Obamacare Survives SCOTUS

#226
#226
Septic said:
What difference would it make? The local "urgent care" clinics would still need to pass the buck to the .gov for repayment or they'd go out of business as well. Ultimately, someone has to pay for it and it will not be the for profit health systems taking the bath.
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My understanding is that the ER is pretty much the most expensive "general" health care one can get. Maybe that's wrong, but it's what I have read.

Whatever that ER premium is goes away. And by reducing the demand on the ER the system can adjust for more regular health care and adjust costs overall.
 
#227
#227
Velo Vol said:
I'll have to look at it. I haven't thought much about state standing versus the federal government.
The regulation changes are a separate matter, but yes, adding 20-somethings into the insured basket lowers the average cost in the pool.
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By screwing the healthy 20 somethings. Yay ponzi scheme.

Pay for something now, that you dont need, and cant afford, so that 40 years in the future you can screw over those 20 somethings.

A better fix instead of relying on a government mandated pyramid scheme would be mandated personal HSAs. But the government and insurance doesnt make money off of that so we wont see DC backing it.
 
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#229
#229
LouderVol said:
When the possible solutions are worse than the current situation it's not unreasonable to let things lie.

It's the same argument used against capitalism all the time. Well we didnt really give capitalism a chance by interfering, and things failed. So clearly its capitalism's fault, and not our own.

The way healthcare has provided and used by the general public has changed completely with government interference. And the capitalist core isnt allowed to make the adaptations it needs to because its "not fair".

Unless people are willing to accept about a 50% increase in taxes to get their "free" health care, the european model that gets championed is just blowing smoke.

You could do a lot more to fix the issue by fixing the people who use the broke system. The reason europe doesnt have the same health issues we have isnt because their system is better. It's because they have healthier people. Healthier people is less demand on the system, and less demand on cutting edge life changing procedures/medicines, which means lesser costs. Transplanting their system here wont work. We have eaten ourselves out of that possibility.
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Aside from it being a bad solution to begin with, the ACA was hamstringed from the beginning and destined to fail.

When people stop bitching about the cost of health insurance going up and start focusing on how to get the millions of uninsured American's cared for, then perhaps they'll understand what the ACA was intended to do. You can't have cheap insurance and expect to have everyone uncovered. Either everyone has health care 'security' or readily admit that you don't really give a sh*t about millions of people in America.
 
#231
#231
LouderVol said:
Way to move goalposts. I didnt say costs were in check before ACA. I even pointed out there were existing government interference before ACA. So all you are demonstrating is my point. We havent tried the leave it alone strategy in a long long time.
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LOL, you have more faith in an unchecked/unregulated health and pharma system than I do.

Drug Goes From $13.50 a Tablet to $750, Overnight (Published 2015)

Why Did Mylan Hike EpiPen Prices 400%? Because They Could
 
#232
#232
LouderVol said:
My understanding is that the ER is pretty much the most expensive "general" health care one can get. Maybe that's wrong, but it's what I have read.

Whatever that ER premium is goes away. And by reducing the demand on the ER the system can adjust for more regular health care and adjust costs overall.
Click to expand...

It's not that simple - right or wrong, MILLIONS of American's rely on ER's for all of their healthcare. How do you make "that" need go away? Where does it go to? And when it gets "there", who is going to pay for it?

Emergency Room Crowding: A Marker of Hospital Health


Again, you either concede that everyone needs to share in the burden to help pay for the costs to have all American's have healthcare security or you'll need to concede you don't g.a.s. about the uninsured American's.
 
#233
#233
Septic said:
Again, you either concede that everyone needs to share in the burden to help pay for the costs to have all American's have healthcare security or you'll need to concede you don't g.a.s. about the uninsured American's.
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For many Americans, like me, the pre-existing problem is even worse than ER cost.

A lot of people are not able to pay $25,000+ a year for healthcare insurance.
 
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#234
#234
LouderVol said:
By screwing the healthy 20 somethings. Yay ponzi scheme.

