Will Obamacare succeed where term limits failed?

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Originally Posted by Fisherking

Instead they just believe the lies of their preferred group and blame the other side. And nothing changes.

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As stated earlier, I expect that something useful might grow out of the exchanges. Example:

Health Plan Cost for New Yorkers Set to Fall 50%

State insurance regulators say they have approved rates for 2014 that are at least 50 percent lower on average than those currently available in New York. Beginning in October, individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly. With federal subsidies, the cost will be even lower.

Supporters of the new health care law, the Affordable Care Act, credited the drop in rates to the online purchasing exchanges the law created, which they say are spurring competition among insurers that are anticipating an influx of new customers. The law requires that an exchange be started in every state.

-edit, yet another example-

Vermont Releases Final Health Insurance Rates

The Green Mountain Care Board — the regulatory authority for insurance and hospital rates in Vermont — announced this week that it negotiated 4.3% to 5.3% rate cuts in individual and small-group plans offered by Blue Cross Blue Shield of Vermont and MVP Health Care. The rates go into effect Jan. 1.

Vermont approved six “metal” plans in its health insurance Marketplace, also called an Exchange. There are two bronze, two silver, one gold, and one platinum plan, each with different combinations of copayments, coinsurance rates, and limits on annual out-of-pocket spending.

McClatchy has reported that in 2013, 97% of jobs created have been part-time jobs!~:eek:

Ok, so where does Obamacare come in? Here:

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“There is something going on if such a large share of the hiring is part time,” Hall said.

He said the overall share of part-time jobs to all jobs, 19 percent, wasn’t a problem – yet.

Hall speculated that the implementation of the Affordable Care Act, shorthanded as Obamacare, might be resulting in employers shifting workers to part-time status to avoid coming health care obligations.

“There’s been so much talk about the effects of Obamacare on part-time work,” he said. “This is such an unusual thing to see.”

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So who's "Hall" you're thinking? From the article...

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Hall is no ordinary academic. He ran the Bureau of Labor Statistics, the agency that puts out the monthly jobs report, from 2008 to 2012.

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Assuming just a straight hourly wage, companies would prefer to hire full-time over part-time. It would mean less people to train up, less people to manage, and less schedules to coordinate. Any disincentives for full-time employees are going to be attributable to government interference- some necessary.... some not.

Obamacare is saying that if you have employees work for more than 30 hours a week, it's going to cost you more money. So what do you do? Hire as many people at under 30 hours a week as you can. I don't get where you're seeing this as something nefarious on the part of business owners. They're trying to save money- the same as most anyone would.

You still have that two party mind set GC. There are plenty of Rich Corporate Types that pay tribute to the DNC and their candidates. McDonald’s got a government exemption from Obamacare and no one screamed.

Then there are guys like the owner of Obama’s next vacation home. David M. Schulte http://www.chilmarkpartners.com/davi...e-pages-18.php

http://newsbusters.org/blogs/michell...neyard-vulture

Personally, I still think the plan is more about helping Insurance Companies than people. But hay, that is just me.

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Originally Posted by Fisherking

I still think the plan is more about helping Insurance Companies than people. But hay, that is just me.

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You're not wrong.

To look at it from a genealogical/Biblical perspective:

Swisscare begat Heritage Foundationcare, which begat Romneycare, which begat Obamacare.

But what got lost pretty much the moment the plan left Switzerland was the deep governmental (and therefore public, and publicly debated) involvement in the foundation-level, minimum insurance. That was tossed out from Heritagecare on.

Swiss are required to purchase basic health insurance, which covers a range of treatments detailed in the Federal Act. It is therefore the same throughout the country and avoids double standards in healthcare. Insurers are required to offer this basic insurance to everyone, regardless of age or medical condition. They are not allowed to make a profit off this basic insurance, but can on supplemental plans.

Regulations also restrict the allowable policies and profits that a private insurer may offer, as noted by healthcare economics scholar Uwe Reinhardt in a review in the Journal of the American Medical Association:

"To compete in the market for compulsory health insurance, a Swiss health insurer must be registered with the Swiss Federal Office of Public Health, which regulates health insurance under the 1994 statute. The insurers were not allowed to earn profits from the mandated benefit package, although they have always been able to profit from the sale of actuarially priced supplementary benefits (mainly superior amenities).

Regulations require "a 25-year-old and an 80-year-old individual pay a given insurer the same premium for the same type of policy.... Overall, then, the Swiss health system is a variant of the highly government-regulated social insurance systems of Europe... that rely on ostensibly private, nonprofit health insurers that also are subject to uniform fee schedules and myriad government regulations."

The insured person pays the insurance premium for the basic plan up to 8% of their personal income. If a premium is higher than this, the government gives the insured person a cash subsidy to pay for any additional premium.

I take it that the Swiss fees are flat given the example of a 25 yr old paying the same as an 80 yr old.

So I assume the 8% of your income is to cover low wage earners.

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Originally Posted by Gelatinous Cube

Maybe I'm just a poor capitalist because I don't sympathize with them at all, nor do I think they should be doing it. Its not really nefarious, its just lazy and greedy. If our pitiful attempt at subsidized healthcare is going to fail because business owners are cheap, then we should have just fought for true universal healthcare to begin with. The healthcare act, as it is, is a gentle nudge in the right direction for businesses. Chambers of commerce and small business associations can be major republican lobby bases, and I wouldn't be surprised if there was a lot of pressure coming from those places to put the blame on Obamacare and make a public stink about it all. Either way, their reaction proves that they need a harsher prodding instead.

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Do you go out of your way to pay more for American made products? If not that, do you make sure you only buy FairTrade produce? Do you shop small, local businesses instead of big box stores? If not, can I call you lazy and greedy?

I remember when I lived in Santa Cruz, they heavily restricted the amount of chain stores coming in. I couldn't find a single McDonalds and I am pretty sure they banned Wal-Mart from coming in entirely.

They had to cave in to the college students though and let about 4 Taco Bells into town.

An interesting historical note from a blogger: Socialized medicine came to the USA in 1986, and was signed into law by Saint Reagan the Immaculate:

[S]ince 1986, hospitals have been legally required to treat anyone seriously ill who presents himself at an emergency room, with clear medical needs. In the most fundamental way, that was the moment the US socialized medicine – and Ronald Reagan signed the bill. Alas, like so many Reagan domestic initiatives, there was no federal money provided to pay for this. And we all know what happened next: all those extra costs for the uninsured drove up premiums for everyone else, drove up hospital costs, giving them a reason to raise prices even further, and played a role in rendering healthcare unaffordable for many others.

What Obamacare does, like Romneycare before it, is end this free-loading.

The law is telling these young adults that if you want to go without insurance, you are not going to make everyone else pay for it if your risk-analysis ends up faulty. You have to exercise a minimum of personal responsibility to pay for your own potential healthcare. In other words, rights come with responsibilities in a liberal democracy. At least that is what I always understood the conservative position to be.

