And the winner of tonight's Republican debate...

madmallard wrote:

friedgreencorrado wrote: Okay, here's a wrench into the mix..my current doctor does not take insurance *at all*. (and this reflects upon madmallard's comments about paying the staff to handle the paperwork as well) None whatsoever, whether private-or public! As a result of not having to hire staff to handle the paperwork, his fees are only slightly more than what my co-pay had risen to under my health plan ...

thank you! Insurance is NOT the end-all, be-all. Neither is social medicine. if it was, guys like these wouldn't make it as practicing doctors. Now add an average 2 income household using an HSA (which is essentially cash to a doctor like this), and the only thing the government did was allow the household to save for their medical free of income tax. No different than exempting income tax on a health insurance premium.

Or on your retirement plan (401k accounts, right?). Government can make stuff to support society as well! The only reason I didn't get on an HSA during the last open enrollment is because I'm a heart patient, and need BP control drugs. Any help at all with that cost was welcomed. And since I had a good job then (and my doc's fees were so cheap), I figured it wouldn't bankrupt me to keep the HMO just to buy the drugs..and pay the doc straight out of pocket. It's a great model for people who still have good jobs, and as such, I support it.

Now that I no longer belong to that economic group, I can't be so sure that it's the solution for everyone. And of course, why so many people have fallen out of that economic group is a completely different subject. One that I hope we'll discuss one day with the same kind of intelligence & respect that we've used on this thread.

Full Disclosure: I did not even attempt to address the issue of personal responsibility for health problems. That's due to my heavy cocaine usage as a younger man. I haven't touched that E36 M3 in more than 25yrs, but it seems that much of the damage to my heart actually came from that period of my life. Which, to me..begs another question. How do we even attempt to define personal responsibility? Yes, I admit I did it. And then, I quit. Should I be "punished" (for lack of a better word ATM) for an unhealthy habit I had & eventually abandoned a quarter-century ago?

whats the expression they told me about missing posted speed limits, ignorance of the law is not a defense?

While I'm glad you survived your ordeal, you'll likely be paying a price indefinietly for that choice, and I've never used recreational drugs, so i couldn't begin to imagine your difficulties.

but to say 'but NOW i'm okay' may be unintentionally mimising the consequences of those acts. If you were really okay, your heart would've recovered, right? But the truth is, its scarred permanently at this point.

addiction is more effectively managed thru treatment than it is thru criminal punishment alone, so its in everyone's interest for the addicted to get help.

But while you may see it as being 'punished', perhaps the more appropriate POV is 'still paying the debt' for the habit. You aren't better yet, you're not out of the woods (and may not be ever with our current limited medicines), and I wish you the best of luck in your struggles.

But why didn't you go for the HSA anyways? If you know you have an ongiong condition, the HSA doesn't expire, it rolls over. You know you're gonna need diagnostics and regular perscription maintenance, it seems like you'd be a prime candidate for HSA use...

madmallard wrote: whats the expression they told me about missing posted speed limits, ignorance of the law is not a defense?

Ignorance of civil law is one thing..ignorance of the complications of biology is another. I really don't see the relevance of that comparison here.

madmallard wrote:

While I'm glad you survived your ordeal, you'll likely be paying a price indefinietly for that choice, and I've never used recreational drugs, so i couldn't begin to imagine your difficulties.

In the spirit of conversation, berkeley my personal difficulties, I'm trying to express a larger issue here, which I will adress after one of your other comments.

madmallard wrote:

but to say 'but NOW i'm okay' may be unintentionally mimising the consequences of those acts. If you were really okay, your heart would've recovered, right?

No.
http://heartdisease.about.com/lw/Health-Medicine/Drugs-and-treatments/Cocaine-and-the-Heart.htm

I'll admit that the link I provided isn't much of a cite..but the footnotes/sources for it actually are.

madmallard wrote:

But the truth is, its scarred permanently at this point.

Yes.

madmallard wrote:

addiction is more effectively managed thru treatment than it is thru criminal punishment alone, so its in everyone's interest for the addicted to get help.

But while you may see it as being 'punished', perhaps the more appropriate POV is 'still paying the debt' for the habit. You aren't better yet, you're not out of the woods (and may not be ever with our current limited medicines), and I wish you the best of luck in your struggles.

