Author Topic: The ACA/Obamacare Thread  (Read 36405 times)

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Offline XJDenton

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Re: The ACA/Obamacare Thread
« Reply #700 on: February 27, 2020, 03:08:27 PM »
I think there's an argument for universal healthcare that is wealth independent.

Which is?
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Offline XeRocks81

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Re: The ACA/Obamacare Thread
« Reply #701 on: February 27, 2020, 03:17:26 PM »
everyone has to be covered in universal healthcare because that's the whole point of it. Everyone in the country is covered because everyone contributes. An individual making very little money and paying virtually no taxes gets to be covered  at the same level as the person who makes a lot money and pays a lot of taxes.  They both live in the same country (or state, province, etc) and contribute to it in different ways.   More importantly the whole society benefits on a myriad of levels from having better healthcare.

Offline El Barto

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Re: The ACA/Obamacare Thread
« Reply #702 on: February 27, 2020, 03:39:54 PM »
You lost me on the "something has to step in and replace that".    If we're doing single payer, then there's that.   You go transact the coverage that you're qualified for and that provider gets compensated by the government.  In the absence of that system, you go and transact the coverage you want the same way you transact your auto insurance or your electrical service at the house.   I get it; there are subsidies there that have to be accounted for, but if GE is paying me $1.00/hour, and providing benefits that cost them $0.50/hour, then certainly paying me $1.40 an hour and having me get it myself is more cost-effective for me, AND I get to leverage a pool of 325 million people as opposed to the 400,000 of GE employees (that's not exactly how it works, I know that, but the point is that we're cutting out layers and cutting out costs, and we can share those savings).
Lucky you. When my company was forced to stop providing insurance and pay that money out, it effectively amounted to raise for everybody else, and I really took it up the ass.

And I'm not dumping this on you. I didn't blame the people who got sizeable raises. I didn't blame my boss who really had no choice but to do this. I wasn't bitter about how it all shook down. It was all pretty reasonable, honestly. I was genuinely disgusted to find out how little regard there is for the sick in this country, though.
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Offline Chino

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Re: The ACA/Obamacare Thread
« Reply #703 on: February 27, 2020, 04:03:27 PM »
everyone has to be covered in universal healthcare because that's the whole point of it. Everyone in the country is covered because everyone contributes. An individual making very little money and paying virtually no taxes gets to be covered  at the same level as the person who makes a lot money and pays a lot of taxes.  They both live in the same country (or state, province, etc) and contribute to it in different ways.   More importantly the whole society benefits on a myriad of levels from having better healthcare.

No one seems to have a problem with the poor who pay little to no taxes getting fire and police services, libraries, or parks. I don't understand what it is about healthcare that people gets so up in arms about. Better that they can go to GPs and specialty clinics rather than having to walk into the ER every time their kid sneezes.


Offline jammindude

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Re: The ACA/Obamacare Thread
« Reply #704 on: February 27, 2020, 06:45:23 PM »
everyone has to be covered in universal healthcare because that's the whole point of it. Everyone in the country is covered because everyone contributes. An individual making very little money and paying virtually no taxes gets to be covered  at the same level as the person who makes a lot money and pays a lot of taxes.  They both live in the same country (or state, province, etc) and contribute to it in different ways.   More importantly the whole society benefits on a myriad of levels from having better healthcare.

No one seems to have a problem with the poor who pay little to no taxes getting fire and police services, libraries, or parks. I don't understand what it is about healthcare that people gets so up in arms about. Better that they can go to GPs and specialty clinics rather than having to walk into the ER every time their kid sneezes.

