Replacing Obamacare

[Twilight Hue]

So you're against forcing people to have motor-vehicle insurance, as every state does?

My observations on health insurance:
Public health insurance works, as in France.
Private health insurance regulated by the government works, as in Germany.

Running health care as a nationalised industry, as in the UK or Italy, is a bureaucratic mess, unless in a small country like Sweden.

The free market doesn't exist. I recently read of a New Yorker who needed a new knee joint, and that knee was excluded from his current insurance. He got his knee replaced in Belgium: the total cost, including air fares, was less than the cost of the joint alone in the US! It just so happens that all US joint manufacturers charge the same prices — what a surprise! Or consider the epipen: $300 in the USA, about $50 in the UK and France.

Well for starters. Owning a car isn't compulsary. Not a good comparison. !0)

Mandates like this are clear red flag threats to individual freedom and liberty as it creates a permanent debtor's class dependent on a central authority for collection and enforcement. Unlike taxes , where one only to file without penality regardless of ability or inability to pay.

Mandates are suttle yet very nasty pieces of legislation when structured in a specific way. This particular mandate definitely dosent belong in any free society. Its clearly intentional , and unconstitutional.


How it ever got considered a tax is beyond me. No one can even explain it. Even judges. It was just an accepted declaration without question.

 

[Valjean]

My observations on health insurance:
Public health insurance works, as in France.
Private health insurance regulated by the government works, as in Germany.

But don't both countries use a Bismark system -- Regulated, non-profit health insurance? http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/models.html

Running health care as a nationalised industry, as in the UK or Italy, is a bureaucratic mess, unless in a small country like Sweden.

But a socialised system seemed to be working well in the UK -- till the politics began shifting to the right and tweaking it.

The free market doesn't exist. I recently read of a New Yorker who needed a new knee joint, and that knee was excluded from his current insurance. He got his knee replaced in Belgium: the total cost, including air fares, was less than the cost of the joint alone in the US! It just so happens that all US joint manufacturers charge the same prices — what a surprise! Or consider the epipen: $300 in the USA, about $50 in the UK and France.

That was a great series. It should be cited whenever the American healthcare "system" is discussed.

 

[columbus]

Mandates are suttle yet very nasty pieces of legislation when structured in a specific way. This particular mandate definitely dosent belong in any free society. Its clearly intentional , and unconstitutional.

I was gobsmacked when that passed Constitutional muster in the Supreme Court.

Seriously Chief Justice Roberts? A penalty isn't really a penalty if the IRS collects it?
Tom

 

[Acim]

So you're against forcing people to have motor-vehicle insurance, as every state does?

My observations on health insurance:
Public health insurance works, as in France.
Private health insurance regulated by the government works, as in Germany.

This is why I wanted to have this discussion with conservatives, cause it tests us. And easier to deal with the tests minus the liberal bias, IMHO.

I also see it as a debate for us to have. I used to be more passionate about it than I am now. Not sure why it's different, other than I'm older and seems like the passion doesn't amount to much.

I see health insurance (industry) as quasi-socialistic. Stating that, I am against forcing people to have motor-vehicle insurance. But am used to it, and because motor-vehicle insurance doesn't impede on free market of service / maintenance of motor-vehicles, it doesn't seem like fair comparison. And is what I was thinking about in OP (surprised I didn't mention it) with regards to first idea. Imagine you have to take your car in for oil change and that is covered by automobile insurance. As are all possible services. I think it would make it so consumer demand wouldn't be a significant determining factor in setting prices whereas whatever service industry and insurance industry negotiate is what would determine pricing there. Such that an oil change for $200+ wouldn't be out of the question, and would be wonderful from consumer perspective cause "it was free!"

Plus with motor-vehicle insurance, every time it is used, your rates go up. Yet, not with health insurance. Imagine if that were the case with health insurance. Instead the quasi-socialistic aspect kicks in, and everyone's premiums go up.

The idea of abandoning free market among middle/lower class when it comes to health care doesn't sit well with me, but I don't see us going back to basic level of trust in that market, so is perhaps off the table. Thus costs can be inflated in a way that consumers seemingly have no way of influencing. I think that sucks. Sucks for everyone involved, and is more and more visibly the case. Though guessing those getting rich from healthcare don't feel it sucks all that bad. Yet, because it is health care, it kinda does, cause it does seem to me that profit/cost control is put above care, at least some of the time. Seems like exactly the wrong industry to have that type of perception occurring, allowed to occur.

