Social Safety Nets

[_Droopy]

Obamacare was largely written by conservative think thanks years ago and pushed by the insurance industry, as it acts as a massive forced subsidy to them, for years leading into the passage of the ACA.

Interesting, since one of its inevitable structure consequences, when implemented, will be pretty much the destruction of the private sector insurance industry. "Obamacare" is textbook cultural Marxism, E; its a classic incremental "long march" strategy who's purpose is to gradually force employers to drop their employees from their own programs, and citizens to abandon private insurance companies as the price of insurance goes into the stratosphere. At that point, the only alternative, if one wants to be insured, will be the government exchanges (which will later morph into a full-fledged national health service).

"Obamacare" wasn't "written by conservative think tanks" but by leftist Democrats, the core concepts having been fleshed out by Robert Creamer in his book Stand Up Straight! How Progressives Can Win, published in 2007. The nuts and bolts of the plan come, most likey, from soem of the big names among the Democrats in the House and Senate, but we probably won't know until hell goes into its next major glacial period.

As to the leftist meme that the Heritage Foundation created the initial idea years ago, as with most memes on the Left, it is, as a whole, a frank deception:

http://www.usatoday.com/news/opinion/fo ... 52951140/1

I'm not in full-throttle defense of Heritage here, as I think a much more comprehensive free market system in which the federal government is substantially removed from the funding, subsidy, and provision of medical services and market forces are allowed a radically greater influence on the provision of healthcare services, is called for. However, the reality of the old Heritage plan, from the 1990s, is substantially more nuanced than your blanket statement implies.

[_ajax18]

So you know sjogren's can be physically debilitating, and it can involve far more than dry eyes. It can look like severe lupus. But you know enough about the case to know that it was frivolous and should have been rejected.

So why, in your view, did it go through?

She wasn't coming to a rheumatologist for disability. She was coming to an ophthalmologist. Sjogren's syndrome wasn't even mentioned when I reviewed the case. I was a student doctor at the time and it was my staff doctors who were appalled at the bogus claim. This case didn't go through. But the sad truth is that if you have a close friend who is a physician you can push stuff like that through when it shouldn't go through. Doctors can be just as bad or worse than lawyers. Thankfully there aren't as many of them like that still. Venus Williams has Sjogren's syndrome. Do you think she should be eligible for disability?

I think she has a case for a lawsuit.

But that's why having the government in control (and her working for government) makes it even worse. Do you realize how difficult it is to sue the government? It was a cold and calculated move on the part of the government. They knew she didn't have the resources to fight it. Sometimes people find pro bono attorneys and can get some justice, but the government is far worse than any insurance company for people like this woman. If she's still alive, I gurantee you that she's not in favor of expanding government.

Maybe social safety nets worked out nice for some people when they were down, but it didn't happen that way for me. So I'm not buying into it. I don't like one sided relationships. I don't even like health insurance that well, especially for things like dental or vision. Insurance makes no sense in these cases because it doesn't spread risk. Nearly everyone over 40 is going to need glasses or contacts. And we need about three times as many dentists as we have eye doctors. Everyone needs the dentist. How often does your health insurance pay out more than your premium? Very rarely. When you bet against the house, the house is always going to win. Insurance is there for companies to make money, not to provide healthcare. Nobody is in it to lose, not even the federal government. If people were just responsible enough to manage their money they'd pay less if they just paid cash for their spectacles or even the $1000 crown on their left molar.

[_ajax18]

If the Affordable Care Act would have been in place, you would have been required to purchase excellent health insurance, and would have received financial assistance to be able to afford it. You should be a huge supporter of that system so that people won't have to go through what you did.

Does this apply to college students as well? Or do they just force the students to purchase the policy that the school offers? The required to purchase part I believe. The financial assistance to purhase it is what I have doubts about. What would that assistance be? "Here's the bank Mr. Ajax go sign your life away. We only pay premiums for women with children. You're not valued but when you do make some money, we'll take your taxes just the same, so we can pay for more women and their many illegitimate children. Heck lets bring them from other countries if we can't find enough here. By the way, these people you're paying for could care less about who you are and probably don't appreciate the labor it cost you to pay for them one bit. Sucks to be you, but the important thing is that the women are taken care of and free to reproduce and be taken care of when it suits their fancy, with or without a man. No wonder people stay unmarried to keep welfare benefits.

How would the affordable health care act effect Mormon missionaries serving abroad and coming home sick? I know from experience that the Church does not have health insurance. They just pay out of pocket. So if a missionary needs to go to the doctor too much or for something too expensive, the Church usually just sends him home probably to avoid the healthcare cost liability. Missionary medical pays for 3 months of treatment after returning home at most. I had friends who came home with cancer. Often times they were cut off from their parents insurance because they weren't college students. Cancer will bankrupt you for sure.

