Healthcare going forward

[Kulindahr]

Oh, please.... everything I've said about Voter ID is true. It's a farce. No attempt at diversion by you will change that fact... not even your diversion that I'm really the diverting one, lol.

And of your crocodile tears regarding how you wish America would become united again... for years Jewish, Catholic and Asian immigrants were discriminated against heavily and seen as "others". They believed in the ideals of this country far better than prejudiced native born bigots who decried their numbers and place for being here and treated them as second class citizens. You defend an America that never truly existed for many. I only wish I could write and express my points as well as Kuli... I will say I thoroughly will enjoy watching the total implosion of the Donald Trump presidency and will work to support an America that is truly forward thinking, humane and compassionate. THAT will be an America that will be great and worth defending to the very end.

I'm not sure I'm expressing my points very clearly this evening, not after a day "enjoying" the system Ben thinks is so wonderful, getting bounced from one entity to another trying to get someone to start the ball rolling on getting my mom's insurance providing home care kicked in so we can get someone in to help. The run-around from insurance and other agencies is exactly what Ben defends when he opposes admitting the Judeo-Christian obligation to care for others who are part of your own people.

And yes, they are part of our people so long as they are here legally, or if this is the only country they've ever known, or they've gotten a skilled job or started a business benefiting those here legally.

 

[KaraBulut]

America's greatness has been in avoiding the lure of socialism/communism. Why should someone else have to work and pay taxes so that you can keep your money and house? You are totally focused on how great it is to receive charity, while ignoring the ugly confiscation from others to pay for the charity.

This is actually one of the "great again" fictions. For the first 150 years of the US' history, it was a 3rd world country with massive debts, a largely illiterate populace, an economy dependent upon unpaid indentured servants/slaves- a country with little sources of income to pay off the countries like France and Spain that it owed.

It wasn't until slavery was abolished, immigration increased, incomes were taxed and massive amounts of federal dollars were invested in infrastructure that the US became the land of plenty that we live in today.

And yes, like most of the civilized world, the US also put in place social safety programs that are also investments into the country.

Remember we had tuberculosis almost eliminated in the US. The resurgence is the result of our flood of third world immigrants.

More fiction.

Other countries have had very effective TB elimination programs including mandatory immunization for TB (US is one of the few countries that doesn't mandate immunization for TB).

So, here's your fact checks for the day, compliments of the CDC:

• The primary cause for the rebirth of TB in the US was the HIV epidemic in the 1980s. Aggressive treatment with antiretrovirals decreased the incidence of TB in the US until the latest increases.
• A total of 9,557 TB cases (a rate of 3.0 cases per 100,000 persons) were reported in the United States in 2015.
• The rates of TB among foreign-born US residents has been decreasing since 1996. Rates for persons born in the US have remained constant during this time.
• The majority of foreign-born persons who were diagnosed with TB were Asian or Pacific-Islanders who had been in the country more than 5 years.
• American Indians and Alaska natives still account for a disproportionate number of TB cases (they're American citizens)

And they wanted to remove those entirely from what insurance is required to cover, right? That's how I understood it?

The ACA also required that insurance policies sold by insurance companies actually provide basic coverage -- unlike many plans that covered nothing prior to the ACA....

The summary of the prior state of affairs by thewiz is in agreement with the way that I recall the pre-ACA days based upon my decades in the healthcare industry.

There's a lobbying effort underway by the libertarians (small "l" liberatarians, Koch brothers, Mercer family, et al) and the insurance lobby to try to bring back the substandard individual policies that existed before the ACA. Those policies were capped ($50,000 might be a typical cap) and the policies didn't have preferred provider contracts or discounts, so that capped amount didn't go very far. You might have a $100 premium, but not very many providers would accept the policy, so you would be expected to put down a cash deposit because the coverage was so limited.

While I do think that there is some loosening of some of the requirements, we never want to return to those "minimal coverage" or "catastrophic" policies- they were not worth the paper they were printed upon and the insurers were notorious for using fine-print in the policy to deny payment. "Pre-existing condition" was created solely to allow these insurers to avoid payment where possible.

Your description of insurance ignores to 500 lb gorilla. Coverage of preexisting illnesses cannot be insurance; it is charity

You've brought this up several times. Pre-existing condition will never return. It was a convenient excuse for insurance companies to avoid paying large claims. The only people who don't have pre-existing conditions are newborns. For the rest of us, all it takes is an insurance reviewer/auditor, a release of information document and a modicum of time to find some pre-existing condition that will result in a claim denial.

