taking 20% off the top having to answer to shareholders with the incentive to deny coverage when people are sick.
This post was edited on 6/8 2:41 PM by Merge

Single payer systems pay all claims all the time without ever denying coverage???

 

[Merge]

That is not what I was suggesting.

Insurance companies have to answer to shareholders who expect growth. The more sick people they can drop, the better. The more they deny the better.

Executives from insurance companies have admitted denying legitimate claims JUST to make the company more money.

We don't need a profit motive when discussing if a person deserves healthcare or not.

A single payer system would not have that moral dilemma.

 

[SPK145]

Originally posted by Merge:
Insurance companies have to answer to shareholders who expect growth. The more sick people they can drop, the better. The more they deny the better.

That's such a broad brush you paint with there. An insurance company that does that as much as you imply would go out of business. Sure, it does happen, many time for legitimate reasons, many times not.

Originally posted by Merge:
We don't need a profit motive when discussing if a person deserves healthcare or not.

Sorry, I just believe in the individual. Having a right to something doesn't mean paid for by the ever-dwindling taxpayers. Having a right means if you want something, you should be able to get it. And if you choose not to have insurance, you are treated and then have to pay the bill. (The truly indigent can be given some help. That number is very low.)

Enough with the lack of responsibility, that seriously weakens America. (And we're never going to agree on that, LOL!!)

 

[HALL85]

Originally posted by shu09:

Originally posted by HALL85:
We should actually move to having only catastrophic coverage. It makes no sense that every part of your healthcare experience has to be covered by insurance. There is so much fraud and abuse that occurs regarding normal preventative or doctor visits that if you make that pay as you go, you eliminate all of it. Also, why do we reimburse elective surgeries such as gastric bypass? Shouldn't that be 100% on the patient?? We are a country that enables people to not be responsible and there is also a sense of entitlement that health insurance should just cover everything. If we used the same analogy for your car, would you expect your car insurance to pay for gas and normal repairs???

All that would do is massively increase costs on individuals and discourage them from making regular doctor visits. That results in a population even more unhealthy than it already is.

Health insurance should cover everything in my opinion. Why should you have to pay hundreds of dollars for something like a simple test at a doctors office, hospital, etc? The price of medical care is ridiculous to begin with.

A few years ago while I was in school I went to the ER for a few stitches. The bill was well over $2,000 and if I wasn't covered on my parents' plan I'd have been screwed. Why should anyone have to pay that much for a simple procedure? I'm sure there are many more examples much worse than this out there.

This post was edited on 6/8 10:19 AM by shu09

No, it would actually have the opposite effect. If basic care was out of pocket, people would actually shop for cost effective health care and the market would adapt to those competitive dynamics.

At the very least, insurance companies should have the option to offer such a catastrophic policy with a super low premium, where someone can choose a very high deductable ($10,000 or $25,000) and pay for their basic care on their own. But you know what??? The government prohibits insurance companies from doing that...go figure. Why should healthcare insurance cover everything??? Should your homeowners insurance cover everything like lawn care, utilities, etc.??? If you want a healthcare insurance policy to cover "everything", then you should pay a very high premium for that coverage. I'm fine with that.

The whole process needs an overhaul, but the biggest problem is that you need to set up a market where there can be real competition and choices so the individual can make the best decision for what they need. This single payer idea is just nonsense. The federal government has proven time and time again that they are failures when it comes to running businesses. Why would you give them a monopoly on running something when Medicare fraud alone is $60 billion/year??? As SPK said, have a safety net for the real indigent, but we need to inject some personal responsibility back into the equation.
This post was edited on 6/9 6:58 AM by HALL85

 

[Merge]

Originally posted by HALL85:

Originally posted by shu09:

Originally posted by HALL85:
We should actually move to having only catastrophic coverage. It makes no sense that every part of your healthcare experience has to be covered by insurance. There is so much fraud and abuse that occurs regarding normal preventative or doctor visits that if you make that pay as you go, you eliminate all of it. Also, why do we reimburse elective surgeries such as gastric bypass? Shouldn't that be 100% on the patient?? We are a country that enables people to not be responsible and there is also a sense of entitlement that health insurance should just cover everything. If we used the same analogy for your car, would you expect your car insurance to pay for gas and normal repairs???

All that would do is massively increase costs on individuals and discourage them from making regular doctor visits. That results in a population even more unhealthy than it already is.

