Will Obamacare succeed where term limits failed?

[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. 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.

[drone]

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.

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.

[Xiahou]

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.

The ACA isn't realistic.

[Lemur]

The ACA isn't realistic.

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.

[Xiahou]

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

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.

[Lemur]

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

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.

[Husar]

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.

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.

[ICantSpellDawg]

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.

[Lemur]

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

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

why are we disparaging the dead guy?

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?

[ICantSpellDawg]

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.

[Husar]

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.

Well, the entire society of people in your health insurance is actually caring about your health. Not having health insurance is more akin to carrying your own health since the entire point of insurance is to distribute a risk and carry it together with a group/society of people. It's a business model because people love to distribute risks. The real question is whether a non-profit organization could maybe provide the same thing cheaper since they wouldn't have to add a profit margin onto the monthly bill. In return one might then also add people who are refused by private insurers since they would not be profitable customers.
One could also say that private insurers try to accept only people who most likely do not ever or just very rarely need the insurance because these are more profitable given that they pay more into it during their lives than they ever get back/use. And insurances make money from that while the people who actually need the services provided get nothing out of it. This leaves both extremes of the spectrum "scammed" by the system, since the needy do not get what they need and the less needy pay for something they do not need.

In a unified system at least the needy get what they need and if you include some proper safeguards, the less needy won't pay overhead to line the pockets of investors and know that at least their money goes to helping those in need.
The last bit is of course hard to manage and I'm not claiming our system here is perfect, our insurances are vultures as well but kept somewhat in check by the government. I wouldn't mind a change of our system away from for-profit either, as it is they like to beg the government for more money and then use that to increase top management salaries and to celebrate bunga-bunga parties in other countries...

[Beskar]

Thing is: "I will simply skip the health insurance and just pay the fine, it's cheaper"

In minds of Republicans: "Lol, eat that obamacare, nothing to pay here"

In reality means: "Honey.. there is no inheritance for you and the kids, I just spent it all on treatment and we ran out, I am saddling you with debt.. perhaps the fine is not cheaper after all.. *cough cough* if we just spent that little bit more, I would have the treatment or at the very least, leave some money for you all"

[Seamus Fermanagh]

Thing is: "I will simply skip the health insurance and just pay the fine, it's cheaper"

In minds of Republicans: "Lol, eat that obamacare, nothing to pay here"

In reality means: "Honey.. there is no inheritance for you and the kids, I just spent it all on treatment and we ran out, I am saddling you with debt.. perhaps the fine is not cheaper after all.. *cough cough* if we just spent that little bit more, I would have the treatment or at the very least, leave some money for you all"

T:

There are plenty who make such a choice about all forms of insurance (life, health, auto) under the present system. The large majority of those under age 45 get away with it too. Most folks under 45 do not end up dead, and most do not get seriously ill or injured. A hefty slice of that age group looks at both life and health insurance and says "fugetaboutit, I would rather buy X."

Under the ACA, we're all mandated to buy insurance....but with the penalties as is, it will be more costly for many of the under 45's to buy insurance than to pay the fines, and they ALREADY have the least sense of need of any group in the market.

I think it is the responsible choice to protect your family. So, obviously, do you. But there is a significant minority who just aren't motivated at all -- they KNOW they aren't going to die, get injured, or fall sick. And with the latter, they now know they can buy the insurance then, when they need the discounted services.

[ICantSpellDawg]

Thing is: "I will simply skip the health insurance and just pay the fine, it's cheaper"

In minds of Republicans: "Lol, eat that obamacare, nothing to pay here"

In reality means: "Honey.. there is no inheritance for you and the kids, I just spent it all on treatment and we ran out, I am saddling you with debt.. perhaps the fine is not cheaper after all.. *cough cough* if we just spent that little bit more, I would have the treatment or at the very least, leave some money for you all"

Clearly health insurance is no joke. I've worked consistently at points solely to keep health insurance. I am intimately involved with the balance between the need for collective action to avoid massive individual costs and the importance of individual responsibility to ensure that care is appropriate, paid for with incentives for sound treatment and medical development.

The current system doesn't work because it allows costs to run rampant, which encourages adverse selection. The new system does not address this in the right ways. Individuals saving money in an HSA with high deductibles will allow individuals to determine which treatments are appropriate for their situation under the guidance of their Dr, but leaves the impoverished out in the cold (or leaves their care in the hands of other insured peoples and tax payers)

Some combination is needed. Possibly a more thorough review of who should qualify for medicaid, more reliance on individual HSA's to fund the majority of health care, and some catastrophic risk pooling to be done by either tax payers or the masses of insured individuals or both. This, I believe, is the solution that will allow healthcare to grow at a healthy rate without undue burden on healthy people while protecting everyone from catastrophe and rampant costs.

This is a moderate approach and is not the position of "libertarians" genrally, as was suggested in Lemur's annual "death of the GOP is imminent" thread.