... the democrats...

So speaks the forum's resident expert on Democrats... especially when the facts get in the way again.

 

[Benvolio]

This is actually one of the "great again" fictions. For the first 150 years of the US' history, it was a 3rd world country with massive debts, a largely illiterate populace, an economy dependent upon unpaid indentured servants/slaves- a country with little sources of income to pay off the countries like France and Spain that it owed.

It wasn't until slavery was abolished, immigration increased, incomes were taxed and massive amounts of federal dollars were invested in infrastructure that the US became the land of plenty that we live in today.

And yes, like most of the civilized world, the US also put in place social safety programs that are also investments into the country.

You are wrong about preexisting illnesses. It is little different from trying to buy fire insurance after your house is on fire. Insurance is to cover risk, but preexisting illness is no longer a risk, it has already progressed to the payable event.

The summary of the prior state of affairs by thewiz is in agreement with the way that I recall the pre-ACA days based upon my decades in the healthcare industry.

There's a lobbying effort underway by the libertarians (small "l" liberatarians, Koch brothers, Mercer family, et al) and the insurance lobby to try to bring back the substandard individual policies that existed before the ACA. Those policies were capped ($50,000 might be a typical cap) and the policies didn't have preferred provider contracts or discounts, so that capped amount didn't go very far. You might have a $100 premium, but not very many providers would accept the policy, so you would be expected to put down a cash deposit because the coverage was so limited.

While I do think that there is some loosening of some of the requirements, we never want to return to those "minimal coverage" or "catastrophic" policies- they were not worth the paper they were printed upon and the insurers were notorious for using fine-print in the policy to deny payment. "Pre-existing condition" was created solely to allow these insurers to avoid payment where possible.


You've brought this up several times. Pre-existing condition will never return. It was a convenient excuse for insurance companies to avoid paying large claims. The only people who don't have pre-existing conditions are newborns. For the rest of us, all it takes is an insurance reviewer/auditor, a release of information document and a modicum of time to find some pre-existing condition that will result in a claim denial.


So speaks the forum's resident expert on Democrats... especially when the facts get in the way again.

At the time of the revolution the Industrial Revolution was largely limited the Britain and the nascent US, and we had the most advanced governmental system in the world, a free enterprise economy and a culture eager for innovation. So we were never a third world economy. By 1870 we and Britain were almost tied for the highest GDPs among industrial economies. By 1913 our GDP was twice that of any other country with very little resulting from government spending. https://en.m.wikipedia.org/wiki/List_of_regions_by_past_GDP_(PPP)
Liberals love to over emphasize the benefit slavery, which was of course limited to the nonindustrial south. The economy was not dependent upon slave labor.

 

[johaninsc]

thought this pic belonged here...right up under Benny's ass

 

[Benvolio]

thought this pic belonged here...right up under Benny's ass

No. High salaries may contribute to high premiums, but how do insurance salaries cause high healthcare costs' doctors bills, hospitals, drugs? They don't. High costs are largely because most people have insurance to pay them.

 

[gsdx]

^ We've tried to tell him. Perhaps he'll pay attention to someone with 'Dr.' in front of his name.

(By the way, that was the 'joke of the day'.)

EDIT: See? I told ya.

 

[smokeshadow]

If you thought the conservatives first attempt at a health care proposal was hogwash, just wait until you see what they are up to now

http://americablog.com/2017/04/gop-congress-let-women-pre-existing-condition.html

I especially loved how women become "pre-existing conditions" ***end snark***

 

[Benvolio]

If you thought the conservatives first attempt at a health care proposal was hogwash, just wait until you see what they are up to now

http://americablog.com/2017/04/gop-congress-let-women-pre-existing-condition.html

I especially loved how women become "pre-existing conditions" ***end snark***

Nonsense. Women are not treated as pre existing coditions, but premiums are based on risk, I.e. the probability of disease at in the near future. If women statistically have more or higher medical expenses then they should pay higher premiums than men. If not, then you are requiring men to pay part of the premiums for women. Equal premiums treat people unequally.
If the policy covers preexisting illness the premium has to be much higher, or that have to charge health people much higher premiums than they would have to pay based on their own risk. Many or most healthy people will be unable or unwilling to pay those high premiums.
The ACA scheme charges healthy people very high premiums to care of others with preexisting illnesses.

 

[gsdx]

^ What is your answer for people who cannot afford insurance to pay for treatment that will keep them alive? So far, I get the impression that you would rather they die "and decrease the surplus population."