Health insurance should cover everything in my opinion. Why should you have to pay hundreds of dollars for something like a simple test at a doctors office, hospital, etc? The price of medical care is ridiculous to begin with.

A few years ago while I was in school I went to the ER for a few stitches. The bill was well over $2,000 and if I wasn't covered on my parents' plan I'd have been screwed. Why should anyone have to pay that much for a simple procedure? I'm sure there are many more examples much worse than this out there.

This post was edited on 6/8 10:19 AM by shu09

No, it would actually have the opposite effect. If basic care was out of pocket, people would actually shop for cost effective health care and the market would adapt to those competitive dynamics.

At the very least, insurance companies should have the option to offer such a catastrophic policy with a super low premium, where someone can choose a very high deductable ($10,000 or $25,000) and pay for their basic care on their own. But you know what??? The government prohibits insurance companies from doing that...go figure. Why should healthcare insurance cover everything??? Should your homeowners insurance cover everything like lawn care, utilities, etc.??? If you want a healthcare insurance policy to cover "everything", then you should pay a very high premium for that coverage. I'm fine with that.

The whole process needs an overhaul, but the biggest problem is that you need to set up a market where there can be real competition and choices so the individual can make the best decision for what they need. This single payer idea is just nonsense. The federal government has proven time and time again that they are failures when it comes to running businesses. Why would you give them a monopoly on running something when Medicare fraud alone is $60 billion/year??? As SPK said, have a safety net for the real indigent, but we need to inject some personal responsibility back into the equation.
This post was edited on 6/9 6:58 AM by HALL85

There are a few problems with that. Do you still implement a mandate?
Even if it was cheaper, people would not buy it. We would still be spending over 50 billion every year for the cost of the uninsured.

The vast majority of people would choose to pay a high deductible and when they get really sick they will have no means to pay for it.

It penalizes sick people. I understand the argument from healthy people about why they should have to subsidize the sick, but they will be sick one day too. A single payer system with higher copays would help even that out a little while making the program cost effective for the government.

Medicare/medicaid fraud is somewhere around 10% of total spending. That is horrible and needs to be fixed. Still, in theory, if that number stayed at 10% under single payer, we would be spending less with insurance companies taking 20% profit.

Single payer would be easier to implement than making people buy their own coverage. As SPK mentioned, companies will not make their employees whole when we move away from employer sponsored coverage. Healthcare costs would make a lot of people very poor very quickly if they have to pay for their own plans and cost of care. We can't just jump into that system, whereas single payer would be a tax for the employer and employee and could be accomplished very quickly without crippling the middle class.

 

[HALL85]

Merge, no offense, but your arguments are so flawed I don't know where to start.

First of all, insurance companies are not making 20% profit. They pay 80 cents on the dollar that they take in and the remaining 20% includes their SG&A, taxes (yes, they pay taxes) other costs and also a profit - for instance Aetna is running at 5.2% for the last twelve months ($1.8B NI on $34.1B of revenue). And if you extrapolate using your numbers to a single payer goverment system, than we would expect to have over $200 billion in fraud right off the bat. Sorry, but I can't sign up for that. As much as you want to bash the private insurance industry, their fraud rate is miniscule compared to that of the government.

I don't follow your thinking at all on ability to pay. If someone is paying $1,500/month on Cobra today and they could get a high deductable catastrophic policy for $500/month, they now have $12,000 a year that they didn't have before to pay for their routine healthcare. Don't you think some people would now go to a "minute-clinic" for a $20 strep test administered by a Nurse Practitioner, vs. going to a Primary Care Doc at $100, vs. going to the ER and pay $1,000. Sounds to me like when the patient is informed and can make choices, the market will move to lower cost alternatives.

Finally, I'm not advocating eliminating companies offering health plans, but rather with more access and fewer restrictions, I would have the choice to select my employers plan (if it was offered) or choose my own individual policy. That will force companies and their carriers to offer competitive programs. Thankfully, single payer is NOT going to happen. A single payer, forced compliance program as you suggest forcing people into a proven inefficient system is akin to the government forcing every American to purchase a Hum-Vee (at 5 miles a gallon) as their personal car, instead of giving you choice on what car to buy that meets your budget, commuting and personal needs. But I'm sure if you're one of the unfortunate that gets a "free car" because others will pay higher taxes to subsidize, you would be fine with that, especially since you would get free gas too. But what are we left with? A wasteful program that put a bunch of gas guzzlers on the road that adds cost and ruins the environment, that is not sustainable.
This post was edited on 6/9 9:55 AM by HALL85
This post was edited on 6/9 10:02 AM by HALL85

 

[Merge]

Private companies are not free of fraud. I really wouldn't expect Medicare/Medicaid fraud to stay at 10% with a single payer system as we would have a much higher incentive to stop the fraud. We have also been going after medicare fraud heavily recently and have made seem progress there.

