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  1. Default The U.S healthcare fiasco

    I'm personally sick of this topic and the misinformation out there.

    Yes ACA has problems but anyone who knows the facts understands that healthcare was a mess before ACA and ACA was never going to fix the many problems a privatized system offers. When healthcare submits to profits (privatized), sick people simply become unprofitable and trying to force insurers to insure the unprofitable at affordable costs is a no win crusade. It's obvious that for insurers to recoup costs of the sick, they must make up losses elsewhere - the healthy. To even suggest that we can solve these problems by not forcing everyone to pay insurance and having the healthy pay more, is stupidity. I have yet to hear a reasonable solution to this problem.. Why do you all think every MAJOR developed country has a nationalized healthcare system?

    Now... to those who say 'repeal', i ask 'for what?' because the healthcare before ACA was as bad or worse than it is now. Not only were costs the highest of any major developed country (by a lot), millions were discriminated against for having pre-existing conditions or for being sick. The costs were also increasing at the same rate (if not more) than they are increasing now. What i don't understand is how people forget that healthcare was a mess before ACA, ACA didn't make it a mess.

    So here we are, instead of trying to improve ACA (attempting to keep the good, solving the bad) here we are with the GOP trying to go back to a system was was arguably even worse. Can congress ever get together to try and improve things? This is embarrassing and just pathetic.

    Good luck trying to come up with a better healthcare plan under a largely privatized system, it is an unsolvable riddle. Healthcare is a right, not a privilege where having healthcare is viewed as the same as having a car, a yacht or a mansion. When sick people are unprofitable business, they need to be paid for by tax payers, end of story. So let's see what Trump and GOP come up with but i anticipate cold feet very soon, because if things get worse (which they probably will), TrumpRyanCare will be to blame and Trump will not want this to be part of his legacy.
    Last edited by Mike12; Jan 04 2017 at 12:38 PM.

  2. #2

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    It is too bad that politicians can't just use some common sense and easy math to put this problem to bed.

    For example ... Medicare Part A covers our elderly (65+) who represent 13% of the population. Part A is fully funded, mostly by our 2.9% payroll tax.

    But the elderly account for about 75% of health care spending. Everyone less than 65 account for about 25%. If you do the math you can see that if we raised the payroll tax to 5% we could provide the population with Part A Medicare.

    This would not provide totally free health care. There would still be deductibles and gaps in coverage. This is where insurance companies and employers could come in - to fill in those gaps.

    This is not rocket science. Politics and politicians are what make it hard.
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  3. #3
    Location: Texas nee midwest and east
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    Default

    Medicare Part A covers only a minority of average healthcare cost. And Medicare will be bankrupt in a few years.

  4. Default

    Quote Originally Posted by RodB View Post
    Medicare Part A covers only a minority of average healthcare cost. And Medicare will be bankrupt in a few years.
    Medicare will not go bankrupt, this fund during the productive years of the baby boomers enjoyed triple digit surpluses (surpluses is the same as profit). It is now double digit surpluses since the baby boomers are retiring. If the government were not allowed to spend those surpluses for other than healthcare, we would not be in the mess we are in.

  5. #5
    Location: Texas nee midwest and east
    Posts: 318

    Default

    Quote Originally Posted by lynnlynn View Post
    Medicare will not go bankrupt, this fund during the productive years of the baby boomers enjoyed triple digit surpluses (surpluses is the same as profit). It is now double digit surpluses since the baby boomers are retiring. If the government were not allowed to spend those surpluses for other than healthcare, we would not be in the mess we are in.
    Well, the trustees say it will be broke in 10-15 years without any corrective action.

  6. Default

    Quote Originally Posted by RodB View Post
    Well, the trustees say it will be broke in 10-15 years without any corrective action.
    They always say that to scare the public, its just a scare tactic.

  7. Default

    Quote Originally Posted by Seth Bullock View Post
    It is too bad that politicians can't just use some common sense and easy math to put this problem to bed.

    For example ... Medicare Part A covers our elderly (65+) who represent 13% of the population. Part A is fully funded, mostly by our 2.9% payroll tax.