As far as I know, the Dutch system is superficially similar to the Swiss, in that:

1) health care insurance is mandatory
2) as far as the "base package" is concerned, a government defined group of medical procedures, insurance companies are not allowed to refuse clients. For stuff that's not included, like dental care or eyeglasses, they're a lot more free in what they offer and at which cost.

The insurance obligation lies on the individual; however many employers in the Neth's have brokered deals with insurance companies that allow the employees to apply there at lower rates.
To be clear, is this how Obamacare works (?):
- an individual obligation to get insured
- companies with >X full time employees must offer a collective package for their workforce

Obamacare is terrible legislation that does nothing but deliver a fat payday to insurance companies. The best healthcare in America is still "Don't get sick, asshole"

The part time jobs thing seems counter intuitive to me. The company I work for is raising wages and making more people full time but hiring less. This seems to be the same course of action other business are taking, based on my conversations. Perhaps this is selection bias.

Companies are going to cut costs. Why let a good crises go to waste? Cut some fat and endear half the country towards you in the process. I feel the same way about the companies that I do the goverment, don't hate them for doing what they were made to do.

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Originally Posted by Kralizec

To be clear, is this how Obamacare works (?):
- an individual obligation to get insured
- companies with >X full time employees must offer a collective package for their workforce

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Yup, that's about the size of it. Major difference is that the controls on the "basic" health insurance aren't nearly as broad or well-defined as the Swiss/Dutch model. And the "X" number is 50, I believe.

It's the best we could do under the circumstances, which is a long way from saying it's good.

If the Republicans ever undo their cranial-rectal inversion on the subject, they could be rather helpful in debating it like grownups, and ultimately making its implementation less worse.

Unfunded giveaway to big pharma and seniors? Yes please! Private-insurance-based reform modeled on the Swiss/Dutch model? SOCIALISMO!

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Originally Posted by Lemur

If the Republicans ever undo their cranial-rectal inversion on the subject, they could be rather helpful in debating it like grownups, and ultimately making its implementation less worse.

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Although I personally do not support Obamacare, I have to agree that the obstructionism generated by the House Republicans has crossed all the possible lines out of civilized discourse and firmly into hardcore ideological frothing.

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Originally Posted by rvg

Although I personally do not support Obamacare, I have to agree that the obstructionism generated by the House Republicans has crossed all the possible lines out of civilized discourse and firmly into hardcore ideological frothing.

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That is nothing new, just the Out of Power Syndrome.

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Originally Posted by Fisherking

That is nothing new, just the Out of Power Syndrome.

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Actually, by any objective metric you care to choose, the Republican congressional members under the Obama admin have taken obstructionism to new and uncharted heights. Among other achievements, they've pretty much wrecked the filibuster.

To say they're just experiencing Out of Power Syndrome is willfully ahistorical.

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Originally Posted by rvg

Although I personally do not support Obamacare, I have to agree that the obstructionism generated by the House Republicans has crossed all the possible lines out of civilized discourse and firmly into hardcore ideological frothing.

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I'm morally opposed to the mandate, but it'd be a lot easier to swallow if it allowed for low-priced catastrophic / high deductible plans. From what I've seen, even the bronze level plans are required to offer comprehensive coverage. But then, making young, healthy people pay for coverage they don't need is how Obamacare gets the numbers to add up...

Any real healthcare insurance reform (let's face it, that's what it is- not healthcare reform, but insurance reform) needs to decouple coverage from employment. I don't know that Obamacare helps much in that regard.

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Originally Posted by Lemur

Actually, by any objective metric you care to choose, the Republican congressional members under the Obama admin have taken obstructionism to new and uncharted heights. Among other achievements, they've pretty much wrecked the filibuster.

To say they're just experiencing Out of Power Syndrome is willfully ahistorical.

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Seems just like what the Democrats did with W. I guess they are still learning. They both play this little games. I thought ‘what comes around goes around’ was rich because she was there when it was them holing up nominations. But I expect most people may have covalently forgotten that.

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Originally Posted by Gelatinous Cube

Its all in the numbers dude. This congress has accomplished less than any other congress. They've accomplished much less than half of a particular congress that was actually dubbed the "Do-Nothing" congress.

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Judging form what gets passed when they work, I would count that as a big plus.
:laugh4:

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Originally Posted by Gelatinous Cube

Its all in the numbers dude. This congress has accomplished less than any other congress. They've accomplished much less than half of a particular congress that was actually dubbed the "Do-Nothing" congress.

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Why is that a bad thing? When everything they do is a screwup, maybe nothing is better. What happened to the people who used to wish for gridlock?

Personally, I think number of bills passed is a very poor metric for success...

As to the filibuster, it's been wrecked ever since they decided you could have endless debate without actually having to debate (or speak). :yes:

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Originally Posted by Fisherking

Seems just like what the Democrats did with W. I guess they are still learning. They both play this little games. I thought ‘what comes around goes around’ was rich because she was there when it was them holing up nominations. But I expect most people may have covalently forgotten that.

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The difference between the Dems with W and the GOP with Obama is huge. The Dems would whine and complain for a while, then cave in when the right-wingers started calling them freedom-hating pinkos. Pelosi and Reid were spineless and naive as party leaders, and it never even occured to them to shut things down like the GOP is doing at the moment. And now they only have themselves to blame, since Reid is the one responsible for shutting down the Senate with the 60-vote rule. Self-serving idiots, the both of them.

Halting nominations is child's play compared to the current situation.

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Originally Posted by Xiahou

I'm morally opposed to the mandate, but it'd be a lot easier to swallow if it allowed for low-priced catastrophic / high deductible plans. From what I've seen, even the bronze level plans are required to offer comprehensive coverage. But then, making young, healthy people pay for coverage they don't need is how Obamacare gets the numbers to add up...

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That really depends on...which way you look at it, or something.

Young people not wanting to be in the same insurance scheme as old people is an example of negative selection. Meaning; you think that being in the same pool as some old guy (more prone to disease) is a bad choice, and so you refuse. As a result, the insurance payments of all the old people will rise.

As a young person, I'm in effect paying for the medical care of the elderly. But since I hope and expect to become old too, I don't think it's unfair. Besides, the scheme also covers a lot of treatments that could theoretically befall me too and which I can't possibly afford on my own. Insurance is a form of solidarity.

There will always be questions: in one case, I remember looking at the optional choices of one insurance company and noticed that the only way I could get dental coverage with that company was to buy Package A which included dental care but also various forms of bull****, sometimes called "alternative medicine". I refused out of principle, which is another form of negative selection I suppose.

If you accept that it's morally undesirable to deny a patient treatment for a certain condition, then mandatory insurance is pretty much inevitable.

NBC realizes the obvious...

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Employers around the country, from fast-food franchises to colleges, have told NBC News that they will be cutting workers’ hours below 30 a week because they can’t afford to offer the health insurance mandated by the Affordable Care Act, also known as Obamacare.

