Obamacare

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Kraichgauer
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05 Dec 2013, 2:26 am

American wrote:

Kraichgauer wrote:

American wrote:

I agree with Zer0 and have invoked the fire insurance analogy frequently. The question of "what are we supposed to do with people with preexisting questions" is an important question but it has nothing to do with what the nature of insurance is. "Insurance" that is forced to cover people with expensive preexisting conditions for the same price as a healthy person is not insurance at all. That's the problem and I think that that was the point Zer0 was making.

The question remains - what becomes of people with preexisting conditions but are without insurance? There is a matter of simple mercy involved here.

I acknowledged the importance of that question to our society. However, that is completely irrelevant to this particular discussion because of what insurance is and is not. And insurance is a business of statistics. It should never be the the case that, from the outset based on known facts, it is practically certain that an insured person will cost the insurance company more money than the insured person pays in premiums. I refer you back to the fire insurance analogy. If fire insurance companies had to cover the "preexisting condition" of one's home having burned down without charging that person more than they would charge someone whose home had not already burned down, it would cease to be insurance. It would be ridiculous is what it would be. The same is true for this new type of health "insurance" that Obamacare creates.

But covering the uninsured and those with preexisting conditions is the only point, as far as I'm concerned. As I had stated earlier, I don't believe any legitimate insurance companies will go out of business because they will have to cover those with preexisting conditions from now on, as people regardless who they are will always need insurance.

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sonofghandi
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05 Dec 2013, 8:12 am

Jacoby wrote:

sonofghandi wrote:

Jacoby wrote:

There has never been a coverage issue for healthcare in this country, the actual amount of people that were denied coverage for pre-existing conditions or lifetime caps or whatever is pretty miniscule. Congress would of been much better off crafting some law that specifically targeting these "uninsurables" and trying to bringing down the costs of healthcare in general which helps everybody and government getting the hell out would go a long way to doing that. Government interference and their total servitude to their corporatist financiers is the reason why we're in this mess.

I don't quite follow your logic here. Corporations are making the government do things that will increase their profits, which is why the ACA is bad, but if the government stayed out of healthcare (which they have in regards to the ACA - it is insurance regulation and has almost nothing to do with actual health services) these same corporations would be somehow motivated to bring healthcare costs down? I must be missing something; could you please clarify?

These corporate interests use government to raise barriers of entry to stifle competition while at the same to stimulating demand by so heavily subsidizing healthcare. Government getting out of the way would make these corporations accountable to the market economy which ups quality and lowers prices. We're not getting our money's worth for healthcare in this country, we spend more on healthcare than any other country in the world and something like a third or more goes to overhead and the bureaucracy.

So you think that the pre-ACA insurance market wasn't run by large insurance companies that stifled the entry of any new competitors? You think that large corporate insurance companies are going to have lower rates? Without the ACA, less Americans would be insured every year as the premiums continued to sky-rocket. How exactly would private industry have suddenly decided to change things? Those companies don't care how much health care costs; they use increased health costs as a way to increase their revenues more than their additional expenses. In addition, increased expenses leads to lower effective tax rates. They have zero incentive to do anything without external intervention.

Where exactly do you get your numbers for how much is spent on overhead and beeaucracy? I have found much more required paperwork and wild goose chases to be worried about when filing an insurance claim than anything I have ever had to to deal with at a medical center.

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sonofghandi
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05 Dec 2013, 8:16 am

American wrote:

I refer you back to the fire insurance analogy. If fire insurance companies had to cover the "preexisting condition" of one's home having burned down without charging that person more than they would charge someone whose home had not already burned down, it would cease to be insurance. It would be ridiculous is what it would be. The same is true for this new type of health "insurance" that Obamacare creates.

Your comparison is inaccurate. If you want to use the fire insurance analogy it would be more like having a small kitchen fire, and then the rest of your life you are refused fire insurance. Or perhaps your house has older electrical wiring, so you are refused coverage.

Your version of the fire insurance analogy would be more like someone getting into a car accident and picking up insurance in the ambulance on the way to the hospital.

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DrHouseHasAspergers
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05 Dec 2013, 9:54 am

http://news.yahoo.com/harry-reid-exempts-some-of-his-senate-staff-from-obamacare-exchanges-192925037.html

Quote:

One of the biggest public supporters of the Affordable Care Act has reportedly decided that some of his staff should be exempted from the new law.

Quote:

The news will likely provide another talking point to critics of the healthcare law, commonly known as Obamacare. After all, members of Congress and their staff are not only required to buy insurance through the exchanges, they must buy plans in the “gold” tier, the second most-expensive option available.