Scrooge was a miser, thinking of nobody but himself and his bank account. Trump is the modern-day Scrooge who doesn't give a shit about Americans, their health, their education, their poverty level, their hunger, or anything else if it takes money from his wallet or the bank accounts of his millionaire and billionaire friends.

 

[frankfrank]

That's hogwash. Insurance companies pay out most of their premiums. Your dishonest exaggerations poison your thinking and any debate.

Yes, they do - because that's the LAW. Part of Obamacare. They must use 80% of revenues toward actually paying for healthcare for those insured.

The Repuke plan will simply be happy to take that 80%, and remove the 8.

 

[frankfrank]

Nonsense. Women are not treated as pre existing coditions, but premiums are based on risk, I.e. the probability of disease at in the near future. If women statistically have more or higher medical expenses then they should pay higher premiums than men.

If women are treated differently, then what? That opens the door to parsing "risk" ad infinitum. I don't even think that age-related premiums should vary, within the pre-Medicare community younger than 65**.

**I would possibly make an exception for people younger than perhaps 30, who would indeed be allowed to pay much lower premiums, as people in that age group are often still settling into their life careers, or trying to dig themselves from under oppressive college loans, or winding their way up the wage-price stairs by working in low-wags jobs, etc. This would be a KNOWN age-plateau for premiums, and not at all subject to the whims of insurance companies.

Give unbridled reign for companies to parse women versus men, then insurance companies will start parsing rates to people who are unmarried, to people who are LGBT, people who like the wilderness and its critters, people who live in "dangerous" neighborhoods, people working in "dangerous" professions, people who smoke, people with genetic predispositions toward...whatever, people who happen to scan a lot of HFCS-heavy prepared foods and candy/cookies/ice cream on their supermarket savings cards (I mean, who knows?)...

Some of this is done already, sometimes, such as the smoking thing.

Will insurance companies be allowed to rescind policies, and declare a pre-existing condition, because somebody is busted for smoking "illegally-obtained" pot?

I always thought that ALL people should be in one massive insurance pool, regardless of status or risk, with a universal rate for all. (OK, I am of course assuming something that at least resembles a single payer system as well.) I have changed my mind enough to allow lower rates for children and young adults...and it might be justified to have another somewhat higher rate tier for children younger than 2 years old, because their immunity and other systems aren't entirely broken-in and developed yet, and babies do get sick much more than children who have reached pre-school or kindergarten age.

The mind boggles.

Indeed, the insurance companies DO want us to pay them tons of tribute or extortion just to perpetuate their right to exist while they do ABSOLUTELY NOTHING, if they all manage to get what Agent Orange wants for them.

 

[Kulindahr]

There's a lobbying effort underway by the libertarians (small "l" liberatarians, Koch brothers, Mercer family, et al) and the insurance lobby to try to bring back the substandard individual policies that existed before the ACA.

The Kochs and their associates are NOT libertarians -- they're propertarians, believing that those with more property are superior and may properly dictate to others how to live... or fail to live. In other words, they don't actually believe in the foundation of libertarianism, which is self-ownership; they believe that great wealth gives them ownership over others.

 

[Kulindahr]

This is actually one of the "great again" fictions. For the first 150 years of the US' history, it was a 3rd world country with massive debts, a largely illiterate populace, an economy dependent upon unpaid indentured servants/slaves- a country with little sources of income to pay off the countries like France and Spain that it owed.

You missed the fact that a fair amount of the then-existing prosperity, such as it was, rested on having a frontier to exploit.

 

[Kulindahr]

Nonsense. Women are not treated as pre existing coditions, but premiums are based on risk, I.e. the probability of disease at in the near future. If women statistically have more or higher medical expenses then they should pay higher premiums than men. If not, then you are requiring men to pay part of the premiums for women. Equal premiums treat people unequally.
If the policy covers preexisting illness the premium has to be much higher, or that have to charge health people much higher premiums than they would have to pay based on their own risk. Many or most healthy people will be unable or unwilling to pay those high premiums.
The ACA scheme charges healthy people very high premiums to care of others with preexisting illnesses.

So basically you believe in eugenics, except you want to carry it out via for-profit economic structures. Creative!

 

[Kabluey]

Like many others, I pay high taxes and pay hundreds a month for health care. Now the democrats say that I must also buy full insurance and pay for care for all those who do not work, or pay income taxes, or buy insurance, and then see my health care degraded as I wait in line behind those I am paying for. Worse the democrats will search for ways to discriminate against whites and males as for example in the Dodd Frank Act.