    But the elderly account for about 75% of health care spending. Everyone less than 65 account for about 25%. If you do the math you can see that if we raised the payroll tax to 5% we could provide the population with Part A Medicare.

    This would not provide totally free health care. There would still be deductibles and gaps in coverage. This is where insurance companies and employers could come in - to fill in those gaps.

    This is not rocket science. Politics and politicians are what make it hard.
    Medicare Part A only covers hospital charges, you must also have part B to cover physician and other medical services. The increase in health spending starts in the 50 year age bracket and older since chronic conditions begin to emerge when people reach 50 and over. Actually health spending is concentrated among people with dual coverage that have Medicare and Medicaid and the higher income brackets population.

  8. Default

    Quote Originally Posted by Mike12 View Post
    I'm personally sick of this topic and the misinformation out there.

    Yes ACA has problems but anyone who knows the facts understands that healthcare was a mess before ACA and ACA was never going to fix the many problems a privatized system offers. When healthcare submits to profits (privatized), sick people simply become unprofitable and trying to force insurers to insure the unprofitable at affordable costs is a no win crusade. It's obvious that for insurers to recoup costs of the sick, they must make up losses elsewhere - the healthy. To even suggest that we can solve these problems by not forcing everyone to pay insurance and having the healthy pay more, is stupidity. I have yet to hear a reasonable solution to this problem.. Why do you all think every MAJOR developed country has a nationalized healthcare system?

    Now... to those who say 'repeal', i ask 'for what?' because the healthcare before ACA was as bad or worse than it is now. Not only were costs the highest of any major developed country (by a lot), millions were discriminated against for having pre-existing conditions or for being sick. The costs were also increasing at the same rate (if not more) than they are increasing now. What i don't understand is how people forget that healthcare was a mess before ACA, ACA didn't make it a mess.

    So here we are, instead of trying to improve ACA (attempting to keep the good, solving the bad) here we are with the GOP trying to go back to a system was was arguably even worse. Can congress ever get together to try and improve things? This is embarrassing and just pathetic.

    Good luck trying to come up with a better healthcare plan under a largely privatized system, it is an unsolvable riddle. Healthcare is a right, not a privilege where having healthcare is viewed as the same as having a car, a yacht or a mansion. When sick people are unprofitable business, they need to be paid for by tax payers, end of story. So let's see what Trump and GOP come up with but i anticipate cold feet very soon, because if things get worse (which they probably will), TrumpRyanCare will be to blame and Trump will not want this to be part of his legacy.
    I do have a reform package for the disaster that is the ACA. Unfortunately, I won't be elected until 2018. So we're just going to have to deal with an internet post formulating what must be done for the path forward. The ACA is the worst piece of legislation ever passed in the history of the USA.

    Furthermore, the assertion that Health Care "is a right", is a blind assumption. To provide for this right, doctors must take long hours out of the day. To provide for this right, nurses must look after their patients. To provide for this right, drug companies must create effective medicines, go through testing and regulations(that I largely support, BTW.)

    In short, the cost of health care is very real and to deny these people the right to their financial rewards due to their service in their various sectors is borderline cruel. So, we have to figure out how to afford the cost of health care. There is no 'right' to someone else's property or service.

    So, what drives the cost of health care? Quite a few things: Administrative costs, health care usage. Scarcity is the main driver of health care. Not enough drugs, aforementioned usage creates a lack and the demand can't keep up. If you look at the other nations around the world, it's not so much that their health care is cheaper, but that they have less people per capita to actually cover. And thus, their health care is cheaper.

    But look at the EU as a whole, and the need for the VAT tax among others, becomes clearly a necessity to the nations of Europe. But high taxation takes dollars out of circulation(guess what also does, mandatory programs like the ACA). Said dollars out of circulation prolongs the recession/decline, whatever you want to call it.

    To put it bluntly: The ACA promotes class warfare. From having to force people to buy a product(Insurance), that they may or may not need. At rates they
    may or may not be able to afford. The withdrawal from the marketplace now restricting doctor access. The 40 hr work week that forces small businesses to cut hours or outright cut workers. And that's not even the worst offense of the bill. Let's talk about those subsidies.

