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mazdeuce
mazdeuce UltimaDork
1/10/17 12:19 p.m.
KyAllroad wrote: In reply to mazdeuce: Just FYI. Not all veterans, while any veteran may use VA facilities, there are income or disability benchmarks that must be met or we pay for services just like everyone else.

Yes, those numbers aren't quite as cut and dry as the other two groups. For what it's worth, I'm as equally frustrated by veterans that I know who vocally despise government getting involved in health care as I am at people who want to reduce VA benefits.

Duke
Duke MegaDork
1/10/17 12:29 p.m.
alfadriver wrote: Also, there was an interesting small article on NPR this morning, mentioning about the great advancements Cuba has made with cancer treatments- and ALL of their funding is from a communist government. These are things that our hospitals are really trying to get. For whatever reason, our model of healthcare didn't find them. Kind of illustrates that our model of health care development may not be the best one out there. Again.

Do you really think that our healthcare system and medical-scientific community "didn't find" these treatments? Or do you think that maybe there is a significant difference between the US FDA's bureaucratic approval and regulation process and that of a small, dictator-driven country?

Hell, the FDA's annual budget is about 6% of Cuba's entire GDP!

SVreX
SVreX MegaDork
1/10/17 3:55 p.m.
mazdeuce wrote: Calling medicaid "not insurance" isn't quite fair.

On that I'm afraid I must disagree.

That's like saying a parachute is the same thing as flight insurance. While both may insure that I don't hit the ground at high speed, both are NOT insurance.

Insurance is a product I purchase to protect me against losses I can not afford. Medicaid is a government assistance program.

And, it is NOT a single payer system. It is a large payer within a multi-payer system.

The number of participants is irrelevant.

But you did hit on the problem I am trying to address. We are TREATING it like a single payer system, simply because the largest payer is a bully who dictates how the rest of the payers have to participate. This is grossly unfair to all of the other payers.

Socialized medicine is a single payer system. We had a system that everyone paid for their own. It was fair, but it was unequally distributed based on wealth. Everyone who could afford it could buy insurance.

We now have a system that is completely out of balance and unfair, because the big bully payer dictates the rules.

From this point forward, I think it is possible our best option is single payer- socialized medicine. As Duke noted, not the best system, but perhaps the best way out of the mess we've gotten ourselves into.

pheller
pheller PowerDork
1/10/17 4:09 p.m.

Unrelated to numbers:

1) I've never talked to a Canadian who didn't like having their single-payer system. They might not like the taxes, but they certainly like the benefits. One guy in particular had a good thought; "I can afford health insurance in the USA, but as a Canadian citizen with high taxes I should be able to get some sort of credit for being able to prove that I hadn't used the Canadian Medicare."

2) Along those boundaries: I'm completely in support of being able to buy Health Insurance across state lines. In fact, we should be able to buy it across international boundaries. If someone who is an immigrant of China, speaks Mandarin, and wants to talk to insurance providers in China (who also cost less), they should be able to do it. Of course the worry is that Health Insurers will dupe consumers into shady policies and not have any recourse to file suit because of state (or international) lines.

3) As long as their are profits to be made, medical costs will continue to go up. We've got the best in the world, and those whom sell it to us are free to charge what they want. If you limit their earning potential, you limit your quality.

4) Regulation and previously mentioned cost of entry seem to really hold us back. People or researchers with good ideas can't bring stuff to market without gazillions of buckaroos. It's like the alternate reality of Atlas Shrugged, where philanthropic and good natured scientists will need to run to other countries in order to help people for FREE.

5) I suspect that HSAs will continue to be a very strategic way to deal with these costs. HSAs are banks, banks love money and they hold incredible power in the USA. HSAs also do a great job of putting responsibility into the hands of the consumer by rewarding saving, and of course in the hands of savy investors they can also be a great way of stashing away way more cash than you'd ever need. If costs came down, or if we were able to buy medication from out of the country (Canada), HSAs would become even more appealing. I wish I could use my HSA for more stuff, like gym membership, mountain bikes, perhaps cycling helmet, hell I should be able to use my HSA to eat vegetarian, because isn't that prevention?

