"Obamacare"

doubtingmerle

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What should we do if a poor person shows up at the hospital with a life-threatening condition that can be easily cured? Industrialized nations have long realized that it would not be ethical to let that person die. But how do we deal with the financial costs? Since WWII American presidents have tried to deal with that problem. Johnson tried, but could only get Medicare and Medicaid passed. Nixon passed a law that all emergency rooms must care for emergency conditions, regardless of the patient's ability to pay. The Clintons tried, but didn't get very far.

There was a time when almost all Americans had health insurance. Those who did not could still go to an emergency room. But now many Americans are uninsured. The result is long lines at emergency rooms, which is the only source of care for some people.

When the Clintons tried to reform heathcare, the Republicans had a counter-proposal where everybody would be mandated to buy health insurance. Neither the Clinton proposal nor the Republican proposal became law, but a few years later the Republican mandate plan became law under a Republican governor in Massachusetts (Romney). Obama was dedicated to reforming healthcare, and not having the political might to pass the Democratic plan, he compromised to a version of the Republican mandate plan, now commonly called "Obamacare".

That plan is, of course, very controversial. So what should we do about "Obamacare"?
 

Rion

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Repeal it, allow for tort reform (driving down malpractice ins), allow people to purchase insurance across state lines (breaking regional monopolies), and allow people to purchase the kind of ins. They want (I'm not married, I don't need ins. related to women's health).
 
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Grizzly

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Repeal it, allow for tort reform (driving down malpractice ins), allow people to purchase insurance across state lines (breaking regional monopolies), and allow people to purchase the kind of ins. They want (I'm not married, I don't need ins. related to women's health).

Will that solve the problem?

Specifically, what happens when someone purchases "cheapo" insurance and they suddenly get cancer or some life threatening disease that they are not covered for? Specifically, do we let them die? Will we not treat those with cheap insurance who cannot pay?
 
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doubtingmerle

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Repeal it, allow for tort reform (driving down malpractice ins), allow people to purchase insurance across state lines (breaking regional monopolies), and allow people to purchase the kind of ins. They want (I'm not married, I don't need ins. related to women's health).

OK, but 50 million Americans don't have health insurance. How is this going to fix that problem? If you can lower rates it will help a few afford insurance, but it certainly won't fix that problem.

And 40,000 people die each year because they don't have health insurance. What about them? Should we just let them die?

And emergency rooms are jammed because that is the only source of care for some people. What should we do about that?
 
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From the articles I've been reading of late, it does seem that Obamacare was rushed through with out enough care given to how the law was written. Recall this piece in particular from last week about how the uninsured problem could become worse. Additionally, while there is a penalty for not buying insurance, the IRS was given no enforcement abilities. Basically if you do not want to buy health insurance while healthy, you do not need to. Instead you can spend your money on other things.

"Could ObamaCare Make The Uninsured Problem Worse?"

Could ObamaCare Make The Uninsured Problem Worse? - Investors.com


Additionally, another problem with Obamacare is lobbying of government officials to be included in insurance coverage. I think a better option would be to allow people to choose how they want to spend money in their health care. The firm Whole Foods has a nice program currently that does that for their employees. I though that idea to be a step in the right direction for providing quality health insurance and helping to keep medical costs down.

"Obamacare Killing Affordable Student Insurance"

Obamacare Killing Affordable Student Insurance | Via Meadia

snippet:

...We seem to remember that advocates of Obamacare told us that Americans who were happy with their current health insurance wouldn’t face any changes under the new law. Apparently, that wasn’t true.
One of the problems with the American health care system is the ability of lobbies to persuade Congress and state legislators to mandate coverage for their own pet causes or diseases. Chiropractors, acupuncturists, psychologists, drug companies: everyone wants to be included in mandatory coverage.
Unfortunately, every year special interests will find ways to hook new mandates onto the insurance requirements, and every year the cost of coverage will inexorably rise.
At one level there is nothing wrong with this; the more coverage for consumers, the better. But there’s the question of cost. If all insurance plans have to be gold-plated, full-service — and pre-existing conditions have to be covered — then health insurance is going to be unaffordable for many and perhaps most people. Young people in particular need low cost options; their incomes are low and their health risks are less so for some students choosing a cheap plan with limited coverage makes sense....

