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Stinkum
09-25-2013, 01:37 PM
Premiums Unveiled For Health Overhaul Plans
by The Associated Press

With new health insurance markets launching next week, the Obama administration is unveiling premiums and plan choices for 36 states where the federal government is taking the lead to cover uninsured residents.

Before tax credits that work like an upfront discount for most consumers, sticker-price premiums for a mid-range benchmark plan will average $328 a month nationally for an individual, comparable to payments for a new car.

The overview of premiums and plan choices, released Wednesday by Health and Human Services Secretary Kathleen Sebelius, comes as the White House swings into full campaign mode to promote the benefits of the Affordable Care Act to a skeptical public. Congressional Republicans, meanwhile, refuse to abandon their quest to derail "Obamacare" and flirt with a government shutdown to force the issue.

Sebelius stressed the positive in a preview call with reporters. Consumers will be able to choose from an average of 53 plan options when the new markets open Oct. 1 for people who don't have health care on the job.

"For millions of Americans, these new options will finally make health insurance work within their budgets," she said.

A report by her department estimated that about 95 percent of consumers will have two or more insurers to choose from. And the administration says premiums will generally be lower than what congressional budget experts estimated when the legislation was being debated. About one-fourth of the insurers participating are new to the individual coverage market, a sign that could be good for competition.

But averages can be misleading. When it comes to the new health care law, individuals can get dramatically different results based on their particular circumstances.

Where you live, the plan you pick, family size, age, tax credits based on your income, and even tobacco use will all impact the bottom line. All those variables could make the system hard to navigate.

For example, the average individual premium for a benchmark policy known as the "second-lowest cost silver plan" ranges from a low of $192 in Minnesota to a high of $516 in Wyoming. That's the sticker price, before tax credits.

In the three states with the highest uninsured population, the benchmark plan will average $373 in California, $305 in Texas, and $328 in Florida. Differences between states can be due to the number of insurers competing and other factors.

"One surprise is Texas," said Larry Levitt of the Kaiser Family Foundation. "That is a state that has put up roadblocks to implementation, but the premiums there are below average."

The second-lowest-cost silver plan is important because tax credits are keyed to its cost in local areas.

But consumers don't have to take silver. They can pick from four levels of coverage, from bronze to platinum. All the plans cover the same benefits and cap annual out-of-pocket expenses at $6,350 for an individual, $12,700 for families.

The big difference is cost sharing through annual deductibles and copayments. Bronze covers 60 percent of expected costs; silver, 70 percent, on up to platinum at 90 percent. Bronze plans have the lowest premiums and the highest cost sharing.

The administration report found that factoring in tax credits, a 27-year-old making $25,000 a year would see the premium for the benchmark silver plan drop to $145 in nearly every state. But if that hypothetical young adult used the tax credit to buy the cheapest bronze plan, he or she could cut the monthly premium to $74 in the Dallas-Fort Worth area, $102 in Orlando, and $119 in Pittsburgh.

For a family of four making $50,000, the tax credit would cut the monthly premium for the benchmark silver plan to $282. But if the family used its tax credit to buy the cheapest bronze plan, the premium would be $26 a month in Dallas-Fort Worth, $126 in Orlando, and $209 in Pittsburgh.

In the Washington, D.C., metro area, the hypothetical family could find a zero-premium bronze plan, while the lowest an individual could get after applying their tax credit would be $66.

Such differences are sure to leave many people scratching their heads. Officials said they're due to complicated interactions between the tax credits and insurance company pricing strategies in dynamic markets.

Another outside analyst said the administration analysis of premiums is consistent with what the 14 states running their own insurance markets have reported.

But Dan Mendelson, president of the market analysis firm Avalere Health, said the focus on premiums is too narrow. "The analysis doesn't account for cost sharing," Mendelson said. "This is a limitation." To get an idea of the true cost of coverage, consumers have to add up premiums and their expected out-of-pocket costs.

"Consumers are going to need to shop," Mendelson added. "Sometimes a silver offering doesn't cost much more than a bronze."

He added two other caveats: Be ready for significant cost sharing, and check carefully that your doctors and nearby hospitals are in the plan's network.

Starting Jan. 1, virtually all Americans will be required to carry health insurance or face fines. At the same time, the health care law will prohibit insurance companies from turning away people in poor health, or charging them more. And it will limit what insurers can charge their oldest customers.

Experts say the plans under the health care law are not comparable to what's currently sold on the individual health insurance markets, because the coverage is broader and the financial protection for policyholders is more robust.

Obama is directly engaging in the promotional campaign for the health care law. Tuesday, he and former President Bill Clinton talked health care during a session sponsored by Clinton's foundation. And Obama is planning a speech on the law on Thursday.

In response to the administration's premium and plan-choice information, a spokesman for Senate Republican leader Mitch McConnell, R-Ky., said that premiums that are "lower than projected" are not the same as "lower than they are now."

"The White House is making every effort possible to spin the bad news that seems to come every day, but the American people know that even this rosy scenario is not what they were promised when Democrats were ramming this bill through Congress on a party-line vote," McConnell spokesman Don Stewart said in a statement.

Also on the size of the networks:

It seems that another reason that the rates are lower — at least some of them — is that insurance companies have limited the size of their doctor and hospital networks in some of the cheaper plans.

"The lowest-cost plans are coming in a lot lower than people were predicting, because the networks are coming in with a lot fewer doctors and hospitals than people were predicting," says Robert Laszewski. He's an and longtime observer of the health care system.

Because the law requires all insurers to basically offer , varying the size of the network was about the only tool they had left to try to create a less expensive plan.

"For example, in California, the lowest cost Silver plan is one that has only about half the doctors and hospitals that particular health plan has in their standard employer network," says Laszewski. Silver is the among bronze, silver, gold and platinum.

Laszewski says that for people who are currently uninsured, these more limited network plans will probably be just fine. But for people who have been buying their own insurance, or if they've had employer-provided insurance, they're likely used to having a freer choice of doctors and hospitals. And they're going to find that comes with a price.

"You're going to have to pay $100, $150 a month more than that to be able to get access to those kinds of networks," he said.

MrSparkle001
09-25-2013, 11:29 PM
Get ready for the shitstorm.

All the plans cover the same benefits and cap annual out-of-pocket expenses at $6,350 for an individual, $12,700 for families.

You know what that is for a healthy individual? Worthless. Spending all that money every month and you still have thousands in out-of-pocket expenses.

If you have a preexisting condition that prevented you from getting care, or a chronic condition that's costing you more than $6,350 per year, you will make out well. If you are young and healthy and don't have insurance, you could be fucked. Those without health insurance also tend to be the ones who can't easily afford the extra monthly expense of premiums. Even with tax credits it's an extra expense forced on them, to preserve the insurance companies' profits. As if working class monthly budgets aren't already stretched thin...

This is going to be good. The labor unions are starting to bitch now but the shitstorm hasn't even started yet.

runlvlzero
09-26-2013, 12:05 AM
Insurance companies in America are 100% corrupt.

Health insurance companies in America are 2000% corrupt. Might as well be a case for logans run.

Social health care can be debated. The evil nature of American hospitals and insurance is not really up for debate in my mind lol.

Stinkum
09-26-2013, 12:08 AM
Yeah, I don't understand how some people are happy about this. The plans for these have outrageous deductibles, extremely small networks, high co-pays, and we are FORCED to buy them.

Those without health insurance also tend to be the ones who can't easily afford the extra monthly expense of premiums.

The big unanswered question. I don't personally know any single people or families who didn't or couldn't afford to buy health insurance before that suddenly have a few extra hundred dollars a month to throw around now.

If you are young and healthy and don't have insurance, you could be fucked.

According to the Kaiser ACA premium calculator , a single, nonsmoker age 45 earning $8,000 a year (part time minimum wage job or a full time job bartending/waitressing) in a state that did not expand Medicaid would have to pay 50% of their income towards health insurance.

runlvlzero
09-26-2013, 12:13 AM
According to the Kaiser ACA premium calculator , a single, nonsmoker age 45 earning $8,000 a year (part time minimum wage job or a full time job bartending/waitressing) in a state that did not expand Medicaid would have to pay 50% of their income towards health insurance.

For little to no benefit to the individual other than making it easier for the government to subsidize treatment at hospitals while some white collar rich ass with several insurance worker certifications rolls around in a paycheck that trickles up to the CEO's pleasure palace out of country.

I'm so glad this is what I have to look forward to for the rest of my life.

IMO the best option would be to let us all rot without insurance but force this measure on anyone who makes over $400,000 USD yearly. Make them pick from these plans and bar all other insurance. You know because those rich asses are so valuable and important to our society. We couldn't have them getting sick on top of their piles of cash.

Even better force the Congresscritters and president to take the bronze plan by default. To save on government spending.

***Income number used as arbitrary as the numbers for these insurance plans, nothing personal.

****At least currently for this very moment I'm an out of work "veteran" with no income who is a dependent. This means I have access to tricare free of charge. Wonder if there is a loophole somewhere for me?