Ay, there's the rub! My "habit" was twenty five years ago. There is no longer any struggle at all! I've beaten it, and I've beaten it like a bad rug. Am I to be forever punished for being so berkeleying stupid as an adolecent?

madmallard wrote: But why didn't you go for the HSA anyways? If you know you have an ongiong condition, the HSA doesn't expire, it rolls over. You know you're gonna need diagnostics and regular perscription maintenance, it seems like you'd be a prime candidate for HSA use...

Didn't go for the HSA because I didn't discover that my heart problems were due to my ancient substance abuse problem..until I was diagnosed with it, and did some research. Basically, I skipped the HSA because I was ignorant. And (in the spirit of honesty that we've all shown in this thread) probably in denial, as well. Again, I haven't touched the stuff in years. The thing that actually caused me to research it was my doc's comment, "..well, I can't find what it is. Did you ever use cocaine as a kid?.."

As I said previously, my combination of staying with the HMO to keep drug costs down, combined with my wonderful doctor that doesn't accept "insurance", regardless of public or private, was the perfect solution for my previous situation (well-paid professional technician). For anyone who still has a "good" job, and who has good health, HSA is the way to go, especially if you can find a doctor like mine!!

All I'm asking is..since I'm not one of you anymore..should I die simply because I made that mistake as a dumb kid a quarter of a century ago? Does the fact that I reformed (and found a great job, and contributed to society through that job for 20yrs before my layoff) mean nothing?

Apologies in advance for screwing up the attribution boxes. I used to participate in conversations like this on the old "Usenet" BBs. I attempted to respond to you point-by-point, and probably screwed up copy & pasting the "blockquote" and "cite blockquote" commands in here.

friedgreencorrado wrote: Am I to be forever punished for being so berkeleying stupid as an adolecent?

Punished because you're a higher health risk? Punished because you have a higher than normal health care cost?

It's going to sound cold-hearted, but yes. Let me put it another way, who else should pay for your mistakes earlier in your life? How is it different than someone who is obese, someone who has diabetes, someone who fell of a tree and was paralyzed? There isn't another soul who should be made to pay for those mistakes...

Interesting posts in here. I'm not sure how I feel about the "punished for health risk" thing.

Just a hypothetical. Say I'm 17 and I use some drug or other. I kinda like it and I do a lot for a couple of years. Kind of run with a bad group or whatever. Then, I dunno, my family moves and I go with them at age 19 and fall in with a much better group. Never got caught doing the bad stuff and never had any problems.

How would anyone know when I'm 40 that it ever happened? What right to privacy do I have when filling out a questionnaire for insurance? I dunno. Can they ask if I did drugs and can I be forced to answer truthfully of risk losing coverage? How far does that go? Can they ask about my sexual practices with my wife? There was a story this week or last about the risks of oral sex. Can they raise my rates if my wife and I do that? do they have a right to know?

I dunno. I take care of myself, eat okay, but exercise a good bit. I'm not super healthy, but for a middle-aged American, I'm probably ahead of the curve. So, yeah, I'd like to pay less than a 300 lb. guy who smokes. But is it really fair? I'm not sure.

In reply to fast_eddie_72:

Good points. I didn't mean that as a "fill out a questionnaire that says all of the times you may have kicked your dog", but as a "should a guy with multiple surgeries for heart bypass pay more out of pocket (not necessarily for insurance) than a guy with none.

I retract my statement because of how it could be misconstrued.

Although I do fully respect the right of a company to have any sort of risk analysis approach to support their business... hmmm... not sure either.

friedgreencorrado wrote:

92CelicaHalfTrac wrote: ^My last 8 minute visit (Seriously) with my doctor was for a cough. They weighed me (huh? why?), checked my blood pressure, and listened to my lungs, then prescribed me a steroid Inhalant. Total charge from doctor? $126. Ok, that didn't surprise me that much, because i work in the business. Insurance paid $78. Are you serious? Even if they only billed for a 15 minute consultation (they did), insurance is paying them over $300/hr. It's not so much the greed of the doctors... or even individual doctors. It's because the insurance companies are actually paying these outrageous amounts, and who in their right mind turns down money?

