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So basically like ALL health care.

All health care subsidies end up being "age based" subsidies if you use that logic.

sourclams wrote:

Easy E wrote:2. It forces you increase your risk pool, by taking on more people. Therefore, more people paying premiums to cover the other sick ones.

The people being taken on, however, are primarily young and healthy people who don't need health insurance/much health insurance. In its simplest form, this is an age-based subsidy where young people subsidize older (older meaning less healthy) people.

And poor people don't forget that.

Except of course the unions and companies that have been exempted because ...er why again? oh yea I remamber now
$$$$$

Melissia wrote:So basically like ALL health care.

All health care subsidies end up being "age based" subsidies if you use that logic.

Well no.

You could have a pool based entirely around elderly people with premiums scaling with income. Then age has nothing to do with it.

And that's not a subsidy of the elderly, how...?

They'll still have to make enough money to pay for the elderly insurees' healthcare, which is by nature higher costing than the healthcare of younger or middle-aged people.

sourclams wrote:

Easy E wrote:2. It forces you increase your risk pool, by taking on more people. Therefore, more people paying premiums to cover the other sick ones.

The people being taken on, however, are primarily young and healthy people who don't need health insurance/much health insurance. In its simplest form, this is an age-based subsidy where young people subsidize older (older meaning less healthy) people.

How is that different than any othe rHealth Insurance? The health insurance company WANTS healthy people so it can gain premiums, sit on the money they don't spend on sick ones; and place it in investments until needed, and thereby making a profit.

Oh I get it. it's only good and virtuous if a company does it. Check.

Easy E wrote:

sourclams wrote:

Easy E wrote:2. It forces you increase your risk pool, by taking on more people. Therefore, more people paying premiums to cover the other sick ones.

The people being taken on, however, are primarily young and healthy people who don't need health insurance/much health insurance. In its simplest form, this is an age-based subsidy where young people subsidize older (older meaning less healthy) people.

How is that different than any othe rHealth Insurance? The health insurance company WANTS healthy people so it can gain premiums, sit on the money they don't spend on sick ones; and place it in investments until needed, and thereby making a profit.

Oh I get it. it's only good and virtuous if a company does it. Check.

Pretty basic difference. In one, a person freely chooses to enter or not enter the pool. In the other case, the person MUST enter the pool or be punished. So, threat of force vice free choice. Seems pretty easy to see the difference.

True.

As we use to say in the insurance industry, "of course you don't need insurance.... until you need insurance."

I have yet to meet a person who has never needed it, because insurance is synonymous with Healthcare in the US.

broodstar wrote:
Are you saying you can plan my life better than I can plan it myself?

I can.

Easy E wrote:True.

As we use to say in the insurance industry, "of course you don't need insurance.... until you need insurance."

I have yet to meet a person who has never needed it, because insurance is synonymous with Healthcare in the US.

And I would put forward many people agree. What we may agree less on is WHAT insurance we as individuals want and or need. As I mentioned earlier, my 20 something son, assuming he wants coverage, would probably choose a much different plan than a plan my 60 something father might choose. Certain lifestyle choices and even jobs would push a person towards a certain type of coverage. Under Obama care, all plans start to look the same and then start to cost the same. So you are forced into the pool, and cannot decide a level of risk/coverage you think is right for you. I have issues with that as well. In my opinion, I should be able to shop companies and find a plan I think is best for me at a price I am willing to pay. If I don't want certain coverage, I should not have to buy it. Frankly if I want no coverage, I shouldn't be forced into the pool at all.

Obviously many folks on this thread are happy to be forced into the pool and use the Fed Gov't to force others in as well. I am very much against that.

Under Obama care, all plans start to look the same and then start to cost the same.

Actually I see quite the opposite happening-- a widening variety of choices, rather tahn a single comprehensive plan for everyone.

Melissia wrote:

Under Obama care, all plans start to look the same and then start to cost the same.

Actually I see quite the opposite happening-- a widening variety of choices, rather tahn a single comprehensive plan for everyone.

Wrong, certain things MUST be offered in every plan, which means they must be paid for. Employers for example MUST buy plans for employees that meet certain criterea/contain certain provisions. Hence they start looking a lot alike. Since most folks get insurance through their employer, it affects most insured people.

CptJake wrote:Wrong, certain things MUST be offered in every plan, which means they must be paid for.