Tiddlywinks
09-26-2013, 02:31 PM
Nobody forces people to buy this. The tax "penalty" for not purchasing a plan is typically much less than the health insurance premiums are. The tax penalty ends up being, I believe, a max of 1%-2.5% of annual income, whereas the premiums are loosly based around 4-8% of an anual income.

Additionally many people can be exempt. The situation where the guy earns $8,000 per year and the premium would end up costing him 50% of his income is FALSE.

Anytime the premiums end up being over a given threshhold (I think it's currently 9%) that person can apply and will get exemption from needing to purchase the plan.

Tiddlywinks
09-26-2013, 02:33 PM
For example, the tax "penalty" for a 27 year old single individual making $25,000 anually only comes out to like $625 per year.

This website generally has answered any question I've had regarding the process. Here's a link to the tax penalty for those who chose not to be covered bit: http://obamacarefacts.com/obamacare-tax-penalty.php

JayN
09-26-2013, 02:35 PM
Nobody forces people to buy this. The tax "penalty" for not purchasing a plan is typically much less than the health insurance premiums are. The tax penalty ends up being, I believe, a max of 1%-2.5% of annual income, whereas the premiums are loosly based around 4-8% of an anual income.

Additionally many people can be exempt. The situation where the guy earns $8,000 per year and the premium would end up costing him 50% of his income is FALSE.

Anytime the premiums end up being over a given threshhold (I think it's currently 9%) that person can apply and will get exemption from needing to purchase the plan.

Your ruining these racist assholes negroid dreams let them keep on hating.

Tiddlywinks
09-26-2013, 02:49 PM
According to the Kaiser ACA premium calculator , a single, nonsmoker age 45 earning $8,000 a year (part time minimum wage job or a full time job bartending/waitressing) in a state that did not expand Medicaid would have to pay 50% of their income towards health insurance.

Here's the bit about exemptions btw. No clue what you're talking about really. This guy in your example would be exempt like 3 different ways.

http://obamacarefacts.com/obamacare-mandate-exemption-penalty.php

About ObamaCare Tax Exemptions

The mandate's exemptions cover a variety of people, including: members of certain religious groups and Native American tribes; undocumented immigrants (who are not eligible for health insurance subsidies under the law); incarcerated individuals; people whose incomes are so low they don't have to file taxes (currently $9,500 for individuals and $19,000 for married couples); and people for whom health insurance is considered unaffordable (where insurance premiums after employer contributions and federal subsidies exceed 8% of family income).

Stinkum
09-26-2013, 02:49 PM
The situation where the guy earns $8,000 per year and the premium would end up costing him 50% of his income is FALSE. Anytime the premiums end up being over a given threshhold (I think it's currently 9%) that person can apply and will get exemption from needing to purchase the plan.

Hence, leaving him without any insurance.

I'm not sure why this is a "good thing" to you.

That was my whole point that went entirely over your head. How is the person in the state with no Medicaid expansion going to pay for their insurance? They get no subsidies. No Medicaid. But they can pay 50% of their income towards buying insurance through an exchange. For 7 million of the poorest working Americans, that is their only option for insurance. These are the people earning minimum wage at part time jobs. The ones whose hours have been reduced. Whose employers do not offer insurance.

It seems to me that the most humane option is to plug the Medicaid gap by allowing those earning under the poverty level to get subsidies. Why punish the working poor for being "too poor"?

Tiddlywinks
09-26-2013, 03:00 PM
Unless I'm grossly missing something, from a taxpayer perspective it's pretty simple really.

If you are currently uninsured, starting on October 1st of this year, in many states you will be able to shop the "Health Insurance Marketplace" where you will be able to see competing government (public) and corporate (private) plans and premiums and pick one that suits you.

These plans are typically targeted to cost an individual between 5%-8% of their anual income. In the event that an individual cannot get insurance within that percentile of their anual income range, or if they meet any of the other previously posted exemption requirements then they can file for exemption. If granted they can essentially ignore that the system exists entirely.

In the event someone elects not to receive or participate then they will have a tax "penalty" applied anually, not to 1% of their income or $95 in 2014, whichever value is larger. In 2015 that goes up to $325 or 2%, and by 2016 to $695 or 2.5%. By 2017 tax penalty will increase by the rate of inflation going forward, or 2.5% of your Income.

I think the reason it is staggered like this for 3 years until it begins to match inflation is to give people time (seriously people take 3 years to catch on to shit?) to get aboard, but I could be wrong.

That's basically it as far as purchasing a premium or not is concerned.

Personally I think the lower level coverages blow dick, and thankfully my employer offers me much better for only $1500 anually. Carrying health coverage is also a requirement for employment so I don't care all too much. As a (relatively) fit, young individual, if I did not receive coverage through work I would probably just man up and pay the penalties. As it is I'm already paying less than 2.5% of my anual income for better health insurance anyway, so whatever.

Tiddlywinks
09-26-2013, 03:03 PM
Hence, leaving him without any insurance.

I'm not sure why this is a "good thing" to you.

That was my whole point that went entirely over your head. How is the person in the state with no Medicaid expansion going to pay for their insurance? They get no subsidies. No Medicaid. But they can pay 50% of their income towards buying insurance through an exchange. For 7 million of the poorest working Americans, that is their only option for insurance. These are the people earning minimum wage at part time jobs. The ones whose hours have been reduced. Whose employers do not offer insurance.

It seems to me that the most humane option is to plug the Medicaid gap by allowing those earning under the poverty level to get subsidies. Why punish the working poor for being "too poor"?

This is America. Offering government set plans and premiums and creating a Health Insurance Marketplace to help those who MAY be able to afford insurance but otherwise have pre-existing conditions or can't afford premiums as they currently stand now is more than enough to get republitards all riled up and threatening government shutdown and all sorts of shit.

If we want to cover everyone, regardless of income I think that would be spectacular, but legislation like that wouldn't stand a snowballs chance in hell of making it through Washington.

Tiddlywinks
09-26-2013, 03:11 PM
I also have no idea why you put "Good thing" in quotations and attributed it to me, when nowhere did I say it was a good thing, and in my previous post in this thread I advocate universal coverage.

Stinkum
09-26-2013, 03:12 PM
Guess the working poor will be sticking with the duct tape, super glue, Tylenol and prayers scenario then. We will continue to see the poor and the working class destroy their credit with unpaid medical bills and families driven to bankruptcy because they got sick.

Tiddlywinks
09-26-2013, 03:21 PM
At least the overall number of people that happens to hopefully narrows? I think a large portion are just going to opt out and pay the tax anyway.

IDK the uptick of it really. Maybe it will get people eventually thinking of fully nationalized medical care like so many other countries have? If the republican reaction is any indication I'm not holding my breath.

Sularus Oth Mithas
09-26-2013, 03:46 PM
Luckily I still have my Canadian citizenship. I'll suffer through this for a while but I can retire in Canada :)

Swish
09-26-2013, 04:00 PM
Luckily I still have my Canadian citizenship. I'll suffer through this for a while but I can retire in Canada :)

If retirement exists by the time we hit retirement age :p

Orruar
09-26-2013, 04:01 PM
Nobody forces people to buy this. The tax "penalty" for not purchasing a plan is typically much less than the health insurance premiums are. The tax penalty ends up being, I believe, a max of 1%-2.5% of annual income, whereas the premiums are loosly based around 4-8% of an anual income.

Is this kind of logic the same as saying income taxes are voluntary, because you can always decide not to pay them and just go to jail and then pay fines instead?

I have health insurance through my job that only costs me like 3% of my paycheck, but even I have thought about just dropping it altogether, as I'm young, healthy, and take good care of my health.

I really just want a plan that covers disastrous and crazy expensive things like getting hit by a car. You know, how every other form of insurance is structured. Unfortunately, Obamacare just adds to the various mandates of little piddly shit that insurance is now forced to cover.

Can you imagine how expensive car insurance would be if it was mandated to cover gasoline, window tinting, and every knick and ding? Not only would you pay more as the insurance company would take a little extra profit on every gallon of gas, but everyone would be going in for every minor little car problem and driving up the cost for everyone.

Seriously, make it legal and tax deductible to hold an insurance plan that only covers the super-rare and insanely expensive events. If I break an arm and need to pay a few hundred $ out of pocket, I'm cool with that.

You know why such plans are not legal? Because then they couldn't fuck over us young people to pay for all the bad health decisions made by the older generations.

Swish
09-26-2013, 04:07 PM
At least you aren't funding a bunch of eastern/southern European immigrants piggybacking on NHS healthcare in Britain.