Administrative costs would be lower, profit would be 0. Fraud would be close to a wash, and we would have every citizen covered.

I will explain my scenario further since I wasn't talking about anyone in the private market and the vast majority of Americans gets coverage through their employer.

If my employer drooped my coverage and didn't give me a raise to cover purchasing a plan on my own, I am down quite a bit. I would most likely buy a cheap plan with high copays and high deductibles and hope I don't get sick. That is just not the way people should live.

If I buy a more expensive plan, then I will have significantly lowered my take home pay. Again... making that move could cripple families in the middle class.

btw... I have used minute clinic three times. I have had one good experience and two poor experiences. It is the same copay as my doctor, without a copay it would be about $80. They are a great convenience when you don't have time to wait though,.

what your advocating really is the "I hope I don't get sick or injured" plan. Every "healthy" person will not purchase insurance or purchase the cheapest plan, hoping the don't get sick. They will eventually get sick and the taxpayer will ultimately pay their bill anyway.

The costs for the "sick" will go up significantly since the "healthy" aren't paying anything anymore, employers will lower the percentage they pay and middle class families again take the brunt of that.

I wouldn't really call single payer a "Hum-Vee" though... A volt maybe.
Don't worry though, I don't get offended. It is a fun debate on a message board.

back to my original point though. 30% of employers will not drop their healthcare plans. Some will especially in areas where it may be mutually beneficial for the employer/(low waged) employee, but I bet the final number is a lot closer to 0% than it is 30%

 

[HALL85]

Merge, even more flaws in your arguments.

* I didn't say private companies are free of fraud, but they are infinitely better at managing it than the government. That is proven over time. You may not want to hear this, but their "motivation" to manage fraud is because they need to make a "profit". That seems to be a good model, no? Just because the government has been going after fraud shows no evidence that they have reduced it one penny. And you're advocating expanding a program that is fraud ridden, but that's OK because we would eliminate the profit of private companies who by the way are part of peoples 401K's; you know the same people that you are trying to help. I'm amazed that you're soe accepting of such waste. What if your employer said for every dollar you contribute to your pension or 401K, they would subtract 10 cents to cover their fraud cost? Would you be OK with that? I don't have an issue paying my fair share of taxes, but I expect my government spend it effectively and they have proven that they can't in a business environment time and time again.

Your scenario is based on the current model, which is flawed to begin with as I've suggested. In a more open competitive market, your employer would have to offer you options for care that are commensurate with what you can get on the market as an individual if they chose providing health insurance as part of their total comp strategy. With a high deductable policy, there would not be a co-pay for basic care, so there would be cost differentials for minute clinics vs. other sites of care. And let the consumer decide which one meets their needs. What's wrong with that?

Finally, why does the taxpayer end up paying? If I choose to have a high deductable plan, then I am responsible for the deductable, not the taxpayer.

A Volt??? No, I don't think so unless you like the idea of shocking people with that dopey single payer plan...lol.
This post was edited on 6/9 11:36 AM by HALL85

 

[Merge]

I understand that private insurers have more incentive to prevent fraud. We are working on getting rid of it. The healthcare bill even contained some measures to do so.

Yes, it is ok with me to get rid of health insurance as a profit industry.
We can have a private non profit run it, but I think every american needs to be in the same system with the same coverages. Let the people who make a difference in helping us profit, not someone in the middle.

I also understand there would be no copays for high deductible plans, I was just correcting your $20 model, because it isn't $20. $80 is quite different for lower income families than $20. Again, what is wrong with that is when healthy people leave the pool for no plan, or high deductible plans, the cost for the sick people will rise drastically.

and to your last point, you are responsible because of the Emergency Medical Treatment and Active Labor Act in 1986. We don't turn people away when they need treatment, and that will not change. That is why we need a mandate along with adequate coverage. Single payer would do that.It would also benefit US business by making the costs associated with healthcare lower and more predictable.