    First off, because the subsidies cover damn near everyone under the sun, you have to have more of them than you do. Thus talk of the subsidies possibly running out in 2017. But this isn't the worst part of it. The worst part of it, is that you only qualify for said subsidies if you're in a certain income bracket(like most government programs). Once you actually raise your income level, you'll be essentially buying health insurance at the expensive prices.

    The said expensive prices(along with the taxes for the subsidies) that middle/upper class Americans pay. No one wins, regardless of which sector you're on. Even if you "get insurance" on the lower rungs, that's only as long as you STAY there. This law is absolutely terrible. There's no way around it.

    **Throws the ACA in the trash bin**. Let's start reforming the garbage.

    Administrative Costs:
    One of the ways I suggested to reform this, is to actually give the patient control over his insurance plan. The irony is calling it a "market" and having the insurers themselves dictate the cost of the plan lol. Yeah, no. We're going to give patients/doctors the ability to control the plan, they will be the ones who craft the plan. And all Insurers are, are basically middlemen who approve of the plans. There are those who'd go "Wouldn't the plans be more expensive?" Nope. No more men plans covering tampons, they don't need them. Women plans don't need to cover Viagara.

    Already, we addressed a huge reason for costs. But I'll go further. One of the reasons for rising costs were the damn doctor visits for prescriptions.
    Create a government-protected server accessed by the patient/doctor, and have your prescriptions loaded on the account in REAL TIME.

    There, problem solved. You could just load the prescriptions on the account, the pharmacist would get the prescriptions and you'd get your medicines.
    All you'd have to do is attend your daily checkups really, to get the prescription the first time(and/or whenever you need a different prescription.)

    And I'm still not done. Another major cost is the lack of access to drugs over the counter. If we make more drugs over the counter, you'll have less need of a prescription. Which additionally leads to less appointments and thus more time for the doctors.

    Drug Costs:
    In a nugget to the Left, I concur with Senator Bernie Sanders. It's time for the US to negotiate directly with drug companies. However, this will not be the "US Government"(or a faction thereof). They can't even negotiate a proper budget. My confidence is nil in Washington's negotiating ability. Instead, I would author a "Drug Marketplace Organization"(or DMO. Crappy name, but you guys can help me with a better one.) I'd have pharmaceuticals, insurers and doctors on one big panel with the expressed interest of negotiating with current players in the industry.

    With the regulation stipulating that drug prices may not exceed twice their worth(IE: The cancer drug incident isn't happening again.) With those stipulations in mind, and with the vast US market, buyers will eventually cede to a strong US position. It's the one thing Sanders has that I majorly approve of, I just want to give the function to capable players.

    Insurance Regulations:
    Okay, we're getting rid of the mandate. A: It's Anti-American, B: It's not necessary. The reason "the young" had to be brought in, was to de-facto cover the costs for ensuring the Elderly/Terminally Ill. There's much better ways of doing this, such as isolating the Elderly/Terminally Ill from the rest of the pool.

    What I want to do is I want to segregate and shorten the pool. You have de-facto three groups: The Youth(0-12), Teenage/young adult(13-40). Adult/terminally Ill(40-). Each group is its own group, and eventually with insurance companies that will only cover that particular group. This will expand the insurer market as they can now selectively choose who they're going to insure.

    Now that each group is its own group, the costs of insurance have gone down tremendously. It's the one-size fits all, that's increasing prices. Oh, and I'd have a one-time signup. No more of this annual sign-up crap, or the stupid and I mean absolutely STUPID "sign-up periods". Someone might not have the income to pay for it, in that window. But may have that income at a later date. Get rid of the sign-up periods. No other business does business that way. And I suspect it's in the bill.

    Instead, you transfer accounts as you age. Through the transfer system, guess what I did? That's right, everyone has insurance! Without the mandate, I have a much better way of getting people insurance. And through different insurer providers for different age groups, I've even made family plans cheaper.

    When you consider that companies already ensure their workers, we have just utterly fixed health care. But there's one problem remaining: The "keep it until your 26" stupidity. This is putting a bandaid on a serious problem: Adults who have yet to stand on their feet. How do we solve it? Make basic health care a collegiate necessity.