“To tell somebody that you’ve got to decrease their hours because of a law passed in Washington is very frustrating to me,” said Loren Goodridge, who owns 21 Subway franchises, including a restaurant in Kennebunk. “I know the impact I’m having on some of my employees.”

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Many of us have been pointing this out since the law was passed- better late than never NBC.

Really poorly implemented. Just pick any other first world country and implement their health system. It will be better, faster and cheaper then what this monstrosity will get you.

I cannot point to a more expensive, less effective health system then that in the US.

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Originally Posted by Xiahou

NBC realizes the obvious...
Many of us have been pointing this out since the law was passed- better late than never NBC.

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Perhaps less regulation would fix the issue?

The free market stinks at organizing the distribution of anything that is not a non-essential, consumable product. How long until the US figures that out?

Obama's hometown newspaper takes a dump on Obamacare.

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If you've tried to sign up online for health coverage under the problem-plagued Obamacare exchange, our sympathies. Many people have tried to create accounts and shop for insurance under the new law. Few have succeeded. Those that have enrolled have found that the system is prone to mistakes. Some applications have been sent to the wrong insurance company.

Wait. It gets worse. Those who have managed to browse the marketplace have often been hit by sticker shock. Take Adam Weldzius, a nurse practitioner and single father from Carpentersville. He sought the same level of coverage on the exchange as he and his 7-year-old daughter have now, with the same insurer and the same network of doctors and hospitals. At best, Weldzius found, his monthly premium of $233 would more than double. If he chose a plan priced at the same level, the annual deductible would be $12,700, more than three times his current $3,500 deductible.

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It goes on, but you can read it yourself.

If you like your insurance you probably won't get to keep it. If you like your doctor, you might not keep him. Higher premiums, higher deductibles. None of it should be a surprise to anyone.

For giggles, here's a DailyKos blogger who is shocked- shocked that his insurance premiums are going to double...

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My wife and I just got our updates from Kaiser telling us what our 2014 rates will be. Her monthly has been $168 this year, mine $150. We have a high deductible. We are generally healthy people who don't go to the doctor often. I barely ever go. The insurance is in case of a major catastrophe.

Well, now, because of Obamacare, my wife's rate is gong to $302 per month and mine is jumping to $284.

I am canceling insurance for us and I am not paying any fucking penalty. What the hell kind of reform is this?

Oh, ok, if we qualify, we can get some government assistance. Great. So now I have to jump through another hoop to just chisel some of this off. And we don't qualify, anyway, so what's the point?

I never felt too good about how this was passed and what it entailed, but I figured if it saved Americans money, I could go along with it.

I don't know what to think now. This appears, in my experience, to not be a reform for the people.

What am I missing?

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The theme seems to be that if you are young and relatively healthy, you can expect to pay a lot more for healthcare.

So basically you're unable to fix a broken system?

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Originally Posted by Husar

So basically you're unable to fix a broken system?

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Nobody has asked me to. :shrug:

Personally, were I to replace the old broken system with a new broken system, I'd try to make sure it's not worse. I know that's a high standard for politicians though.....

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Originally Posted by Xiahou

Nobody has asked me to. :shrug:

Personally, were I to replace the old broken system with a new broken system, I'd try to make sure it's not worse. I know that's a high standard for politicians though.....

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Not you personally, your country.

The higher rates are a necessity. Adverse selection under the must-insure clause of the ACA guarantees participation by those in greatest need. Costs to insure must be passed on to the broader population or the whole system goes teats up in a hurry. If they truly wish for this new system to work, they are going to have to ramp up the penalties to a level at or near the cost of the least expensive exchanges. Otherwise, the very folks required to make the new system fiscally sound by putting in their higher premiums for relatively little service will opt out, pay the small fine, and self-insure their limited risk until they become chronically ill and the exchange represents an economic windfall.

I can't help but think that actually lowering costs across the board would be more effective as regards the Democrats' ideological goals than merely increasing the costs while forcing more individuals to pay toward them.

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Originally Posted by Seamus Fermanagh

The higher rates are a necessity.

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Not just for the reasons you mention. What happens to prices when you increase demand for a good or service while having the same or decreased supply?

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Originally Posted by Montmorency

I can't help but think that actually lowering costs across the board would be more effective as regards the Democrats' ideological goals than merely increasing the costs while forcing more individuals to pay toward them.

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The total cost of care cannot be lower and must be significantly higher. Government figures suggest roughly 15% of all Americans are uninsured. 70% of that figure is uninsured for economic reasons -- coverage being too costly. Another portion cannot get insurance because they have been denied coverage due to pre-existing conditions that generate a high morbidity risk (these people were screened out of coverage by Insurance companies because insuring them, with their high likelihood of high costs, would have jacked up the overall rates of the coverage more.

Thus, in trying to cover everybody, we are increasing the number of people to be insured by 15-17 percent (depending on illegals). Moreover, some of those 15% include high morbidity cost individuals who are likely to create a greater cost vector than the "average" person. Let us assume that, all things being equal, aggregate cost of healthcare increases by 16% solely on volume (I would actually presume it to be more).

Some of this is supposed to be "headed off at the pass" by a greater reliance on preventive medicine to minimize the need for more costly interventions later. Recent projections put this savings at less than one quarter of one percent...but let's be perky and assume that over time we can make that a full 5%.

That takes our 116% total health costs and drops it back to 110% of current (again, I think I am being kind). However, 60% of that increased medical need (the uninsured) are because they cannot afford it NOW (poor, working poor, above poverty level but no room for frills). So that cost factor MUST be shoved onto those who are already paying (directly or indirectly) for their own insurance. If it isn't, it must be absorbed as additional debt by the Government.

In addition to those for whom the health care exchange packages must be more or less fully subsidized, other groups are being subsidized by the government as well, particularly for those in what we label our "lower middle class," to make their care "affordable." Those subsidies too must be passed on to the full price paying customers or absorbed as debt.

Costs for health care cannot go down and must go up. TANSTAAFL.

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The total cost of care cannot be lower and must be significantly higher.

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Nonsense. The list of treatments, tests, medications, etc. that are identical from country to country yet 5, 10, 20, or more times as expensive in the United States is of untold length. The fact of the matter is that there is a price-race between hospitals and insurance agencies and that obliterating the highly-inflated costs of the medical sector would easily permit the underfunded individuals that ACA purports to service to obtain affordable insurance on their own initiative.

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Costs for health care cannot go down and must go up.

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No, no, and no. This is an extremely dangerous position to take - just pay, and pay, and pay, and who cares why it costs so much or where the money is going, just keep paying! :no:

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Originally Posted by Montmorency

No, no, and no. This is an extremely dangerous position to take - just pay, and pay, and pay, and who cares why it costs so much or where the money is going, just keep paying! :no:

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That's the whole premise of insurance. Who cares what it costs? It's not my money!