Okay, here's a wrench into the mix..my current doctor does not take insurance *at all*. (and this reflects upon madmallard's comments about paying the staff to handle the paperwork as well) None whatsoever, whether private-or public! As a result of not having to hire staff to handle the paperwork, his fees are only slightly more than what my co-pay had risen to under my health plan at (where I used to) work. Co-pay for a general visit under current rules, $50. His fee for a general visit, $60. His fees for lab tests (and I'll admit..so far, all I've had to have is blood tests..$120 for the usual high blood pressure stuff) seem to be *far* less than what my friends are co-paying, or what I've paid for other stuff. My last ER trip (my first plantar fasciitis attack happened so fast that I went to bed with a heel that itched, and woke up in the morning unable to walk) was approx. $700. Insurance covered $400 of that. For my previous condition (well-paid professional), the guy was perfect. His fees are *so* low, that I didn't mind paying slightly more than what my co-pay would have been..just because I supported what he was doing. Also, by doing this, he can run his own practice, without joining one of the Mega-Lo-Mart style places madmallard mentions in his 5:08p post. Old-school individual attention, rather than "assembly line medicine". If I had remained in a good paying job, I would never leave this guy.

I'm in the Atlanta area and have been looking for this option. Care to share his name?

^There's even a way to still work that system, honestly...

If he won't accept insurance, you could still submit the claim to insurance yourself, and they'll process as "out of network" and will reimburse you a percentage directly.

tuna55 wrote: It's going to sound cold-hearted, but yes. Let me put it another way, who else should pay for your mistakes earlier in your life? How is it different than someone who is obese, someone who has diabetes, someone who fell of a tree and was paralyzed? There isn't another soul who should be made to pay for those mistakes...

What he said. Just like all actions, there are consequences, some you live with for the rest of your life. Yes, you DO have to take responsibility for your actions 25 years later. Whether you were an adolescent or not. I have asthma (that wasn't by choice) and I'll suffer and pay for it for the rest of my life.

The fact that you use the word adolescent is worrisome; it does not portray your parents being very active in your life if you were doing coke before the age of 18.

If you were in the 17-18 y.o range, I feel you are also doing a disservice to all kids in that age group by saying things like being stupid as an adolescent. By 17-18, you should know "drugs are bad, mk" without somebody having to tell you. You should be able to accept responsibility for your actions. I've met more bright, thoughtful, caring teenagers than I have "stupid" ones, and I think that says a lot.

DILYSI Dave wrote: I'm in the Atlanta area and have been looking for this option. Care to share his name?

I'll send ya a PM. He's way up in Cartersville, tho. Not too far for me, we live so far out of town now that I actually live in Bartow Cty.

HiTempguy wrote:

tuna55 wrote: It's going to sound cold-hearted, but yes. Let me put it another way, who else should pay for your mistakes earlier in your life? How is it different than someone who is obese, someone who has diabetes, someone who fell of a tree and was paralyzed? There isn't another soul who should be made to pay for those mistakes...

What he said. Just like all actions, there are consequences, some you live with for the rest of your life. Yes, you DO have to take responsibility for your actions 25 years later. Whether you were an adolescent or not. I have asthma (that wasn't by choice) and I'll suffer and pay for it for the rest of my life. The fact that you use the word adolescent is worrisome; it does not portray your parents being very active in your life if you were doing coke before the age of 18. If you were in the 17-18 y.o range, I feel you are also doing a disservice to all kids in that age group by saying things like being stupid as an adolescent. By 17-18, you should know "drugs are bad, mk" without somebody having to tell you. You should be able to accept responsibility for your actions. I've met more bright, thoughtful, caring teenagers than I have "stupid" ones, and I think that says a lot.

Well, to me it's the same as a criminal case. Am I still guilty, even thought I have abandoned the behavior? It's a slippery slope.

As to this particular discussion, it's a really just a point of discussion. It's a moot point for my particular case..I still smoke cigarettes, and in that case higher insurance rates are justified, just as higher auto rates are justified because I drive a high performance car. But what of the ex-smoker who has cleaned up his act? What of the ex-obese who have lost the weight (or need added medical care to lose it)?

friedgreencorrado wrote:

HiTempguy wrote:

tuna55 wrote: It's going to sound cold-hearted, but yes. Let me put it another way, who else should pay for your mistakes earlier in your life? How is it different than someone who is obese, someone who has diabetes, someone who fell of a tree and was paralyzed? There isn't another soul who should be made to pay for those mistakes...

What he said. Just like all actions, there are consequences, some you live with for the rest of your life. Yes, you DO have to take responsibility for your actions 25 years later. Whether you were an adolescent or not. I have asthma (that wasn't by choice) and I'll suffer and pay for it for the rest of my life. The fact that you use the word adolescent is worrisome; it does not portray your parents being very active in your life if you were doing coke before the age of 18. If you were in the 17-18 y.o range, I feel you are also doing a disservice to all kids in that age group by saying things like being stupid as an adolescent. By 17-18, you should know "drugs are bad, mk" without somebody having to tell you. You should be able to accept responsibility for your actions. I've met more bright, thoughtful, caring teenagers than I have "stupid" ones, and I think that says a lot.