&

"Control Your Own Health Care"

Control Your Own Health Care by John Stossel on Creators.com - A Syndicate Of Talent

snippet from John Stossel's article:

....But high deductibles may be the key to lowering costs and putting you in charge of your health care.

Five years ago, the Whole Foods grocery chain switched to a high-deductible plan. If an employee has a sore throat or a sprained ankle, he pays. But if he gets cancer or heart disease, his insurance covers it.

Whole Foods puts around $1,500 a year into an account for each employee. It's not charity but part of the employee's compensation. It's money Whole Foods would have otherwise spent on more-expensive insurance. Here's the good part for employees: If they don't spend the money on medical care this year, they keep it, and the company adds more next year.

It's called a health savings account, or HSA.

CEO John Mackey told me that when he went to the new system, "Our costs went way down."

Yet today, some workers have $8,000 in their accounts.

"That's their money," Mackey said. "It builds up over time because the money is compounding for them."

It will cover all sorts of future out-of-pocket expenses.

Most important, since employees control the money, their behavior changed.


There was no need to ask about costs before because the insurance company seemed to pick up the tab. But that drove up costs for everyone. Now, saving money makes sense to employees because the money belongs to them.

HSA critics ask whether individual accounts will encourage people to save money at the expense of their health.

Mackey has the right response. "The premise in those kinds of questions is that people are stupid. They're not smart enough to make these decisions for themselves. It's sort of an elitist attitude. The individual is the best judge of what's right for the individual."

And apparently, most individuals are making smart choices.

Harvard Business School professor Regina Herzlinger says studies show that "people who have these high-deductible health-insurance policies take a lot better care of themselves. They have more yearly physicals. Because they're saying, 'If I keep myself healthy, in the long run, I'm going to be spending less money.'"...
 
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doubtingmerle

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From the articles I've been reading of late, it does seem that Obamacare was rushed through with out enough care given to how the law was written.
60 years is rushing it? We have been discussing this since World War II. Exactly how long do you want us to talk about it before we do something about the problem?

And this had been heavily debated more than a year after Obama started pressing for it until it finally became law. Exactly how long do you want people to haggle about these laws before we do something?

I agree the law is a mess. It is far too complicated, and doesn't do enough to protect those who are hurting. But it is a step in the right direction. Now let's talk about how we can improve and simplify it so it does what is needed.


Recall this piece in particular from last week about how the uninsured problem could become worse. Additionally, while there is a penalty for not buying insurance, the IRS was given no enforcement abilities. Basically if you do not want to buy health insurance while healthy, you do not need to. Instead you can spend your money on other things.
OK, so you are saying the law is not strong enough? If the law cannot work in its current form without the mandates, and the mandate will not be enforced strong enough, then do we need stronger enforcement?


I think a better option would be to allow people to choose how they want to spend money in their health care.
I see. And if the poor cannot afford bread, then we should let them eat cake?

Multiple unaffordable options won't help the poor.

snippet:...
If all insurance plans have to be gold-plated, full-service — and pre-existing conditions have to be covered — then health insurance is going to be unaffordable for many and perhaps most people. Young people in particular need low cost options; their incomes are low and their health risks are less so for some students choosing a cheap plan with limited coverage makes sense....

Providing the poor with gold-plated plans is not the issue. Providing basic health coverage for all is the issue.

And what do you want to happen to those with serious pre-existing conditions and no insurance. Do you want to just let them die? Is that what you are saying?
 
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Illuminaughty

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When the Clintons tried to reform heathcare, the Republicans had a counter-proposal where everybody would be mandated to buy health insurance. Neither the Clinton proposal nor the Republican proposal became law, but a few years later the Republican mandate plan became law under a Republican governor in Massachusetts (Romney). Obama was dedicated to reforming healthcare, and not having the political might to pass the Democratic plan, he compromised to a version of the Republican mandate plan, now commonly called "Obamacare".

This is why I think it's wrong to pretend that Obama is liberal. Even his major policy triumph is Republican in nature. A band aid intended to stave off the calls for single payer.
 
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Rion

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Will that solve the problem?

Specifically, what happens when someone purchases "cheapo" insurance and they suddenly get cancer or some life threatening disease that they are not covered for? Specifically, do we let them die? Will we not treat those with cheap insurance who cannot pay?

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.
 
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doubtingmerle

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Once again, no. If they purchase cheap insurance they will get treated, just like now.
And you are satisfied with that?