Which means that they can offer several packages, anything from a range of the bare legal minimum to covering everything, even elective surgery such as cosmetics.

Melissia wrote:

CptJake wrote:Wrong, certain things MUST be offered in every plan, which means they must be paid for.

Which means that they can offer several packages, anything from a range of the bare legal minimum to covering everything, even elective surgery such as cosmetics.

I would bet my prediction of less choice being offered is correct. Ask the HR folks for businesses out there what their insurance providers are telling them.

And insurance for elective surgery is asinine. The whole premise of insurance is it covers you when something unexpected comes up. Sometimes that coverage includes access to certain preventive procedures/treatments beacuse it makes good business sense for those to be offered. But elective procedures? If someone wants 10k worth of boobs put on their chest, they are going to pay 10k. No insurance plan SHOULD cover that elective* procedure, and being forced into a pool to subsidize elective surgery for others is morally corrupt.

*Obviously some plans may cover corrective cosmetic surgery, but never elective.

Perhaps less choice from businesses, but more choice in the market.

I have a feeling the business Group plans would cease being one of the main ways people are insured. There are several reasons for this.

1. Cheaper for businesses to not offer Healthcare, if it is widely available through other means. Right now, it is a Golden handcuff. The higher end employers will keep it, but I imagine a lot of smaller firms will dump Group coverage ASAP.

2. People will want customizable options, and to tailor their coverage/premium. They will go to private insurance and the exchanges for this. Plus, it is portable.

Easy E wrote:Perhaps less choice from businesses, but more choice in the market.

I have a feeling the business Group plans would cease being one of the main ways people are insured. There are several reasons for this.

1. Cheaper for businesses to not offer Healthcare, if it is widely available through other means. Right now, it is a Golden handcuff. The higher end employers will keep it, but I imagine a lot of smaller firms will dump Group coverage ASAP.

2. People will want customizable options, and to tailor their coverage/premium. They will go to private insurance and the exchanges for this. Plus, it is portable.

I think you are missing part of the point of Obamacare. Businesses will also get penalized if they don't provide insurance meeting Obamacare standards. Yes, many will drop coverage and pay the penalty, others will not hire as many folks as each they do will cost more/cut into their bottom line more. To think individuals will have the buying power to demand better prices than companies buying 10s to 100s (or more) plans is silly. Individual coverage is going to cost more. And it will be mandatory.

There will not be a lot of 'customizable' options because each plan will have to have minimum coverage as defined by the law, a buyer can not opt out of that coverage because he/she does not want it.

I strongly suspect you folks have not really thought out/looked at the implications of this. Premiums are already going up in anticipation of the mandatory coverage the law requires. That is not a shock. Insurance providers have no real incentive to offer better deals, the Gov't ensures an unlimited customer base (or one only limited by the size of the population) and subsidizes those who cannot afford the minimum coverage. Employers ditching coverage will force more people into that category.

Add in that whole Gov't Force thing and I am very much against this.

As for the Business requirement. I think companies will just accelerate the move to HSA/HRA self-service only plan options; just like they are doing now anyway. These plans are cheaper to administer and have higher deductibles/co-insurance than HMO/PPO plans. Therefore, no real change for the employee, EXCEPT now they can also go look at the Health Exchanges for a better deal and still take advantage of group rates. now, you choose between individual plans or your businesses group plan. This should create more competition, and that is good right?

I will admit I'm not an expert on Obamacare, and in the spirit of learning, what minimum coverages are you talking about? Is it more than just, no pre-existing conditions, no recisions on policies, coverage for college kids to 26, etc. As far as I am aware, it doesn't put too many restrictions around deductibles, Out-off-pocket maximums, and other technical aspects of the plans. However, I could be wrong.

Phanatik wrote:
I explain to you the basic tenets of freedom and you bore me with talk about your beloved models.

What are the basic tenets of freedom?

Phanatik wrote:
Many people are fed up with government meddling and are pushing back. And guess, what? There are more of us.

In the US?

Maybe, but not many more if polling is to be believed.

Phanatik wrote:
I believe you are in Australia? and suffering under socialized medicine? Keep it. Just don't try to foist it off on us.

Their healthcare system is generally considered to be superior to the US system.

Phanatik wrote:
I was probably engaging in economics when you were still a bubble in your momma's martini. Keep your pleadings and explanations to yourself.

