The whole debate really ought to be focused more on making sure people actually have health CARE and less focused on whether people have health INSURANCE. Unfortunately it seems that it is often that case that these two things are confused and people think if you have on then you will automaticallly be able to get the other...
poodling wrote:
eric a blair wrote:the general republican view is that not having health insurance is a choice, and choices equal freedom, and freedom = godliness.
I'm serious - they see not having health insurance as being a solid choice that we can all make.
What most people see as a problem, the repubs see as a giant benefit.
better free than healthy I suppose.
It is very hard to take your post seriously. Not having health insurance is indeed a choice we all can make. Being free and being healthy is not an incompatible combination. You can be both.
well it is a choice but it's not a moral one.
Because if you don't pay for your insurance and you get cancer, your fellow citizens will pay for your multimillion dollar cancer treatments and you will have dodged all those insurance payments. You'd be a massive free loader.
I mean if you want to decline all access to healthcare, live off the grid and live or die by your own money, that's probably moral and ethical.
But if you want to have us as your financial backstop, you need to pay up and join society. The Republican ideal of 'freedom' from having to buy healthcare insurance is not really freedom - it's freeloading.
jimmy bobby wrote:
Healthcare is not a right. It's a service that costs a lot of $. You either pay for it or you don't. Most HHs get it via one HH member's job.
But healthcare is treated as a right in this country. If you show up to the ED, you have the right to be treated.
If it were a service, then treatment will be declined if you can't pay for it.
Hope this is not dumb question wrote:
Unless they are saying turn people away at the emergency room.
Would this be a problem solver?
L L wrote:
zephito wrote:However, most of the time uninsured people are healthy and won't consume healthcare as much as they would if they had a plan (they'll stay home from work if they have a cold rather than visiting their doctor). Even when they do get seriously ill, it probably costs less, as they'll wait and wait until their cancer or heart disease is extremely advanced and they'll die a month after diagnosis. An insured individual with the same condition might go through years of expensive treatment. The GOP plan does save money vis a vis Obamacare.
Yes, it certainly is cheaper for people to not seek healthcare and die quickly.
But I think healthy people in general, even those with healthcare coverage, do not consume healthcare.
So a healthy person paying premiums but not using healthcare is exactly what drives premiums and deductibles down.
As you are concerned here with total cost, not average cost per person with a plan, it still drives total cost up if people do not catch illnesses early and eventually get very expensive treatments when they find out they are in an advanced stage.
Routine cancer screenings at Planned Parenthood often saves money in the long run, not to mention saves lives.
And then there is this pesky idea that we want people to be healthy.
Yes, I agree. I get the impression that you think I agree with the GOP proposal or that I only care about total cost. That's not correct. I'm just commenting on the notion previously stated that it's cheaper overall for everyone to have insurance because of preventative medicine and whatnot. The OP seemed to take this for granted. I'm not sure it's true, even if I want it to be true.
All things considered, I think it would be best if everyone paid into the system and everyone were covered.
Healthcare is simply too expensive in the united states, and world wide even, for healthcare insurance to not exist.
If there was no such thing as healthcare insurance in the USA then only the mega rich would be able to pay for healthcare. 99% of the population that got a serious illness would just die as if medicine hasn't advanced beyond the middle ages.
From there we have to make some decisions.
Either we accept that only the rich should be able to afford healthcare.
Or we have to come up with some method of equalling the costs of healthcare among all of us. This could be through a system paid for by taxes or by insurance companies spreading the costs of healthcare amongst its customers.
There really aren't many ways around this issue.
What if nobody had insurance? wrote:
Healthcare is simply too expensive in the united states, and world wide even, for healthcare insurance to not exist.
If there was no such thing as healthcare insurance in the USA then only the mega rich would be able to pay for healthcare. 99% of the population that got a serious illness would just die as if medicine hasn't advanced beyond the middle ages.
From there we have to make some decisions.
Either we accept that only the rich should be able to afford healthcare.
Or we have to come up with some method of equalling the costs of healthcare among all of us. This could be through a system paid for by taxes or by insurance companies spreading the costs of healthcare amongst its customers.
There really aren't many ways around this issue.
That's where you're wrong. You have the cause and effect reversed. The costs aren't so high "just because"; they're that high because the health care system is 1) fee-for-service business model and 2) every single transaction involves a third party payment ("insurers"). It's pretty much designed in the most inefficient way possible.
