This has been tried many times throughout the years, as a matter of fact, Nixon and Reagan even suggested an INDIVIDUAL MANDATE as an alternative to a single payer option!
^^^^^Liberal spread the wealth mentality in one sentence. Why the hell should I pay more because someone can't control their drug habit? Or refuses to take the responsibility to bring their diabetes under control?
I am not sure what you mean; for example, I am advocating eliminating simple poverty with existing legal and physical infrastructure, and letting Individuals pursue their best opportunity costs under Any form of Capitalism but not truer forms of Socialism. From one perspective and in that alternative, it should be about placing the blame on Individuals who can no longer claim (official) poverty as an Excuse.
If the rules for insurance companies are changed, and this change increases the cost of doing business, then someone somewhere must make up this increase. One thing you forget is insurance companies, right or wrong, are private businesses. It is 100% their decisions how to model their business, in this case, who to accept as clients, who to drop if the risks become too high. This identical model exists for life insurance, car insurance, home insurance, etc. Insurance companies are in the risk business and they must manage the risks or close the doors. Again, right or wrong, they are private businesses. Everyone is not going to have insurance. When Obama first started talking about this he was using the number ~46 million Americans are uninsured. Down the road a few months and this number turned to ~30 million Americans. Recently I have heard 10-15 million Americans will sign up. Fact is we don't know how many will sign up or how many will remain uninsured. Yesterday I read maybe 75,000 have signed up for Obamacare. It is stupid to believe all of those uninsured will pay penalties? Is Obama going to have Nazi police or IRS enforcers hunting down 5-30 million Americans? IMO the thing I hate about Obamacare is Obama forcing policy changes on the 'private' insurance companies, thereby forcing higher costs to those who have insurance, and the zillion government subsidies and credits and penalties, etc. that will require 5 million accountants to keep straight. I'm 100% for universal healthcare to cover 'every' American but let the entire nation pay for it. If the nation won't pay for it then don't do it...
[video=youtube;IsVqOe07cdY]http://www.youtube.com/watch?feature=player_embedded&v=IsVqOe07cdY[/video] I do think if you WATCH it... you will see he is not counting tails.
Then we can even up the cost of housing among all. Then transportation. Then household goods. Then ....
Here I'm with you 100%. First, I think we can agree that medicine is expensive. Providing medical care to more people is going to cost more. Hopefully we can agree that if the US has the world's most expensive health care and the 39th best national health, there is surely some slack that can be taken up somehow. As I understand it, the Democrats wanted a national healthcare system, no private insurance industry involved, where there is a single payer and all medicine is paid for with taxes. But even Obama had enough savvy to realize that such a system, despite being a lot more effective than the current system without being a lot more expensive, was going to be absolutely unacceptable to too much Big Money - much of which Democrats also relied in in their election campaigns. So we ended up with a system at best marginally better than the prior system - it will provide medical care to some people who couldn't get it before, at least in some states, but it will do so at the expense of enormous and unnecessary confusion, complexity, red tape, special cases, and so on. And while medical care isn't entirely a zero-sum game, neither can it benefit everyone at extra cost to nobody. For some to get care they didn't used to, someone must pay somehow. My hope is that once all the dust settles and the wrinkles are ironed out, the US can improve from that 39th position.
Are you sure that you aren't counting tails as legs, as the old cliche goes? You assume that a lower level of "national health" necessarily is the result of a substandard health care system. That completely ignores the reality that a large portion of Americans make poor health decisions that result in...poor health. That is independent of the care they may receive after the fact. It also ignores the fact that health care outcomes in the US rank fairly high. For instance, the US cancer survival rate is higher than that of most of the world. Now I'm not saying that the cost of health care in the US isn't overpriced but we should at least keep some perspective on causes and effects.