It's not surprising that costs spiral upwards when you setup perverse incentives like this....

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Originally Posted by Montmorency

Nonsense. The list of treatments, tests, medications, etc. that are identical from country to country yet 5, 10, 20, or more times as expensive in the United States is of untold length. The fact of the matter is that there is a price-race between hospitals and insurance agencies and that obliterating the highly-inflated costs of the medical sector would easily permit the underfunded individuals that ACA purports to service to obtain affordable insurance on their own initiative.
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No, no, and no. This is an extremely dangerous position to take - just pay, and pay, and pay, and who cares why it costs so much or where the money is going, just keep paying! :no:

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My comments were directed at the current system as modified by the ACA. What you are suggesting would involve a far more sweeping alteration than what is scheduled to occur. Perhaps we will head that way in time, but that is not the impact this law, as currently constituted, will have.

Fair enough, though I don't see why

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Costs for health care cannot go down and must go up.

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would be justified even in a narrow context.

It really is an alarming thought.

Of course it is alarming. That's one of the reasons so many on the political right in the USA oppose it -- and I am not talking about the fruit bat fringe.

The basic idea is that more people will be provided service (the purpose of the act in the first place). That greater total amount of service will require more health care spending overall, even if there is somewhat less spending on a per capita basis (which is being argued).

Can that be altered? Yes.


To alter it in a substantial way would require:

1) A decrease in services.

2) An alteration in the services provided (shift to preventative for example).

3) An alteration in the population's behavior (overeating, under-exercising, & tobacco use).

4) Price controls on various elements of the health care system, notably salaries for medical licensed health care providers.

or some combination of 1-4.

#1 runs counter to the stated goal of making health care better for all, while 3 & 4 are problematic in implementation under our current system of governance. 3 & 4 would really only become possible under a full-on national health care system.


I should note here that any number of those on America's political left, along with some issue-by-issue types among the moderates, are angry with the situation and with the ACA precisely because it does NOT take the necessary steps to shift us to a true national health care system. I suspect that they're frustrated as well precisely because they believe that nothing less than such a system could truly influence the largest components of American Health Care costs: Poor lifestyle choices, Physician and specialist salaries, and Medical malpractice/insurance therefrom.

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Originally Posted by Seamus Fermanagh

Poor lifestyle choices, Physician and specialist salaries, and Medical malpractice/insurance therefrom.

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To which I would add the biggest rotting apple in the barrel: Unrealistic pricing.

You don't see many $500 hammers like you did in the old days of government contracting, but now you see plenty of $800 bags of saline solution that cost $1 to manufacture and distribute.

Price gouging, like so many government functions, has been privatized.

Unfortunately I doubt that the long-term trend would look much different with a continuation of the (former) status quo. The ACA isn't enough, but it's conceivable that overall the net is at least a little benefit. It could also be argued for as a component of a minimalist program - after all, the TPers weren't just spontaneously generated by the mooting of health-care reform...

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notably salaries for medical licensed health care providers.

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First, get at the chargemasters and the admin layers. If services rendered become much cheaper, insurers will in turn be left without an excuse to maintain high premiums. Physician and specialist salaries are not so harmful as the rest.

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An alteration in the services provided (shift to preventative for example).

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Simultaneously with discouragement of reflexive recourse to maximalist end-of-life care.

Consider not commissioning 6-figures in services to keep gramps vegging along for another few weeks or months.

Furthermore: Get providers to treat tried-and-true technologies and procedures with more respect, as opposed to pushing the latest pricy-yet-ineffective 'device of wonder' on credulous or bewildered patients. It makes no sense to invest hugely in expensive-but-unproven techs, especially with short-term obsolescence being the norm, unless it's all just a marketing trick on the part of hospitals, far closer to rock-walls and multimedia centers at colleges than anything else...

This hi-tech fetish has permeated American culture for something like a century, though, so - tied closely to the end-of life care issue, it is urgent that the public at large be divorced from such notions of 'newer is better', 'more expensive is better', and most importantly: 'I deserve the best!'

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Originally Posted by Lemur

To which I would add the biggest rotting apple in the barrel: Unrealistic pricing.

You don't see many $500 hammers like you did in the old days of government contracting, but now you see plenty of $800 bags of saline solution that cost $1 to manufacture and distribute.

Price gouging, like so many government functions, has been privatized.

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Most of which is nothing but a game. The manufacturer pays 1, charges more makes profit. The hospital charges 800 to offset costs on other levels. Insurance pays 32. The whole thing is a damn shell game.

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Originally Posted by Montmorency

...This hi-tech fetish has permeated American culture for something like a century, though, so - tied closely to the end-of life care issue, it is urgent that the public at large be divorced from such notions of 'newer is better', 'more expensive is better', and most importantly: 'I deserve the best!'

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Now you're calling on a full-on alteration of a culture. Such changes rarely happen swiftly and virtually never by fiat. In fact, that last statement -- I deserve the best -- is much of the practical motivation behind the ACA, at least as far as creating the political support for it.

Heh, maybe there could be workarounds that don't entail tackling it head-on?

I'm just outlining detrimental elements of the system; of course I lack the ability to compel them out of existence by "fiat".

I'm just one of the tourists. :shrug:

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Originally Posted by Montmorency

This hi-tech fetish has permeated American culture for something like a century, though, so - tied closely to the end-of life care issue, it is urgent that the public at large be divorced from such notions of 'newer is better', 'more expensive is better', and most importantly: 'I deserve the best!'

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Nonsense. Science and technology will deliver unto us all, heaven on Earth. Who are you to decide that my grandma should not get as many procedures and machines as possible?

DEATH PANELS

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Originally Posted by Seamus Fermanagh

The manufacturer pays 1, charges more makes profit. The hospital charges 800 to offset costs on other levels.

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There's truth in what you say, but the bolded bit is ... shall we say an extremely generous interpretation of hospital behavior.

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Originally Posted by Lemur

There's truth in what you say, but the bolded bit is ... shall we say an extremely generous interpretation of hospital behavior.

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Well, one of the costs they are offsetting is that of indigents and illegals receiving primary care in hospital emergency rooms on a (like it or not) pro bono basis. It must mount up somewhere, because as a sector health care facilities don't show huge profit margins compared to pharmaceuticals (license to print money) or biotechnology (license to print money in large denominations).

Still, it must be noted that the ACA is an attempt (how effective we shall see) to stop the entirely pro bono care in emergency rooms in favor of complete health coverage and increased preventative care.

Out of random curiosity...

Mandatory insurances have existed in the Neth's for a considerable time now in some form or another. There is a group of people here, which was never that big and is considerably diminished today, which is opposed to the very concept of insurance on religious grounds. I gather that their idea is that random misfortunes are not random at all, but the Will of God, and that it's blasphemy or at least hubris to try to avoid the consequenses.

Is this line of thought at all common in the US?

