"Obamacare"

[kermit]

My primary care physician doesn't do always on call. Neither do his partners. They have PAs for that and then only on weekdays. . If there is a weekend or night time emergency? Guess what,the answering service will tell you to go to the ER or one of the Immediate Care facilities in the area and call on monday to let the doctor know what happened.

A few years ago my wife and I were visiting my parents over Thanksgiving. We were about an hour from their house and about 2.5 from mine when my wife realized that she forgot to pack our medications (it was around 9pm on Wednesday). Most of them are non-critical and can be replaced for a few days by over-the-counter med, but my asthma medication cannot. I called him first thing Thanksgiving morning. His answerting service answered but he called me back within an hour and called in the perscription to a pharmacy that we found that was open. He told me that I was not his first call of the day.

 

[cow451]

I take issue with the statement I bolded. My primary care physicians not only control their hours but are paid quite well. They make less than specialists but they do get paid well. I wasn't aware that those in ERs controlled their hours and thought that they were scheduled by the hospital as the hospital deemed necessary.How do the hospitals remain staffed at all hours if the ER doctors control their hours? I would think you would have a glut of physicians at some times and no one at others.

Hospitals typically have a contract with a company (usually a group of physicians) that staff the ER's. That's why you typically get a separate doctor's bill and a hospital bill for an ER visit. Those doctors have privileges but they are not employees.

 

[MachZer0]

Good to know. Too bad that's not true of everybody.

I'm not so sure about that

That battle was lost 47 years ago (to the day, actually.) Good luck getting rid of Medicare.

You asked for my solution and I gave it. Medicare is one of the worst programs the government ever devised

But the larger question: Why should employers be providing health insurance to employees?

It's not a matter of should. It's a matter of liberty. If the employer wants to use medical benefits to attract good employees, he should have the LIBERTY to do so

 

[Grizzly]

Once again, no. If they purchase cheap insurance they will get treated, just like now. Hospitals will work out a payment plan, and if costs are reduced, there will be a less likely chance of them being bankrupted. There's other things that could be done, but I'm not an expert on medical care.

Now, let me ask you something. Why do you keep trying to paint those who disagree with you on healthcare reform as wanting poor people to die? I'm not saying this just on this post, but on the fact that you have stated previously your belief that we want let poor people to die or the rich to be treated better.

Hi Rion. I was about to go "Mach" on you and ask you point out where I said that you wanted poor people to die. We could then drag this thread down into some semantic hell-hole and accomplish nothing.

Instead, I wanted to say that straight-out I don't think people who oppose healthcare reform want poor people to die. I really and truly don't believe that. But here's where I am coming from.

1) Some conservatives here believe that the individual mandate to carry health insurance is wrong and is a violation of our rights as Americans. Reasonable arguments can be made on either side.
2) Some conservatives here believe that taxing citizens to pay for health care for the uninsured is morally wrong. They believe that a government does not have rights over the "fruits of another persons labor".
3) Most conservatives believe that health care is not a right. I even believe that health care is not a right.

So what happens when you put these things together and stir them with a capitalistic stick?

Some conservatives believe that people should be allowed to decide for themselves whether or not they carry insurance or not. Some strong arguments can be made for this position. Some conservatives also believe that they should not be taxed to pay for another persons healthcare.

So, uninsured person X gets into a car accident. He has no insurance. He also has no "rights" to the fruit of another persons labor and receiving health care is not a right. Under the "conservacare" approach, this persons choices are

1) hope for charity
2) go into debt for the rest of his life (assuming the hospital will allow this debt to occur). But I would argue that all this does is pass the costs of health care back on to the rest of us. Which is again, taking the fruits of my labor.
3) crawl back home and hope for a miraculous healing.

So, no, I don't think conservatives want people to die. What I am saying is that following the Conservacare approach, that's exactly what will happen. More people will die.

What I really wished the government had the courage to do is to issue health insurance waivers to anyone who wants one. All they have to do is sign a document that says their health care costs will not be passed onto us. I would be completely fine with that. Life, Liberty, and the Pursuit of Happiness.

 

[cow451]

So, uninsured person X gets into a car accident. He has no insurance. He also has no "rights" to the fruit of another persons labor and receiving health care is not a right. Under the "conservacare" approach, this persons choices are

1) hope for charity
2) go into debt for the rest of his life (assuming the hospital will allow this debt to occur). But I would argue that all this does is pass the costs of health care back on to the rest of us. Which is again, taking the fruits of my labor.
3) crawl back home and hope for a miraculous healing.