Educated guy wrote:
What if nobody had insurance? wrote:Healthcare is simply too expensive in the united states, and world wide even, for healthcare insurance to not exist.
If there was no such thing as healthcare insurance in the USA then only the mega rich would be able to pay for healthcare. 99% of the population that got a serious illness would just die as if medicine hasn't advanced beyond the middle ages.
From there we have to make some decisions.
Either we accept that only the rich should be able to afford healthcare.
Or we have to come up with some method of equalling the costs of healthcare among all of us. This could be through a system paid for by taxes or by insurance companies spreading the costs of healthcare amongst its customers.
There really aren't many ways around this issue.
That's where you're wrong. You have the cause and effect reversed. The costs aren't so high "just because"; they're that high because the health care system is 1) fee-for-service business model and 2) every single transaction involves a third party payment ("insurers"). It's pretty much designed in the most inefficient way possible.
Again.....
"Every damn health insurance thread on Letsrun is terribly void of identifying the root of the problem with our health care system. Hasn't anyone taken an economics class around here? Jeez.
Here's what needs to be addressed in the US "health insurance" system:
1) It's based on a fee-for-service business model (incredibly inefficient), and 2) it is "managed" by a third party payment system (also incredibly inefficient).
The ACA did virtually nothing to address either of these characteristics. It approached the problem from the demand side. Which, of course, only exasperates the problem by increasing demand [for the inefficiently-provided care].
Neither party wants to actually fix the problem. If you believe otherwise, you're a fool.
Fixing the problem would involve reducing health insurers' involvement for basic health-related goods and services. Eliminating it in most cases. If I have a cold or flu, or have a basic broken finger, or need a prescription for something, I shouldn't need to have Mr Health Insurer come in and skim some off the top of every single transaction between me and the doctor/hospital. Those prices should be published and doctors/hospitals can compete for the business of helping me resolve these basic health problems.
Complimentary to the above, fixing the problem would involve more properly defining and allowing insurance companies to actually do what "insurance" is supposed to do (risk/actuarial management). They are currently NOT allowed to do this. I repeat: Insurance companies are not allowed to function as real insurance. Anyway, since the basic health-related issues would now NOT skimmed off the top by the health insurance companies, they'd be making their money here. We could have a true "risk pool" for the truly catastrophic health events that occur in our lives. And yes, go ahead and cover everyone here. This could be a relatively standard proportion of an individual's income, with perhaps some progressiveness built in for the upper few percentile folks.
With just these two changes (albeit major changes, in the current climate), we'd greatly reduce the fee-for-service business model and the third-party payment system we have in place, and costs would actually start to come down. And AFTER costs start to come down, then guess what you can do? That's right, you can COVER MORE PEOPLE.
Our genius lawyer-trained (also a FEE-FOR-SERVICE industry, mind you) politicians tried to cover more people first, and not deal with the costs at all second."
Hope this is not dumb question wrote:
What if these people don't have money to pay for their services? Is this cost factored into the Republican plan? Are there any estimates on this cost?
It doesn't cost anything to just let them die.
Seriously folks, sometimes you make things WAY too complicated.
I don't mean to cast a vote in favor of overwhelming socialism, but American history has demonstrated that pretty much every time we ask the free market or private citizens to opt for a preferred way of doing business they end up dumping on the average citizen so bad that it violates all reasonable ethics or costs the people much more money to try and regulate on their own.
Look at the meat packing industry a hundred years ago: deplorable conditions, unbearable work hours, and unsafe products. This is how corporate America and the free market chose to operate. If you were a company that wanted to have better conditions and better quality products, well, your margin was worse than the competitors and you would be driven out of business. The 1% gets rich until a populist revolt leads to election uprising and new regulations. De-regulating as Trump and the Republicans intend to do has already been proven throughout our history to be when our nation is at its least healthy so to speak. It's typically an indirect relationship.
And now they are intent upon doing this directly to our healthcare system. They are directly trying to create a system that allows the corporations to optimize margin over basic health. If you already have bad health or don't have much money, well, you don't deserve health care. I find it laughable in a nation with a Bill of Rights that something like basic healthcare can be so overlooked.
I love the example from the guy talking about if you privatized roads and allowed people to collect their own tolls. Total pandemonium! Regulation has saved this country time and again. It's been a mark of civilization.
It's hilarious that the current Republicans are more regressive than the Libertarians. This is what happens when greed is the actual motivation instead of liberty.