I pay about the same taxes as I would in the USA and get free healthcare and accident insurance. Other people can pay less and get the same deal.
Beat that.

 

[Benvolio]

Insurance premiums charge for the risk assumed. Insurance on a large house costs more than for a small house. Life insurance is based upon age; the older you are the more you pay because your life expectance decrease with age. Life insurance has been a little different because the older are so much more likely to need the insurance that they could not buy insurance based strictly on risk. So it has usually been sold in groups with the younger paying more than they would based on their own risk.
But the fairest premiums are based on the risk assumed and insurance companies hire actuaries to study the risks involved.

 

[Kabluey]

Insurance premiums charge for the risk assumed. Insurance on a large house costs more than for a small house. Life insurance is based upon age; the older you are the more you pay because your life expectance decrease with age. Life insurance has been a little different because the older are so much more likely to need the insurance that they could not buy insurance based strictly on risk. So it has usually been sold in groups with the younger paying more than they would based on their own risk.
But the fairest premiums are based on the risk assumed and insurance companies hire actuaries to study the risks involved.

That's socialist.
Surely under Ben's logic, the old would be paying proportionally more than the young, rather than leeching premiums from other customers.

 

[Benvolio]

Yes, they do - because that's the LAW. Part of Obamacare. They must use 80% of revenues toward actually paying for healthcare for those insured.

The Repuke plan will simply be happy to take that 80%, and remove the 8.

They always paid out most of their premiums.

 

[rareboy]

That's socialist.
Surely under Ben's logic, the old would be paying proportionally more than the young, rather than leeching premiums from other customers.

And this is why Benvolio makes the most convincing case for single payer coverage through a universal class of citizens who contribute to their healthcare costs through everything from buying a stick of gum to state and federal income tax.

Every single person in the US is going to need health care. Some more. Some less. Many of these people have no control over their need for health care. Genetic based conditions, viruses, bacterial infections, accidents.....no one asks for them.

The reason that Benvolio is so unconvincing for me is that I am one of those who through the luck of the genetic draw, has a rare coagulopathy condition. In my early thirties, without universal care, I would have died. Pure and simple. I just would have died.

Instead, I had the best care in North America, including having the Chief of Medicine and the head of Haematology of the University Health Network as my physicians. I spent almost a month in Hospital and had some difficult and dangerous treatments...and participated in research and teaching activities while I was there. I had two more follow-up episodes over a few years and each time, there was one of the largest hospital organizations in the world right behind me.

It meant that I was able to continue on with my life and contribute back....all the money that was invested in my life came back into the system through my productivity and income. In some years, I paid an Ontario Tax health surcharge of close to $15K...but it didn't bother me a bit. Compared to an impossible burden of costs that I would have been left with under the US private insurance plans.

For all of its problems...the public health system treated me as a person instead of a bank account. Because an insurance company wasn't making decisions about what treatment I could or couldn't receive....my physicians were unfettered and I'd like to think that I helped in the screening and treatment of genetic blood disorders that would then help others over the next decades.

And as I get older, I understand very well the incidence of age related disease and the likelihood that I will need procedures and treatments along with an entire cohort of ageing baby boomers. But I know that from the sales tax on my booze, through the HST I pay on all the goods and services that I consume, that I am effectively paying into an insurance scheme that will cover these services when I need them...without paying multi-million dollar salaries...or employing hundreds of thousands of insurance agents and office staff who literally contribute no value added to the delivery of care.

I keep pointing out that Benvolio lacks the ability to even barely comprehend how a well managed universal health delivery system actually works. He is so blinded by his racist hatred that all he sees is some plot for brown people to take something that he feels should only be the right of whites to have. And yet he has no problem apparently with continuing to fund expensive, episodic and catastrophic care interventions through his federal taxes.

I think after reading and re-reading this thread...the truth is obvious.

The US is fucked when it comes to health care.

Until the country creates a state level based system of funding and managing care with some input from the Federal level, allows interstate pooling and management of health care services and establishes a public option for coverage...it is doomed to a future of higher and higher case costs with poorer and poorer outcomes and at some point, refusal within the system itself to pay the vastly overinflated prices that a private insurance system bakes into health service delivery.

By that time though, The US will effectively be the equivalent of a second world banana republic and the result will be something that resembles those countries where the rich and middle class hide inside their gated communities while the poorest of the poor live without hope.

 

[kallipolis]

^This post is much appreciated for its plain, and simple explanation of the benefits...for all...attached to a universal health care system.