Quote:

The offices of Ron Wyden, Tim Johnson, Barbara Boxer, Patty Murray and Thomas Carper, all Democrats, said they were exempting some of their staff. Reid, a Democrat from Nevada, has not responded.

Quote:

Lamar Alexander (R-TN): No

Kelly Ayotte (R-NH): No

Tammy Baldwin (D-WI): No

John Barrasso (R-WY): No

Barbara Boxer (D-CA): Some

Sherrod Brown (D-OH): No

Richard Burr (R-NC): No

Ben Cardin (D-MD): No

Daniel Carper (D-DE): Some

Saxby Chambliss (R-GA): No

Thad Cochran (R-MS): No

Susan Collins (R-ME): No

Christopher Coons (D-DE): No

Bob Corker (R-TN): No

John Cornyn (R-TX): No

Ted Cruz (R-TX): No

Richard Durbin (D-IL): No

Diane Feinstein (D-CA): No

Dean Heller (R-NV): No

Mazie Hirono (D-HI): No

John Hoeven (R-ND): No

Johnny Isakson (R-GA): No

Ron Johnson (R-WI): No

Tim Johnson (D-SD): Yes

Patrick Leahy (D-VT): No

Mike Lee (R-UT): No

Joe Manchin (D-WV): No

Robert Menendez (D-NJ): No

Barbara Mikulski (D-MD): No

Lisa Murkowski (R-AK): No

Christopher Murphy (D-CT): No

Patty Murray (D-WA): Yes

Rob Portman (R-OH): No

Jack Reed (D-RI): No

James Risch (R-ID): No

Marco Rubio (R-FL): No

John Thune (R-SD): No

Pat Toomey (R-PA): No

Mark Udall (D-CO): No

David Vitter (R-LA): No

Roger Wicker (R-MS): No

Ron Wyden (D-OR): Some

Funny how only Democrats are exempting themselves and their staff...

sonofghandi
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05 Dec 2013, 10:33 am

DrHouseHasAspergers wrote:

http://news.yahoo.com/harry-reid-exempts-some-of-his-senate-staff-from-obamacare-exchanges-192925037.html

True, but misleading.

Under the ACA, the phrase “congressional staff” means “all full-time and part-time employees employed by the official office of a Member of Congress, whether in Washington, D.C., or outside of Washington, D.C.” Thoses exemptions are aids that are not full time members or not on a congressperson's office staff. Some of these personnel are being allowed to remain in the FEHB program that all other federal employees are enrolled in. And before you start going on about special subsidies, the OPM has merely granted an amount of money to be paid for insurance premiums that would have been "equal to or less than" their employer's share prior to the ACA going into effect, so they are not getting some sort of special treatment.

This story is twisting something minor into some sort of imaginary travesty.

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zer0netgain
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06 Dec 2013, 9:21 am

sonofghandi wrote:

Don't you realize that a large portion of the reasoning behind the individual madate was to limit the risk to insurers in regards to covering pre-existing conditions and to establish a larger customer base and revenue stream to offset possible financial consequences? People have to have insurance now, so they aren't just going to wait until they need it, so your arguments make little sense to me. I could see your concern if the individual mandate had been struck down by the SCOTUS.

Ah, but that's not so. If you don't have insurance, you just pay a tax. For many, the tax is cheaper than the cost of coverage. So, they have no need to buy a policy.

sonofghandi
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06 Dec 2013, 9:59 am

zer0netgain wrote:

sonofghandi wrote:

Ah, but that's not so. If you don't have insurance, you just pay a tax. For many, the tax is cheaper than the cost of coverage. So, they have no need to buy a policy.

The individual mandate limits the risk; it does not eliminate it. Taking risks is built into the stucture of the insurance industry. The tax may cheaper for now, but it does go up each year until it reaches its maximum (which is still likely to be less than the premiums for the cheapest plans before any subsidies). The demographic that would be most suited to paying the penalty vice becoming insured are the youngest adults, who are also the most likely to qualify for full/partial subsidies for their premiums (lowering their effective rates).

So you could avoid getting insurance if you think that you are definitely not going to have any health problems, get hurt on the job, get injured at home, or get into a car accident. Or if you just like gambling with your life and/or future quality of life. You can go ahead and try to get insurance after you get sick/injured, but you won't be covered for a single penny of any medical expenses you incur before the policy goes into effect, which could take months. It seems to me that the only realistic reasons to avoid health insurance are those who would have enough money that they would not qualify for subsidies (which means they would likely be able to afford health insurance anyway) or for purely political reasons. Neither of these seem very reasonable to me.