So, no, I don't think conservatives want people to die. What I am saying is that following the Conservacare approach, that's exactly what will happen. More people will die.

What I really wished the government had the courage to do is to issue health insurance waivers to anyone who wants one. All they have to do is sign a document that says their health care costs will not be passed onto us. I would be completely fine with that. Life, Liberty, and the Pursuit of Happiness.

Any insurance system is cost-sharing. Re: your choices:

1) Lots of luck unless you happen to have serious burns and get to a Shriner's Hospital
2) Get treated and declare bankruptcy
3) Welcome to the Land of Opportunity.

Your waiver idea is from another planet. Only the Romneys of the nation could afford healthcare.

 

[jayem]

You asked for my solution and I gave it. Medicare is one of the worst programs the government ever devised

Medicare is also one of the most popular.

You gave a general proposition that the federal government should not be involved. I asked for specifics. The devil is in the details, as they say. If Medicare were to be replaced, how would elderly--and more specificially high risk, chronically ill persons obtain health coverage?

It's not a matter of should. It's a matter of liberty. If the employer wants to use medical benefits to attract good employees, he should have the LIBERTY to do so

In 30+ years of working in health care, I've yet to meet an employer who really wanted to be a health insurance provider. It's a burdensome and continually increasing cost for them. But you know a major reason why employer group health plans are so popular? It's because these plans are prohibited by law from refusing coverage to any employee in the group based on health status. There may be waiting periods and such, but the carrier must cover every eligible employee and cannot raise an individual employee's premium due to high utilitzation. If this requirement were eliminated, how will high risk persons find insurance? Do you really believe that in a free market, insurance companies will compete to insure them?

BTW: One of the reasons Medicare was enacted was because private insurance companies were refusing to cover elderly persons. What makes you think that without some regulatory requirement they would do so in the future?

 

[doubtingmerle]

And where did you pull that number from?

Here, for instance: Study links 45,000 U.S. deaths to lack of insurance | Reuters

Now back to my question: Is that OK with you that tens of thousands die without insurance, or should we change that?

If healthcare is cheap and affordable, the uninsured rate will go down.

Obviously, yes.

But is your plan going to make it cheap enough that the poor can afford it?

If offering low-cost basic insurance to poor people was such a profitable business, somebody would be doing it now. But it is not profitable. Unless you will make it profitable, it won't get done. And I don't see how your plan would make it profitable.

So we are left with the problem. Millions would still be without insurance, and many would die. Is that OK with you?

(See, I can make baseless accusations too! )

Excuse me, but I did not make a baseless accusation. I asked a question.

Hospitals are required to give emergency care, but they are not required to give preventive care. If a condition could be caught early, wouldn't it be better to treat it before it becomes life threatening? Wouldn't it be better if the currently uninsured were somehow covered to treat these conditions early before they arrive in emergency care? If so, isn't it better that we provide a means of helping them get basic health care before they arrive in the emergency room? The Affordable Care Act does that.

 

[cow451]

Repeal it - debate it openly, not behind closed doors, buying votes, bribery and any other thing they could do to get it passed. Open it up so we can see what is in it - Get some advice from people that have to decide on the rules for their employees. They are still finding things in this bill that is unbelievable. The amendments in the bill counter each other - if you follow one part - you are in breaking the law in another part. I saw a business owner yesterday say he has lawyers trying to decide what he has to do - they don't have a clue. It is impossible to follow - get rid of it, break it down to where an intellegent discussion can be held and take out all the bribery so each politican can have what they want for their own district.

Looks like this legislation was handled the same way as all others. You don't really think many of these people read every bill cover-to-cover before voting, do you?

Repealing it is far more expensive than taking it and modifying it. Much of what is in place is what most people want. When the Supremes nixed the Medicaid expansion, it actually made it cheaper and deficit friendly.

 

[MachZer0]

Medicare is also one of the most popular.

One reason it's popular is that we forced into it, as in no choice or very little choice.

You gave a general proposition that the federal government should not be involved. I asked for specifics. The devil is in the details, as they say. If Medicare were to be replaced, how would elderly--and more specificially high risk, chronically ill persons obtain health coverage?

The same way they did before Medicare

In 30+ years of working in health care, I've yet to meet an employer who really wanted to be a health insurance provider. It's a burdensome and continually increasing cost for them. But you know a major reason why employer group health plans are so popular? It's because these plans are prohibited by law from refusing coverage to any employee in the group based on health status. There may be waiting periods and such, but the carrier must cover every eligible employee and cannot raise an individual employee's premium due to high utilitzation. If this requirement were eliminated, how will high risk persons find insurance? Do you really believe that in a free market, insurance companies will compete to insure them?