Because society doesn't want a healthy and thriving poor population.
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Offline Chino

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Re: The ACA/Obamacare Thread
« Reply #705 on: February 28, 2020, 06:17:54 AM »
You lost me on the "something has to step in and replace that".    If we're doing single payer, then there's that.   You go transact the coverage that you're qualified for and that provider gets compensated by the government.  In the absence of that system, you go and transact the coverage you want the same way you transact your auto insurance or your electrical service at the house.   I get it; there are subsidies there that have to be accounted for, but if GE is paying me $1.00/hour, and providing benefits that cost them $0.50/hour, then certainly paying me $1.40 an hour and having me get it myself is more cost-effective for me, AND I get to leverage a pool of 325 million people as opposed to the 400,000 of GE employees (that's not exactly how it works, I know that, but the point is that we're cutting out layers and cutting out costs, and we can share those savings).
Lucky you. When my company was forced to stop providing insurance and pay that money out, it effectively amounted to raise for everybody else, and I really took it up the ass.

And I'm not dumping this on you. I didn't blame the people who got sizeable raises. I didn't blame my boss who really had no choice but to do this. I wasn't bitter about how it all shook down. It was all pretty reasonable, honestly. I was genuinely disgusted to find out how little regard there is for the sick in this country, though.

If we get to a point on a federal level where an employer no longer has to pay for medical coverage, I wouldn't mind seeing some verbiage in the legislation that states that your employer needs to compare your new and prior year's W2 and pay you the difference in the absence of coverage. It would offset the costs of the presumably more expensive single payer system.

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #706 on: February 28, 2020, 07:30:09 AM »
I think there's an argument for universal healthcare that is wealth independent.

Which is?

Anything other than "universal healthcare as a clandestine vehicle for wealth redistribution".  It's not rocket science.   Some of you are acting as if I'm proposing that we cut off all our toes at birth, or require we walk through life with a bone through our nose.   It's not that hard; for me, it's baffling that we're even equating the two to begin with.   I'm not a huge fan of laws for morals or the like, but even just saying "we need universal healthcare because we're not dicks" is an argument that is wealth independent.

No offense, here, but this last page or so has basically confirmed I'm onto something here; the notion of universal healthcare has become SO intertwined with the concept of wealth distribution that it's now accepted as fait accompli, it seems.   For any of you that wonder why it's so hard to get this "simple" concept done, I offer that as the reason. 


Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #707 on: February 28, 2020, 07:38:11 AM »
everyone has to be covered in universal healthcare because that's the whole point of it. Everyone in the country is covered because everyone contributes. An individual making very little money and paying virtually no taxes gets to be covered  at the same level as the person who makes a lot money and pays a lot of taxes.  They both live in the same country (or state, province, etc) and contribute to it in different ways.   More importantly the whole society benefits on a myriad of levels from having better healthcare.

None of that REQUIRES that wealth be reallocated.  First, though, I've already commented on the notion of "taxation as wealth reallocation"; so I'm not really being strict in terms of my definitions there.  Implicitly, progressive taxation is wealth redistribution, and I'm sort of not singling that out for criticism; as a matter of real politik, okay, we have that already.  I'm more talking about the "above and beyond" that seems to raise it's ugly head when universal healthcare comes into play. 

There are plenty of government programs that I indirectly fund with my tax dollars that I'm not required to participate in, and there's no problem.  I pay my property taxes to the Town Of E***** each year, roughly 52% of which go to the public school system, and I do not have to send my kid to that school.   One went to a private school here in CT, and one (the youngest) will be in private school just as soon as we can get the court to agree that it's the proper move for him (more complicated than that, but this is not about my kid's school).  Leave it at tax dollars and be done with it.  Why penalize me if I don't want to participate in actually being in a program, or I want to participate in another, different program?  You're just advocating a shell game here, and bolstering why Jonathan Gruber said what he said about the stupidity of the American populace.  No, I'm not calling ANYONE stupid here, but this part of the genesis of that comment. 