    And if it sounds far-left, it's actually quite innoative: For these people to get a benefit(health care), they actually have to attend college. In fact, let's extend it to a "Productive Citizen Credit". And the PCC can in effect be insurance for those who are productive in any capacity, but don't necessarily want to pay for it in the form of a costly insurance plan. We'll deduct it from their tax earnings instead.

    Oh and finally: Go from Single-Payer, to a Double-tier model like Singapore and other highly developed countries. Thus enabling both choice and expanding coverage capabilities.

    Your welcome America.
    "Fascism is against the destructiveness of the left and the backwardness of the right" - Benito Mussolini

    "It originated as a movement in which one man alone believed, then a band of martyrs, then finally a population and then a Nation!"-Benito Mussolini.

    "Anti-intellectualism has been a constant thread winding its way through our political and cultural life,
    nurtured by the false notion that democracy means that 'my ignorance is just as good as your knowledge."
    Isaac Asimov
    `

  9. Default

    Quote Originally Posted by AmericanNationalist View Post
    I do have a reform package for the disaster that is the ACA. Unfortunately, I won't be elected until 2018. So we're just going to have to deal with an internet post formulating what must be done for the path forward. The ACA is the worst piece of legislation ever passed in the history of the USA.
    a slight exaggeration and this type of rhetoric isn't productive. The ACA DID solve some problems (lifetime caps, discrimination against the most in need etc..) but didn't work simply because we have a privatized system where premiums not only pay for our healthcare but also pay for billions in insurance profits. Not only this, the system currently has the highest administrative costs of any industrialized nation, it's ironic that it's largely private yet more bureaucratic and wasteful than nationalized or single payer systems. Explain to me why the US govt. spends more in healthcare as a % of GDP when compared to Canada or UK?

    Furthermore, the assertion that Health Care "is a right", is a blind assumption. To provide for this right, doctors must take long hours out of the day. To provide for this right, nurses must look after their patients. To provide for this right, drug companies must create effective medicines, go through testing and regulations(that I largely support, BTW.)

    In short, the cost of health care is very real and to deny these people the right to their financial rewards due to their service in their various sectors is borderline cruel. So, we have to figure out how to afford the cost of health care. There is no 'right' to someone else's property or service.
    . So you care more about doctors, insurance company and drug company employees making big bucks vs. the sick people who can't afford healthcare when they most need it? Your priorities seem to be upside down my friend. Also, what you speak of can be easily remedied by a single player system. Under a single payer system many of today's problems are solved and the people you speak of get paid (yes doctors and employees of drug companies in Canada are doing just fine). Under a single payer system, everyone chips in via a payroll tax so everyone contributes to ensure everyone has the right to take care of their health! It is amoral that someone can go bankrupt because they can't afford healthcare or be denied coverage because they are self employed and unhealthy. No-one should have to go through financial hardship due to health problems and those who think this fine are not right in their head, IMO. A single payer system also reduces administrative costs of hospitals (they are MUCH lower in Canada vs US) and also eliminates the funding of massive profits (our premiums also go towards billions in profits). There is no way to bring premiums down significantly in a privatized system... very hard to do.

    So, what drives the cost of health care? Quite a few things: Administrative costs, health care usage. Scarcity is the main driver of health care. Not enough drugs, aforementioned usage creates a lack and the demand can't keep up. If you look at the other nations around the world, it's not so much that their health care is cheaper, but that they have less people per capita to actually cover. And thus, their health care is cheaper.
    no, their system is more cost effective.

    But look at the EU as a whole, and the need for the VAT tax among others, becomes clearly a necessity to the nations of Europe. But high taxation takes dollars out of circulation(guess what also does, mandatory programs like the ACA). Said dollars out of circulation prolongs the recession/decline, whatever you want to call it.
    Medicare is funded with like a 2% payroll tax and medicare pays for the elderly who are the most expensive. A 5-7% payroll tax would cover everyone and before you start whining, most people would actually save money by avoiding premiums, out of pocket medical expenses by instead paying more in payroll tax. All i hear from people is 'these premiums are SO EXPENSIVE and deductibles SO HIGH'....WELL... wouldn't it be best to save these expenses and instead pay a few more in payroll taxes? do the math...