Saying that makes me racist by media standards btw... I'm now a bad person :(

Thulack
09-26-2013, 04:09 PM
I'm 30 and havent had health insurance since i was 18. In those 12 years ive broken my hand twice and had 3 doctors visits for colds/pinched nerve. I look at it this way. I've spent about 6k in medical bills in 12 years so i'm still ahead rather having insurance to cover me all those years. I will pay the penatly atleast the first year if not the 1st 2 years. depending on what the actual fee will be 3rd year i might get insurance or just work part time and get welfare :)

Orruar
09-26-2013, 04:13 PM
I'm 30 and havent had health insurance since i was 18. In those 12 years ive broken my hand twice and had 3 doctors visits for colds/pinched nerve. I look at it this way. I've spent about 6k in medical bills in 12 years so i'm still ahead rather having insurance to cover me all those years. I will pay the penatly atleast the first year if not the 1st 2 years. depending on what the actual fee will be 3rd year i might get insurance or just work part time and get welfare :)

Over the past 6 years, I've paid probably $11k in premiums and I've received no more than maybe $2k in benefit from it... I really just keep it because I'd hate to be financially ruined by a stroke of bad luck. What really sucks is I know my employer has also probably paid about $11k towards the insurance as well. If it wasn't for the insane marriage of employment and health insurance, I would have received a good chunk of that in compensation instead.

Pringles
09-26-2013, 04:35 PM
I like the idea of self-insuring, but I hate the idea of a 1 million dollar++++ hospital visit

Orruar
09-26-2013, 04:50 PM
I like the idea of self-insuring, but I hate the idea of a 1 million dollar++++ hospital visit

Self-insuring still means having insurance, right? That's what insurance is for, to handle crazy expensive hospital visits.

Orruar
09-26-2013, 04:51 PM
Self-insuring still means having insurance, right? That's what insurance is for, to handle crazy expensive hospital visits.

Correction, insurance "should be" for handing crazy expensive events. Apparently in our society, insurance is for handling that $50 for a routine tetanus shot.

runlvlzero
09-26-2013, 06:02 PM
For example, the tax "penalty" for a 27 year old single individual making $25,000 anually only comes out to like $625 per year.

This website generally has answered any question I've had regarding the process. Here's a link to the tax penalty for those who chose not to be covered bit: http://obamacarefacts.com/obamacare-tax-penalty.php

I heard that the tax penalty keeps increasing every year you don't purchase. Can anyone clarify?

runlvlzero
09-26-2013, 06:05 PM
Unless I'm grossly missing something, from a taxpayer perspective it's pretty simple really.

If you are currently uninsured, starting on October 1st of this year, in many states you will be able to shop the "Health Insurance Marketplace" where you will be able to see competing government (public) and corporate (private) plans and premiums and pick one that suits you.

These plans are typically targeted to cost an individual between 5%-8% of their anual income. In the event that an individual cannot get insurance within that percentile of their anual income range, or if they meet any of the other previously posted exemption requirements then they can file for exemption. If granted they can essentially ignore that the system exists entirely.

In the event someone elects not to receive or participate then they will have a tax "penalty" applied anually, not to 1% of their income or $95 in 2014, whichever value is larger. In 2015 that goes up to $325 or 2%, and by 2016 to $695 or 2.5%. By 2017 tax penalty will increase by the rate of inflation going forward, or 2.5% of your Income.

I think the reason it is staggered like this for 3 years until it begins to match inflation is to give people time (seriously people take 3 years to catch on to shit?) to get aboard, but I could be wrong.

That's basically it as far as purchasing a premium or not is concerned.

Personally I think the lower level coverages blow dick, and thankfully my employer offers me much better for only $1500 anually. Carrying health coverage is also a requirement for employment so I don't care all too much. As a (relatively) fit, young individual, if I did not receive coverage through work I would probably just man up and pay the penalties. As it is I'm already paying less than 2.5% of my anual income for better health insurance anyway, so whatever.

Answered my questions. Thanks for the informative post. I still think we should rebel and force these fuckers at the top to buy the shit that we can't afford.

Pringles
09-26-2013, 06:05 PM
Self-insuring still means having insurance, right? That's what insurance is for, to handle crazy expensive hospital visits.

Self insuring means = you pay 100% out of pocket for any and all medical related expenses, otherwise keeping your money instead of paying premiums.

runlvlzero
09-26-2013, 06:10 PM
And how exactly are we racist if we don't believe in being forced to pay for subsidizing the U.S. medical industry? This won't help poor families of black children with 6 people. They will just end up paying a tax penalty on everyone in their family and still have to go to the ER uninsured AFAIK.

Orruar
09-26-2013, 07:16 PM
Self insuring means = you pay 100% out of pocket for any and all medical related expenses, otherwise keeping your money instead of paying premiums.

Ah yeah, I'm with ya. Is why I'd rather just have a plan that covers for anything over about $5k, which likely won't happen in the next 30 years of my life.

Tiddlywinks
09-26-2013, 10:00 PM
Is this kind of logic the same as saying income taxes are voluntary, because you can always decide not to pay them and just go to jail and then pay fines instead?

I have health insurance through my job that only costs me like 3% of my paycheck, but even I have thought about just dropping it altogether, as I'm young, healthy, and take good care of my health.

I really just want a plan that covers disastrous and crazy expensive things like getting hit by a car. You know, how every other form of insurance is structured. Unfortunately, Obamacare just adds to the various mandates of little piddly shit that insurance is now forced to cover.

Can you imagine how expensive car insurance would be if it was mandated to cover gasoline, window tinting, and every knick and ding? Not only would you pay more as the insurance company would take a little extra profit on every gallon of gas, but everyone would be going in for every minor little car problem and driving up the cost for everyone.

Seriously, make it legal and tax deductible to hold an insurance plan that only covers the super-rare and insanely expensive events. If I break an arm and need to pay a few hundred $ out of pocket, I'm cool with that.

You know why such plans are not legal? Because then they couldn't fuck over us young people to pay for all the bad health decisions made by the older generations.

I mean, these already are going to exist. They're referred to as "catastrophic plans". Basically you pay a much lower amount, and instead you get a higher deductible, but still get preventative care, and coverage in case of some crazy high medical expense.

http://obamacarefacts.com/obamacare-health-insurance-rules.php
Catastrophic plans have lower premiums, protect against high out-of-pocket costs, and cover recommended preventive services without cost sharing—providing affordable individual coverage options for young adults and people for whom coverage would otherwise be unaffordable.

http://www.cnn.com/2013/09/26/health/obamacare-open-enrollment/?hpt=he_c1
Catastrophic insurance covers three doctor visits per year at no cost and preventive care such as screenings and vaccines. This plan will carry a higher deductible.
All plans bought through the exchanges must offer the same coverage benefits. All offer free preventive care. Nearly all cap out-of-pocket costs to $6,350 and $12,700 per family. No one can be turned away. No one will be penalized because of their gender (women often paid more in the old insurance system). Only smokers may be penalized in some plans and some older people may pay more.

They're essentially targeted at young individuals who don't need to spend thousands of dollars a year for health insurance they may, or most likely will NOT need to use.

A good site with comparison info to the other lowest plan (the bronze tier) can be found here:

http://health.usnews.com/health-news/health-insurance/articles/2013/08/28/aca-obamacare-bronze-tier-vs-catastrophic-health-insurance

Tiddlywinks
09-26-2013, 10:19 PM
Over the past 6 years, I've paid probably $11k in premiums and I've received no more than maybe $2k in benefit from it... I really just keep it because I'd hate to be financially ruined by a stroke of bad luck. What really sucks is I know my employer has also probably paid about $11k towards the insurance as well. If it wasn't for the insane marriage of employment and health insurance, I would have received a good chunk of that in compensation instead.

That's the give and take of insurance in general really. For every story like yours though there are people like me. I'll give you mine really quick:

I began working for my company a little over a year ago, and they require that I carry health insurance as part of the terms of my employment. It's only around $56 a month, but were it elective, being under 30 and in relatively decent health I probably would not have opted in. This past february I messed my knee up pretty bad, and ended up with a patella sublexation.

That night I went to the ER and had an x-ray. Were I not insured that would have wound up costing me $900. Later that week I went to an ortho and he had me get an MRI. I honestly don't even remember what that cost, but I think ballparking it around $1500 is more than fair. After that I went through 2 months of Physical therapy. Out of pocket that would have cost me $1900, my insurance covers 90% of PT costs, I payed $94. The MRI I paid a $600 deductible for. The ER visit ended up costing me about $300.

All told this cost me under a grand. Without insurance I would have been looking at about $4,500-$5,000. I also pay around $4 a month for dental insurance that offers a max coverage of $1,000 per year, and I've used that for a year.

In the last year and a half I've gotten ~$6,000 worth of medical expenses taken care of for $1500 + ~$60 a month for 18 months.

Now obviously my plans aren't terrible, and my employer covers a good chunk of the monthly costs.. but my injury was nowhere near "catastrophic" and aside from my dental (I really let my teeth go throughout college), being young and healthy absolutely none of this was expected. Without insurance it would have sucked. A lot. I can't even imagine what a large injury, or even something more common such as a pregnancy would wind up costing somebody who was uninsured.