40,000 people die each year because they don't have health insurance. Is that OK with you? Do you want them to be treated "just like now"?

Hospitals are required to provide care to anybody who shows up with an emergency. This puts a huge burden on hospitals in poor areas, where many are uninsured. As the uninsured rate goes up, this gets worse. This hurts the care for everybody in poor areas. Are you OK with that?

In many cases it is cheaper to treat people in the early stages of a disease, rather then wait until the person is forced to go to the emergency room. If it is cheaper and more effective to treat it early, why not find a plan that will do that? Why ask for things to stay "just like now"
 
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John Lee Pettimore III

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Will that solve the problem?

Specifically, what happens when someone purchases "cheapo" insurance and they suddenly get cancer or some life threatening disease that they are not covered for? Specifically, do we let them die? Will we not treat those with cheap insurance who cannot pay?

Do people have a right to medical care?

Do people have a right to do as they see fit with their labor?
 
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Lion Hearted Man

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The American health care system is broken right now. Anything that expands coverage is a good thing, because that will nip potential problems in the bud (like getting a diabetic's glucose under control early as opposed to sawing their foot off or putting them on dialysis).

Believe me, metformin is cheaper than dialysis.
 
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MachZer0

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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.
We could also encourage medical professionals to provide their services for free or reduced rates by giving them tax incentives
 
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John Lee Pettimore III

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I think so. It is already mandated that emergency rooms cannot turn patients away.

That's because every single person has a right to life, isn't it? To be free to live their life the way they like?
 
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John Lee Pettimore III

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Not to rain on anyone's parade...but:

RIVERSIDE, Calif. — In the Inland Empire, an economically depressed region in Southern California, President Obama’s health care law is expected to extend insurance coverage to more than 300,000 people by 2014. But coverage will not necessarily translate into care: Local health experts doubt there will be enough doctors to meet the area’s needs. There are not enough now.

There aren't enough doctors to provide health care even if everyone is insured.
 
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jgarden

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For 2010-11, the average life expectancy rate for those residing in Hawaii was 81.5 years, while for those in Mississippi it was 74.8 - a difference of 6.7 years.

John Lee Pettimore III has argued that when it comes to healthcare, Americans all deserve "to be free to live their life the way they like?" - which in this case means dying before you reach 75 if you live in Mississippi.

Unless one is prepared to accept the argument that the whole state of Mississippi has a collective "death wish" for choosing to die before reaching 75, then there would appear to be something fundamentally wrong when the citizens in one state outlive the citizens of another state by an average of 6.7 years!

This is particularily troublesome in a modern nation which many claim has the highest level of medical research and private healthcare in the world.

Do the good citizens of Mississippi deserve to die 6.7 years before their Hawaii counterparts largely because of where they were born and/or their inability to access the kind of private healthcare that would extend their lives?


List of U.S. states by life expectancy - Wikipedia, the free encyclopedia
 
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John Lee Pettimore III

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For 2010-11, the average life expectancy rate in Hawaii was 81.5 years, while that in Mississippi was 74.8 - a difference of 6.7 years.

Unless one is prepared to argue that the whole state of Mississippi is guilty of not buying adequate private health insurance that would promote a longer lifespan. then there is something fundamentally wrong when the citizens in one state outlive the citizens of
another state by an average of 6.7 years!

Do the good citizens of Mississippi deserve to die 6.7 years before their Hawaii counterparts largely because they can't afford access to private healthcare that would extend their lives?


List of U.S. states by life expectancy - Wikipedia, the free encyclopedia

Do tell, how is one supposed to obtain health care when there isn't a doctor to provide it, as in certain areas of Mississippi?
 
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jgarden

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Do tell, how is one supposed to obtain health care when there isn't a doctor to provide it, as in certain areas of Mississippi?
Its a documented fact that 60 000 to 85 000 medical tourists from outside the country enter America every year for medical proceedures - while 750 000 Americans leave annually in search of more affordable healthcare in other nations.

As long as these foreigners have the money, they are welcomed with open arms - nobody is telling them that "there isn't a doctor to provide it." America seems to have the doctors and medical facilities to meet THEIR needs.

If I lived "in certain areas of Mississippi," I'd be asking my state and federal respresentatives as to why I should be expected to do without and accept "second class" status in my own country?


Medical tourism - Wikipedia, the free encyclopedia
 
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