STM317
STM317 HalfDork
1/10/17 5:04 p.m.
pheller wrote: 3) As long as their are profits to be made, medical costs will continue to go up. We've got the best in the world, and those whom sell it to us are free to charge what they want. If you limit their earning potential, you limit your quality.

In the market of goods and services, consumer have the choice to purchase something, or not. That's really not a choice in the case of health care. IF the choice is "pay whatever we demand, or suffer/die" that's more threat or ransom than free choice.

I am not an expert, but it seems to me like there is some precedent for regulating things like this, and it tends to benefit the consumer and foster growth and innovation within the industry. The utility industry is regulated in part to protect the consumer. Utilities are seen as basic needs for a standard of living that society has deemed appropriate. Why is medical care not considered a basic need for an agreed upon standard of living? Through regulation the cost of electricity has consistently decreased since the 80s. Due to increased competition utilities are forced to operate more efficiently, and many offer programs to consumers to reduce their usage. Where is that competition right now in the healthcare system? How are they getting more efficient?

bastomatic
bastomatic UltraDork
1/10/17 5:49 p.m.
SVreX wrote:
mazdeuce wrote: Calling medicaid "not insurance" isn't quite fair.
On that I'm afraid I must disagree. That's like saying a parachute is the same thing as flight insurance. While both may insure that I don't hit the ground at high speed, both are NOT insurance. Insurance is a product I purchase to protect me against losses I can not afford. Medicaid is a government assistance program.

I disagree. Medicaid and Medicare absolutely function as health insurance and trying to remove their numbers from total insured in the US doesn't make sense in this context. Part of the stated intent of the ACA was to increase Medicaid rolls so trying to discount it ignores a big part of the intent of the law.

I'd say it's like arguing that welfare isn't money, it's a government assistance program.

Call it medical coverage if you object to insurance I suppose.

RX Reven'
RX Reven' Dork
1/10/17 6:33 p.m.
pheller wrote: I suspect that HSAs will continue to be a very strategic way to deal with these costs.

Hi pheller,

As I understand it, HSA’s “Health Savings Accounts” simply shield participants from having to pay income tax on the money they put into their accounts…no different than a 401K account.

If this is the case, they do nothing to improve the cost / benefit ratio of our healthcare system which is what I think we need to be focused on.

Isn't every dollar saved by a HSA a dollar that won’t be collected in taxes…we’ve currently got a 20 trillion dollar debt…aren't the exact same people that are on the hook to pay that debt the one's that would participate in a HSA.

Perhaps I’m missing something (honestly, educate me if I am) but HSA’s seem like a totally pointless endeavor who’s only function is to allow politicians to give the impression that they’re accomplishing something.

Knurled
Knurled MegaDork
1/10/17 6:47 p.m.
RX Reven' wrote: Isn't every dollar saved by a HSA a dollar that won’t be collected in taxes…we’ve currently got a 20 trillion dollar debt…

That isn't debt like a credit card bill, it's more like you bought savings bonds so the government owes you $xxx. If the US weren't such a solid economy, people/other countries wouldn't be buying our government bonds.

Fueled by Caffeine
Fueled by Caffeine MegaDork
1/10/17 6:52 p.m.

I don't like hsa's. I have one. I use it. I feel like I'm being ripped off constantly.

Fueled by Caffeine
Fueled by Caffeine MegaDork
1/10/17 6:54 p.m.
RX Reven' wrote:
pheller wrote: I suspect that HSAs will continue to be a very strategic way to deal with these costs.
Perhaps I’m missing something (honestly, educate me if I am) but HSA’s seem like a totally pointless endeavor who’s only function is to allow politicians to give the impression that they’re accomplishing something.

If I didn't have a stupid high deductible plan I wouldn't need an HSA. I agree with you.

z31maniac
z31maniac MegaDork
1/10/17 7:49 p.m.