But as sad as all that is, I still have to question how a nation with $16 trillion in debt could ever afford to do much more than it already does for people.

[_Gunnar]

In principle, I like the idea of universal health insurance to spread the cost of health care so that major illnesses won't inevitably cause the less affluent unfortunate enough to suffer from them to have to choose between resigning themselves to an untimely, unpleasant death or bankruptcy and economic ruin for them and their families. What gives me pause, though, is the tendency of at least some medical professionals to charge more (sometimes much more) than twice as much for medical treatments covered by insurance as they charge patients requiring the same treatment who have no insurance, and therefore have to pay directly out of their own pockets. Health insurance doesn't seem so attractive an option when health insurance premiums wind up costing consumers even more than the medical care itself would have cost them, had they not had the insurance (which, it appears to me, is a worsening trend).

I have a growing suspicion that the rapidly escalating cost of medical care (so much faster than the general rate of inflation) is driven more by avarice, greed and unconscionable fraud by insurance companies, medical professionals, lawyers and others than it is by any actual increase in the cost of providing medical care and services.

[_EAllusion]

I work in a field that is para-professional to the health care industry and I continually see the phenomenon you are describing. When insurance (especially medicare) covers something, the cost of it is significantly more than out of pocket. And yes, this feels like fraud.

That said, I'm pretty sure the rapid increase in health care costs are really being driven by two other factors. First, the population is getting older and less healthy and therefore more expensive to take care of. Second, there have been many rapid, expensive advances in biotechnology to extend life expectancy and those services are highly inelastic. People prioritize a healthy life such that they will pay a lot for the very best health care services. MRI machines are more expensive than leeches. We're better and better at creating costly, but efficacious solutions.

[_MeDotOrg]

"Obamacare" wasn't "written by conservative think tanks" but by leftist Democrats, the core concepts having been fleshed out by Robert Creamer in his book Stand Up Straight! How Progressives Can Win, published in 2007. The nuts and bolts of the plan come, most likey, from soem of the big names among the Democrats in the House and Senate, but we probably won't know until hell goes into its next major glacial period.

As to the leftist meme that the Heritage Foundation created the initial idea years ago, as with most memes on the Left, it is, as a whole, a frank deception:

According to Politicfact, Obama's statement that ""A lot of the ideas in terms of the (health insurance) exchange, just being able to pool and improve the purchasing power of individuals in the insurance market, that originated from the Heritage Foundation." rates mostly true.

In a 1989 Heritage Foundation brief, Stuart Butler, the foundation’s health-care expert, argued, “Many states now require passengers in automobiles to wear seat-belts for their own protection. Many others require anybody driving a car to have liability insurance. But neither the federal government nor any state requires all households to protect themselves from the potentially catastrophic costs of a serious accident or illness. Under the Heritage plan, there would be such a requirement.”

[_Analytics]

If the Affordable Care Act would have been in place, you would have been required to purchase excellent health insurance, and would have received financial assistance to be able to afford it. You should be a huge supporter of that system so that people won't have to go through what you did.

Does this apply to college students as well? Or do they just force the students to purchase the policy that the school offers?

College students would have a lot more options. It becomes a lot easier to stay on your parents insurance. They could purchase insurance on the exchanges, even if they have preexisting conditions. There will be a subsidy depending upon income, and it becomes easier to qualify for Medicaid. In your past case, quite frankly the safety net wasn't designed to catch you. Under the ACA, it is.

The required to purchase part I believe. The financial assistance to purhase it is what I have doubts about.

The program is going to be expensive to tax payers because it does in fact give large tax credits to people with low income.

What would that assistance be?

You've received Earned Income tax credits, haven't you? It will be like that--file your taxes, and if your income is low and you have insurance premiums, you'll get a huge tax refund.

How would the affordable health care act effect Mormon missionaries serving abroad and coming home sick?

It will allow them to acquire insurance, even though they are already sick. Insurance companies will be required to give insurance to everybody in the same age bands the same insurance rates, without underwriting or restrictions on preexisting conditions.

But as sad as all that is, I still have to question how a nation with $16 trillion in debt could ever afford to do much more than it already does for people.

If we can afford to spend $700 billion a year running around the world playing GI Joe, we can afford to provide all of our citizens with basic health care. Despite the national debt, we are a very wealthy nation.

[_beastie]

She wasn't coming to a rheumatologist for disability. She was coming to an ophthalmologist. Sjogren's syndrome wasn't even mentioned when I reviewed the case. I was a student doctor at the time and it was my staff doctors who were appalled at the bogus claim. This case didn't go through. But the sad truth is that if you have a close friend who is a physician you can push stuff like that through when it shouldn't go through. Doctors can be just as bad or worse than lawyers. Thankfully there aren't as many of them like that still. Venus Williams has Sjogren's syndrome. Do you think she should be eligible for disability?