Well, to me it's the same as a criminal case. Am I still guilty, even thought I have abandoned the behavior? It's a slippery slope. As to this particular discussion, it's a really just a point of discussion. It's a moot point for my particular case..I still smoke cigarettes, and in that case higher insurance rates are justified, just as higher auto rates are justified because I drive a high performance car. But what of the ex-smoker who has cleaned up his act? What of the ex-obese who have lost the weight (or need added medical care *to* lose it)?

As a counterpoint, are you comfortable limiting what a given company can charge for a good or service based on largely circumstantial concerns? Honda can charge me more for a Civic than they can for you because my income is higher? There is a slippery slope in either direction.

I can't explain this, so I'll just post the reference. You guys should read Outliers by Malcolm Gladwell. This notion that people should just know better is flawed. People don't just know better. Witout the life experience all of us were lucky enough to have, we wouldn't be where we are. I worked hard to get where I am, for sure, but woudn't ever have gone down the path I did if I hadn't had the parents I had.

In reply to fast_eddie_72:

In general, it's an excellent point.

I've found myself both in this thread and a couple of others wanting to try to explain my background, my situation, and as much as I understand them, my philosophical leanings.

It kept seeming too far off-topic. It was touched on a bit by madmallard's "where did you learn about savings" thread, but this is obviously a lot broader.

More specifically to your point, I would also say that hard work is part of what got me where I am, but I also boggle when I think about the things I lucked out on in terms of time/place/background/resources, and how they affected my life. And I mean that in terms of both influences that caused me to make good decisions with tolerable frequency, and just in terms of what I got from my environment in general.

In general a libertarian would think that people are better off making decisions for themselves and a statist would think that a person is better off having some important decisions made for them. This is how socialism starts, basically. It's interesting that we're here in this thread, obviously I tend towards libertarianism. Even if people don't know better (which I think they CAN) they should be responsible to make those decisions anyway.

tuna55 wrote: I retract my statement because of how it could be misconstrued.

May I just say, that is twice in as many days that you have adjusted what you've said after I maid (maid? Really? Did I really just type that?*) a point. Thanks for that. Being able to adjust when another thought is presented shows a lot of smarts. And even though all this whining on the internet is a waste of time, it makes it feel like there is at least some point in thinking something through and sharing your thoughts. The two sides have worked so hard to tell us what we're supposed to think people are slow to think for themselves. Nice that a few of us here are willing to talk about an issue and admit that we aren't sure about our position. This one is a good example. I really don't know exactly what's right. I see both sides.

*I've been working like 14 hour days this week. Little loopy.

fast_eddie_72 wrote:

tuna55 wrote: I retract my statement because of how it could be misconstrued.

May I just say, that is twice in as many days that you have adjusted what you've said after I maid (maid? Really? Did I really just type that?*) a point. Thanks for that. Being able to adjust when another thought is presented shows a lot of smarts. And even though all this whining on the internet is a waste of time, it makes it feel like there is at least some point in thinking something through and sharing your thoughts. The two sides have worked so hard to tell us what we're supposed to think people are slow to think for themselves. Nice that a few of us here are willing to talk about an issue and admit that we aren't sure about our position. This one is a good example. I really don't know exactly what's right. I see both sides. *I've been working like 14 hour days this week. Little loopy.

Seriously. We're pretty much polar opposites on these issues and yet I'd still buy you a beer. I've said it before on this thread - if congress worked this well, our country would be far better off. Perhaps some of us need to run for office;...

tuna55 wrote: As a counterpoint, are you comfortable limiting what a given company can charge for a good or service based on largely circumstantial concerns? Honda can charge me more for a Civic than they can for you because my income is higher? There is a slippery slope in either direction.

This is true. I wish I hadn't used the "still a criminal" example, now it takes away my ability to say "but we're talking about human life here!" without being a hypocrite.

I think the best part of the conversation is that we're actually discussing the nuts & bolts of the complexities, rather than repeating the same accusations over and over. I've certainly learned that the concerns expressed by the people who disagree with me are honestly earned, and not just a reflexive reaction to those of who support a Canadian/European style system.

For the record, I would support the GRM party.

In reply to z31maniac:

We couldn't agree on a doggone thing, and we'd all think we were right.

Tom Heath wrote: In reply to z31maniac: We couldn't agree on a doggone thing, and we'd all think we were right.