Pay for something now, that you dont need, and cant afford, so that 40 years in the future you can screw over those 20 somethings.

A better fix instead of relying on a government mandated pyramid scheme would be mandated personal HSAs. But the government and insurance doesnt make money off of that so we wont see DC backing it.
Click to expand...

The spread of risk is how insurance works. While the generally healthy 20 somethings pay a lower health premiums because they have lower risk - it doesn't mean they are without risk. Is it also a ponzi scheme that older drivers pay less auto insurance premium and that younger people pay more? Or would you agree that younger people should pay more because they pose a greater loss threat to insurance companies?

Or would you agree that it's the same actuarial principles at work...?
 
#236
#236
Velo Vol said:
For many Americans, like me, the pre-existing problem is even worse than ER cost.

A lot of people are not able to pay $25,000+ a year for healthcare insurance.
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What no one wants to admit is that they simply don't care that millions of their American neighbors are a bad diagnosis away from bankruptcy. If folks want to strut around and talk about how to "make America great," having health care security for all would be a pretty great place to start.
 
#237
#237
AshG said:
On the ER issue: I would enjoy seeing Urgent Care Centers adjacent to Emergency Rooms. You go to the triage station first, and they sort you where to go.

The only issue then becomes the yahoos who use ambulances for de facto taxi services.

When an ambulance is used like a taxi, 911 callers can face criminal charges
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Most ER's are already just a urgent care clinic with the capability of taking care of more serious issues. Heck, I'd be surprised if most systems didn't have a separate trauma service that operated independently of the ER. The one I worked for did because they didn't want to pay the "more" qualified trauma pro's to treat sore throats and UTI's,
 
#238
#238
Septic said:
What no one wants to admit is that they simply don't care that millions of their American neighbors are a bad diagnosis away from bankruptcy. If folks want to strut around and talk about how to "make America great," having health care security for all would be a pretty great place to start.
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Just paid $700 after insurance for my glasses because I'm damn near blind. Wife and daughter both have $4000 pairs of hearing aids (the "cheap" models). I still owe $7000 in medical bills in Mississippi. Wound care and prescriptions ate 100% of our HSA this year. I just got home from being told I need bariatric surgery plus a knee replacement.

One bad month, and we're goners. God, family, and friends have helped fill in the few gaps we've had, but one catastrophe and we're toast. And no, I'm not saying that all y'all should be responsible for the costs. Just that the reality of the health issues we can't control makes us have to be very careful so we can afford the things we can control.
 
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#240
#240
LouderVol said:
By screwing the healthy 20 somethings. Yay ponzi scheme.

Pay for something now, that you dont need, and cant afford, so that 40 years in the future you can screw over those 20 somethings.

A better fix instead of relying on a government mandated pyramid scheme would be mandated personal HSAs. But the government and insurance doesnt make money off of that so we wont see DC backing it.
Click to expand...

Even worse, Obamacare bans HSAs for most plans. It's crap. They thought that gave the rich an unfair advantage
 
#241
#241
Septic said:
What no one wants to admit is that they simply don't care that millions of their American neighbors are a bad diagnosis away from bankruptcy. If folks want to strut around and talk about how to "make America great," having health care security for all would be a pretty great place to start.
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Catastrophic plans are cheap, HSAs help and both should be available. Honestly, I only care up to the point the other person stops. Why should I go above and beyond for something a person won't choose for themselves?
 
#242
#242
Septic said:
It's not that simple - right or wrong, MILLIONS of American's rely on ER's for all of their healthcare. How do you make "that" need go away? Where does it go to? And when it gets "there", who is going to pay for it?

Emergency Room Crowding: A Marker of Hospital Health


Again, you either concede that everyone needs to share in the burden to help pay for the costs to have all American's have healthcare security or you'll need to concede you don't g.a.s. about the uninsured American's.
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You put a significant co-pay on it.
 
#243
#243
#244
#244
NorthDallas40 said:
That is the example you want to use in presenting drug cost rises? Remind us all what happened to good old Martin again? GTFO with that hyperbolic BS dude.
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He never worked for Mylan and was convicted of securities fraud for using funds raised in an IPO to pay back investors of prior failed ventures.
 