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Originally Posted by Kralizec

Out of random curiosity...

Mandatory insurances have existed in the Neth's for a considerable time now in some form or another. There is a group of people here, which was never that big and is considerably diminished today, which is opposed to the very concept of insurance on religious grounds. I gather that their idea is that random misfortunes are not random at all, but the Will of God, and that it's blasphemy or at least hubris to try to avoid the consequenses.

Is this line of thought at all common in the US?

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No. Those who believe in full and complete pre-ordination are quite rare.

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Originally Posted by Montmorency

I can't help but think that actually lowering costs across the board would be more effective as regards the Democrats' ideological goals than merely increasing the costs while forcing more individuals to pay toward them.

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Not sure if serious. I enjoyed the chuckles anyhow. Liberals feel less miserable only when everybody feels some of the misery.

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Originally Posted by Xiahou

Not just for the reasons you mention. What happens to prices when you increase demand for a good or service while having the same or decreased supply?

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Increased demand causes increased cost.

However you need to do a couple more iterations on this one or all you will do is prove firemen cause fires.

There is also the reduced cost in supplying something that is mass manufactured particularly designed once electronically manufactured many times.

There is no overall increased demand for being ill. People get sick regardless of having insurance or not. The overall healthcare system ie private and public has to care for the people and with chronically ill rarely if ever recovers any money.

What is increasing is demand for the insurers product. Which is highly scalable. What isn't is the doctors and hospitals so the insurers will be in a bidding war and/or build their own training hospitals to provide sufficient coverage. If anything they will make it scalable by trading between each other at a pittance and making the patients pay a significant markup ie ATMs

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Originally Posted by a completely inoffensive name

Nonsense. Science and technology will deliver unto us all, heaven on Earth. Who are you to decide that my grandma should not get as many procedures and machines as possible?

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Given how much Monty spanks your butt I always assumed Monty was your grandma...

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Given how much Monty spanks your butt

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???

...

Oh.

OOOOHHHHH

...

How much do you want?

But the loser of the game is the self covered or out of pocket customer. They get the full 800$ charge for salt water in a plastic wrap and are charged 2 dollars each Tylenol administered when a bottle of hundreds costs under a few dollars at Costco. The problem of the insane pricing and the 'charge list' charade was examined in Time magazine a year back really well. It's what's wrong with healthcare and no one gets into it. Much more important than tort reform second maybe only to national health care or public option decision. That its just standard to not be told what any of the arbitrary or jacked up charges are being leveled at you by your healthcare provider is maddening. No one would accept buying software or food this way. So the freemarket works there in a way it can't in healthcare.

What I've learned as a therapist in the US army, some hospitals and some nursing centers for ten years. We're all being fleeced.

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Originally Posted by Seamus Fermanagh

Most of which is nothing but a game. The manufacturer pays 1, charges more makes profit. The hospital charges 800 to offset costs on other levels. Insurance pays 32. The whole thing is a damn shell game.

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I few years ago I had to get a chest x-ray and I didn't have insurance coverage. I called several hospitals... and none of them could tell me what a chest x-ray would cost me out of pocket. They honestly did not know. I was transferred to different departments, talked to different people, I never got a clear answer. Basically, I would have to come get the x-ray and they'd bill me- then I'd know what it costs.

Finally I found an outpatient surgery center in the phone book and they told me- $80. So guess where I went?

The point is- healthcare providers and consumers are both far isolated from the actual costs of their services. There is zero incentive on either side to keep costs low. If you want to see costs go down, you have to make people care what their healthcare costs.

If my car needs work done, I shop around for the best deal. People need to do the same for healthcare. For emergencies, you don't have much choice- but for everything else, there should be a price incentive.

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Originally Posted by Papewaio

There is no overall increased demand for being ill. People get sick regardless of having insurance or not. The overall healthcare system ie private and public has to care for the people and with chronically ill rarely if ever recovers any money.

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This is a gross oversimplification. The threshold at which people seek treatment can vary greatly. If you have costly coverage or no coverage, you're less likely to go to a doctor for less serious problems.

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Originally Posted by Proletariat

But the loser of the game is the self covered or out of pocket customer. They get the full 800$ charge for salt water in a plastic wrap and are charged 2 dollars each Tylenol administered when a bottle of hundreds costs under a few dollars at Costco. The problem of the insane pricing and the 'charge list' charade was examined in Time magazine a year back really well. It's what's wrong with healthcare and no one gets into it. Much more important than tort reform second maybe only to national health care or public option decision. That its just standard to not be told what any of the arbitrary or jacked up charges are being leveled at you by your healthcare provider is maddening. No one would accept buying software or food this way. So the freemarket works there in a way it can't in healthcare.

What I've learned as a therapist in the US army, some hospitals and some nursing centers for ten years. We're all being fleeced.

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When I've insisted on paying out of pocket, or when the mother in law goes out of pocket to her dentist, there are different prices available. One can even negotiate a bit on them (the mother in law has few teeth left of her own, getting her cleanings done at the pediatric rate by arrangement).

On the other hand, prole', I do not doubt that many (most? all?) of us ARE being over-charged. As you have direct industry experience and I have not, your points carry weight with me. I've argued before that the current system is, in some ways, the proverbial camel (horse designed by committee) with too many in-built gaffes and shenanigans. It is neither a fee-for-service with insurance negotiated to suit each client situation NOR a government mandated and controlled system that is applied equally to all. It is a Frankenstein of both.

My thrust here has been to argue that the ACA is not going to get the job done in terms of making things better.

As the reports come in documenting the logistical train wreck that has been the Obamacare exchanges, we're beginning to hear murmurs that suggest that it may be postponed anyway, lest it collapse under it's own fail.

Obamacare Website Failure Threatens Health Coverage For Millions Of Americans

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Under these circumstances, the lion's share of the people who do whatever is necessary to sign up through HealthCare.gov are likely to be the sickest and most expensive to cover because they have the greatest need, Laszewski said. That would make the pool of people covered very costly, causing health insurers to lose money and likely rethink whether they want to participate in the exchanges, he said. "The fundamental threat to Obamacare is we don't get enough healthy people in the pool to keep the rates reasonable, and they are in grave danger of that problem," he said.

If these problems persist longer -- weeks, months, a whole year -- the entire Obamacare project falls apart, Laszewski said: "It's a holy shit moment."

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"Under these circumstances, the lion's share of the people who do whatever is necessary to sign up through HealthCare.gov are likely to be the sickest and most expensive to cover because they have the greatest need"—yup, that's the scariest part.

Interesting that the Obama campaign was a best-practices model of how to do web, but once normal federal procurement is the basis, it all breaks down. Ah, dysfunction. Good article about it here.

The launch of the federal Obamacare website has been unforgivable, for a variety of reasons. Just a shocking mess. And I suspect it was preventable.