Always love the age argument. Nothing like an old man who thinks being an old man somehow makes him smarter, more knowledgeable, or otherwise superior.

dogma wrote:
Their healthcare system is generally considered to be superior to the US system.

A friend of mine from there as genuinely shocked at how backward the US healthcare system was, pre 'Obamacare'. Particularly how certain life saving medical procedures that were commonly in practice in Australia were prohibited in the US for ideological reasons. (Such as those based on stem cell research)

BaronIveagh wrote:
A friend of mine from there as genuinely shocked at how backward the US healthcare system was, pre 'Obamacare'. Particularly how certain life saving medical procedures that were commonly in practice in Australia were prohibited in the US for ideological reasons. (Such as those based on stem cell research)

While I'm not convinced that Obamacare is a good solution, or even really a solution, to the problems we have with medical care in the US I do generally agree with that sentiment.

Hell, I got better treatment in France at 60% coverage than I did here with a 1200 USD deductible, and in France I didn't have to pay a premium.

dogma wrote:Always love the age argument. Nothing like an old man who thinks being an old man somehow makes him smarter, more knowledgeable, or otherwise superior.

The human brain deteriorates just as much as the body does. It's just harder to notice as it is not a visible deterioration unless you'r going in for regular CAT scans.

I think somebody mentioned it, but the way I understand it, Obamacare is an imperfect solution that aims to fix a broken system without having to demolish it and rebuild from scratch. A patch to make do so there are at least quick results. So of course it's not going to be really satisfying (for anybody, mind you), but if the Republicans had drawn the same plan before, you'd think there is at least a consensus about the existence of a problem and therefore about the need for a solution...

I was wondering : would drawing a parallel with vehicle insurance be relevant ? If I'm not mistaken it is mandatory in a number of states and in the ones where it's not, you pay a fee to the state if you choose not to cover your car.
No need to pounce on me screaming, just trying to figure it out.

BaronIveagh wrote:And we don't need to steal Switzerland's politicians, we just need to make lobbying ours a capital crime, punishable by death by keelhauling. Or maybe having molten gold poured over them. Something nice and ironic. Oh, and making political campaign ads illegal. Just have them debate each other on TV and give each candidate equal coverage. Mind you, this would require burning everyone at Fox News and MSNBC at the stake, but I can get behind that too...

I'd agree, but judging from what we have here, you'd likely find it boring once the smoke is gone

My loathing of the medical industry has grown significantly over the last few days.

I think simply making the evil bs that insurance companies get up to illegal would be a nice step.

Hyd wrote:
I was wondering : would drawing a parallel with vehicle insurance be relevant ? If I'm not mistaken it is mandatory in a number of states and in the ones where it's not, you pay a fee to the state if you choose not to cover your car.
No need to pounce on me screaming, just trying to figure it out.

Not really. For example, my brother who lives in Washington DC and previously lived in Atlanta does not own a car. He isn't forced to buy one nor to buy auto insurance. In most cases, mandatory auto-insurance requirements are to cover OTHER peoples' cars and medical costs if you hit them. You can have very limited coverage for your own car. Additionally, if you get into wrecks or have a bad driving record (lots of moving violation tickets) the insurer is allowed to do the financially correct thing and raise your premiums or even drop you from coverage. Additionally requirements are set BY STATES vice the Federal Gov't. Our Fed Gov't, like it or not, is supposed to be pretty limited in power by the Constitution...

Also, you really only need to be licensed and insured to drive on public roads (and again, to cover damage you cause vice damage to you). I know this is not the norm for most people, but there are folks who have ranches and such where they have ranch vehicles that they can drive unregistered and uninsured on their property if they choose.

So, though you can make some parallels, there really are a lot of differences, the key one being the Fed Gov't cannot force you to buy auto insurance or buy a car. States may deny you the privilege to drive on public roads (yes I said privilege vice right) if you refuse to register your vehicle and get insurance.

CptJake wrote:

Hyd wrote:I was wondering : would drawing a parallel with vehicle insurance be relevant ? If I'm not mistaken it is mandatory in a number of states and in the ones where it's not, you pay a fee to the state if you choose not to cover your car.
No need to pounce on me screaming, just trying to figure it out.

Not really. For example, my brother who lives in Washington DC and previously lived in Atlanta does not own a car. He isn't forced to buy one nor to buy auto insurance. In most cases, mandatory auto-insurance requirements are to cover OTHER peoples' cars and medical costs if you hit them. You can have very limited coverage for your own car. Additionally, if you get into wrecks or have a bad driving record (lots of moving violation tickets) the insurer is allowed to do the financially correct thing and raise your premiums or even drop you from coverage.