    To put it bluntly: The ACA promotes class warfare. From having to force people to buy a product(Insurance), that they may or may not need. At rates they
    may or may not be able to afford. The withdrawal from the marketplace now restricting doctor access.
    The idea was to increase the pool of people paying in to cover more affordable care for the sick. The problem is that the ACA attempted to put a bandaid on a wound that needed serious treatment, surgery and stitches. This privatized system will never work as efficiently as single payer. Premiums were increasing before ACA and continue to increase...

    The 40 hr work week that forces small businesses to cut hours or outright cut workers. And that's not even the worst offense of the bill. Let's talk about those subsidies.

    First off, because the subsidies cover damn near everyone under the sun, you have to have more of them than you do. Thus talk of the subsidies possibly running out in 2017. But this isn't the worst part of it. The worst part of it, is that you only qualify for said subsidies if you're in a certain income bracket(like most government programs). Once you actually raise your income level, you'll be essentially buying health insurance at the expensive prices.

    The said expensive prices(along with the taxes for the subsidies) that middle/upper class Americans pay. No one wins, regardless of which sector you're on. Even if you "get insurance" on the lower rungs, that's only as long as you STAY there. This law is absolutely terrible. There's no way around it.
    People who were denied insurance before ACA win, people with pre-existing conditions win and people with low income win... Now, they win largely at the expense of the younger and more healthy people who think they don't need insurance. Guess what, this is not due to ACA, it's due to having a privatized insurance system. it has always been expensive, way before ACA and all ACA did was reduce the pain for some but increase the pain for others. Again, a bandaid on a wound that never heals unless it's treated properly.

    **Throws the ACA in the trash bin**. Let's start reforming the garbage.

    Administrative Costs:
    One of the ways I suggested to reform this, is to actually give the patient control over his insurance plan. The irony is calling it a "market" and having the insurers themselves dictate the cost of the plan lol. Yeah, no. We're going to give patients/doctors the ability to control the plan, they will be the ones who craft the plan. And all Insurers are, are basically middlemen who approve of the plans. There are those who'd go "Wouldn't the plans be more expensive?" Nope. No more men plans covering tampons, they don't need them. Women plans don't need to cover Viagara.
    geez.... be real, don't come up with these delusional ideas. We need to be pragmatic. Not only is this naive but very low on specifics...

    Already, we addressed a huge reason for costs. But I'll go further. One of the reasons for rising costs were the damn doctor visits for prescriptions.
    Create a government-protected server accessed by the patient/doctor, and have your prescriptions loaded on the account in REAL TIME.

    There, problem solved. You could just load the prescriptions on the account, the pharmacist would get the prescriptions and you'd get your medicines.
    All you'd have to do is attend your daily checkups really, to get the prescription the first time(and/or whenever you need a different prescription.)
    This won't make much of a difference... the system will still remain loaded with needles admin costs and overhead. It would be nice though to make the prescription process more efficient.

    And I'm still not done. Another major cost is the lack of access to drugs over the counter. If we make more drugs over the counter, you'll have less need of a prescription. Which additionally leads to less appointments and thus more time for the doctors.

    Drug Costs:
    In a nugget to the Left, I concur with Senator Bernie Sanders. It's time for the US to negotiate directly with drug companies. However, this will not be the "US Government"(or a faction thereof). They can't even negotiate a proper budget. My confidence is nil in Washington's negotiating ability. Instead, I would author a "Drug Marketplace Organization"(or DMO. Crappy name, but you guys can help me with a better one.) I'd have pharmaceuticals, insurers and doctors on one big panel with the expressed interest of negotiating with current players in the industry.
    what drug companies charge for drugs is a crime, some of the profit margins are criminal. Profits cost, simple as that and they are funded by us via what we pay for them (directly or via premiums). I would argue the US govt would have more negotiating power and maybe under Trump, he can make it work better.

    With the regulation stipulating that drug prices may not exceed twice their worth(IE: The cancer drug incident isn't happening again.) With those stipulations in mind, and with the vast US market, buyers will eventually cede to a strong US position. It's the one thing Sanders has that I majorly approve of, I just want to give the function to capable players.