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Originally Posted by Lemur

"Under these circumstances, the lion's share of the people who do whatever is necessary to sign up through HealthCare.gov are likely to be the sickest and most expensive to cover because they have the greatest need"—yup, that's the scariest part.

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Are you being serious? .....I cant tell. :inquisitive:

Of course I'm being serious. The whole Swiss/Heritage Foundation/Romneycare/Obamacare premise is based on the idea of broadening the insurance pool so that the high-risk, high-usage patients are balanced out by healthy people. A system that (through incompetence) encourages only the high-risk people to enroll is broken, utterly broken. It's bad news. It flips the bird at the whole let's-do-universal-insurance-with-private-insurers concept. It's nine or ten shades of bad.

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Originally Posted by Papewaio

Given how much Monty spanks your butt I always assumed Monty was your grandma...

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https://i.imgur.com/BBjlvOJ.jpg

Well, October is drawing to a close, and Healthcare.gov is still a virtually unusable mess.

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The administration is now promising that the site's problems will be, for the most part, resolved by the end of November. Yet even if the technical glitches on HealthCare.gov are resolved, this week revealed that the new insurance marketplaces the site serves still need to overcome huge hurdles, both technically and politically, to succeed.

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The end of Novermber? Awesome.

Now we're also learning that at least part of the reason for the website's failed rollout was due to political concerns...

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CBS News' Sharyl Attkisson has been digging into the cause of the delays in preparing the website for the government's health insurance market and has learned was a major interruption in the months before President Obama's re-election. At the height of the 2012 presidential election campaign, it was crunch time for the Obama administration to release key instructions so contractors could work toward the October 2013 deadline.

But a Health and Human Services official who was closely involved tells CBS News that in late summer, the administration stopped issuing proposed rules for the Affordable Health Care Act until after the election.

The result was what many viewed as a serious delay as contractors, states and insurance companies awaited crucial guidance to move forward.

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And at the risk of beating a dead horse, if you like your insurance.... no, you can't keep it. :no:

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Gerry Kominski, director of public health policy at UCLA said: "About half of the 14 million people who buy insurance on their own are not going to be able to keep the policies that they had previously."

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Lastly, the administration has been trying to point to the state-run exchanges as an Obamacare success. Some of them aren't experiencing the same level of technical glitches, but not everything is unicorns and rainbows there either- new Medicaid enrollments (expanded under Obamacare) are far outpacing actual insurance registrations....

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a CBS News analysis shows that in many of the 15 state-based health insurance exchanges more people are enrolling in Medicaid rather than buying private health insurance. And if that trend continues, there's concern there won't be enough healthy people buying health insurance for the system to work.

As the Obamacare website struggles, the administration is emphasizing state-level success. President Obama said Monday, "There's great demand at the state level as well. Because there are a bunch of states running their own marketplaces."

But left unsaid in the president's remarks: the newly insured in some of those states are overwhelmingly low-income people signing up for Medicaid at no cost to them.

Matt Salo, executive director of the National Association of Medicaid Directors, said, "We're seeing a huge spike in terms of Medicaid enrollments."

He says the numbers have surprised him and state officials.

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The technical incompetence of the web portal, at least, could have been avoided. However, all these other "unforseen" problems have been pointed out repeatedly- before, during, and since the law's passage.

According to an NBC investigation, Obama knew he was lying when he repeatedly stated "If you like your heath insurance, you can keep it.", and the law was written in such a way to make it almost impossible for a plan to get 'grandfathered' in.

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President Obama repeatedly assured Americans that after the Affordable Care Act became law, people who liked their health insurance would be able to keep it. But millions of Americans are getting or are about to get cancellation letters for their health insurance under Obamacare, say experts, and the Obama administration has known that for at least three years.

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Here's the real money shot from the article:

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George Schwab, 62, of North Carolina, said he was "perfectly happy" with his plan from Blue Cross Blue Shield, which also insured his wife for a $228 monthly premium. But this past September, he was surprised to receive a letter saying his policy was no longer available. The "comparable" plan the insurance company offered him carried a $1,208 monthly premium and a $5,500 deductible.

And the best option he’s found on the exchange so far offered a 415 percent jump in premium, to $948 a month.

"The deductible is less," he said, "But the plan doesn't meet my needs. Its unaffordable."

"I'm sitting here looking at this, thinking we ought to just pay the fine and just get insurance when we're sick," Schwab added. "Everybody's worried about whether the website works or not, but that's fixable. That's just the tip of the iceberg. This stuff isn't fixable."

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And that, folks, will be why the ACA fails.

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Originally Posted by Lemur

Of course I'm being serious. The whole Swiss/Heritage Foundation/Romneycare/Obamacare premise is based on the idea of broadening the insurance pool so that the high-risk, high-usage patients are balanced out by healthy people. A system that (through incompetence) encourages only the high-risk people to enroll is broken, utterly broken. It's bad news. It flips the bird at the whole let's-do-universal-insurance-with-private-insurers concept. It's nine or ten shades of bad.

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I've been as patient as an ideological opponent can possibly be. When a law passes called "the affordable care act" is it ignorant to believe that at least someone wants it to make care more affordable? It is now less affordable for everyone I've spoken to, blue collar, white collar, no collar.
My healthy brother had a $98 catastrophic policy. It cancels in January because it fails to adhere to new insurance guidelines and has been replaced by a $260 per month catastrophic policy which he intends to drop and instead pay the $300 per year penalty (approx 1% of his income). His unhealthy brother (me) had a $510 policy which cancels in January and is replaced by a $628 per month policy. Additionally, my gastroenterologist is not covered under this plan.

My idiotic friend who loves everything Barack Obama and is an environmental science major and started his own business is super excited to find a policy that he can finally afford. The site doesn't work. If he couldn't afford the $98 per month policy that my brother had, what makes him think that he can suddenly afford the $300 policy that may or may not be available if the website starts working?

The apocalyptically stupid rollout has led me to suspect my base assumption is true. This is an attempt to make health care so unaffordable that people begin to clamor for single payer. It cannot happen. There are ways to fix even this broken system and keep many of the things that were fixed by the ACA. Single payer must not happen, even though I would be tremendously benefitted by it, but something radical must be done to make health insurance more like car insurance, possibly coupling it to a minimal extent with government subsidy.

Personally, I would like to see itemized and standard deductions on tax returns for health costs eliminated and see HSA's open up to everyone regardless of the deductible size of their health plans, for starters. I'm open to mandating that employers make an HSA available to all employees for pre-tax deduction of income. Likewise, I'm open to forcing employers to make health insurance portable, pre-tax for employee the and cutting employer benefit. These are things that shouldn't cost the employer money, but will merely give all employed individuals access to these things and allow individuals to get the tax relief. It will also allow the individual to shop around and simply let his employer know when he or she has signed a contract with a new company. This will also help avoid individuals lapsing coverage. This type of competition has led to low cost of car insurance and has never thrived in the health insurance market.