Is it so difficult to believe that you are paying for those RIGHT NOW. . . because the cost of health care (whatever it is) is spread over ALLTHOSE WHO HAVE INSURANCE. . .and if there are less people with insurance. . .the cost doesn't change. . .it is just higher for the smaller group of insured. On the contrary, if the group of insure is larger (and healthier), the cost per capita shrinks. The cost of health care will also shrink because the PREVENTIVE care will detect health problem at the beginning. . .when it can be cured without major expenses (i.e., a person with diabetes diagnosed and treated early may NEVER need surgery to amputate a leg. . .and may never need a wheelchair or a prosthesis) and will therefore cost less. How do you explain that all the other countries (many use a combination of government and private insurance) show a cost per capita that is at least 1/3 less than in the US for LESS people covered? And those health care system (although they differ from one country to the next) have managed to survive and thrive for over 40 years, without affecting the economy, and without affecting the ability of small business (or big ones) to make profits. It's simple. . .all the US companies who have subsidiaries in Europe ARE, BY LAW, forced to fall under the regulations of the country where they do business. . .if it was THAT more costly, why did they choose to do business there?
You are right that I assume that a competent national health care system would place more emphasis on preventive measures. You know, things uninsured people don't do because prevention isn't anything that ever becomes urgent. Urgency is what happens when prevention isn't done. Things like screenings, yearly checkups, routine blood tests, advice about diet and exercise. These things ARE emphasized under Obamacare - there isn't even any copay for them, even with bronze plans. Now, you seem to be assuming that Americans make poor health decisions even though they know better. You may be right. US cancer survival rates are calculated NOT on the basis of how many Americans are diagnosed with cancer, but on the basis of how many of THOSE recover, or how long they live. So in other nations the survival rates are lower, but the incidence rates are also lower. Would you rather not get cancer, or get it but survive it? It's entirely possible that Americans in general (not counting the 5+ million in Republican states who get no insurance) will simply ignore their checkups and screenings, no copay notwithstanding. But hopefully there will be some improvement.
Preventative care isn't going to stop people from eating fast food everyday or smoking two packs a day. They already know that it isn't healthy. A woman could go see a doctor everyday for her entire life but if she's going to get breast cancer then more than likely she's going to get breast cancer regardless. Sure there are some things that could be less severe with preventative care but, for the most part, preventative care isn't going to change the unhealthy behaviors that Americans are notorious for. It's easy to take a statistic such as a lower relative life expectancy and attribute that to the health care system. In fact it's too easy. So easy that it amounts to simple-Simon thinking when you actually look at the causes. Almost all of the difference in mortality rates is accounted for by people dying below the age of 50. An overwhelming majority of American men who die before the age of 50 do so from non-disease related causes. That isn't the case in most other developed countries. The average American consumes 4000 calories a day which is far more than anywhere else in the world. Whereas his European counterparts are walking or biking to work, Americans take their cars. Obese people know that exercise is a healthy lifestyle choice and overeating while leading a sedentary lifestyle is unhealthy. They don't need a doctor to tell them that; it isn't some mysterious piece of privileged knowledge. Even insured, upper income Americans have worse health than their counterparts in other developed countries. Lifestyle choices account for the differences not sub-par care. I realize that you'll just shake everything I've said off but those are facts. If you actually care about the truth of the matter you'll look into these things but for some reason I think you're just looking for any type of justification that you can latch on to and have found one justification that sounds good on the face of it and doesn't require any heavy lifting and you are content with that.
I'm not disagreeing with you here. I already conceded that it's likely Americans live unhealthy lifestyles despite knowing better, and that preventive medicine may be pretty much wasted on them. I think we can hope for some lifestyle improvements based on better information, but I wouldn't get my hopes too high. Your approach sounds like "Americans are lazy slobs and there's nothing anyone can do about that", and this is a bit too fatalistic for me. Since cigarette ads on TV were outlawed (to pick a date, more than a cause), smoking is down by about 2/3. So improvements CAN be made, slowly.
I didn't say that nothing can be done about. I'm saying that it's foolhardy to think that the ACA will do anything about it.
Well, as I wrote earlier, the ACA stresses preventive medicine. If preventive medicine won't help (and it might not), what would you suggest?