 

[SPK145]

Originally posted by Merge:
That is why we need a mandate along with adequate coverage. Single payer would do that.

Can you show me how that is Constitutional?

 

[Merge]

Sure. The mandate or single payer? I'll start with the mandate.

Every American can go to a hospital when in need and receive access to medical care. This is a service not comparable to really any other industry where the act of living gives you access to the service. (unlike buying a car being a choice and needing to purchase car insurance)

The actions of the uninsured have a direct effect on commerce. Taxpayers and insurance holders are forced to pay extra to subsidize the cost of the uninsured. Congress may regulate this commerce as the actions of one in one state can have a direct impact on interstate commerce.

Single payer... There is some precedent with Medicare, but I will go with the power to collect taxes for the general welfare. We can debate the meaning of general welfare but I can frame my argument for it being of the people or of the country and our economic welfare relatively easily.
This post was edited on 6/9 12:23 PM by Merge

 

[HALL85]

Originally posted by Merge:
I understand that private insurers have more incentive to prevent fraud. We are working on getting rid of it. The healthcare bill even contained some measures to do so.

Yes, it is ok with me to get rid of health insurance as a profit industry.
We can have a private non profit run it, but I think every american needs to be in the same system with the same coverages. Let the people who make a difference in helping us profit, not someone in the middle.

I also understand there would be no copays for high deductible plans, I was just correcting your $20 model, because it isn't $20. $80 is quite different for lower income families than $20. Again, what is wrong with that is when healthy people leave the pool for no plan, or high deductible plans, the cost for the sick people will rise drastically.

and to your last point, you are responsible because of the Emergency Medical Treatment and Active Labor Act in 1986. We don't turn people away when they need treatment, and that will not change. That is why we need a mandate along with adequate coverage. Single payer would do that.It would also benefit US business by making the costs associated with healthcare lower and more predictable.

The government has been working at reducing fraud forever and they have failed. They can't do it nor do they have any plan that will reduce it to anywhere near what private pay does today. And just because it's written in a bill means it is going to happen??? Pass the crack pipe, please.

The answer isn't profit or non profit, the answer is competition and free market. The answer is also getting our healthcare costs under control and providing lower cost alternatives for treatment that the consumer can choose. Let people choose the plan or risk that they want and free up the restrictions that prevent competition. Merge, you miss the point completely...we are paying for the sick people today but the current system is both inefficient, rife with fraud and has misaligned incentives. What other industry does the consumer have so little control in what they spend and what they get in return?

A single payer plan is nothing more than a wealth redistribution plan that does nothing to improving care, reducing waste (fraud) or reducing the cost of healthcare that continues to rise faster than inflation.

 

[SPK145]

Originally posted by Merge:
The actions of the uninsured have a direct effect on commerce. Taxpayers and insurance holders are forced to pay extra to subsidize the cost of the uninsured. Congress may regulate this commerce as the actions of one in one state can have a direct impact on interstate commerce.
This post was edited on 6/9 12:23 PM by Merge

Two thngs oin this paragraph:

1) Since it is illegal to buy insurance across state lines, your "actions of one in one state can have a direct impact on interstate commerce" is false.

2) Congress can regulate interstate commerce. To regulate means make regular. Means allow commerce to take place across state lines without interference from the respective states. Mandates do not fit this at all even with your "life or death" scenario. It just doesn't.

Originally posted by Merge:
>Single payer... There is some precedent with Medicare, but I will go with the power to collect taxes for the general welfare. We can debate the meaning of general welfare but I can frame my argument for it being of the people or of the country and our economic welfare relatively easily.
This post was edited on 6/9 12:23 PM by Merge

1) Medicare should be unconstitutional. No power for that for the federal government to get involved in healthcare. No power for the federal government to force you into Medicare and not even allow you to opt out. (Unless you also want to forgo Social Security.)

2) Without twisting the meaning of the term "general welfare" but rather using the definition of it when the Constitution was written as well as the accompanying Federalist Papers, it's clear that your meaning is nothing more than a twisting to meet your agenda. Well-intentioned but illegal.

 

[Merge]

Originally posted by HALL85:

Originally posted by Merge:
I understand that private insurers have more incentive to prevent fraud. We are working on getting rid of it. The healthcare bill even contained some measures to do so.