I believe that it is an honest and balanced approach - coming from someone who truly would benefit by just passing the buck to someone else. I refuse to do that in good conscience. I have taken a more sensible approach than the aforementioned deceased; to avoid simply defaulting on my obligations, most likely because I am responsible and have a wife whom I would leave behind.

[Montmorency]

A deepening of the status quo is a moderate position only in the sense that a coma is the moderate answer to the question, "To be or not to be"...

[ICantSpellDawg]

Brilliant.

We have the most advanced medical system in the world, it is just wildly overpriced and people are left out.

We want to keep the most vibrant system in the world, stabilize prices without relying on a command economy, and bring more people in from the cold. This isn't like putting gum in a leaky boat, it's like saying we don't want to risk sinking an amazing ship because some people travel cargo.

I don't know if that is a good analogy because it needs to sink in. Probably not, as I am not great at analogies.

[Beskar]

I think it is the responsible choice to protect your family. So, obviously, do you. But there is a significant minority who just aren't motivated at all -- they KNOW they aren't going to die, get injured, or fall sick. And with the latter, they now know they can buy the insurance then, when they need the discounted services.

If I am honest, the way your healthcare system is set-up, it truly scares me, Seamus. Whilst I might make little pokes here and there, if I actually imagine being under system tomorrow, I would be mortified. Perhaps to you who grew up with the system, it is different, but for me, the actual concept of if I get ill, knowing I would be able to have treatment is a complete load off my mind. Knowing if I get some disease, cancer or involved in a traffic accident, I would be cared for and stand a good chance of getting better.

You say "All is fine" for the age group, but perhaps I have been unlucky, but I know this is false and under reported. Everyone of my cousins have had medical emergencies, about half of my siblings too. All different kinds due to various reasons. I got a cousin who was really into sports, working out everyday, really watching their diet, even in Oxford Rowing team, ended up with a heart attack and rushing to hospital where they discovered he had a heart defect. I had another cousin (his brother) who was a gym instructor turned police officer , who had pancreatitis and had to be rushed to hospital. Another cousin had a very severe allergic reaction who was in hospital for a week. I got a brother who had kidney failure and is terminally ill (hit the point where transplant is no longer an option), only reason he is still alive is because he is still having some treatments which only there to prolong his life. I could go on with this, by even bringing in older generations and the c-word.

Just imagining my family in the American system.. they would all be bankrupt and perhaps dead. Their families and children without fathers simply because of the system in place.

I read all these stories including how people try to raise money to pay for medical bills, most likely going to end up in the afterlife they believe in, hearing how people are suffering from issues, saying they won't seek a doctor because of the costs that might be involved, it is truly insane from my point of view. How can a system be so barbaric which lets the populace suffer and die ?

You might see this as 'Liberal Whining' or similar, but I am being honest, I am glad to have my healthcare system. I am happy for the money to come out of my taxes. I am happy to know when those worse times come, there is someone there to hold my hand and attempt to make things better for me.

[Beskar]

We have the most advanced medical system in the world, it is just wildly overpriced and people are left out.

Hybrid system, like in the UK.

"What do you mean?"
In the UK, Healthcare is paid through taxes, this provides healthcare to everyone in the country, so no one is left out in the wild. However, there is also a private sector, this is mostly paid for by the rich (or they sometimes go to countries like America). These people obviously have the money to waste on such things and pay those overpriced amounts. Implementing a bottom-line in the United States, like an AHS (American Health Service) would supply that, whilst also keeping the private sector in place to keep that innovation you desire.

[Montmorency]

We want to keep the most vibrant system in the world, stabilize prices without relying on a command economy, and bring more people in from the cold. This isn't like putting gum in a leaky boat, it's like saying we don't want to risk sinking an amazing ship because some people travel cargo.

It's like the ship is sinking already and you want to save it by tossing the crew overboard and waiting for the quarterdeck to head down and work shifts to evacuate the growing pool. It's silly, plain and simple.

[Seamus Fermanagh]

If I am honest, the way your healthcare system is set-up, it truly scares me, Seamus. Whilst I might make little pokes here and there, if I actually imagine being under system tomorrow, I would be mortified. Perhaps to you who grew up with the system, it is different, but for me, the actual concept of if I get ill, knowing I would be able to have treatment is a complete load off my mind. Knowing if I get some disease, cancer or involved in a traffic accident, I would be cared for and stand a good chance of getting better.

You say "All is fine" for the age group, but perhaps I have been unlucky, but I know this is false and under reported. Everyone of my cousins have had medical emergencies, about half of my siblings too. All different kinds due to various reasons. I got a cousin who was really into sports, working out everyday, really watching their diet, even in Oxford Rowing team, ended up with a heart attack and rushing to hospital where they discovered he had a heart defect. I had another cousin (his brother) who was a gym instructor turned police officer , who had pancreatitis and had to be rushed to hospital. Another cousin had a very severe allergic reaction who was in hospital for a week. I got a brother who had kidney failure and is terminally ill (hit the point where transplant is no longer an option), only reason he is still alive is because he is still having some treatments which only there to prolong his life. I could go on with this, by even bringing in older generations and the c-word.

