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Pipe dream? Obamacare
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mac



Joined: 07 Mar 1999
Posts: 17736
Location: Berkeley, California

PostPosted: Sun Oct 20, 2013 2:14 pm    Post subject: Reply with quote

I listened to techno's link. I guess some people think that non-yelling right wing hacks are more persuasive than yelling right-wing hacks. If you don't understand the fundamental dishonesty of Dave Ramsey's screed, I feel sorry for you. By the numbers: 1) the fundamental principal is that a broader coverage base will accompany the law, due to the mandate. Of course that is why it is unpopular with the right, and I understand that. But a larger pool of younger payees, with better pooling of risks, is intended to offset the cost of covering those not covered. 2) There are a number of cost control measures in the law, largely as pilots, that are intended to slow the rate of increase of health care costs. As only one example, with heart disease, one of the leading causes of death and high costs, treatment with statins has the potential to decrease costs.

Now this might not work. That is an honest argument. Ramsey's quiet bullshit about the math ignores the math. An honest conservative would lay out the theory behind the ACA and disagree with it. Ramsey doesn't do that. The other dishonest argument from the right runs "costs of healthcare went up last year, therefore Obamacare isn't working. "

In fact, health care costs have risen 54% over the past 5 years. That is much faster than the increase in any other commodity, and is due to both more disease and more treatment. The cost increase between 1960 and 2010 was even more dramatic, as total costs increased from $27 billion to $2.6 trillion, and nearly quadrupled as an element of GDP, from 5% in 1960 to 18% in 2010.
http://www.economist.com/blogs/graphicdetail/2012/08/mapping-americas-healthcare-costs

Many of those who support Obama care would also support changes that send an economic signal to consumers that consumption of health care, and bad health habits, have costs. Ironically, the worst modification to the system was George's Bush's Medicare program that covered drug benefits. Currently, consumers pay less than 20% of the cost of drugs--leaving the pharmacological companies free to reap large profits without pricing backlash.

The utter incompetence of the Tea baggers, and their pathological hatred of Obama, makes any real coalition politics impossible. As a friend who is an elected official said, the Tea Party has no learning curve.
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techno900



Joined: 28 Mar 2001
Posts: 4161

PostPosted: Sun Oct 20, 2013 4:14 pm    Post subject: Reply with quote

mac said:
Quote:
By the numbers: 1) the fundamental principal is that a broader coverage base will accompany the law, due to the mandate. Of course that is why it is unpopular with the right, and I understand that. But a larger pool of younger payees, with better pooling of risks, is intended to offset the cost of covering those not covered.

Let's take this a step further. A typical young person in good health making too much for an ADA subsidy, not currently choosing to buy medical insurance is confronted with the ACA. What will motivate that person to cough up $5,000 or more per year for insurance? Take a look at the penalties below and guess what the answer will be. NOTHING! Even if the person is making 100K, the highest penalty is $2500. By not buying insurance, the person is $2,500 ahead. Of course, the person may decide that for an additional $2,500 he/she could get coverage. Some will likely go for the insurance, but the vast majority of folks will be well below 100K of income and many will not opt for the insurance. Any idiot could see this flaw in the system. I could be wrong, but we shall see.

It would be nice if the "transparent" government would keep us informed abut the number of folks that have actually bought insurance through the ACA (not visited the site). It would not surprise me to see the Democrats make a move to postpone the individual mandate for another year once they realize the ship really is sinking.
Quote:
Here is a brief summary of the penalties for not having health insurance:

Individuals: From 2014 (reported in 2015), individuals who did not have insurance would owe $95, or 1 percent of income, whichever is greater. In 2015 it rises to the greater of $325 or 2 percent of income. But the penalty would subsequently rise in 2016, reaching $695, or 2.5 percent of income, whichever is greater. From 2017, the minimum tax penalty per person will rise each year with inflation.
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nw30



Joined: 21 Dec 2008
Posts: 6485
Location: The eye of the universe, Cen. Cal. coast

PostPosted: Sun Oct 20, 2013 5:47 pm    Post subject: Reply with quote

Feds: We don't need the best and brightest,,,,,,,, we are the best and brightest!