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ruveyn
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06 Dec 2013, 12:29 pm

What there should be is some form of quit-claim where a person is not taxed to support medical care on the condition that he never receives a penny of care from some subsidized agency or treatment center. That includes emergency room admission. He he does not pay, does not receive.

ruveyn

Mamselle
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06 Dec 2013, 1:59 pm

ruveyn wrote:

This will work great when a four-year-old whose parents never arranged for insurance is brought to an emergency room for treatment of an asthma attack or an injury, say. Are you going to be the one standing there telling this four-year-old that s/he has to just suffer?

LKL
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07 Dec 2013, 4:41 am

Not to mention that those of us who work in health care are often hard-wired to help people in need, and would either treat a suffering patient anyway (and be fired for it), or would suffer serious psychological harm from watching someone die in front of us and not taking any action. FFS, most of us carry ghosts from the people we *did* try to help, but couldn't.

In other words, someone without insurance is still harming other people

Jacoby
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10 Dec 2013, 4:52 pm

Quote:

The Affordable Care Act forces companies with more than 50 workers to buy them all health insurance or pay hefty fines
The IRS says volunteer firefighters are 'employees,' even though the Department of Labor says they're 'volunteers'
Out of more than 1 million fire departments in the U.S., 87 per cent are staffed entirely or mostly by life-saving volunteers
Members of Congress are weighing in, but the Obama administration hasn't taken any action yet to carve out a fire-fighting exception

Volunteer fire departments all across the U.S. could find themselves out of money and unable to operate unless Congress or the Obama Administration exempts them from the Affordable Care Act.

'I thought the kinks were worked out of Obamacare at the first of the month, Central Florida volunteer firefighter Carl Fabrizi told Sunshine State News.

'Man, oh, man, this could potentially destroy some real good companies in Florida.'

The U.S. Department of Labor takes the term 'volunteer' literally, but the IRS says volunteer firefighters are technically employees if they're on the job more than 30 hours per week, making them subject to Obamacare's employee-mandate rules.

link1
link2

appletheclown
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10 Dec 2013, 5:00 pm

LKL wrote:

Not to mention that those of us who work in health care are often hard-wired to help people in need, and would either treat a suffering patient anyway (and be fired for it), or would suffer serious psychological harm from watching someone die in front of us and not taking any action. FFS, most of us carry ghosts from the people we *did* try to help, but couldn't.

In other words, someone without insurance is still harming other people

You believe in Ghosts?

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ruveyn
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10 Dec 2013, 9:47 pm

Mamselle wrote:

ruveyn wrote:

Clearly an exception for children and non-competent people should be made. I am talking about a person who is able to make the decision for himself. If he wants to be free of the system he should be offered (under law) a way out or a buy out.

Locking people in is a form denies freedom of association, one of the unenumerated rights protected by the 9 th Amendment.

ruveyn

LKL
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11 Dec 2013, 12:37 am

appletheclown wrote:

LKL wrote:

Not to mention that those of us who work in health care are often hard-wired to help people in need, and would either treat a suffering patient anyway (and be fired for it), or would suffer serious psychological harm from watching someone die in front of us and not taking any action. FFS, most of us carry ghosts from the people we *did* try to help, but couldn't.

In other words, someone without insurance is still harming other people

You believe in Ghosts?

Metaphorical. Aka PTSD, maybe. Something like that.
I have a couple of bad deaths inside my skull that, like un-tamed birds in a cage that fling themselves against the bars when a human walks by, occasionally rise up and rattle around in my thoughts, preventing me from thinking of anything else until they settle. I call my mental death-birds 'ghosts' because that's the word that makes most people best understand what I'm trying to say.

sonofghandi
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11 Dec 2013, 8:18 am

Jacoby wrote:

Quote:

link1
link2

As of 2011, there were around 756,000 volunteer firefighters in the entire US, only some of whom work "full time," and even less who work in a department with more than 50 "employees," seeing as how the majority of volunteer firefighters are protecting smaller townships and rural areas. You also must consider that the majority of volunteer firefighters have jobs in addition, where thay are likely to be eligible for healthcare and not a financial burden on their departments. You are talking about a very small number of people.

For someone who is against making individuals pay for health insurance, I thought that an employer providing health insurance rather than enroll on the exchanges would be right up your alley.

Quote:

The DOL allows volunteer firefighters to receive benefits such as worker's compensation, health insurance, life insurance, disability insurance, pension plans, length of service awards, and property tax relief. DOL defined volunteer firefighters may be paid nominal fees on a per call basis, per shift basis, or various service requirements, but may not be compensated based on productivity such as with an hourly wage.

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sonofghandi
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24 Dec 2013, 8:08 am

So even though people who already have health insurance do not have to deal with the exchanges at all, Obama has just signed up for a bronze family plan through the federal exchange. Interesting.

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