Educated guy wrote:
What if nobody had insurance? wrote:Healthcare is simply too expensive in the united states, and world wide even, for healthcare insurance to not exist.
If there was no such thing as healthcare insurance in the USA then only the mega rich would be able to pay for healthcare. 99% of the population that got a serious illness would just die as if medicine hasn't advanced beyond the middle ages.
From there we have to make some decisions.
Either we accept that only the rich should be able to afford healthcare.
Or we have to come up with some method of equalling the costs of healthcare among all of us. This could be through a system paid for by taxes or by insurance companies spreading the costs of healthcare amongst its customers.
There really aren't many ways around this issue.
That's where you're wrong. You have the cause and effect reversed. The costs aren't so high "just because"; they're that high because the health care system is 1) fee-for-service business model and 2) every single transaction involves a third party payment ("insurers"). It's pretty much designed in the most inefficient way possible.
I agree that the insurers take something from every service they help you pay for. Isn't that where your free market comes in though? The insurers that have the lower premiums will be more successful and people will pay less? Or you can regulate them to make sure their slice of pie isn't too big.
Anyway I don't agree that healthcare could be reduced to affordable levels for the average American by removing insurance companies. That's just the biggest fallacy that doesn't hold any water whatsoever.
I'm completely fine with the idea that if a person wants to opt out of insurance they can. But if that person gets a serious illness then they should pay for it themselves. They made a risky decision as an adult. You can't have your cake and eat it.
What if nobody had insurance? wrote:
Educated guy wrote:That's where you're wrong. You have the cause and effect reversed. The costs aren't so high "just because"; they're that high because the health care system is 1) fee-for-service business model and 2) every single transaction involves a third party payment ("insurers"). It's pretty much designed in the most inefficient way possible.
I agree that the insurers take something from every service they help you pay for. Isn't that where your free market comes in though? The insurers that have the lower premiums will be more successful and people will pay less? Or you can regulate them to make sure their slice of pie isn't too big.
Anyway I don't agree that healthcare could be reduced to affordable levels for the average American by removing insurance companies. That's just the biggest fallacy that doesn't hold any water whatsoever.
I'm completely fine with the idea that if a person wants to opt out of insurance they can. But if that person gets a serious illness then they should pay for it themselves. They made a risky decision as an adult. You can't have your cake and eat it.
but the decisions will affect kids..whether it means the child will lose a parent because the parent couldn't afford a simple operation or because the child has no health insurance either. Do we want to make orphans because we won't pay $200 a week for insulin?
we're heading for single payer and everyone knows it
No insurance, cant afford care; tough luck. Don't see why taxpayers have to pay for someone else's boob job or sex change or diabetes 2 care.
moanswers wrote:
jimmy bobby wrote:Healthcare is not a right. It's a service that costs a lot of $. You either pay for it or you don't. Most HHs get it via one HH member's job.
But healthcare is treated as a right in this country. If you show up to the ED, you have the right to be treated.
If it were a service, then treatment will be declined if you can't pay for it.
Not even close to true. Yes, ER's cannot turn indigent's away, but if you have a significant illness (e.g., cancer, heart condition, etc.), they aren't going to treat you for that.
What if nobody had insurance? wrote:
Educated guy wrote:That's where you're wrong. You have the cause and effect reversed. The costs aren't so high "just because"; they're that high because the health care system is 1) fee-for-service business model and 2) every single transaction involves a third party payment ("insurers"). It's pretty much designed in the most inefficient way possible.
I agree that the insurers take something from every service they help you pay for. Isn't that where your free market comes in though? The insurers that have the lower premiums will be more successful and people will pay less? Or you can regulate them to make sure their slice of pie isn't too big.
Anyway I don't agree that healthcare could be reduced to affordable levels for the average American by removing insurance companies. That's just the biggest fallacy that doesn't hold any water whatsoever.
I'm completely fine with the idea that if a person wants to opt out of insurance they can. But if that person gets a serious illness then they should pay for it themselves. They made a risky decision as an adult. You can't have your cake and eat it.
I don't think you understand what free market means. In my solution, insurance being removed from the basic health resolution portion of "risk management" is taking things in the direction of real free market (consumer and producer of care only...no third party skimmers needed for me to get checked out for my cold.....that will probably just clear up in a few days anyhow).
To lower costs of things, you reduce demand for them, not increase demand for them (like the ACA did). We have to collectively reduce the demand for health care for costs to come down.