I also think, in general terms, that if conservative types can manage to justify vast industry, paid for by taxation, known as Defense, that the same can and ought to be done with regards to healthcare. If not wanting to do it with healthcare, then I really (really really) do not want it done with defense. Get rid of standing armies and cut defense by at least 50%, I'd go as hight as 90%. Free market/privatization can handle that. Yes, that has drawbacks, but having a military industrial complex has very clear drawbacks, some of which IMO relate directly to 2nd amendment.

But all that is perhaps off on a tangent in left field. I really don't currently see a way to rein in costs in health insurance industry and so not sure how the situation resolves itself. With $20 trillion in debt being seemingly okay, I guess what's another $100 trillion in debt via universal health care that seemingly would have no problem bankrupting the nation, and seemingly no one really caring that it is occurring.

Yep, it's gotten that dismal for me.

 

[GoodbyeDave]

I really don't currently see a way to rein in costs in health insurance industry and so not sure how the situation resolves itself.

As I showed with my epipen example, we have no problem reining in costs in Europe: regulation, combined with legislation against cartels and monopolies.

 

[Acim]

As I showed with my epipen example, we have no problem reining in costs in Europe: regulation, combined with legislation against cartels and monopolies.

I'd like to see those regulations / legislation to see if they align with conservative principles. I guess I could've stipulated my earlier statement with idea of me not seeing a conservative way to reign in costs. I think we already have legislation against monopolies.

I also see FDA (and it's regulatory bureaucracy) as part of reason why Epipen is compelled to charge so much for their product in America. It ain't cheap to get a drug related product sold on the (legal) markets in America.

 

[GoodbyeDave]

I also see FDA (and it's regulatory bureaucracy) as part of reason why Epipen is compelled to charge so much for their product in America. It ain't cheap to get a drug related product sold on the (legal) markets in America.

The price has gone up from $50 to $300 since 2009. It was already authorised before that, so there was no extra testing to pay for. And do you think we have no regulation in Europe? Mylan didn't even have development costs to recover: it's manufactured under licence from Merck.

I'm afraid that you come across to me as typical of US "conservatives": almost everything the "bureaucracy" does is bad and almost every bit of vulture capitalism is excusable.

 

[gerobbins]

Health care is a right, its not a privilege.. That is the Canadian take on it

A Canadian Doctor owns a U.S. Senator

 

[Acim]

The price has gone up from $50 to $300 since 2009. It was already authorised before that, so there was no extra testing to pay for. And do you think we have no regulation in Europe? Mylan didn't even have development costs to recover: it's manufactured under licence from Merck.

I'm afraid that you come across to me as typical of US "conservatives": almost everything the "bureaucracy" does is bad and almost every bit of vulture capitalism is excusable.

Looking into it further, I see a few things, one of which is the other competing products have had to deal with FDA BS, and were not approved. Thus, the company knew, that in America, they could get away (at least for awhile) with charging that amount (or really any amount) because of lack of competition, stemming from FDA crap.

 

[David1967]

Non-corporate free market. Everyone should be able to purchase whatever they wish to purchase from other individuals (not corporations), and not be forced to purchase what they don't want or need.

I agree. But what can be done to keep cost down?

 

[Twilight Hue]

Health care is a right, its not a privilege.. That is the Canadian take on it

A Canadian Doctor owns a U.S. Senator

I tend to agree on principle. Too bad dental care in Canada for one reason or another isn't a part of that equation.

Unfortunately, there is always that nagging matter of money and how in the world does all this gets payed for when the majority of Americans barely live paycheck to paycheck? One check away from homelessness in a fair number of situations?

 

[Valjean]

I agree. But what can be done to keep cost down?

Three quarters of the cost is pork. Our medical system has grown into a massive Rube Goldberg, with everyone getting a piece of the action -- weather they're contributing anything or not.

Consider:
The British government spends ~$3,000 per person, per year for healthcare.
Everybody gets as much healthcare as they need. There are no caps or limits.
There are no out-of-pocket payments; no co-pays; no insurance payments. Nobody gets a bill.
Outcomes are superior to those in the US.