I don't understand why you use this as an example of disability fraud when it didn't go through.

In regards to Sjogren's, there is a wide range of severity in the disease. I might as well share some personal information and let you know that I have Sjogren's myself. I count myself fortunate that I have a fairly mild case, although it is quite annoying and problematic. However, I know enough about the disease through my own self-education to know that some people are seriously debilitated by the syndrome, and completely incapacitated, in particular by severe arthritic symptoms. There is a reason sjogren's is listed as one of the diseases that can be considered as justification for disability.

But that's why having the government in control (and her working for government) makes it even worse. Do you realize how difficult it is to sue the government? It was a cold and calculated move on the part of the government. They knew she didn't have the resources to fight it. Sometimes people find pro bono attorneys and can get some justice, but the government is far worse than any insurance company for people like this woman. If she's still alive, I gurantee you that she's not in favor of expanding government.

I'd love to know more details about this case. It's a bit odd. I've never heard of a teacher being fired due to being sick. I've also never heard of a school board firing individuals. Normally that is a decision made by the personnel office of the respective school district. I'm betting that this case must have gotten some press. Can you provide a link for me to read more information about it?

Maybe social safety nets worked out nice for some people when they were down, but it didn't happen that way for me. So I'm not buying into it. I don't like one sided relationships. I don't even like health insurance that well, especially for things like dental or vision. Insurance makes no sense in these cases because it doesn't spread risk. Nearly everyone over 40 is going to need glasses or contacts. And we need about three times as many dentists as we have eye doctors. Everyone needs the dentist. How often does your health insurance pay out more than your premium? Very rarely. When you bet against the house, the house is always going to win. Insurance is there for companies to make money, not to provide healthcare. Nobody is in it to lose, not even the federal government. If people were just responsible enough to manage their money they'd pay less if they just paid cash for their spectacles or even the $1000 crown on their left molar.

I'm not saying this is a perfect solution. I frankly think there is no perfect solution. As EA said, we have an aging population with higher expectations of medical intervention, for one thing.

But I can't understand your desire to throw out the entire system because it did not help you when you needed it. There are many who are helped, in particular children who would have no access to medical care and go to be hungry without government assistance. Unless we're willing to accept a permanent, starving and ill underclass (like some countries do), we have to work with the imperfections we have. Simply demanding or expecting that people somehow save enough money to pay for their healthcare when it involves catastrophic care in particular is completely unrealistic. After all, her financial adviser thought even Ayn Rand needed government assistance when faced with the cost of her lung cancer.

[_Gunnar]

I work in a field that is para-professional to the health care industry and I continually see the phenomenon you are describing. When insurance (especially medicare) covers something, the cost of it is significantly more than out of pocket. And yes, this feels like fraud.

That said, I'm pretty sure the rapid increase in health care costs are really being driven by two other factors. First, the population is getting older and less healthy and therefore more expensive to take care of. Second, there have been many rapid, expensive advances in biotechnology to extend life expectancy and those services are highly inelastic. People prioritize a healthy life such that they will pay a lot for the very best health care services. MRI machines are more expensive than leeches. We're better and better at creating costly, but efficacious solutions.

You're right, of course, that an aging and less healthy population are factors that drive up total health care costs, and I also see some validity in the argument that more advanced, cutting edge technology that is initially quite expensive to acquire can also tend to drive up those costs.

However, in the case of more advanced technology, there is also a strong tendency for it to become less expensive as it matures. Computers (which are increasingly important as both diagnostic and treatment devices) are a good example of that. I am typing and sending this message using a relatively modest and very affordable and even obsolete (by today's standards) computer with capabilities that exceed those of computers that cost literally millions of dollars apiece just a few decades ago. My large, flat screen, HD TV set is incomparably better than the first color TV I bought decades ago (a 19" model), and even better and bigger TVs than mine are sometimes sale priced in stores for less than I paid for that first color TV--despite massive inflation! Most of us now own and use mobile phones, which not long ago were luxuries that only the very wealthy could afford. One would think that at least some medical technology should be able to come down somewhat in cost as the development and manufacturing techniques of ever more capable and cheaper integrated circuits continue to advance. Advances in arthroscopic and micro surgery techniques that are minimally invasive and much less traumatic, and thus greatly reduce recovery periods, length of hospital stays and post operative care should also have a great potential for reducing the cost of health care (or, at least, slowing the rate of rise in costs).

[_EAllusion]

Economy of scale and advances in technique tends to bring down costs, sure. What I'm suggesting is that the advances in biomedical technology are outpacing that if you try to get the best care possible, which is what people tend to seek out if they can afford it.