As a former insurance agent and claims adjuster, irresponsible people will NEVER fail to lose coverage through non-pay termination. This is because poor people are too physically or mentally I'll, or are morons (by nature, culture, or opportunity). Something as important as health insurance cannot be allowed to expire like a morons car insurance.

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Originally Posted by ICantSpellDawg

I've been as patient as an ideological opponent can possibly be. When a law passes called "the affordable care act" is it ignorant to believe that at least someone wants it to make care more affordable? It is now less affordable for everyone I've spoken to, blue collar, white collar, no collar.
My healthy brother had a $98 catastrophic policy. It cancels in January because it fails to adhere to new insurance guidelines and has been replaced by a $260 per month catastrophic policy which he intends to drop and instead pay the $300 per year penalty (approx 1% of his income). His unhealthy brother (me) had a $510 policy which cancels in January and is replaced by a $628 per month policy. Additionally, my gastroenterologist is not covered under this plan.

My idiotic friend who loves everything Barack Obama and is an environmental science major and started his own business is super excited to find a policy that he can finally afford. The site doesn't work. If he couldn't afford the $98 per month policy that my brother had, what makes him think that he can suddenly afford the $300 policy that may or may not be available if the website starts working?

The apocalyptically stupid rollout has led me to suspect my base assumption is true. This is an attempt to make health care so unaffordable that people begin to clamor for single payer. It cannot happen. There are ways to fix even this broken system and keep many of the things that were fixed by the ACA. Single payer must not happen, even though I would be tremendously benefitted by it, but something radical must be done to make health insurance more like car insurance, possibly coupling it to a minimal extent with government subsidy.

Personally, I would like to see itemized and standard deductions on tax returns for health costs eliminated and see HSA's open up to everyone regardless of the deductible size of their health plans, for starters. I'm open to mandating that employers make an HSA available to all employees for pre-tax deduction of income. Likewise, I'm open to forcing employers to make health insurance portable, pre-tax for employee the and cutting employer benefit. These are things that shouldn't cost the employer money, but will merely give all employed individuals access to these things and allow individuals to get the tax relief. It will also allow the individual to shop around and simply let his employer know when he or she has signed a contract with a new company. This will also help avoid individuals lapsing coverage. This type of competition has led to low cost of car insurance and has never thrived in the health insurance market.

As a former insurance agent and claims adjuster, irresponsible people will NEVER fail to lose coverage through non-pay termination. This is because poor people are too physically or mentally I'll, or are morons (by nature, culture, or opportunity). Something as important as health insurance cannot be allowed to expire like a morons car insurance.

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Gelcube will get his wish and you will not get yours.

As the adverse selection bias by higher risk insureds magnifies the functional cost of the plan -- since it will be cheaper to pay the penalty than the premiums -- the strain on the insurance industry will force the government to make changes to maintain healthcare affordability and rescue the system.

In fairly rapid stages, this will lead us to a national health system. This has been a major goal among numerous democratic party leaders for a generation. This is simply a step on the path.

Establishment of a national health care system will bring us in line with the developed countries and will almost complete the social safety network that is expected in a developed country (Old Age Pension, minimum subsistence allowance for the indigent, healthcare, education [partial]). Once undergraduate education is placed under government control the support network will be complete. The current administration has already begun that part of the process as well.

We'll see what happens. Who knows. I don't believe in pre-destination and I don't believe that Democrats are particularly competent. I know that Republicans aren't competent, they don't even pretend to be. They just want to take the power away from the incompetent narcicists.

One could say; if they can't be trusted to put out a website, why should we just ante up and put something so important in the hands of fools?

Republican strategy is to throw a monkey wrench in government. If the Democrats think that ruining government will make people want more, I would suggest that they are mistaken.

Reality has a liberal bias.

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Originally Posted by Gelatinous Cube

The website problems are a bit overblown. Name any online product that had to meet that kind of demand on launch and succeeded... you can't. Overflowing servers are the norm with any launch.

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"I could give a 12-year old a hundred bucks and he'd make me a website in three hours..."

It is indeed amazing how a government healthcare database is now equal to a myspace page. But it proves the Republicans right in that people are spoiled and want things they cannot afford.

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Originally Posted by Husar

"I could give a 12-year old a hundred bucks and he'd make me a website in three hours..."

It is indeed amazing how a government healthcare database is now equal to a myspace page. But it proves the Republicans right in that people are spoiled and want things they cannot afford.

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Oh come on. That kind of line is the usual snide political hyperbole. Such cheap shots have been a political norm, I feel certain, at least since the Greek city states. I dare say you could find a few home-grown German examples without stressing your google-fu all that much.

Gelcube is correct about the overwhelm factor. I put down most of the initial problems to the volume thing. Only the most recent spate of issues can be said to be design problems. It still wasn't that well thought out a web-site system -- they were planning on hits in the millions from the outset. That was the point of the program. Trouble free was never possible, but this was still a bit sloppy.

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Originally Posted by Gelatinous Cube

The website problems are a bit overblown. Name any online product that had to meet that kind of demand on launch and succeeded... you can't. Overflowing servers are the norm with any launch.

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I agree insofar as the website not being the "big" story, but the magnitude of the technical failure that is heathcare.gov is most definitely not being overblown....

They didn't begin any actual testing of the site until just a couple weeks before launch- far too late to make any significant changes. But, even with the testing they did, the website was crashing under a load of just a few hundred users- on a website that was expecting to receive millions. Some problems are to be expected when you roll out a major e-commerce portal. The problems with heathcare.gov go far beyond that. It was essentially non-functional on its go-live date.

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Originally Posted by article

The President's healthcare sign-up web page was supposed to handle tens of thousands of people at once. But in a trial run days before its launch, just a few hundred users flatlined the site.

Despite the problems, federal health officials pushed aside the crash cart and rolled out HealthCare.gov on October 1 as planned, The Washington Post reported.

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As disgusted and saddened as I am about the Obamacare rollout, I'm forced to root for its implementation, because there simply is no other realistic plan. Either we achieve something similar to the Swiss model, which is what all of these plans are based on, or we fall back into the Reagan-created jackalope socialist/crony capitalist hybrid.

As a tonic and corrective, have a quick read about Ron Paul's campaign manager, who died of pneumonia with massive debt (handed on to his surviving mom), because the jackalope insurance system ratcheted up his rates due to a pre-existing condition.

This is what Randian freedom looks like, folks. Drink it in.

Back in 2008, Kent Snyder — Paul's former campaign chairman — died of complications from pneumonia. Like the man in Blitzer's example, the 49-year-old Snyder was relatively young and seemingly healthy* when the illness struck. He was also uninsured. When he died on June 26, 2008, two weeks after Paul withdrew his first bid for the presidency, his hospital costs amounted to $400,000. The bill was handed to Snyder's surviving mother, who was incapable of paying. [...]

After Snyder's death, Paul posted a message to the website for his Campaign for Liberty — a pre-Tea Party organization which served Paul as both presidential marketing tool and platform to promote his non-interventionist, free market ideals.