BTW: One of the reasons Medicare was enacted was because private insurance companies were refusing to cover elderly persons. What makes you think that without some regulatory requirement they would do so in the future?

I have no reason to believe that's true. Employees accept a tradeoff between lower wages and health insurance and the employer gets to provide lower wages because of health insurance

 

[Vylo]

You asked for my solution and I gave it. Medicare is one of the worst programs the government ever devised

Except for it being ridiculously more efficient and cost effective then private insurance... Yeah, awful having affordable healthcare

 

[MachZer0]

Except for it being ridiculously more efficient and cost effective then private insurance... Yeah, awful having affordable healthcare

Say what. Private health insurance turns a profit whereas Medicare is insolvent. It can only stay afloat by "robbing Peter to pay Paul". Some doctors will no longer accept new Medicare patients and that promises to get worse.

 

[dogs4thewin]

Hi Rion. I was about to go "Mach" on you and ask you point out where I said that you wanted poor people to die. We could then drag this thread down into some semantic hell-hole and accomplish nothing.

Instead, I wanted to say that straight-out I don't think people who oppose healthcare reform want poor people to die. I really and truly don't believe that. But here's where I am coming from.

1) Some conservatives here believe that the individual mandate to carry health insurance is wrong and is a violation of our rights as Americans. Reasonable arguments can be made on either side.
2) Some conservatives here believe that taxing citizens to pay for health care for the uninsured is morally wrong. They believe that a government does not have rights over the "fruits of another persons labor".
3) Most conservatives believe that health care is not a right. I even believe that health care is not a right.

So what happens when you put these things together and stir them with a capitalistic stick?

Some conservatives believe that people should be allowed to decide for themselves whether or not they carry insurance or not. Some strong arguments can be made for this position. Some conservatives also believe that they should not be taxed to pay for another persons healthcare.

So, uninsured person X gets into a car accident. He has no insurance. He also has no "rights" to the fruit of another persons labor and receiving health care is not a right. Under the "conservacare" approach, this persons choices are

1) hope for charity
2) go into debt for the rest of his life (assuming the hospital will allow this debt to occur). But I would argue that all this does is pass the costs of health care back on to the rest of us. Which is again, taking the fruits of my labor.
3) crawl back home and hope for a miraculous healing.

So, no, I don't think conservatives want people to die. What I am saying is that following the Conservacare approach, that's exactly what will happen. More people will die.

What I really wished the government had the courage to do is to issue health insurance waivers to anyone who wants one. All they have to do is sign a document that says their health care costs will not be passed onto us. I would be completely fine with that. Life, Liberty, and the Pursuit of Happiness.

Keep in mind that they can't lose what they have already paid off (unless they sale it which is a volunteer action. For example, my mother's parents OWN their house. have finished paying it off. The ONLY way they are losing that house (in terms of debt) is if they couldn't come up with the money for property tax ( which they could sale some land (they own a farm) to keep the land the house is on (If they HAD to). Same goes with a paid off car/ trunk/ van/ whatever If it is COMPLETELY paid off they can't lose it because of a debt because it is THEIRS not the bank's not to dealership's but THEIR'S. Therefore how much the hospital/any other creditor can take ONLY what a person has NOT gotten completely paid off.

 

[Grizzly]

Keep in mind that they can't lose what they have already paid off (unless they sale it which is a volunteer action. For example, my mother's parents OWN their house. have finished paying it off. The ONLY way they are losing that house (in terms of debt) is if they couldn't come up with the money for property tax ( which they could sale some land (they own a farm) to keep the land the house is on (If they HAD to). Same goes with a paid off car/ trunk/ van/ whatever If it is COMPLETELY paid off they can't lose it because of a debt because it is THEIRS not the bank's not to dealership's but THEIR'S. Therefore how much the hospital/any other creditor can take ONLY what a person has NOT gotten completely paid off.

I don't know this for certain, but I think what you wrote about creditors actually varies widely from state to state. I think in some states that's true, but not in other states.

 

[dogs4thewin]

I don't know this for certain, but I think what you wrote about creditors actually varies widely from state to state. I think in some states that's true, but not in other states.

Why would that not be true? If I OWN I OWN it. This is why once you have paid off a house the bank no longer cares if you keep insurance on it because that is your risk. Also for the at least third refusing treatment (even if one CAN afford it) is an option.