Yes, it is ok with me to get rid of health insurance as a profit industry.
We can have a private non profit run it, but I think every american needs to be in the same system with the same coverages. Let the people who make a difference in helping us profit, not someone in the middle.

I also understand there would be no copays for high deductible plans, I was just correcting your $20 model, because it isn't $20. $80 is quite different for lower income families than $20. Again, what is wrong with that is when healthy people leave the pool for no plan, or high deductible plans, the cost for the sick people will rise drastically.

and to your last point, you are responsible because of the Emergency Medical Treatment and Active Labor Act in 1986. We don't turn people away when they need treatment, and that will not change. That is why we need a mandate along with adequate coverage. Single payer would do that.It would also benefit US business by making the costs associated with healthcare lower and more predictable.

The government has been working at reducing fraud forever and they have failed. They can't do it nor do they have any plan that will reduce it to anywhere near what private pay does today. And just because it's written in a bill means it is going to happen??? Pass the crack pipe, please.

The answer isn't profit or non profit, the answer is competition and free market. The answer is also getting our healthcare costs under control and providing lower cost alternatives for treatment that the consumer can choose. Let people choose the plan or risk that they want and free up the restrictions that prevent competition. Merge, you miss the point completely...we are paying for the sick people today but the current system is both inefficient, rife with fraud and has misaligned incentives. What other industry does the consumer have so little control in what they spend and what they get in return?

A single payer plan is nothing more than a wealth redistribution plan that does nothing to improving care, reducing waste (fraud) or reducing the cost of healthcare that continues to rise faster than inflation.

Your making assumptions of what the role of single payer could be. I had a conversation just last week with someone who works for a pharma company and my argument to him was that people don't value doctors and drugs when they are too cheap.

I agree some of those costs should actually go up. I have agreed that we need other types of reform to address the cost drivers, and there is no reason the government couldn't hire a private company to weed out the fraud. There would be much more incentive to do so when the benefits would be much greater.

 

[HALL85]

haha..now you're talking out of both sides of your mouth. "People don't value doctors and drugs when they are too cheap"???, or is it your other line that $100 is catastrophic??? I really don't understand your logic.

And if it's that easy for government to hire a company to fix the fraud issue, why haven't they done it? $60 billion/year not enough motivation??? What other priorities have they had that are more important than $60 billion???

 

[Merge]

Originally posted by SPK145:

Originally posted by Merge:
The actions of the uninsured have a direct effect on commerce. Taxpayers and insurance holders are forced to pay extra to subsidize the cost of the uninsured. Congress may regulate this commerce as the actions of one in one state can have a direct impact on interstate commerce.
This post was edited on 6/9 12:23 PM by Merge

Two thngs oin this paragraph:

1) Since it is illegal to buy insurance across state lines, your "actions of one in one state can have a direct impact on interstate commerce" is false.

2) Congress can regulate interstate commerce. To regulate means make regular. Means allow commerce to take place across state lines without interference from the respective states. Mandates do not fit this at all even with your "life or death" scenario. It just doesn't.

Originally posted by Merge:
>Single payer... There is some precedent with Medicare, but I will go with the power to collect taxes for the general welfare. We can debate the meaning of general welfare but I can frame my argument for it being of the people or of the country and our economic welfare relatively easily.
This post was edited on 6/9 12:23 PM by Merge

1) Medicare should be unconstitutional. No power for that for the federal government to get involved in healthcare. No power for the federal government to force you into Medicare and not even allow you to opt out. (Unless you also want to forgo Social Security.)

2) Without twisting the meaning of the term "general welfare" but rather using the definition of it when the Constitution was written as well as the accompanying Federalist Papers, it's clear that your meaning is nothing more than a twisting to meet your agenda. Well-intentioned but illegal.

1. If I, a resident of NJ, have a heart attack in NY and I have no insurance or money to pay the bill... who pays? That's right... EVERY US citizen with federal tax dollars and NY state citizens with NY State tax dollars and everyone who has an insurance plan.

2. Regulating in this case can mean that people need to pay for the service they have access to and if they choose not to pay for the service, can be taxed.