Just imagining my family in the American system.. they would all be bankrupt and perhaps dead. Their families and children without fathers simply because of the system in place.

I read all these stories including how people try to raise money to pay for medical bills, most likely going to end up in the afterlife they believe in, hearing how people are suffering from issues, saying they won't seek a doctor because of the costs that might be involved, it is truly insane from my point of view. How can a system be so barbaric which lets the populace suffer and die ?

You might see this as 'Liberal Whining' or similar, but I am being honest, I am glad to have my healthcare system. I am happy for the money to come out of my taxes. I am happy to know when those worse times come, there is someone there to hold my hand and attempt to make things better for me.

The choice to opt out of health coverage would be VERY scary for me as well. To my mind it is one of the first benefits of employment that you procure for yourself and your family. Life insurance and retirement planning following immediately after.

You are correct in that, having grown up under our needlessly byzantine system, I am not inherently terrified that I will fall ill during that one or two months between jobs with benefits or other small gap. On the other hand, those folks who blithely assume that "noting can happen to me" and who therefore don't secure any health coverage, life insurance, or the like...well, the technical term for them would be "fools."

[Lemur]

[F]olks who blithely assume that "noting can happen to me" and who therefore don't secure any health coverage [...] well, the technical term for them would be "fools."

I'm not sure how fools and idiots are relevant. They will always be with us, most will get sick, all will die. And under our current system, you and I pay for them in the least efficient manner possible.

Is it not preferable to get as many of those fools and idiots into some sort of insurance pool? Isn't that both more practical and more humane?

[ICantSpellDawg]

Yes, what is your point?

[Lemur]

Yes, what is your point?

What is the premise of SwissCare/HeritageCare/RomneyCare/Obamacare?

[Husar]

As for the people who would rather pay the penalty since it is cheaper, that's a very weird decision.
It is cheaper if you never fall sick, but given that you have to pay at minimum the penatly, the actual full health insurance coverage actually costs only the difference between the penalty and the insurance fee. And if you just do not want to contribute the fee to crash the system, consider that with the penalty you pay less, but you still contribute the penalty, yet for zero return in case you do need the healthcare system one day. People who pay the penalty simply provide free money to the system at a 100% profit for every insured person. To me it makes a lot more sense to pay the additional money which also provides the full benefits of the system in case you actually need it.

[Kadagar_AV]

USAnians commenting on this are like zebras and giraffes arguing on what the most apple-like construction one could get from a cone

WHAT!?!?

You can afford an all-inclusive health plan for your population.

...

...

...

And yeah, that's pretty much it.

Sorry if you think Doctors are better of drugging some artist or perfecting some celebrities boobs, but REALLY??

[drone]

You can afford an all-inclusive health plan for your population.

But there is no money in that.

[Tellos Athenaios]

I think the radical libertarian was well aware of the consequences of his ideology. It's nothing remarkable either way.

Yes, I can see it now: "when you tire of responsibility, when you just wanna be a teenager again there's always libertarianism".

Basically you're saying he fully endorsed the notion of intentionally racking up $400K of debt, going all "oh, well, let's see who I can sucker into paying for me; oh hi, mum, long time no see!"
ICSD seems to think it's a valid way of life, too.

[ICantSpellDawg]

Yes, I can see it now: "when you tire of responsibility, when you just wanna be a teenager again there's always libertarianism".

Basically you're saying he fully endorsed the notion of intentionally racking up $400K of debt, going all "oh, well, let's see who I can sucker into paying for me; oh hi, mum, long time no see!"
ICSD seems to think it's a valid way of life, too.

It is a "valid" way of life, as the guy who used it for the entirety of life proved by dying. Is it the best? Read my post which states my opinion that "no, it is not". You're post is incorrect.

[Papewaio]

Leaving the bill to your parents isn't libertarian it is called being a minor.

With freedom comes responsibility. Your choices have consequences and you should be footing the bill for all of these if you are a true libertarian. The moment your mum or your friends have to fund raise for your existence you cross the line from do it by yourself libertarian to member of society.

It is just another example of ideals meeting reality. Most don't pass the pressure test.

[Husar]

As a campaign worker for Ron Paul he probably believed in serious reform of the healthcare system that would also have completely nuetered the ability of collections to go after his mother for something she was totally not a party to. Libertarians have their own problems with the status quo.

But then what? Who would pay for the bill then? The doctor? And what happens on a free market then? Healthcare only for people who can pay up front? And what would that goal make him considering he got healthcare he couldn't pay for? A fraudster or just a hypocrite? And why would I respect the values of such a person?