Well that's what you get with the government mind set.
~~~~~~~~~~~~~~~~~~~~~~~~~~
'Best and brightest' techies drafted to fix Obamacare computer glitches
Republican lawmakers are demanding that HHS Secretary Sebelius tell them how and why the Obamacare rollout got bogged down with computer problems. HHS says it’s getting expert help.

By Brad Knickerbocker, Staff writer / October 20, 2013


The White House reported this weekend that about 19 million people have visited HealthCare.gov and 476,000 individuals have applied online for health insurance.

But officials have yet to say how many people have actually bought a policy. In any case, it's a long way from the 7 million people the administration wants to see enrolled for health insurance through online exchanges during the six-month sign-up period.

Computer “glitches” seem massive. USA TODAY reports that "the federal health care exchange was built using 10-year-old technology that may require constant fixes and updates for the next six months and the eventual overhaul of the entire system."

Obama, presumably, has been asking sharp questions of his staff.

"I think that there's no one more frustrated than the president at the difficulty in the website," Treasury Secretary Jack Lew said on NBC's “Meet the Press” Sunday.

The coming week should see significant political activity surrounding Obamacare.

Obama is scheduled to speak about it at a health care event Monday.

House Republicans, who had predicted for months that Obamacare implementation would be a “train wreck,” have scheduled the first hearings into the severe flaws in the computer system for this coming week, Politico.com reports. So far Health and Human Services Secretary Kathleen Sebelius has declined to testify before the House Energy and Commerce Committee.

“As the news continues to get worse, it’s time for Secretary Sebelius to provide answers to Congress,” the committee said in a statement Friday. Republican lawmakers are particularly miffed that Secretary Sebelius went on Jon Stewart’s “Daily Show” but so far has declined to appear before Congress.

“Ultimately, Secretary Sebelius will testify,” Sen. Dick Durbin (D) of Illinois told “Fox News Sunday,” although he did not say if “ultimately” might include this Thursday’s scheduled hearing in the House.

Democrats like Durbin and other party leaders in Congress are in an embarrassing spot – having to publicly support a program that not all favored.

“What has happened is unacceptable,” House Minority Leader Nancy Pelosi said Sunday on ABC's "This Week." “There is much that needs to be done to correct the situation."

"This has to be fixed but what doesn't have to be fixed is the fact that tens of millions more people will have access to affordable quality health care," she added.

The answer, Sen. John McCain said on CNN Sunday, is to “send Air Force One out to Silicon Valley, load it up with some smart people, bring them back to Washington, and fix this problem.”

Apparently, that’s sort of what the administration has in mind.

In a blog post Sunday, the Department of Health and Human Services said this:

“Our team is bringing in some of the best and brightest from both inside and outside government to scrub in with the team and help improve HealthCare.gov.

“We’re also putting in place tools and processes to aggressively monitor and identify parts of HealthCare.gov where individuals are encountering errors or having difficulty using the site, so we can prioritize and fix them.

“We are also defining new test processes to prevent new issues from cropping up as we improve the overall service and deploying fixes to the site during off-peak hours on a regular basis.”

“The initial consumer experience of HealthCare.gov has not lived up to the expectations of the American people,” HHS said – an acknowledgement with which there is universal agreement.

http://www.csmonitor.com/USA/DC-Decoder/2013/1020/Best-and-brightest-techies-drafted-to-fix-Obamacare-computer-glitches
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keycocker



Joined: 10 Jul 2005
Posts: 3598

PostPosted: Sun Oct 20, 2013 6:15 pm    Post subject: Reply with quote

Techno,
Your analysis of these facts seems correct but the key fact seems to always be removed in such discussions in the right media.
You and me are currently paying for that uninsured young persons health care.
If he buys ins. thats good.
If he doesn't he gets to put in up to $2500 each year to put a little skin in the game.
You prefer the GOP status quo? Enjoy paying for him?
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KGB-NP



Joined: 25 Jul 2001
Posts: 2856

PostPosted: Sun Oct 20, 2013 6:26 pm    Post subject: Reply with quote

mac wrote:
RR-- You seem to have fallen into a fallacy that we earn our own health conditions because of our life style choices.

Not what I said or think. What I said was, "...that people who are healthy are paying the same as people who are unhealthy either by chance or choice, ...."

Mac,
One of my good friends is a doctor. His specialty is palliative care and end of life. I've heard his stories. I've seen his pictures of people with brain cancer where it has eaten through their skulls. Believe me, I get it.
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keycocker



Joined: 10 Jul 2005
Posts: 3598

PostPosted: Sun Oct 20, 2013 7:58 pm    Post subject: Reply with quote