I don't relay the story to say "Obama care is awesome!" but rather to point out that for every story like yours, there are probably a pretty decent amount that are just like mine. I'm the same as you with my car insurance. I live in a state that does not require it, however I've paid in my entire driving-aged life because if I hit somebody I sure as fuck don't want to be sued for an insane amount of money.

I'm not entirely sure I agree with saying that the amount our employers end up paying in to our insurances would wind up in our paychecks. It would be nice, but there is just no way that I believe I would see much, if any of that money as direct-pay compensation.

Anyway, I'm off-topic, and rambling, but just wanted to say, that for everyone that pays in and doesn't use it, there are those that do. Personally, I don't think it's worth the gamble, even at a young age.

That's at least kind of why I enjoy the notion of those that are going to gamble paying SOMETHING into the system regardless on the off chance that something terrible does happen to 1/10000 that do and the rest of us get stuck with the costs.

Lojik
09-26-2013, 11:07 PM
And how exactly are we racist if we don't believe in being forced to pay for subsidizing the U.S. medical industry? This won't help poor families of black children with 6 people. They will just end up paying a tax penalty on everyone in their family and still have to go to the ER uninsured AFAIK.

ACA has a lot of new legislation including an expansion of Medicaid in addition to the individual mandate, penalties for being uninsured, pay or play, and these new exchanges. Also the penalty is capped at 3x the flat rate per family, but if they make below a certain threshold they are exempt.

Orruar
09-26-2013, 11:39 PM
"
Catastrophic insurance covers three doctor visits per year at no cost and preventive care such as screenings and vaccines. This plan will carry a higher deductible.
All plans bought through the exchanges must offer the same coverage benefits. All offer free preventive care. Nearly all cap out-of-pocket costs to $6,350 and $12,700 per family. No one can be turned away. No one will be penalized because of their gender (women often paid more in the old insurance system). Only smokers may be penalized in some plans and some older people may pay more.
"

They're essentially targeted at young individuals who don't need to spend thousands of dollars a year for health insurance they may, or most likely will NOT need to use.

A good site with comparison info to the other lowest plan (the bronze tier) can be found here:

http://health.usnews.com/health-news/health-insurance/articles/2013/08/28/aca-obamacare-bronze-tier-vs-catastrophic-health-insurance

Except that covering 3 doctors visits per year is not what I'd call catastrophic. Also, they are required to cover a whole range of things related to maternity and pediatric care that I don't want in a health insurance plan as it only increases premiums with no benefit for me. I'm basically paying for other peoples' kids at that point. Real catastrophic coverage plans were the norm back in the day, but in the past few decades, they have been slowly regulated out of existence. And due to the various tax benefits of receiving insurance through my employer, the insurance closest to catastrophic coverage is not even competitive with my more luxurious plan. I'm paying for it in hidden costs (reduced compensation) that I cannot recoup by switching to one of the Obamacare plans.

runlvlzero
09-26-2013, 11:40 PM
ACA has a lot of new legislation including an expansion of Medicaid in addition to the individual mandate, penalties for being uninsured, pay or play, and these new exchanges. Also the penalty is capped at 3x the flat rate per family, but if they make below a certain threshold they are exempt.

Thanks for the clarification. If they had good legislation they shouldn't have put it in an unpopular and controversial bill if they wanted it passed easily. Its not a good way to do politics if you care about your people.

That being said. I can see how this could maybe be potentially helpful to middle class or lower middle class people.

In fact I'm all for taking money out of the NSA's pockets and giving it to Not for Profit hospitals to take care of the underprivileged. =)

How much might 10 billion out of 53.4 billion do? I wager quite a bit without further burdening the lower classes.

It would also allow for many more jobs for doctors and nurses. Perhaps we could you know give out a few tuitions for people who want to work in those places?

I dunno =)

I don't think disliking the current legislation is racist.

Orruar
09-26-2013, 11:52 PM
too long to quote

You really think that for every story like mine, there are more like yours? You think spending $5k+ a year on health needs is a highly probable thing? I doubt it. Also, you have to keep in mind that the various costs your insurance "paid" were highly inflated due to our insane health insurance scheme. If people paid out of pocket for more things, competition would drive prices way down. Not to mention the greatly reduced costs to health care providers when they don't need a team of people just to file all the insurance paperwork. I mean, the doctor to paper pusher ratio at most doctors offices must be about 1:5.

Also, keep in mind that I could afford a $5k injury like yours every 18 months or so and still only break even with my insurance. It's pretty insane really. I know there are a lot of people who like to go to the doctors office for every little issue, and that's fine. I just shouldn't have to subsidize these peoples' hypochondria.

As for the employer compensation part.. Any employer looks at the total cost of employing someone, and that includes the health care portion. If you removed all employer health care tomorrow, employers would suddenly have a windfall of extra profits. If you think this would just go on forever, you don't know the first thing about business. People would begin to demand more actual compensation, and this would lead to much more room to poach talented individuals and compensation would rise until it's near where it is it with the health care included. There are probably better ways (other than a sudden 100% shift to no employer based insurance) to make sure this process is as smooth as possible. Also, you should understand just where the marriage of employment and health insurance began. It started in WW2 when FDR had placed various wage controls on industry. Industry then began to offer health insurance as a backdoor compensation, and they eventually got this written off on their taxes as well.

Tiddlywinks
09-27-2013, 09:35 AM
Except that covering 3 doctors visits per year is not what I'd call catastrophic. Also, they are required to cover a whole range of things related to maternity and pediatric care that I don't want in a health insurance plan as it only increases premiums with no benefit for me. I'm basically paying for other peoples' kids at that point. Real catastrophic coverage plans were the norm back in the day, but in the past few decades, they have been slowly regulated out of existence. And due to the various tax benefits of receiving insurance through my employer, the insurance closest to catastrophic coverage is not even competitive with my more luxurious plan. I'm paying for it in hidden costs (reduced compensation) that I cannot recoup by switching to one of the Obamacare plans.

The catastropic plans also cap a max out of pocket expenses per year. Meaning that anything truly catastrophic is going to be covered at that point.

I mean, I don't want to pay extra for pregnancy covereage or shit I don't need either. Nobody does, but that's just the way it is. You don't get to pick and choose every little thing you want in your coverage. If you could it would probably be even more expensive. Again, I disagree with the hidden cost factor, because I highly doubt someone like you or I would see much of what our employers are currently paying wind up in our direct compensation if they didn't have to pay it.

Tiddlywinks
09-27-2013, 09:51 AM
You really think that for every story like mine, there are more like yours? You think spending $5k+ a year on health needs is a highly probable thing? I doubt it.

Umm.. ya. Not only is it probable, it's fact that we spend MORE than that on average. The average healthcare cost per citizen is over 8k per year. While that's high compared to other countries, even in a lot of those the average cost is over 5k per year.

http://www.pbs.org/newshour/rundown/2012/10/health-costs-how-the-us-compares-with-other-countries.html

http://www.forbes.com/sites/carolynmcclanahan/2011/11/28/how-much-should-we-spend-on-health-care-the-big-picture/

As for the employer compensation part.. Any employer looks at the total cost of employing someone, and that includes the health care portion. If you removed all employer health care tomorrow, employers would suddenly have a windfall of extra profits. If you think this would just go on forever, you don't know the first thing about business. People would begin to demand more actual compensation, and this would lead to much more room to poach talented individuals and compensation would rise until it's near where it is it with the health care included. There are probably better ways (other than a sudden 100% shift to no employer based insurance) to make sure this process is as smooth as possible. Also, you should understand just where the marriage of employment and health insurance began. It started in WW2 when FDR had placed various wage controls on industry. Industry then began to offer health insurance as a backdoor compensation, and they eventually got this written off on their taxes as well.

I disagree. Compensation structures in places such as where I work (and I'm guessing you work in a similar environment) are generally based off of the compensation structures of other similar businesses so that they remain competitive in the job market. The ONLY reason I am offered benefits such as health insurance, and any form of indirect compensation (which accounts for 20% of my total comp) is due to the fact that this is the standard within my industry, and my company does it to remain competitive when recruiting new talent. That is why we are given what we are.

Companies are greedy. Employees ALWAYS want more compensation. As you mentioned, if they were to stop contributing to employee health plans, the company would instantly have much more profits. The only thing that would make those companies interested in putting that money into direct compensation for their employees would be to stay competitive when recruiting talent (you mentioned this also).

I don't think there is any reason to assume that this would be the case. All of the companies in the industry already have a good amount of talent. The proverbial "line" regarding compensation has already been drawn. The benchmark is there. One company may use some of it's new profits to raise it slightly, but there is no way that they are going to use 100% of their new saved money to directly compensate employees in an attempt to get more talent.

A slight raise (2%-5%) industry wide would still not account for nearly what the employer was paying in the first place to cover their employees.

Millburn
09-27-2013, 09:56 AM
I don't know about you guys but I'm fucking STOKED for this shit.