Tom, read some of this thread! Just think if this were the crop of senators and congressman(women) to choose from for elections. Eddie up there debating with myself on capital hill, we both have good points, respect each others' opinions, come up with some legislation and vote on stuff that makes sense.

fast_eddie_72 wrote: I can't explain this, so I'll just post the reference. You guys should read Outliers by Malcolm Gladwell. This notion that people should just know better is flawed. People don't just know better. Witout the life experience all of us were lucky enough to have, we wouldn't be where we are. I worked hard to get where I am, for sure, but woudn't ever have gone down the path I did if I hadn't had the parents I had.

I raise these points because it's germaine to a great discussion:

Do we completely absolve one of any repurcussions from their previous behaviours?

Should one incur a higher personal expense because he/she make some bad choices, or should we absorb the cost of those consequences and give "that person" a free ride?

Who's really responsible?

The person who made bad choices because he/she was ignorant and/or stupid? The parent/parents because the child wasn't raised with a sense of personal accountability?

Is it a "society" that encourages poking at the boundaries of the "norm" but equivocates the resulting failures?

Please feel free to disagree, but it seems that the "I shouldn't suffer from my bad decisions" attitude is a weak line of defense. I have tremendous amounts of empathy and support for those who are ignorant before the fact; for others, not so much.

How to resolve this depends on the individual - "Do I accept responsibility, or deny it?"

In reply to oldsaw:

Well, just a thought- I think the answer is somewhere in the middle. It's neither extreme.

I use this as an absurd example just to make the point. Say you're 16 and you fail your driver's test. Now, when you go take it again, you're usuing more government resources than I did passing it first time. It costs me money because you didn't study the first time. So, should you lose your ability to get your license because you didn't study? Why should I have to pay for your mistake?

Of course, we let you take the test again because it costs me sooooo little and the punishment for your lack of preperation would be so harsh if you didn't get to drive for the rest of your life.

The point being, like so many things, we don't disagree that there are mistakes that should be forgiven and we all will pay together for your error. The question is always where to draw the line. Certainly at some point you have to say "enough chances" and cut someone off. I know this situation pretty well. I have spoken a bit about my extend family. We tried to help one of those kids. Thought we were going to make a difference, and who knows, maybe we did. But he made some bad decisions. One after another. And I'm pretty much done with him. If he's in trouble and shows up at my door I'll try to help within reason, but he's not living with us anymore and I'm not going out of my way to help him.

So that's kind of the other end. There's a point when I draw the line and say enough. But I think when deciding policy we have to weigh the potential benefit to the individual, soceity at large, the factors that put someone in a situation, etc. to draw the line. As the only point I'm making with regard to responsability is that we all bear some responsability for the socieity we've built. It's very clear to me that we've built something that works well for most, but not at all for a large number. I keep citing the incarseration rates as evidence. We should be able to agree that a self governing country should have a lower incerseration rate than we do. That's just one example. But we built a system that doesn't benefit many people. It seems those of us it does work for owe something to those for whome it does not. How much? That's a legit question. But it's something more than zero and something less than a free ride.

If we did a sweep of everyone who broke into a car and locked them up forever, it would lower rate of care break ins (a subject close to my heart). But at what cost to American citizens subjected to unfair punishment and to taxpayers who have to foot the bill for keeping them locked up?

I'm rambling - very tired. Very long winded way of saying it's not a simple, black and white issue. It's somewhere in between.

Just one more note about the kid we tried to help. Living with him for a while I learned some things. He's a smart kid, no question. He learned coping skills at a very early age that he uses well. Unfortunately, some of those skills are emotional blackmail and self deceit. He doesn't do it on purpose, but he can NOT accept that he is responsable for anything. That is in part because so much of the situation he is in is NOT his fault. But each passing year, his decisions play more of a factor in the course of his life. Yet he doesn't see it. It's not that he's stupid. It's just a result of a very, very poor early childhood. He'll feel the punishment for it for the rest of his life. Some of it is his fault. Some of it is not. It's complicated. I feel bad for him and I'm really glad I was given the tools at an early age to make better decisions.

tuna55 wrote: Tom, read some of this thread! Just think if this were the crop of senators and congressman(women) to choose from for elections. Eddie up there debating with myself on capital hill, we both have good points, respect each others' opinions, come up with some legislation and vote on stuff that makes sense.

If nothing else got in the way - we could lock the door and hash things out - I bet we'd come up with stuff that makes a LOT more sense than most of what we have now, for sure.