I don't suggest anything. It is up to each individual to make their own life decisions. It isn't for me, you or anyone else to force things on other people.
Oh really? How does the ACA "stress preventive medicine"? Are the outrageous deductibles LOWERED for preventative medicince? For example, how does the ACA "stress preventative medicine" for men having sex with men (MSM to the CDC), to reduce the HIV/AIDS epidemic among them, that we will all have to pay for...massively? ($40,000 per year, for up to 25 years..per infected person.) Please cite all the "stress" in the ACA about these things,and them explain their PRACTICAL APPLICATION...IOW- how do they make a bit of difference?
The idea that the USA medical system is 39th in the world is meaningless in the discussion about typical and every day medical care...when I become diseased or need surgery there is no place in the world I would rather be than in the US medical system. Universal medical care cannot be a political issue; either the nation wants universal care or we do not...no matter the politics. The BS about Obamacare and nearly all government programs is the idiots in Washington are incapable of funding these programs...more and more debt is the status quo and this is BS. Debt is something we increase when we have an emergency or singular temporary issue but should never be used to fund ongoing government programs. Everything about Obamacare is bastardized! It is a quasi government program, forced into the private economy, forcing costs to increase, and is not fully funded...and will not insure all Americans! It's a half-assed Band-aid approach founded 100% in politics. I know few people who are not in support of universal health care...but all of them want anything better than half-assed Band-aid and political Obamacare...
This is comical, really. What do you think being 39th MEANS? Apparently, you see the number, you wave it away, and you wish to have good old American medicine. And what if you can't afford it? The reason the US is 39th is because so few people CAN afford it. For those who can, it's about the same medicine you can get anywhere - the US is not a bastion of medical secrets and know-how. This is also comical. You have basically DEFINED what it is to be political -- that some want some government program and others do not -- and then waved it away as "not political." You probably could not name any issue more political than universal medical care if your life depended on it. And would you consider the question of whether we should initiate programs we know will exceed revenues on an ongoing basis to be a political question? Or is this another issue that's not a matter of politics? But in any case, you're correct that the idiots in Washington have, for the last 80 years and counting, enacted spending programs known to exceed any rational projected revenues, and they keep doing so because that's what we elected them to do. Ah, another issue that's not political, right? My take is that you're entirely correct, Obamacare is the worst of all possible worlds except the world we have now. It tried to extend medical insurance to the poor without offending the AMA, the insurance industry, the pharmaceutical industry, academia, the individual states, etc. Because these agencies represent Big Money, without which (more accurately against the funding provided by which), even the Democrats could not get re-elected. This point needs to be emphasized. A coherent, efficient, effective, affordable national health care program was not politically achievable. The opposition to such a program is too big, too well-funded, too entrenched. So as must always be the case in politics, we have to work incrementally, chipping away at a big problem in small steps. Vested interests DEMAND half-assed band-aid approaches. And even those, as we see, get mindlessly virulent opposition from those willing to wreck the country to keep the poor uninsured.
The premise of my statements were based on "meaningless in the discussion about typical and every day medical care"...if you wish to go to China or others ranked higher by WHO for your disease treatments and surgeries...be my guest...but for me I will be using the US medical system. Whether or not people can afford health care does not define the quality of the health care? If you can't afford to buy a Rolls Royce does this mean Rolls is crap? The problem with medical care, just as it is with all other products and services in the USA, is the US prefers capitalism to all other options which exist...and this IS NOT going to change. If the government wants more than capitalism can provide, in your case inexpensive medical care which more people can afford, then the government needs to either subsidize it's citizens or create a Medicare-type program or create a separate and parallel medical heath care system. If the government program is created 100% by one political party and 0% by the other political party, then it will be designed around politics instead of in the best interest of people and the private sector...this is what Obamacare is doing. Medicare works just fine and is fully funded so please explain why Obamacare cannot be managed the same way? In fact Obamacare could of just been an extension of Medicare which is already in place and working within the private sector. Instead you have Obamacare which is 100% political, bastardized, forced, Band-Aid, and not funded.