I've had type 1 diabetes for 24 years now and the shit it's done to my savings account is ridiculous. I have to maintain health insurance even if it doesn't do anything for me so that I can keep a certificate of credible insurability which would guarantee that going forward I wouldn't be denied coverage due to my pre-existing condition. Most (read: 99%) of plans don't cover anything that I need and the ones that do are split between both prescription insurance and health insurance due to diabetic supplies being a medical supply and insulin being a medication. So that's two things that sap my income without providing any benefit.

All in all my monthly expenses are about $300 for insulin, $100 for strips, $75 for syringes and pen needles. That's almost $500 a month and that's the BARE necessity of what I need. That is essentially a second apartment lease and that's just to survive.

The affordable care act is pretty much a dream come true if I understand it correctly.

Orruar
09-27-2013, 11:00 AM
The catastropic plans also cap a max out of pocket expenses per year. Meaning that anything truly catastrophic is going to be covered at that point.

I mean, I don't want to pay extra for pregnancy covereage or shit I don't need either. Nobody does, but that's just the way it is. You don't get to pick and choose every little thing you want in your coverage. If you could it would probably be even more expensive. Again, I disagree with the hidden cost factor, because I highly doubt someone like you or I would see much of what our employers are currently paying wind up in our direct compensation if they didn't have to pay it.

Well, of course all insurance is going to cover catastrophes. That's the original point of insurance. And that's ALL I want covered. I don't want my regular checkups covered, because by definition insurance is for unexpected events.

"that's just the way it is"

lol... That's exactly my point. It's not that way because of some underlying economic reason. It's that way because the government mandates it, and has for quite a while. We force people who are in groups that use the health system less to subsidize those who use it more. Clearly it's wrong on moral grounds, but it's also fucked up on utilitarian grounds. I mean, we're basically encouraging people to be unhealthy.

And if you think we wouldn't get all or most of the hidden costs that our employers pay in the form of compensation, you're wrong. Economists from pretty much every diverse school of thought would agree on this. I bet you also think the minimum wage is the only reason we're not all being paid 5 cents an hour?

Orruar
09-27-2013, 11:18 AM
Umm.. ya. Not only is it probable, it's fact that we spend MORE than that on average. The average healthcare cost per citizen is over 8k per year. While that's high compared to other countries, even in a lot of those the average cost is over 5k per year.

http://www.pbs.org/newshour/rundown/2012/10/health-costs-how-the-us-compares-with-other-countries.html

http://www.forbes.com/sites/carolynmcclanahan/2011/11/28/how-much-should-we-spend-on-health-care-the-big-picture/


Ah, I was speaking of people our age. Old folks use a lot of health care, but not necessarily for insurable events, just "getting older" problems. This chart kind of shows what I'm talking about.

http://blogs-images.forbes.com/danmunro/files/2012/12/HCcostsbyAge.png


I disagree. Compensation structures in places such as where I work (and I'm guessing you work in a similar environment) are generally based off of the compensation structures of other similar businesses so that they remain competitive in the job market. The ONLY reason I am offered benefits such as health insurance, and any form of indirect compensation (which accounts for 20% of my total comp) is due to the fact that this is the standard within my industry, and my company does it to remain competitive when recruiting new talent. That is why we are given what we are.


Your understanding of history and economics is sorely lacking. Companies don't offer health insurance "based on compensation structures of other similar businesses" just for that reason. They structure it like they do because government regulations make the current structure most effective in giving the employee the maximum amount of compensation for the least amount of cost to the business owner. They could offer us 100% pay and no benefits, but then the employer would have to pay more money overall to get the same bang for their buck. If we removed all tax incentives, you would see many more companies with no health insurance, giving their employees cash instead. You don't buy your car insurance, food, housing, or any other goods through your employer. Why don't you do these things? For economic reasons, and the same economic reasons would encourage you to buy health insurance on the open market absent government influence is keeping our health insurance tied to our job.


Companies are greedy. Employees ALWAYS want more compensation. As you mentioned, if they were to stop contributing to employee health plans, the company would instantly have much more profits. The only thing that would make those companies interested in putting that money into direct compensation for their employees would be to stay competitive when recruiting talent (you mentioned this also).

I don't think there is any reason to assume that this would be the case. All of the companies in the industry already have a good amount of talent. The proverbial "line" regarding compensation has already been drawn. The benchmark is there. One company may use some of it's new profits to raise it slightly, but there is no way that they are going to use 100% of their new saved money to directly compensate employees in an attempt to get more talent.

A slight raise (2%-5%) industry wide would still not account for nearly what the employer was paying in the first place to cover their employees.

You seem to agree with me at first, but then only to a degree. It seems you understand that people are just as greedy as the employers. And you have to realize that people aren't stupid. If they were suddenly without health insurance through the employer and needed to pay another $5k a year on insurance, they would ask their employer for nearly all of that in increased compensation. In fact, I bet this process would happen automatically for most companies, as employees would be incredibly unhappy to suddenly lose such a big chunk of compensation. Companies that don't immediately increase compensation when the health coverage goes away would lose a lot of people. You have to remember that people who run businesses aren't as economically ignorant as you. And lucky for you many of us employees aren't either, and we'd make sure our (and by extension your) compensation rises as it should in this case.

Tiddlywinks
09-27-2013, 11:36 AM
I don't know about you guys but I'm fucking STOKED for this shit.

I've had type 1 diabetes for 24 years now and the shit it's done to my savings account is ridiculous. I have to maintain health insurance even if it doesn't do anything for me so that I can keep a certificate of credible insurability which would guarantee that going forward I wouldn't be denied coverage due to my pre-existing condition. Most (read: 99%) of plans don't cover anything that I need and the ones that do are split between both prescription insurance and health insurance due to diabetic supplies being a medical supply and insulin being a medication. So that's two things that sap my income without providing any benefit.

All in all my monthly expenses are about $300 for insulin, $100 for strips, $75 for syringes and pen needles. That's almost $500 a month and that's the BARE necessity of what I need. That is essentially a second apartment lease and that's just to survive.

The affordable care act is pretty much a dream come true if I understand it correctly.

Awesome man. I'm wicked happy for people like you, and what this changes for those with pre-existing conditions. It's really barbaric the way you people have been treated for so long by health care providers and insurers.

Tiddlywinks
09-27-2013, 11:44 AM
Ah, I was speaking of people our age. Old folks use a lot of health care, but not necessarily for insurable events, just "getting older" problems. This chart kind of shows what I'm talking about.

http://blogs-images.forbes.com/danmunro/files/2012/12/HCcostsbyAge.png




Your understanding of history and economics is sorely lacking. Companies don't offer health insurance "based on compensation structures of other similar businesses" just for that reason. They structure it like they do because government regulations make the current structure most effective in giving the employee the maximum amount of compensation for the least amount of cost to the business owner. They could offer us 100% pay and no benefits, but then the employer would have to pay more money overall to get the same bang for their buck. If we removed all tax incentives, you would see many more companies with no health insurance, giving their employees cash instead. You don't buy your car insurance, food, housing, or any other goods through your employer. Why don't you do these things? For economic reasons, and the same economic reasons would encourage you to buy health insurance on the open market absent government influence is keeping our health insurance tied to our job.



You seem to agree with me at first, but then only to a degree. It seems you understand that people are just as greedy as the employers. And you have to realize that people aren't stupid. If they were suddenly without health insurance through the employer and needed to pay another $5k a year on insurance, they would ask their employer for nearly all of that in increased compensation. In fact, I bet this process would happen automatically for most companies, as employees would be incredibly unhappy to suddenly lose such a big chunk of compensation. Companies that don't immediately increase compensation when the health coverage goes away would lose a lot of people. You have to remember that people who run businesses aren't as economically ignorant as you. And lucky for you many of us employees aren't either, and we'd make sure our (and by extension your) compensation rises as it should in this case.

I don't really understand the maliciousness in your tone. Calling me ignorant and telling me what I have no background or experience with is quite comical really. I don't pretend to know you, and for that reason I don't pretend to know what you do and don't know simply because I don't agree with you.

That said, I still disagree whole heartidly. It doesn't matter that we as employees would ask for the money our employers would be saving, they would have zero incentive to give it. I'm fairly confident they would just as soon have us walk away entirely.

The reason is that if everyone within a given industry did that, the compensation plans accross that industry would still be competitive, which is part of why we are receiving those benefits in the first place.

When the comeptition anywhere within the same industry is the same, the threat to walk and go elsewhere does not exist.

You're correct in that I do partially agree with you, because I feel for a given industry if this were to occur then pay would indeed rise, but like I said not by much, and definately nowhere near 100% of what our employers had been paying.

Tiddlywinks
09-27-2013, 11:48 AM
Also, you can't really just look at the small subset of age brackets when discussing health costs per year. Of course younger people are on average going to spend far less than the elderly. Part of the way that insurance is set up is so that the unused Premiums of people such as yourself are used to cover the woman with breast cancer. You are not paying ONLY for directly what you will benefit from, that's not how insurance works. That's what savings accounts are for.