People have the option to not drive. They don't have the option to not get sick and not need healthcare.

This approach would only work if we as a society were willing to let sick people without coverage die in our ER waiting rooms. Or probably parking lots, as presumably we'd ask them to leave once finding out they didn't have coverage. But that's not what we do. We have decided, for many years, to provide care to people in need regardless of whether they can afford coverage.

Right now the costs of that coverage are passed on to everyone else in the forms of higher costs at the hospitals (raising service charges to compensate for unpaid-for care), higher premiums from insurers (again, raising charges to compensate for the hospitals charging more), and higher taxes (compensating for tax write-offs given to the hospitals for unpaid-for care). We're ALREADY paying for this stuff, only we're doing it the stupid way, after the fact and with no control.

If we require everyone to either buy insurance or pay a penalty, we create a larger risk pool with more healthy people in it, and we're (or the insurance companies are) able to invest that money ahead of time. This makes funding the healthcare we ALREADY provide to the unisured in emergency form more feasible. It actually SAVES us money in many areas, because insured people actually tend to go to the doctor and get a (fairly) cheap appointment and maybe a prescription, rather than waiting until they feel desperate and going to the ER, which is what uninsured people commonly do. Compare a $100 doctor's visit and $100 prescription with a $1000 ER visit.

Remember that the "Obamacare" solution is the Republican-devised option. The one focused on using private-sector insurance companies rather than moving to a single-payer system like most of the rest of the civilized world has. The Republican arguments for it, going back to the ancient days of 2006 when Mitt Romney and Newt Gingrich were talking about what a great idea it was, included that requiring people to buy insurance or be penalized is requiring people to take "personal responsiblity".

Here's a quote from Mitt Romney, from the ancient days of six years ago, talking about this same concept:

Mitt Romney wrote:“But once we put in place the reforms I am describing, with new affordable products as well as a subsidized product, where your premium can be as low as $2.30 a week, now everybody can get insurance,” said Romney. “And that’s basically what this slide says. And that is, look, now that we have these products available for you, we want everybody to get insurance and you have responsibility of having insurance, and we are going to mandate that you have insurance.

“Now, how do we mandate it?” said Romney. “Well, I won’t spend a lot of time on this, other than to indicate that we are going to insist that everybody be covered one way or the other and that those who don’t comply have certain problems. They are going to lose their personal tax exemption. We will withhold any of their tax refund. We will keep it in an account at the state level which we will be able to tap to pay the hospital if they go there for free care. The legislature has also put in place consideration of not providing drivers’ licenses to people unless they can show their health insurance coverage, and so forth.

“We also, I just note there, we also, if people go and get free care and don’t pay for it, we go after them,” said Romney. “We garnish wages if we have to make sure that we get paid. People are either going to buy insurance or they are going to pay for their own care. They’re not going to say, I got care and you, Mr. Taxpayer, or you Mrs. Premium Payer, you have to pay for me.”

If I don't get coverage and insure myself I am being irresponsible, and I am dumping the consequences and costs of my decision off on every other American taxpayer and healthcare consumer.

CptJake wrote:Additionally requirements are set BY STATES vice the Federal Gov't.

The requirement has to be set at the Federal level to deal with the fact that people move from state to state. If I spent all my young and healthy years up here paying my premiums into a separate NH pool, then retired down in FL and stuck them with my older, sick years, they're not benefitting from the pool the way they need to.

Mannahnin wrote:The requirement has to be set at the Federal level to deal with the fact that people move from state to state. If I spent all my young and healthy years up here paying my premiums into a separate NH pool, then retired down in FL and stuck them with my older, sick years, they're not benefitting from the pool the way they need to.

Why? Folks with auto insurance surely move from state to state as well, no?

As for it saving everyone money, that is a poor, poor argument. Again, premiums are already going up due to the types of coverage mandated by the law, and there are a lot of estimates most folks will see up to a 30% increase in premiums when everything is implemented. Add in the cost to businesses which directly results in less employees and your argument falls apart quickly.

Add in that the latest CBO predictions say this law adds a huge chunk to the debt over the next decade and it is VERY difficult to see how this 'saves' money. In fact, it burdens us quite a bit.

And again, using force to make people buy something is wrong in my opinion.