    Insurance Regulations:
    Okay, we're getting rid of the mandate. A: It's Anti-American, B: It's not necessary. The reason "the young" had to be brought in, was to de-facto cover the costs for ensuring the Elderly/Terminally Ill. There's much better ways of doing this, such as isolating the Elderly/Terminally Ill from the rest of the pool.
    there is a better way - medicare or single payer. Everyone pays in, everyone is taken care of. You can keep trying to work your way around the privatized system maze but will never find the way out. It's plagued with problems which are very hard to address.

    What I want to do is I want to segregate and shorten the pool. You have de-facto three groups: The Youth(0-12), Teenage/young adult(13-40). Adult/terminally Ill(40-). Each group is its own group, and eventually with insurance companies that will only cover that particular group. This will expand the insurer market as they can now selectively choose who they're going to insure.

    Now that each group is its own group, the costs of insurance have gone down tremendously. It's the one-size fits all, that's increasing prices. Oh, and I'd have a one-time signup. No more of this annual sign-up crap, or the stupid and I mean absolutely STUPID "sign-up periods". Someone might not have the income to pay for it, in that window. But may have that income at a later date. Get rid of the sign-up periods. No other business does business that way. And I suspect it's in the bill.
    Let me tell you what would happen under this scenario. Insurance will be cheap for the healthy brackets but incredibly expensive under the terminally ill/elderly. Do you seriously think that such a simpleton idea would work? how would insurance companies continue to make their billions in profits and how would the overhead/admin costs be covered? There are only two ways for insurance companies to continue funding their billions in profits and for hospitals to recoup the admin/overhead costs - charge the healthy more to cover for the unhealthy or charge the unhealthy insane rates. Again, single payer is best option. This is profit making 101 and why this privatized system sucks.

    Instead, you transfer accounts as you age. Through the transfer system, guess what I did? That's right, everyone has insurance! Without the mandate, I have a much better way of getting people insurance. And through different insurer providers for different age groups, I've even made family plans cheaper.
    sure, i pay cheap premium early on and then later in life, it increases to outrageous rates. Once again, all you are doing is moving the burden around, just as ACA did but you are doing it in different ways. In this privatized system, all these ideas just move the burden around pools of people. What you are doing is coming up with your own ACA. Under your plan, the younger and more healthy would be happier but the sick and aging group, very very unhappy with you. You would be hero for some and an evil man for others.

    When you consider that companies already ensure their workers, we have just utterly fixed health care. But there's one problem remaining: The "keep it until your 26" stupidity. This is putting a bandaid on a serious problem: Adults who have yet to stand on their feet. How do we solve it? Make basic health care a collegiate necessity.

    And if it sounds far-left, it's actually quite innoative: For these people to get a benefit(health care), they actually have to attend college. In fact, let's extend it to a "Productive Citizen Credit". And the PCC can in effect be insurance for those who are productive in any capacity, but don't necessarily want to pay for it in the form of a costly insurance plan. We'll deduct it from their tax earnings instead.
    sounds good but how is this funded? who pays for the collegiate insurance and PCC?

    Oh and finally: Go from Single-Payer, to a Double-tier model like Singapore and other highly developed countries. Thus enabling both choice and expanding coverage capabilities.
    maybe better than the privatized system we are trying to put on a bandaid on here in US.
    Last edited by Mike12; Jan 06 2017 at 09:50 AM.

  10. Default

    Quote Originally Posted by Seth Bullock View Post
    It is too bad that politicians can't just use some common sense and easy math to put this problem to bed.

    For example ... Medicare Part A covers our elderly (65+) who represent 13% of the population. Part A is fully funded, mostly by our 2.9% payroll tax.

    But the elderly account for about 75% of health care spending. Everyone less than 65 account for about 25%. If you do the math you can see that if we raised the payroll tax to 5% we could provide the population with Part A Medicare.

    This would not provide totally free health care. There would still be deductibles and gaps in coverage. This is where insurance companies and employers could come in - to fill in those gaps.

    This is not rocket science. Politics and politicians are what make it hard.
    Your calculations are correct, however neither party want to have meaningful health care system.
    Health care is a corporate slavery tool, it forces people to work hard and scares them to loose their employment.
    No employment = no health care, that is a law of the land.
    Last edited by kreo; Jan 07 2017 at 10:44 AM.

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