Orruar
09-27-2013, 12:05 PM
I don't really understand the maliciousness in your tone. Calling me ignorant and telling me what I have no background or experience with is quite comical really. I don't pretend to know you, and for that reason I don't pretend to know what you do and don't know simply because I don't agree with you.

That said, I still disagree whole heartidly. It doesn't matter that we as employees would ask for the money our employers would be saving, they would have zero incentive to give it. I'm fairly confident they would just as soon have us walk away entirely.

The reason is that if everyone within a given industry did that, the compensation plans accross that industry would still be competitive, which is part of why we are receiving those benefits in the first place.

When the comeptition anywhere within the same industry is the same, the threat to walk and go elsewhere does not exist.

You're correct in that I do partially agree with you, because I feel for a given industry if this were to occur then pay would indeed rise, but like I said not by much, and definately nowhere near 100% of what our employers had been paying.

Perhaps your employer would just let you walk away if you asked for a raise. Many wouldn't. I mean, if your theory is correct, why don't all employers just reduce compensation by 10% tomorrow? Your theory would dictate that they could do exactly that.

Compensation is determined by supply and demand for labor. Changing the law so that it's no longer advantageous to provide health insurance as part of the compensation does not change the number of people in the job market or the number of jobs needing to be filled. Therefore the total compensation, which would then be more pushed towards direct pay and less towards insurance, would remain the same. If anything, it would increase overall compensation, and here is why. Many people feel tied to their job because they need to maintain the same health insurance. This reduces the competitiveness in the job market and allows employers to pay somewhat less than they otherwise would have to.

Orruar
09-27-2013, 12:07 PM
Also, you can't really just look at the small subset of age brackets when discussing health costs per year. Of course younger people are on average going to spend far less than the elderly. Part of the way that insurance is set up is so that the unused Premiums of people such as yourself are used to cover the woman with breast cancer. You are not paying ONLY for directly what you will benefit from, that's not how insurance works. That's what savings accounts are for.

Actually, that's exactly how insurance works in every other type of insurance. And it's how insurance would work with health insurance if not for regulations. Older folks get to pay far less on car insurance because they are less likely to have an accident. Older folks also have to pay a lot more on life insurance because it's more likely that they will die. For any insurance, any one person needs to pay exactly what their risk is at that point in time. Our health insurance is structured the way it is because old folks voted in people who told them that they'd force young people to subsidize their health care.

MrSparkle001
09-27-2013, 12:50 PM
I don't know about you guys but I'm fucking STOKED for this shit.

I've had type 1 diabetes for 24 years now and the shit it's done to my savings account is ridiculous. I have to maintain health insurance even if it doesn't do anything for me so that I can keep a certificate of credible insurability which would guarantee that going forward I wouldn't be denied coverage due to my pre-existing condition. Most (read: 99%) of plans don't cover anything that I need and the ones that do are split between both prescription insurance and health insurance due to diabetic supplies being a medical supply and insulin being a medication. So that's two things that sap my income without providing any benefit.

All in all my monthly expenses are about $300 for insulin, $100 for strips, $75 for syringes and pen needles. That's almost $500 a month and that's the BARE necessity of what I need. That is essentially a second apartment lease and that's just to survive.

The affordable care act is pretty much a dream come true if I understand it correctly.

As happy as I am for you, I'm pissed that other people will now be paying for you. That's what the individual mandate is for. They may spin it to sound otherwise, but that's what it is. The insurance companies want to keep their profits, and in order to pay for preexisting conditions and maintain a profit they need young, healthy people to pay. Young, healthy people are forced to buy lousy insurance with ridiculously high deductibles in order to pay for people who cost the insurance companies too much. Your costs are forced on others. Great system huh.

Without the individual mandate this whole law would fail.

I'm also pissed that big corporations and even Congress got themselves exemptions because it's too expensive for them, yet the average working guy who will see his monthly expenditures increase significantly can't get an exemption. You know it's bad when there's members of Congress fighting to get Congress not to exempt itself.

Pringles
09-27-2013, 01:41 PM
The affordable care act is pretty much a dream come true if I understand it correctly.

I don't think you understand it correctly.

Orruar
09-27-2013, 03:56 PM
I don't think you understand it correctly.

Read the rest of his story. This thing is a dream come true for those who would like to be subsidized by healthy people.

runlvlzero
09-27-2013, 06:29 PM
I don't know about you guys but I'm fucking STOKED for this shit.

I've had type 1 diabetes for 24 years now and the shit it's done to my savings account is ridiculous. I have to maintain health insurance even if it doesn't do anything for me so that I can keep a certificate of credible insurability which would guarantee that going forward I wouldn't be denied coverage due to my pre-existing condition. Most (read: 99%) of plans don't cover anything that I need and the ones that do are split between both prescription insurance and health insurance due to diabetic supplies being a medical supply and insulin being a medication. So that's two things that sap my income without providing any benefit.

All in all my monthly expenses are about $300 for insulin, $100 for strips, $75 for syringes and pen needles. That's almost $500 a month and that's the BARE necessity of what I need. That is essentially a second apartment lease and that's just to survive.

The affordable care act is pretty much a dream come true if I understand it correctly.

I don't think you should have to pay anything for your insulin or supplies. That whole sub unit industry could be run cheaply and efficiently enough that it could be entirely subsidized by everyone. I'm not sure how this will help people who are barely surviving with diabetes though who can't hold down a full time job. But if this is indeed going to help you I am happy. I don't think people should be murdered just because they aren't perfect.

Below just general thoughts not directed at you:

I just think it could be done much much better than our current regime is doing it. It's not even Obama's fault he doesn't have control over the entire medical industry. But as a leader he could publicly demand solutions and point out the corruption and issues it does have.

I think everyones biggest gripe in general is how vague and mis-advertised this whole idea is. And that a large number of us think we could do so much better as far as health care is concerned in this country. And that this is just a band aid.

Yep I think a lot. Nothing is written in stone as far as my opinion goes. I am not certified to know for sure in absolute terms =)

Orruar
09-27-2013, 06:43 PM
...I don't think people should be murdered just because they aren't perfect.
...

What a shocking and controversial statement. I'm sure all those non-perfect-people-murderers are going to come here in droves to debate you on that position.

runlvlzero
09-27-2013, 06:58 PM
What a shocking and controversial statement. I'm sure all those non-perfect-people-murderers are going to come here in droves to debate you on that position.

I could have phrased it differently. But seriously. We don't have to let people die to issues like diabetes. The damn world has the technology to deal with it. Its douchey to just be like "fuck you die" in this case.

It goes back to the whole argument about automation (which is going to take this whole subject off topic if we do it here). But you can automate a ton of shit now which gives people free time to do other shit. And automate it cheaply.

Cleaning clothes for example. Very automated. Cheaper to do with machines. We don't force prisoners wear dirty rags. We tax payers pay for the laundry machines they use to automate it. Textiles. Though that goes into other issues with economies. But the diabetes industry is not new technology. Sure there's improvements here and there. But the majority of diabetes cases can be treated by tech that is refined and been around for 20 years. We know exactly how much resource it takes and what the cost to distribute is and we can project that for the increase and decrease yearly.

Its a good target for a social (civil) program. Think of it a bit like civil engineering with an investment in the future of our society. And I'm only going there because Obamacare is supposed to achieve this exact gaol. Make this affordable for everyone.

I'm arguing that it already is. From a technical standpoint. Either government can contract private industry, or we can run it as a civil program. Payed for by a small portion of our huge debt. We could slim down and fix the government and still have room to do things like this. Maybe you know transfer some of those administrators to this new program.

Now do we want to get all gattaca about diabetes? Thats irrelevant to whether we treat it or not and provide those people opportunities to live fulfilling more or less meaningful lives.

Millburn
09-27-2013, 08:07 PM
As happy as I am for you, I'm pissed that other people will now be paying for you. That's what the individual mandate is for. They may spin it to sound otherwise, but that's what it is. The insurance companies want to keep their profits, and in order to pay for preexisting conditions and maintain a profit they need young, healthy people to pay. Young, healthy people are forced to buy lousy insurance with ridiculously high deductibles in order to pay for people who cost the insurance companies too much. Your costs are forced on others. Great system huh.

Without the individual mandate this whole law would fail.

I'm also pissed that big corporations and even Congress got themselves exemptions because it's too expensive for them, yet the average working guy who will see his monthly expenditures increase significantly can't get an exemption. You know it's bad when there's members of Congress fighting to get Congress not to exempt itself.

If I take myself out of my own situation I totally empathize, in a perfect world we could take some of the defense budget that goes towards the Military Industrial Complex and use that money responsibly to bring universal health care standards of decency to everyone who lives in this country.

With that said, thank god for healthy people because hot damn have I waited for this day.