HSA plans make sense for young, healthy people with a decent income. I happen to be one of those.

I recently went to work for a very large software company. I pay $12/month for my HDHP and they put $1000/year in my account. I signed up to put another $600 or so every year. I've always thought the whole point was to make people more responsible for their healthcare decisions.

I know I'm about to get the "OMG I'LL DIE" but I know many people that spend co-pays and waste dollars visiting the doctor a few times for what amounts to a cold that they need a 1-2 days of rest and some Alka-Seltzer, and with the huge overhead it takes to process insurance, it's a waste.

But it's also hard to shop when you don't know the price up front. But I've found with my HSA (from a previous company) I paid less by being able to pay cash, on the spot for the entire visit.

YMMV and all that.

RevRico
RevRico Dork
1/10/17 8:15 p.m.
RX Reven' wrote: Isn't every dollar saved by a HSA a dollar that won’t be collected in taxes…we’ve currently got a 20 trillion dollar debt…aren't the exact same people that are on the hook to pay that debt the one's that would participate in a HSA. Perhaps I’m missing something (honestly, educate me if I am) but HSA’s seem like a totally pointless endeavor who’s only function is to allow politicians to give the impression that they’re accomplishing something.

Well... Kinda. That $20 trillion dollar debt is different. No one is really on the hook for it, and it shouldn't be considered debt as such. It's an impossible debt. To pay it off, it would require more money than exists. That "national debt" is the result of every single cent borrowed from the federal reserve to be used as money. When every single red cent is loaned to you with interest attached, you cannot possibly pay it back without inventing money from another source altogether.

On topic... I guess maybe it has helped some hourly employees and some poorer people get insurance that weren't able to before, but locally and personally, it has caused far more problems. A lot of business owners I know have drastically cut their hours of operation and employees because of how the law is written to lower their expenses.

My mom is in the fun position of wanting a part time job, to afford new glasses and hearing aids that her insurance plan won't cover, but working on top of her social security destroys her social security payment AND prices her health insurance out of a feasible range. I would argue vision and hearing slightly more important than blood tests or doctors visits, based on use alone.

I cannot and will not buy insurance until the fine at tax time is more than the monthly premiums, which are surprising considering I'm only 29. But overweight and a smoker don't help me with that either.

It seems the entire rest of the developed world has figured out this healthcare/prescription drug cost issue, but not us. A point brought home more by certain drugs costing pennies on the dollar in other countries while they're thousands here.

I do have to thank Medicaid and Medicare for prolonging my father's suffering for years once he was dropped by his insurance companies, but I'm also still very spiteful for a visit I made to their offices before the ACA thing was passed. I was told to get a drug problem or change my skin color in order to get coverage when I was unemployed and needed a doctor, and that still doesn't sit well with me. I'm still not a fan of this whole thing supporting junkies and giving them the world for free while people who haven't voluntarily thrown their lives away can't get into see doctors or get any kind of coverage that won't send them to the poor house on the way to treatment, but I guess that's another issue. Although free trips to rehab probably have a lot to do with padding the insured people numbers, so it must be helping ...something.

ProDarwin
ProDarwin PowerDork
1/10/17 8:26 p.m.

I like HSAs. Its like another tax-sheltered retirement account. I max mine every year

SVreX
SVreX MegaDork
1/10/17 8:47 p.m.

In reply to bastomatic:

Of course welfare isn't money. It IS government assistance.

The user can not spend it like money, does not earn it, can only use it in approved ways, and has to meet all kinds of criteria. Everyone I know who has ever received any form of welfare (including me) would MUCH rather have cash that THEY earned. It's degrading, demoralizing, and hard to accept.

If you'd like to give me some money, I'd be glad to accept it.

But even if the user gets to utilize it for some similar benefits (with no freedoms), the source matters a great deal to a lot of people as well.

If you take your money and spend it, very few people have a problem with it. But if you take welfare and spend it, it's money that came from someone else- it's theirs. Most people want some influence in how their money is spent.