 

[jayem]

The same way they did before Medicare

As I said, they couldn't get insurance. That's why we have Medicare. Got any other ideas?

I have no reason to believe that's true. Employees accept a tradeoff between lower wages and health insurance and the employer gets to provide lower wages because of health insurance

Believe it. I work in occupational health for a Fortune 500. My client's single biggest expense is not materials, not wages, not R & D. It's health care costs--over 90% of which is for current employee and retiree health benefits. For the last fiscal year, they spent as much on health insurance as they made in profits. That's not so atypical--check the operating expense statement of most any big manufacturing company. Health insurance costs are far more burdensome than salaries. Salary and hourly wages will generally increase at about the rate of inflation. Health insurance costs are rising much faster, and are less predictable. These expenses also put American products at a cost disadvantage vis-a-vis their foreign competitors operating in countries with national health systems.

All the candidates talk about "creating jobs." The best thing that could be done to stimulate new business formation and new job creation is to remove from our employers the burden of providing health benefits.

 

[Grizzly]

Why would that not be true? If I OWN I OWN it. This is why once you have paid off a house the bank no longer cares if you keep insurance on it because that is your risk. Also for the at least third refusing treatment (even if one CAN afford it) is an option.

Maybe we are talking about two different things. If, for example, you run up a large medical bill that you are unable to pay, its possible that these creditors can take you to court and force you to sell your house in order to pay your debts. I believe in some states this is possible, but in other states it is not.

 

[dogs4thewin]

Maybe we are talking about two different things. If, for example, you run up a large medical bill that you are unable to pay, its possible that these creditors can take you to court and force you to sell your house in order to pay your debts. I believe in some states this is possible, but in other states it is not.

wait would they be forcing you to sell your house or simply forcing you to come up with the money? There is a difference.

 

[Vylo]

Say what. Private health insurance turns a profit whereas Medicare is insolvent. It can only stay afloat by "robbing Peter to pay Paul". Some doctors will no longer accept new Medicare patients and that promises to get worse.

Profit means nothing. That just means they take more from the patients. Per capita, medicare crushes private insurance.

 

[doubtingmerle]

Many times they will still work with you to treat you, even if the condition is not yet fatal. By the way I meant any condition that one could think could likely become fatal even if it is not yet. For example stage one cancer. Now you may ruin your credit you may lose everything you have to your name but you will still get treated. By the way, I have nothing against people helping other people PRIVATELY afford medical bills. For example, when my father got cancer there ARE grants to help people come up with the money. Sometimes churches and other PRIVATE NON-PROFIT organizations will help as well. Mater of a fact, if I knew someone in my community at my school or whatever that was having trouble coming up with the money to pay a medical bill for a chronic condition and I had the money to help I would. I have NO problem with that.

OK, that is sorta how it is done now. And you are OK with that?

40,000 people die each year in America because they don't have health insurance. They may try to get others to help, but the bills are huge, and they cannot pay, so they go without the needed care, and they die.

They die. Are you OK with that?

What I DO have a problem with is being FORCED to buy insurance (or pay a fine) and people who treat emanengy services as their general doctor for little things.

Are you OK with forcing hospitals to provide emergency services to the uninsured? Then you are not opposed to all forcing.

Are you OK with forcing people to pay taxes to pay for military protection and police forces, even though they personally would rather not pay their taxes? Then you are not opposed to all forcing.

If it is OK to force hospitals to treat the uninsured, and OK to force people to pay taxes, why is it wrong to force people who could afford insurance but choose not to do so to pay a fee that makes up for the free services they can get at the emergency room?

If a person can afford to get insurance and doesn't, and then is in an accident and this forces the hospital to treat him even though he is uninsured, what would be wrong with forcing such people to pay an annual fee to cover this? If we don't do that, we are forcing hospitals to cover these people who want something for nothing. Are you OK with that?

 

[doubtingmerle]

If healthcare is cheap and affordable, the uninsured rate will go down.

It doesn't seem to me that your plans to lower insurance rates will help much, but how much do you think you can lower rates? 5%? 20%?

What are the poor going to say if you offer them a cut-rate insurance plan at 50% off? Many will still not be able to afford it. And if they need serious care they often will die.

And what about those who cannot get insurance because they have a preexisting condition or have reached a lifetime limit. Your "plan" to lower rates does nothing to help them. If they need serious care, they often will die.

Are you OK with that?