Frieza_Prexus
09-27-2013, 08:11 PM
I don't think you should have to pay anything for your insulin or supplies. That whole sub unit industry could be run cheaply and efficiently enough that it could be entirely subsidized by everyone. I'm not sure how this will help people who are barely surviving with diabetes though who can't hold down a full time job. But if this is indeed going to help you I am happy. I don't think people should be murdered just because they aren't perfect.


This type of sentiment makes for exceptionally bad policy. Why should an otherwise healthy diabetic receive free supplies at the expense of the tax base? Can we start buying groceries for everyone too? (wait a minute, that's already happening).

No one's being "murdered", and it's a complete disservice to the dialogue to frame it so strongly. Few people object to a safety net for the truly and permanently disabled. But why should otherwise healthy diabetics get a free pass? If a person is reasonably capable of supporting themselves, there should be no duty to directly subsidize their consumer requirements.

Also, I think it's somewhat insulting to diabetics to make a general implication that their condition impairs them so substantially that they cannot provide for their own medical needs.

runlvlzero
09-27-2013, 08:17 PM
If I take myself out of my own situation I totally empathize, in a perfect world we could take some of the defense budget that goes towards the Military Industrial Complex and use that money responsibly to bring universal health care standards of decency to everyone who lives in this country.

With that said, thank god for healthy people because hot damn have I waited for this day.

This guy said it best.

runlvlzero
09-27-2013, 08:18 PM
This type of sentiment makes for exceptionally bad policy. Why should an otherwise healthy diabetic receive free supplies at the expense of the tax base? Can we start buying groceries for everyone too? (wait a minute, that's already happening).

No one's being "murdered", and it's a complete disservice to the dialogue to frame it so strongly. Few people object to a safety net for the truly and permanently disabled. But why should otherwise healthy diabetics get a free pass? If a person is reasonably capable of supporting themselves, there should be no duty to directly subsidize their consumer requirements.

Also, I think it's somewhat insulting to diabetics to make a general implication that their condition impairs them so substantially that they cannot provide for their own medical needs.

As individuals you cant really farm out insulin. A few can change their diets etc... But its not something everyone can do. Its either corporate socialism. Or social socialism. They're the same damn thing. Except in one there is a really unrestricted ponzi scheme. It seems we either defend and regulate private industry or work out a way to do this fairly as a group.

An alternative solution is to give diabetics the option to opt in to a group plan in order to do it more cheaply. But why force diabetics who earn a living to pay for those that don't?

The reality is though that we can do a lot in this world if wealth was more equitably distributed. Period. Since where going with obamacare and this thread is about our new social health system. I said fuck it, lets think about how to do it better.

Your already paying for this kind of stuff. Whether you want to or not.

Millburn
09-27-2013, 08:18 PM
This type of sentiment makes for exceptionally bad policy. Why should an otherwise healthy diabetic receive free supplies at the expense of the tax base? Can we start buying groceries for everyone too? (wait a minute, that's already happening).

No one's being "murdered", and it's a complete disservice to the dialogue to frame it so strongly. Few people object to a safety net for the truly and permanently disabled. But why should otherwise healthy diabetics get a free pass? If a person is reasonably capable of supporting themselves, there should be no duty to directly subsidize their consumer requirements.

Also, I think it's somewhat insulting to diabetics to make a general implication that their condition impairs them so substantially that they cannot provide for their own medical needs.

Type 1 diabetic here, and I say type 1 for a reason. Almost all type 1's are diagnosed as a child, that's why it's generally called early onset diabetes. Keeping that in mind, you can see how hitting adulthood and right out the gate having an additional rent lease worth of monthly expenses subtracted from your income can be a bit of a burden. Yes, you're absolutely right we can take care of ourselves and I do...but I do it paycheck to paycheck. I work harder than most people, and because of it I just scoot by and survive. Yes I live comfortably, but mostly because I live humbly and don't care about expensive things. If I didn't have this disease I would be prospering and be living nice and cozy. I work harder to just break even. It's a struggle, but not one I generally complain about.

We now have things like children being able to be on their parents insurances until age 26 which help out DRAMATICALLY, and I mean FUCKING DRAMATICALLY. It still isn't enough though. This only accounts for families in the lower middle class and up, it doesn't account for families riding above the poverty line. Those kids just don't have a chance.

runlvlzero
09-27-2013, 08:25 PM
It doesnt actually cost 500$ a month to take care of a person with type 1 diabetes. Thats what I'm trying to say.

When you set up a program like obamacare, or a real social civil program payed for by everyone its done more cheaply.

$$$ are completely arbitrary. The reason it costs 500$ to do it now is because of economic reasons. Not actual energy required to produce it.

Obamacare is not looking at the actual economic issues around the cost of health care.

All that being said I don't want to take this away from people either.

Frieza_Prexus
09-27-2013, 08:38 PM
As individuals you cant really farm out insulin.

Most individuals also cannot make their own cars. Should we start handing those out too?

You're right that the issue should be examined through the lens of economics. Subsidy is rarely advisable in most other areas as it leads to waste, and monopolies/gatekeeper systems are what generally drive up costs. The idea that we need more intervention generally flies in the face of established economic wisdom.

There certainly are exceptions to the general fallacy of subsidy, and perhaps healthcare could be one, but that burden has yet to be met.

Yes, you're absolutely right we can take care of ourselves and I do...but I do it paycheck to paycheck.

I empathize with your position, and I understand the difficulties it presents. But how is this different from anyone else who lives paycheck to paycheck through no fault of their own? How is the former case different from this latter? There's very little justification presented as to why certain classes, that are otherwise capable of supporting themselves, should be subsidized.

It's simply bad policy.

runlvlzero
09-27-2013, 08:58 PM
No but do you seriously have something against public transportation?

Why can't we do that. Insulin is not a luxury really IMO. Were not talking about handing out Lamborghinis.

If Canada can do something like this: http://en.wikipedia.org/wiki/Needle_exchange_programme

Simply to decrease the spread of aids between drug users. Seriously diabetes is a NO BRAINER.

And I'm a fairly Libertarian individual, our federal government is way to big and out of control. But I don't believe in saying "fuck everyone me me me me me".

Frieza_Prexus
09-27-2013, 09:01 PM
No but do you seriously have something against public transportation?

In some cases, no. In many others, absolutely there's a problem. I live in Houston with the disastrous light rail system. There's also that little albatross called Amtrak.

You're right, Insulin is not a luxury. It's a necessity. Type 1 diabetics require it to live. Just like most people require food and shelter to live. Are you telling me that both of those should be provided to those who are otherwise capable of supporting themselves?

runlvlzero
09-27-2013, 09:09 PM
In some cases, no. In many others, absolutely there's a problem. I live in Houston with the disastrous light rail system. There's also that little albatross called Amtrak.

You're right, Insulin is not a luxury. It's a necessity. Type 1 diabetics require it to live. Just like most people require food and shelter to live. Are you telling me that both of those should be provided to those who are otherwise capable of supporting themselves?

It should be provided to people who work and put in if they choose to participate in something that benefits everyone. Those people with type 1 diabetes working are you know. Part of your National Tribe.

Right now we have a problem where a lot of capable people who would otherwise be able to participate in society because of greed and corruption, can not. So I'm in favor of more socialism at this point.

Especially as technology advances further down the roads of automation.

Do we need a lot of conservative reform? Ooooh yeah... but should we say "fuck it theres 2 many people on the planet cause someone says so?"

Nah. We don't need to endlessly cut short all our social welfare overnight without providing people a chance to not need it first.

I'm very on the fence about welfare. I hate how people can abuse it.

But I also hate how the lower classes are made to pay the most for it because some how the most wealthy are above it all etc...

I am constantly looking towards a revised compromise between our dynastic capitalists and Marxism. Because both can be pretty fucking terrible when taken to extremes.

Even the most libertarian societies have social welfare... see Sweden.

And yeah, if I have the means to. I am looking to enrich everyones lives. Better if those means exist in everyones individual control (liberty u know). But not always workable OR the most efficient.

I mean I keep seeing the argument that people must work to live. God for bid we did start being able to feed and care for people without forcing them to work... holy shit what a concept. Its quite possible. Either now or in the near future.

Do people need to work to maintain a high standard of living? Pretty much currently yeah.

Do we need to work hard to live? Nope. Hunter gatherers didn't expend much energy at all. And I have visited places where the 1st world is not all encompassing. Plenty of people still out there working very little to subsist.

Last little thing here....

Is COOPERATION more productive? Generally it is? Damn coorpoeration. Like U know, getting in a group to hold a camp vs trying to do it yourself vs a a group. Makes a difference. Translates perfectly well to real life.

Its pretty much how we got where we are today. Despite the illusion that its everyone for themselves. Even the rich stand on the back of cooperation. They would have nothing with complete anarchy.

I will add that having a productive and creative occupation is very good for peoples sanity, psychology, well-being, and happiness. So I think the more opportunities we can provide people to work the better.

Tiddlywinks
09-27-2013, 09:33 PM
I empathize with your position, and I understand the difficulties it presents. But how is this different from anyone else who lives paycheck to paycheck through no fault of their own? How is the former case different from this latter? There's very little justification presented as to why certain classes, that are otherwise capable of supporting themselves, should be subsidized.