CptJake wrote:

Mannahnin wrote:The requirement has to be set at the Federal level to deal with the fact that people move from state to state. If I spent all my young and healthy years up here paying my premiums into a separate NH pool, then retired down in FL and stuck them with my older, sick years, they're not benefitting from the pool the way they need to.

Why? Folks with auto insurance surely move from state to state as well, no?

Because...
1. States already mandate that all drivers have insurance (my state, NH, has the lowest requirement, only requiring liability coverage; everyone else requires more), so they're already putting safe drivers (the equivalent of young healthy people) in their risk pools.
2. People retire to warmer states when they're older, and age demographics matter a lot more with health insurance costs than with car insurance costs. Older drivers get in fewer accidents, until they get so old that they need their licence taken away.
3. A person who has no car insurance and so can't afford to drive can stop driving. For a sick person who has no health insurance, the only way to do that is to shoot themselves.

If every state required people to sign up the way Massachusetts does, and the way all the states do for car insurance, sure, we could do it state by state. But if they don't, then people living in a no-mandate state while they're healthy and getting sick/old after moving to a mandate state sabotage the funding for the system.

CptJake wrote:As for it saving everyone money, that is a poor, poor argument. Again, premiums are already going up due to the types of coverage mandated by the law,

Have you paid any attention to insurance premiums in the last fifteen or twenty years? They've been spiraling up and up and up for years. Every small business owner whom I've talked to is in support of the ACA or something like it, precisely because something's got to be done about premiums. Yes, some premiums are undoubtedly bumping up right now to compensate for provisions of the law which are already in effect (like allowing kids to stay on their parents' plan until 26) while the funding measures aren't in effect yet. But we've also just put in the 80% rule, where 80% of premiums collected have to be spent on actual care or refunded to the insured.

CptJake wrote:Add in that the latest CBO predictions say this law adds a huge chunk to the debt over the next decade and it is VERY difficult to see how this 'saves' money. In fact, it burdens us quite a bit.

The last time the Congressional Budget Office looked at the whole law was when the House of Representatives tried to repeal the Affordable Care Act. And that report found that the Affordable Care Act reduces the deficit by over $100 billion in the next ten years and even more in the subsequent decade. Here’s what CBO had to say then:

“CBO estimates that enacting H.R. 2 would increase federal deficits during the decade following the initial 10-year period . . . CBO anticipates that enacting H.R. 2 would probably continue to increase budget deficits relative to those under current law in subsequent decades.”

http://www.opposingviews.com/i/politics/cbo-update-shows-lower-costs-new-health-care-law

CptJake wrote:And again, using force to make people buy something is wrong in my opinion.

More wrong than them taking care without paying for it?
More wrong than forcing us all to pay for it when they inevitably do so?

There's no ideal way out of this. Uninsured people DO and WILL use healthcare, and the costs ARE and WILL be passed on to everyone else. As Romney and Gingrich argued six years ago, making people buy insurance is making them take responsibility for those inevitable and inarguable facts.

And again, using force to make people buy something is wrong in my opinion.

Right, so why do you support the uninsured's right to force me to pay for THEIR health care?

Melissia wrote:

And again, using force to make people buy something is wrong in my opinion.

Right, so why do you support the uninsured's right to force me to pay for THEIR health care?

Can you point to where I state my support for that?

I don't think you can.

I'm sorry, health care and insurance are NOT a Federal matter, and if you go with the constitution, it shouldn't be. Does the system need refoms? Yep. Is Obamacare the right way to go about it? No, not at all.

CptJake wrote:
I'm sorry, health care and insurance are NOT a Federal matter, and if you go with the constitution, it shouldn't be.

Well, again, that depends on if you define Heath Care and Insurance as 'commerce' or not. If it is, actually the Constitution says that Congress is well within it's powers to make laws about it. This is sort of why this is at the Supreme Court, because the fundamental question is: Is it Commerce? Technically it involves a service and the exchange of funds, so, by my own measure, yes, it is. How the Court will rule, however...

Remember, the Constitution was intended to LIMIT the power of the Federal Gov't. If you buy off on "it is commerce therefore they can force you and control you", you will have a very hard time defining anything in your personal life they cannot control and anything they cannot force you to buy or do under the same argument.

Honestly, that bothers me. A lot. To use a limiting document to grant damned near unlimited control is wrong. I strongly suspect this is NOT what the founders intended.