#245
#245
RockyTop85 said:
He never worked for Mylan and was convicted of securities fraud for using funds raised in an IPO to pay back investors of prior failed ventures.
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Shkreli was Daraprim for sure. I remember him speaking out in the Epipen fiasco was all. Both of those are extremist cases and a **** hyperbolic reason to base mass legislation on.

His conviction I believe was a karmic reaction to drawing attention to himself however.
 
#246
#246
Septic said:
Aside from it being a bad solution to begin with, the ACA was hamstringed from the beginning and destined to fail.

When people stop bitching about the cost of health insurance going up and start focusing on how to get the millions of uninsured American's cared for, then perhaps they'll understand what the ACA was intended to do. You can't have cheap insurance and expect to have everyone uncovered. Either everyone has health care 'security' or readily admit that you don't really give a sh*t about millions of people in America.
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I dont give a crap about Americans because I dont think my health care premium or taxes should be used to cover a government mandated program designed to fail, in your own words? That's a pretty big stretch.

I care. I want long term, sustainable, non government provided, solutions that dont rely on screwing over millions of other americans.

You cant make the safety net argument when you argument circles around the idea of millions of americans relying on it for primary care.
 
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#247
#247
Velo Vol said:
Correct. We subsidize healthcare for older people. That's life.
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Why didnt the old people save up? HSAs have been around for a while. Its like SS. What was supposed to be supplementary income is instead being relied on as primary income.

How dare people be held accountable for their own lack of action. I guess I have screwed myself over enough times to learn that lesson.
 
#248
#248
Septic said:
The spread of risk is how insurance works. While the generally healthy 20 somethings pay a lower health premiums because they have lower risk - it doesn't mean they are without risk. Is it also a ponzi scheme that older drivers pay less auto insurance premium and that younger people pay more? Or would you agree that younger people should pay more because they pose a greater loss threat to insurance companies?

Or would you agree that it's the same actuarial principles at work...?
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I would say it's fair to place the cost where the demand is. If it's old for healthcare fine. If it's the young for cars, fine. I dont expect someone driving around a pinto getting groceries to pay the same as someone in a Lamborghini with a history of street racing.

Those actuarial principles also play put over an individuals life time too. It isnt just societal pay. I should be paying in 50 bucks a month now, and 1000 bucks a month when I am 80. My costs shouldnt go down when my personal usage goes up. Just like my costs shouldnt go up when my personal usage is low.
 
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#249
#249
LouderVol said:
Why didnt the old people save up? .
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Because those who are making heavy use of it have likely had to spend potential savings throughout their lives. One catastrophe can wipe it all out. That's what we're trying to prevent
 
#250
#250
AshG said:
Just paid $700 after insurance for my glasses because I'm damn near blind. Wife and daughter both have $4000 pairs of hearing aids (the "cheap" models). I still owe $7000 in medical bills in Mississippi. Wound care and prescriptions ate 100% of our HSA this year. I just got home from being told I need bariatric surgery plus a knee replacement.

One bad month, and we're goners. God, family, and friends have helped fill in the few gaps we've had, but one catastrophe and we're toast. And no, I'm not saying that all y'all should be responsible for the costs. Just that the reality of the health issues we can't control makes us have to be very careful so we can afford the things we can control.
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As it should be.

But with the current system we have people who dont have the same expenses you do making those same decisions to go without because of the socialized costs and plans. Heck I did it for a year or two myself.

I was making about 40k, in Atlanta, when ACA jacked my rates from 50 bucks a month to 350 a month. Seeing an additional 10% of my income disappear overnight screwed me hard. That was more than i was saving at the time. I had to change my lifestyle to match.

Septic and others dont get to argue that i should feel bad for those suffering when i was one of those suffering, until I got myself out of that problem.

Is life fair or equal to everyone? Heck no, but as Velo said, that's life. I got some bad news for everyone, we are all going to die. Might as well accept it.
 
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