Everything you're saying is that of a naïve consumer that thinks our system is "pretty good" as it is (as far as efficiency is concerned). You're a politician/insurance lobbyist's dream!
LOL ... millennials do not want to pay a few hundred a month for health insurance. They will wait until a major illness and think they can buy insurance at that time.
If the medical costs of a serious illness is $100k millennials think they can get away with get away with paying a few hundred a month and all is well. They system won't work that way. If a millennial paid $200 a month it would take 500 MONTHS--40+ YEARS for them to pay back the cost of that single illness.
I am all for letting millennials opt-out but only as long as they absorb 100% of the cost of their medical costs. If they have to go bankrupt then that is the price they must pay for making their choice.
Hope this is not dumb question wrote:
What if these people don't have money to pay for their services? Is this cost factored into the Republican plan? Are there any estimates on this cost?
they just die.
Bank Rupped wrote:
LOL ... millennials do not want to pay a few hundred a month for health insurance. They will wait until a major illness and think they can buy insurance at that time.
If the medical costs of a serious illness is $100k millennials think they can get away with get away with paying a few hundred a month and all is well. They system won't work that way. If a millennial paid $200 a month it would take 500 MONTHS--40+ YEARS for them to pay back the cost of that single illness.
I am all for letting millennials opt-out but only as long as they absorb 100% of the cost of their medical costs. If they have to go bankrupt then that is the price they must pay for making their choice.
and they never get pregnant or have kids, because kids may need healthcare
Educated guy wrote:
What if nobody had insurance? wrote:I agree that the insurers take something from every service they help you pay for. Isn't that where your free market comes in though? The insurers that have the lower premiums will be more successful and people will pay less? Or you can regulate them to make sure their slice of pie isn't too big.
Anyway I don't agree that healthcare could be reduced to affordable levels for the average American by removing insurance companies. That's just the biggest fallacy that doesn't hold any water whatsoever.
I'm completely fine with the idea that if a person wants to opt out of insurance they can. But if that person gets a serious illness then they should pay for it themselves. They made a risky decision as an adult. You can't have your cake and eat it.
I don't think you understand what free market means. In my solution, insurance being removed from the basic health resolution portion of "risk management" is taking things in the direction of real free market (consumer and producer of care only...no third party skimmers needed for me to get checked out for my cold.....that will probably just clear up in a few days anyhow).
To lower costs of things, you reduce demand for them, not increase demand for them (like the ACA did). We have to collectively reduce the demand for health care for costs to come down.
Everything you're saying is that of a naïve consumer that thinks our system is "pretty good" as it is (as far as efficiency is concerned). You're a politician/insurance lobbyist's dream!
I don't think it's pretty good, I think it's pretty bad actually. I think a nationalised system is far better where there are many fewer fat cats, everyone that pays their taxes is able to receive healthcare. Yes this involves paying for other people's healthcare but you literally won't be complaining when your cancer treatment doesn't cost you a penny outside of your taxes.
I don't see how you think costs will be reduced to an affordable level by removing insurers.
Please, as an example, talk me through how your system will cause an MRI scan could become affordable by reducing the demand for it, when the machine costs several hundreds of thousands to a couple million of dollars?
I choose this example because one of the favourite tactics of people such as yourself is to just pretend nobody needs healthcare, "my cold will pass".
Educated guy wrote:
What if nobody had insurance? wrote:Healthcare is simply too expensive in the united states, and world wide even, for healthcare insurance to not exist.
If there was no such thing as healthcare insurance in the USA then only the mega rich would be able to pay for healthcare. 99% of the population that got a serious illness would just die as if medicine hasn't advanced beyond the middle ages.
From there we have to make some decisions.
Either we accept that only the rich should be able to afford healthcare.
Or we have to come up with some method of equalling the costs of healthcare among all of us. This could be through a system paid for by taxes or by insurance companies spreading the costs of healthcare amongst its customers.
There really aren't many ways around this issue.
That's where you're wrong. You have the cause and effect reversed. The costs aren't so high "just because"; they're that high because the health care system is 1) fee-for-service business model and 2) every single transaction involves a third party payment ("insurers"). It's pretty much designed in the most inefficient way possible.
You forgot to include 3) Americans are fat, inactive, sick, and addicted to meds... just the way insurers and pharmas like it. This is a circular issue, but in the US the circle is just much bigger with more players.
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