Im not trying to beat a dead horse, but this perspective amazes me.

SVreX
SVreX MegaDork
1/10/17 8:49 p.m.

So, for those of you with that opinion, how would you define government assistance? Sounds like there is no such thing as government assistance, only assets of value that have been transferred to another individual so they can have some money.

That's weird.

jstand
jstand HalfDork
1/10/17 9:14 p.m.
ProDarwin wrote: I like HSAs. Its like another tax-sheltered retirement account. I max mine every year

It took some getting used to, but I like my high deductible plan and HSA.

I don't max mine out, but i do fund it to cover the max out of pocket from my high deductible plan. I don't expect to reach the max out of pocket, but figure that's a good target.

I did the math using the previous years claims and EOBs to have real numbers, and found that my health care cost with the high deductible plan was cheaper annually than the either PPO offered at work. That is for a family of four with 2 kids (7 and 13), and some maintenance meds.

Even if I hit the max out of pocket the high deductible would cost less over the course of the year.

z31maniac
z31maniac MegaDork
1/10/17 9:45 p.m.
SVreX wrote: So, for those of you with that opinion, how would you define government assistance? Sounds like there is no such thing as government assistance, only assets of value that have been transferred to another individual so they can have some money. That's weird.

Where does the gov't get this money to give as assistance to give to someone else?

They take money from me by threat of fine and/or imprisonment and use it for someone else. How is that not a transfer of assets?

z31maniac
z31maniac MegaDork
1/10/17 9:46 p.m.

Keep in mind, I'm all for social safety nets, universal healthcare and the like. I'm addressing your specific question.

Mitchell
Mitchell UberDork
1/12/17 6:24 p.m.

In good news, those 20 million may not have to worry about the high cost of their insurance in the near future. In fact, they may not have to worry about having insurance at all!

Knurled
Knurled MegaDork
1/12/17 6:52 p.m.
Mitchell wrote: In good news, those 20 million may not have to worry about the high cost of their insurance in the near future. In fact, they may not have to worry about having insurance at all!

I was reading an article (facebook post) about how it will be great when Obamacare is repealed because it was ruining the ACA, which was helping families in a good way.

I don't have a large enough hand for the facepalm in my soul.

Beer Baron
Beer Baron MegaDork
1/13/17 10:19 a.m.

The ACA hasn't exactly been repealed yet. And what the senate has done isn't exactly a repeal either. NPR article about the vote on the "repeal".

If I am understanding correctly, the vote would keep the general provisions of the law in place (like children being able to stay on parents' insurance), but uses "budget reconciliation" to play with how congress brings in and spends money. So they could cut out the fee for not having insurance and they can cut the expansion of Medicaid funds.

Which to me looks like the government will end up spending just as much money on everything, but with less revenue to pay for it all.

Dr. Hess
Dr. Hess MegaDork
1/17/17 2:01 p.m.
dculberson
dculberson PowerDork
1/17/17 2:04 p.m.
Dr. Hess wrote: All about that 20 million number.

From the best of sources, Zerohedge. Definitely reputable. Up there with Russia Today and the Sun UK!

Dr. Hess
Dr. Hess MegaDork
1/17/17 2:23 p.m.

If you can't argue with the content, then attack the medium. That's good logic there.

dculberson
dculberson PowerDork
1/17/17 2:56 p.m.
Dr. Hess wrote: If you can't argue with the content, then attack the medium. That's good logic there.

By that standard then we should be discussing Bat Boy. He got tons of coverage in the Weekly World News.

You love Zerohedge, I get it. But multiple people here (meaning, here on GRM, not in this thread) have pointed out that it's a lousy source. I don't believe a single word they write. It's up there with Rense.com and other clearly fictional sources written by people with clear agendas willing to fabricate articles whole cloth in order to advance that agenda.

So yes, it's good logic. I can provide dozens of links to conspiracy theory web sites, doesn't mean you expending hours spinning your wheels debunking every one of their lunatic fringe views is a good use of your time.

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