3. Someone should then challenge Medicare.

4. I have read quotes from Madison that do suggest he would be against the federal government from appointing teachers, and taking over every road in America... If I interpret his meaning as being against the idea that general welfare does not mean Mrs. Smith should be teaching the 3rd grade... but maybe the federal government should ensure that everyone has medical coverage and 18,000-45,000 people don't die due to a lack of coverage. (Institute of Medicine. 2002. Care Without Coverage, Too Little, Too Lat) We don't lose over 100 billion dollars of economic activity due to the uninsured. (Institute of Medicine. 2003. Hidden Costs, Value Lost)

Maybe our founding fathers just might have wanted those kinds of benefits to protect our country?

I think the mandate will be challenged so it will be interesting, although I have little doubt it will stay from everything I have read.

 

[SPK145]

Originally posted by HALL85:
And if it's that easy for government to hire a company to fix the fraud issue, why haven't they done it? $60 billion/year not enough motivation??? What other priorities have they had that are more important than $60 billion???

I'm confused. Why should a private company profit off of healthcare fraud paid for by the federal government?

 

[SPK145]

Originally posted by Merge:
1. If I, a resident of NJ, have a heart attack in NY and I have no insurance or money to pay the bill... who pays? That's right... EVERY US citizen with federal tax dollars and NY state citizens with NY State tax dollars and everyone who has an insurance plan.

And that's wrong. That's the lack of personal responsibility that hurts everyone. YOU are responsible for your health, health care, and health care payment. These forced redistributionist government mandates hurt us all. Let charity care be just that: charity care. Forced charity is not charity at all.

No mkention of healthcare or education in the Coinstitution.

 

[HALL85]

Originally posted by SPK145:

Originally posted by HALL85:
And if it's that easy for government to hire a company to fix the fraud issue, why haven't they done it? $60 billion/year not enough motivation??? What other priorities have they had that are more important than $60 billion???

I'm confused. Why should a private company profit off of healthcare fraud paid for by the federal government?

Well played....lol

 

[Merge]

Originally posted by HALL85:
haha..now you're talking out of both sides of your mouth. "People don't value doctors and drugs when they are too cheap"???, or is it your other line that $100 is catastrophic??? I really don't understand your logic.

And if it's that easy for government to hire a company to fix the fraud issue, why haven't they done it? $60 billion/year not enough motivation??? What other priorities have they had that are more important than $60 billion???

No, I'm really not.
The price for a doctor needs to be cheap enough so people can go when they need to but expensive enough that people don't go for the sniffles. I have been pretty consistent on that point... and what I said was a "few hundred" dollars may be catastrophic to some people. We are talking per doctors visit here. and sometimes you get hit with an illness that takes many doctors visits like when I had lead poisoning from painting houses when I was 19. No way I could afford the treatment I needed if I only had a high deductible plan.

and honestly, I don't understand why the government doesn't hire a private company to go after Medicare fraud. I know they set up a task force in 2007 which has had some success... Actually maybe that is how we can get a single payer system to pass through the house.

Everyone gets insurance and we pay Halliburton to go after the fraud. perfect.

 

[Merge]

Originally posted by SPK145:

Originally posted by Merge:
1. If I, a resident of NJ, have a heart attack in NY and I have no insurance or money to pay the bill... who pays? That's right... EVERY US citizen with federal tax dollars and NY state citizens with NY State tax dollars and everyone who has an insurance plan.

And that's wrong. That's the lack of personal responsibility that hurts everyone. YOU are responsible for your health, health care, and health care payment. These forced redistributionist government mandates hurt us all. Let charity care be just that: charity care. Forced charity is not charity at all.

No mkention of healthcare or education in the Coinstitution.

That doesn't mean that our founding fathers wouldn't want the federal government to regulate what is almost 20% GDP.

Forced charity is already happening. We pay for the uninsured, but instead of people going to the doctor when they have chest pain because they can't afford to go to the doctor... we instead pay for heart surgery.

We are not going to go back to where you have to show your insurance card before you are treated in an emergency. That is just not going to happen, so you need to move forward from that point.

 

[SPK145]

Originally posted by Merge:
That doesn't mean that our founding fathers wouldn't want the federal government to regulate what is almost 20% GDP.

Healthcare costs that much of GDP BECAUSE of the federal government's involvement. It would never be that much if we had stuck to Constitutional principles in the first place.

Originally posted by Merge:
We are not going to go back to where you have to show your insurance card before you are treated in an emergency. That is just not going to happen, so you need to move forward from that point.

No but we should go back to health, health care, and health care payments are YOUR responsibility. Can't refuse to treat but can't refuse to pay either, after the fact. Nobody should have free health care.