I like with RR that he doesn't always state his position with every post.
He comes under flack for this by those who think he is always supporting one position or another. He seems to me to be just saying interesting stuff on the topic and letting it fall naturally on one side or the other.
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mac



Joined: 07 Mar 1999
Posts: 17736
Location: Berkeley, California

PostPosted: Sun Oct 20, 2013 9:38 pm    Post subject: Reply with quote

with all due respect rr, you were ranting against the same 46% that Mitt Romney was--those who pay plenty of taxes, just not Federal income taxes. Your description, and I quote, "unhealthy either by chance or choice.."

I don't believe I misquoted you, you were attributing some people's health condition to their choices and objecting to putting them into your risk pool. You protest too much.
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keycocker



Joined: 10 Jul 2005
Posts: 3598

PostPosted: Sun Oct 20, 2013 10:10 pm    Post subject: Reply with quote

Mac, he was pointing out the effect on the risk pool and correctly noting that some of the unhealthy ones got there by accident and some by bad choices.

The effect on the pool is the same and the idea that bad health falls in one subgroup or the other is correct by definition.
You kinda picked out the part you objected to and it would have been objectionable, but I doesn't seem to be what he said.
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KGB-NP



Joined: 25 Jul 2001
Posts: 2856

PostPosted: Mon Oct 21, 2013 4:45 am    Post subject: Reply with quote

Thanks KC, that is what I was saying. I thought that chance or choice explained that.

Chance: The unknown and unpredictable element in happenings that seems to have no assignable cause.,A force assumed to cause events that cannot be foreseen or controlled,An accidental or unpredictable event.

Choice: The power, right, or liberty to choose; option.,An alternative.



Mac,
I guess you must like the fact that there is a large part of the population that sits on welfare or some sort of scoial assistance then? How about the growing percentage of civil servants? Are you good with the rate of return and what they do with your money? How about that $100 million dollar vacation for your elected monarchy, that cool with you? There's only so much income to give up to taxes before it all stops working. I say let's keep staying on this course and see what happens. It should be great, what do you think? That's not Mitt Romney or Dave Ramsey, that's the dialogue in just about everyone's head with and ounce of common sense and a feeling they have been raped. What makes more sense, more taxation on those already contributing or more people contributing taxes and pulling their weight?


Also,
I would say the relevancy of Isobars anecdote was that he was providing me an example of his options. Those are options that many fear they will not have under the ACA or a system like the Canadian system. I agree and disagree. I don't think our health care lacks options all together but most defintely does not have the options available in Isobars' example. For a frame of reference / anecdote, I have broken 8 bones in my life, had knee surgery for a cyst. Three of the bones required surgery. Hip replacement resulting from skiing accident was done by a hip specialist. Ankles spiral fracture with tissue damage (turned foot backwards windsurfing) also done by specialist in ankles. Collar bone mountain biking done by specialist in collar bones. I had physio through our system but to be honest it was useless I was proactive on my own because not windsurfing is NOT an option but it also my driving force to proactivity. Our system is flawed but it is far from bad, and Isobars is right, we do not have the options or the chosen access the same as his example displays. You would really have to try hard to get the same here. Thanks for sharing your experience Isobars. I hope you mend well and can get out again. I couldn't imagine life without windsurfing.
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coboardhead



Joined: 26 Oct 2009
Posts: 4303

PostPosted: Mon Oct 21, 2013 7:01 am    Post subject: Reply with quote

Reinerehlers

The number of government employees, relative to population, has been, nearly unchanged since President Reagan. In fact, at the end of Obama's first term a lower ratio was measured than at the end of any of the President's terms since, and including, Reagan.

Our expenditures on education and non senior welfare has also been flat relative to GDP.

Our increased size of government is largely a result of exploding healthcare costs and an ever increasing older population. Maybe Grandma needs to get a job to pay part of her knee surgery?

It is convenient to blame our financial ills on "those lazy bums". But, when we look hard at the statistics in your 46 percent, at who those bums are, we find our, formerly hard working, parents at the trough.

The US healthcare system is great at providing the specialized care. Any overweight 50 year old can get a knee replaced with no mention of weight loss. We will provide dialysis to a 90 year old. And, no waiting for these services! But, try getting into a primary care doc on a non-emergent case, and see what the wait times are! I know some that are several months out for a routine office visit.
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