He wrote:

"Like so many in our movement, Kent sacrificed much for the cause of liberty. Kent poured every ounce of his being into our fight for freedom. He will always hold a place in my heart and in the hearts of my family."

And that, friends, is what freedom is really all about.

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Originally Posted by ICantSpellDawg

The apocalyptically stupid rollout has led me to suspect my base assumption is true. This is an attempt to make health care so unaffordable that people begin to clamor for single payer. It cannot happen. There are ways to fix even this broken system and keep many of the things that were fixed by the ACA. Single payer must not happen, even though I would be tremendously benefitted by it, but something radical must be done to make health insurance more like car insurance, possibly coupling it to a minimal extent with government subsidy.

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Single-payer is the only way we are going to get through the baby boomer termination years without the medical industrial complex taking all our money (either via insurance or inherited debt). Having the most selfish generation cling to life regardless of cost and quality will surely bankrupt us otherwise.

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Originally Posted by Lemur

As disgusted and saddened as I am about the Obamacare rollout, I'm forced to root for its implementation, because there simply is no other realistic plan.

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The ACA isn't realistic. :no:

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Originally Posted by Xiahou

The ACA isn't realistic. :no:

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If "realistic" equals X, then give X value of, "Coherent plan based on real-world model that has some chance of being enacted in current dysfunctional political climate."

Obviously there are other plans that are implemented by other industrialized nations, some of which are far superior to the Swiss model. None would make it through the toxic swamp we call Congress.

Your free-market-everything notions are no more likely to be enacted than a Norwegian-style single-payor system.

I realize that sitting in a padded, wing-backed chair made entirely of radical ideology is, if nothing else, comfy—but on this issue I would appreciate seeing you step outside of your comfort zone and address what is possible, all things considered.

The Swiss model (as mutated through HeritageCare, RomneyCare, and Obamacare) can be made to work. It does not need to evolve into single-payor, or national insolvency, or any of the other apocalyptic tropes that appear to give such visceral pleasure when forecast.

The status quo ante was not acceptable, affordable, or humane. See the fate of Ron Paul's campaign manager for reference.

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Originally Posted by Lemur

The status quo ante was not acceptable, affordable, or humane. See the fate of Ron Paul's campaign manager for reference.

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Kent, as an obvious Ron Paul supporter, chose to work for the Ron Paul campaign knowing it did not provide insurance. I'm pretty sure, as a Paul supporter, he would not have supported Obamacare or socialized medicine. I don't think he would want to be used as a political football by Obamacare supporters. You should probably stop.

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Originally Posted by Xiahou

I don't think he would want to be used as a political football by Obamacare supporters. You should probably stop.

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You can choose to read "blatantly ironic example" as "political football," but coming from someone who rubs Benghazi like a magical fetish item, your sudden outbreak of don't-use-the-dead-for-political-purposes is a bit rich.

I think Kent is a very good example of where libertarianism leads—one of many such examples.

Any Rand took social security, for example.

Even when libertarians get handouts, they rarely recognize them as such. Ted Cruz doesn't believe the tax breaks he gets through his wife's medical insurance have anything to do with tax or revenue. Assuming you have a mortgage, I'm willing to bet you don't see your mortgage deduction as a middle-class payoff, even though that is precisely what it is.

You state, with absolutely nothing to back it up, that Kent "would not have supported Obamacare or socialized medicine." Yeah, not so sure about that, especially when he was dying, and possibly aware of the bills he was leaving to mama. Libertarians tend to see the value of collective risk management (i.e., "society") once the repercussions of their peculiar notion of freedom come knocking at the door.

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Originally Posted by Seamus Fermanagh

Oh come on. That kind of line is the usual snide political hyperbole. Such cheap shots have been a political norm, I feel certain, at least since the Greek city states. I dare say you could find a few home-grown German examples without stressing your google-fu all that much.

Gelcube is correct about the overwhelm factor. I put down most of the initial problems to the volume thing. Only the most recent spate of issues can be said to be design problems. It still wasn't that well thought out a web-site system -- they were planning on hits in the millions from the outset. That was the point of the program. Trouble free was never possible, but this was still a bit sloppy.

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:inquisitive: That's exactly what I said when I said it's funny that people compare a huge database with a myspace site.

And our country is quite a bit behind when it comes to utilizing technology in the public and some other sectors, I wasn't claiming that we're better. In fact we are worse. Just because I may have successfully acquired a reputation of being an Anglo-hater, that doesn't have to be true. :stare:

Lemur, are you suggesting that insurance would have saved his life?
Because from what you are suggesting, the guy lived his life without paying into insurance and died of a fast illness that would have killed him anyway. Sounds to me like he got away with 400k.

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Originally Posted by ICantSpellDawg

Lemur, are you suggesting that insurance would have saved his life?

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Last I checked, pneumonia was treatable, if you get to it quickly enough.

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Originally Posted by Gelatinous Cube

why are we disparaging the dead guy?

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Noting that the essential supporter of a libertarian candidate died of preventable causes, uninsured, leaving his mom with $400k in medical bills, is somehow off-limits? Please.

The real-world results of libertarianism are relevant, especially when the only alternatives posited to Obamacare are (a) the status quo ante, or (b) an untested libertarian experiment in national-scale free-market healthcare provision.

ICSD, you clearly didn't read even the bit of the article I snipped. GC ... really? You're falling for this?

I don't understand your point then, Lemur. A friend of mine passed away within 24 hours from pneumonia and a rare blood toxicity. He had a Cadillac plan. Anyone, for any reason, can go into a hospital and get life saving treatment.the bills come later. I read your article and your point seems less clear to me,

All I'm reading is "libertarian, no insurance, died, debt, sucker"

This guy died penniless and with 400k in medical debt. That is how I would like to die because it means that I've cycled out all of my assets and defrauded the corrupt and usurous medical system. His mom doesnt have to pay those bills if she isnt trying to keep anything valuable in his estate. Honestly, though, I have always kept health insurance - I believe in trying to carry my own weight and don't want society spend a minute thinking about my health.

You are using a convoluted argument to suggest that this guy was some ignorant pauper who fell for libertarianism and suffered pneumonia because he couldn't afford a few $50 PCP visits and low cost medicine. The emergency aspect would not have turned him away either.

You usually have better and more poignant arguments than this. Let's get back to talking about how a guy like this is even less likely to have health insurance since Obamacare has spiked the price. He planned to game the system when the prices were lower, now they are all higher for everyone and he can get the same emergency treatment by only paying a miniscule tax penalty instead of Signing up for a crappy insurance policy that costs a months rent every month.

Again, I stress having health insurance, but this law is a stupid mess, as you yourself have stated. The effects of the multi-thousand pages of regulations are now becoming clear. None of this is to say that our evil health insurance market works, just that all of this regulation and expense does little other than exacerbate the problem.