The US government spends about $6,000 per person, per year.
In addition, individual citizens also have to pay for insurance and for out-of-pocket expenses, which are usually more than government expenditures.
There are "co-pays" -- fees for service.
Until Obamacare kicked in, there were caps on services and annual and lifetime limits.
Insurance companies could cancel policies at will if they became too expensive.

Granted, these figures are six or eight years old, and the British NHS is now in crisis -- but not because of any inherent defect in the socialized system, but because of a Neoliberal shift in government.

 

[Valjean]

I agree. But what can be done to keep cost down?

Socialize it?
Go single-payer, eg: Medicare for all?

 

[David1967]

Socialize it?
Go single-payer, eg: Medicare for all?

Do you think there is any truth to the rumor that the ACA is deliberately this bad as a stepping stone to single payer health care?

 

[buddhist]

I agree. But what can be done to keep cost down?

Love, respect, and trust within one's own local community, keeps costs down. Shared values in a cohesive culture, keeps costs down. People willing to stand behind their products or services (via self-proprietorships), keeps costs down.

Basically, everything anti-Corporation.

 

[Valjean]

Do you think there is any truth to the rumor that the ACA is deliberately this bad as a stepping stone to single payer health care?

Not deliberately. Obama is just the world's worst negotiator (dare I say Trump would have done better?).
His Affordable Care Act expands medical access, but that's about it. It just feeds more patients to an already predatory healthcare industry.

The medical/pharmaceutical/insurance industry understood that "public option" would amount to the camel's nose under the tent, and would not have it.
Big pharma, likewise, balked at negotiating wholesale pricing for Medicare and Medicaid, so -- unlike anywhere else in the developed world -- the government has to pay full, retail price.

 

[GoodbyeDave]

Socialize it? Go single-payer, e.g: Medicare for all?

If the US medical industry can rip off the insurers, they can rip off the government! The Germans and the Dutch have private insurance, but it works because the industry is not allowed to overcharge. To return to our friend the epipen, the company bought the rights and then upped the price. In the UK that would actually be illegal, unless they could show the costs had risen. A free market is fine so long as there's free competition, but specialist medical devices and drugs are not like loaves of bread and cans of soup.

 

[buddhist]

If the US medical industry can rip off the insurers, they can rip off the government! The Germans and the Dutch have private insurance, but it works because the industry is not allowed to overcharge. To return to our friend the epipen, the company bought the rights and then upped the price. In the UK that would actually be illegal, unless they could show the costs had risen. A free market is fine so long as there's free competition, but specialist medical devices and drugs are not like loaves of bread and cans of soup.

Welcome to the wonders of the Corporation. It's in the innate nature of the concept of the Corporation to diminish the People.

 

[ShivaFan]

There isn't any good solution and the current Obamacare is horrible and nothing affordable about it and obviously so to many already, the worst is soon approaching.

I have relatives in Canada, who have been very disappointed with the system there and the long delays, last minute cancellations, bad evals and incorrect diagnosis, but even that system is much better than Obamacare and it is workable because Canada has a low populatuon and less social ills and crime.

I don't think there will ever be a good solution to this, not now, not 100 years from now, with the corruption of ever more centralized and unaccountable government class, and these people are idiots and only think about their own retirement plans and pensions etc.. Look at the criminal Clinton family and their toads.

But I think technology can improve the situation a bit - what I would like to see is that doctors and nurses from all over the word can provide medical assistance readily to Americans, either by the ability of Americans to travel abroad for medical procedures by better high speed transportation including flying machines, but until then the ability to purchase affordable USB or other medical devices you can hook up to your laptop and then have doctors and nurses remotely analyse your situation (check for cancer, etc.) from India, Taiwan etc. for a nominal price.

And to have robotics in place in Walmart for example where Doctors could perform heart surgery and other procedures remotely from Serbia, for like $1000 dollars.

No need for insurance once we get the technology up to speed to globalize this. We can go to Mexico to have our dental work, or even one day have handheld computer devices to quickly find various issues.

Also I think we should have a lot more internet trained health professionals and be more lax on medical licenses. Yes some people will die, but it would be better than death by stress of going broke.

 

[buddhist]

Also I think we should have a lot more internet trained health professionals and be more lax on medical licenses. Yes some people will die, but it would be better than death by stress of going broke.

But how will M.D.'s maintain their illusion of authority that they are mini-gods and deserve their extortion money?