It's simply bad policy.

Wow.

Millburn
09-27-2013, 09:35 PM
I empathize with your position, and I understand the difficulties it presents. But how is this different from anyone else who lives paycheck to paycheck through no fault of their own? How is the former case different from this latter? There's very little justification presented as to why certain classes, that are otherwise capable of supporting themselves, should be subsidized.

It's simply bad policy.

Because the same system that makes me live paycheck to paycheck is forcing someone else under the poverty line. My situation improves by it being being fixed for everyone. I'm not the model person you should sympathize with, it's the person who can't stay afloat.

Frieza_Prexus
09-27-2013, 09:49 PM
It should be provided to people who work and put in if they choose to participate in something that benefits everyone. Those people with type 1 diabetes working are you know. Part of your National Tribe.

I'm not entirely certain what you mean to say. Is it that we'd get a lot more done if everyone worked together and more altruistically? Sure! But that's not how the world works. Perhaps someday, but not now. Individuals and personalities have shaped our society and such a utopia is currently unobtainable.

As technology progresses I absolutely agree with you that perhaps our society would be transformed in such a way that subsidy can be sustained far more efficiently than any individual could hope to achieve himself. Perhaps when 3d farming and robotics progresses to fully automated growhouses we can create food and medical supplies for virtually no cost. Perhaps 3d printing will allow for an incredible revolution in cheap engines. However, those technological steps do not currently exist in a way to meaningfully subsidize in the manner that you propose.

That time is not now for many of the subsidies you propose. Creating many of the subsidies you propose is grossly inefficient.

I'm not the model person you should sympathize with, it's the person who can't stay afloat.

Which is why I said that few people will argue against a system that provides for those who cannot support themselves meaningfully. How does it help "everyone" when you, an otherwise capable person, is subsidized for something that you are otherwise capable of obtaining?

Wow.

What's so "wow" about that? I fail to see why we should provide goods to a person that is otherwise capable of earning them while maintaining a comfortable existence.

runlvlzero
09-27-2013, 09:55 PM
Maybe, and your right. Certainly not for everything. And it also eliminates choice and competition. A big downfall of socialism. On the upside if people don't have to work for necessities they can still focus on creating luxuries (Gourmet Pizza instead of soylent geen...). Making new markets. And potentially new currency. (Bitcion is something almost in this realm, though its really just yet another fiat).

I think it could work for some specific situations though.

And I do think prices/costs are artificially or meaninglessly high. This is however just an opinion I can't thoroughly back up with data for the sake of this debate.

I know there are a lot of alternative fuel sources we don't use because our economy and regulations are not fit for them. Pretty well studied.

Those ideas go back to my criticism of Obamacare.

Tiddlywinks
09-27-2013, 10:12 PM
What's so "wow" about that? I fail to see why we should provide goods to a person that is otherwise capable of earning them while maintaining a comfortable existence.

Living paycheck to paycheck is your definition of a "comfortable existence". Where if they were to be fired they would have no savings to fall back on and would most likely end up on unemployment while searching for another paycheck to paycheck job?

God forbid those people get sick and are uninsured or don't have a sold family/friend support system to help them through those rough times. Not to mention all the luxuries I'm sure their paycheck to paycheck jobs is currently affording them.

Not my idea of a "comfortable existence". Then again, they are a member of a certain class, and that is to be expected.

Right?

Orruar
09-27-2013, 10:19 PM
I could have phrased it differently. But seriously. We don't have to let people die to issues like diabetes. The damn world has the technology to deal with it. Its douchey to just be like "fuck you die" in this case.
...


Again, who here is saying "fuck you die" or anything similar?

You know, I really don't think we should be murdering kittens for fun.

Millburn
09-27-2013, 10:25 PM
http://k19.kn3.net/taringa/6/9/9/8/8/1/3/3dher/315.gif?6417

Orruar
09-27-2013, 10:28 PM
Because the same system that makes me live paycheck to paycheck is forcing someone else under the poverty line. My situation improves by it being being fixed for everyone. I'm not the model person you should sympathize with, it's the person who can't stay afloat.

And what about those who are living paycheck to paycheck and now will have a harder time because they have to pay for your healthcare? Or do you just figure the money is only being taken from rich people or something?

runlvlzero
09-27-2013, 10:34 PM
Again, who here is saying "fuck you die" or anything similar?

You know, I really don't think we should be murdering kittens for fun.

I believe the original point was that people think anyone who disagrees with Obamacare is a fascist, racist etc...

I initially started down this path because I was defending that you can DISAGREE with obamacare, yet still be ok with socialistic ideals. And NOT be an asshole.

I dunno. I live in the redneck south. A lot of people here think its the worst thing on the planet. And it definitely colored my point of view for a long time.

Yet those people aren't "evil assholes".

I also wanted to assure that I really do empathize with Millburn. Even if I myself do not have a medical condition like that.

I still think this bill sucks in general. And we need to attack this problem from a completely different viewpoint.

Frieza_Prexus
09-27-2013, 10:35 PM
Living paycheck to paycheck is your definition of a "comfortable existence". Where if they were to be fired they would have no savings to fall back on and would most likely end up on unemployment while searching for another paycheck to paycheck job?

God forbid those people get sick and are uninsured or don't have a sold family/friend support system to help them through those rough times. Not to mention all the luxuries I'm sure their paycheck to paycheck jobs is currently affording them.

Living paycheck to paycheck is not necessarily a "comfortable existence." I was responding directly to Millburn who admitted that while he was check to check, that his existence was "comfortable." In light of his admission, I take exception to the idea that subsidizing his supplies is good policy.

If a person is incapable of meeting their own needs for something, say insulin, there's little objection in a safety net that provides for them for the duration of that inability. I'm not challenging the notion of social spending, I'm challenging the idea that it's somehow good policy to pay for the needs of those who are capable of providing for themselves.

Then again, they are a member of a certain class, and that is to be expected.

Are you implying that I view diabetics as inferior? What's the equivalent of calling someone a racist, but for medical conditions? Conditionist? Is that what you think I'm being here?

Would I have to get diabetes before my opinion is properly qualified?

Millburn
09-27-2013, 10:40 PM
I also wanted to assure that I really do empathize with Millburn. Even if I myself do not have a medical condition like that.


I think you're one of the most well articulated people on these forums right now, you've got my vote!

Misto
09-27-2013, 11:42 PM
Being a doctor is going to suck.

You can multiply the number of crackheads trying to scam pain medication from their doctors by 10.

This country is so fucked.

MrSparkle001
09-29-2013, 02:20 AM
And I do think prices/costs are artificially or meaninglessly high. This is however just an opinion I can't thoroughly back up with data for the sake of this debate.

Way too high. In August I got a small cut from my cat on my inside pinkie right below the first knuckle. It wasn't large but it was sort of deep and bled like a stuck pig at first so I thought maybe it might need a stitch (notice it's singular stitch. The cut was small). It was late on a Saturday so my option was the emergency room. I figured it was no big deal. I put pressure on it, bleeding stopped, I cleaned it up, put some neosporin and a bandaid on it and head out.

They examined it and said it didn't require a stitch. They cleaned it up themselves, put some bacitracin on it, wrapped it in gauze, gave me an antibiotic pill and a prescription for more. That's it.

The hospital bill came to over $1100, not including the doctor's bill. When I voiced my great displeasure at that insane rip-off we settled on $125 for the entire hospital bill. Two weeks later I got a doctor's bill for $400, and a week after that another hospital bill for over $350, after I already agreed to a payment in full. That's over $1850 for a small cut that they put bacitracin and gauze on, which I already did at home for free for fuck's sake. All I wanted to know was if it needed a stitch! I already had neosporin and a bandaid on it, they just replaced it with bacitracin and gauze.

Are they insane? Where the hell does the doctor get off charging me $400 to put bacitracin and gauze on a cut that's maybe a half inch in size, if that (it was smaller than the width of my pinkie nail). Fuck I'm in the wrong business. I'll do that for $200, that's half price! It's a steal! And the hospital charging me almost $1500?? What that really is is what they'd have charged my insurance. That's what insurance would have paid. They would have paid about $1850 for a small cut I could have easily taken care of myself.

These hospitals and doctors are overcharging extreme amounts. It's damned criminal.

The prescription cost me $30. That's reasonable. I have no problem paying reasonable bills, but this doctor will not see a dime of that $400 she's charging me unless she agrees to knock that bill down to under $100.

What sucks is a month before I got ripped off my brother went to the same hospital after a collision playing softball (cut his nose and got banged up). He didn't raise hell over what they were charging him and instead agreed to a payment plan. He has to pay over $2500 for services that were only slightly more involved than mine, and only because they did concussion tests (edit: found out today it's $5200 he owes, not $2500). Holy shit. I didn't know he had to pay that much or I would have never gone myself; I guess I should talk to my brother more often.