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #708 on: February 28, 2020, 07:49:54 AM »
You lost me on the "something has to step in and replace that".    If we're doing single payer, then there's that.   You go transact the coverage that you're qualified for and that provider gets compensated by the government.  In the absence of that system, you go and transact the coverage you want the same way you transact your auto insurance or your electrical service at the house.   I get it; there are subsidies there that have to be accounted for, but if GE is paying me $1.00/hour, and providing benefits that cost them $0.50/hour, then certainly paying me $1.40 an hour and having me get it myself is more cost-effective for me, AND I get to leverage a pool of 325 million people as opposed to the 400,000 of GE employees (that's not exactly how it works, I know that, but the point is that we're cutting out layers and cutting out costs, and we can share those savings).
Lucky you. When my company was forced to stop providing insurance and pay that money out, it effectively amounted to raise for everybody else, and I really took it up the ass.

And I'm not dumping this on you. I didn't blame the people who got sizeable raises. I didn't blame my boss who really had no choice but to do this. I wasn't bitter about how it all shook down. It was all pretty reasonable, honestly. I was genuinely disgusted to find out how little regard there is for the sick in this country, though.

Ugh, I don't want to make this personal, Bart, I really don't.  I've already told you on the board and in person that your situation has enlightened me and made me change my point of view from 10 or 15 years ago.  So I come at this with the deepest respect.

Not everyone has the same choices in life, and I'm not sure how we get around that.  Sure, from a practical point of view, that scenario is a "raise" in that spot moment in time, but that's as much a function of timing and accounting than anything else.  They still have the RISK to deal with, and will have to possibly pay it out at some point. You're just paying it out now.  The point I was trying to make was that whether the amount is in dollars and cents paid in a check, or in risk value, the burden would be shifted to the person and in doing so the burden would - if done right - be smaller.    Presumably the system ought to be such that you can procure the same level of insurance coverage as you had before, but offset by 325 million people, and not the pool that your company participated in before they cut the coverage.  If that's not happening, that's a different discussion and a different solution.   I was asked "how I thought it should look" and to some degree that's the context of this discussion.  It should be clear that this is a system, and it's not enough to piece-meal some of these in and omit others (that's kind of one of my bigger beefs with the ACA: it wasn't a cohesive program and instead was a Frankenstein of competing interests.  Another reason I'm now an advocate for single payer.) 

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #709 on: February 28, 2020, 07:52:56 AM »
everyone has to be covered in universal healthcare because that's the whole point of it. Everyone in the country is covered because everyone contributes. An individual making very little money and paying virtually no taxes gets to be covered  at the same level as the person who makes a lot money and pays a lot of taxes.  They both live in the same country (or state, province, etc) and contribute to it in different ways.   More importantly the whole society benefits on a myriad of levels from having better healthcare.

No one seems to have a problem with the poor who pay little to no taxes getting fire and police services, libraries, or parks. I don't understand what it is about healthcare that people gets so up in arms about. Better that they can go to GPs and specialty clinics rather than having to walk into the ER every time their kid sneezes.

I think I answered that above.    According to some here, "wealth reallocation" and "universal healthcare" are inexorably tied.  When's the last time you had a conversation about the "wealth reallocation aspect" of police services, or fire protection?   Perhaps if we ditched that implicit class warfare aspect of universal healthcare and made it more of a service to society, we'd get somewhere.

I mean this seriously, but it's written tongue in cheek:  I blame Obama.  The Audacity Of Hope framed universal healthcare in exactly this manner, and I think it was unfortunate, in that it turned out to be how many people - pro and con - now look at it.   I can't prove causation, but it's a starting point for a discussion. 

Offline XeRocks81

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Re: The ACA/Obamacare Thread
« Reply #710 on: February 28, 2020, 08:00:37 AM »
but I still donít understand why, if you donít oppose taxation then whatís the problem?

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #711 on: February 28, 2020, 08:14:52 AM »
You lost me on the "something has to step in and replace that".    If we're doing single payer, then there's that.   You go transact the coverage that you're qualified for and that provider gets compensated by the government.  In the absence of that system, you go and transact the coverage you want the same way you transact your auto insurance or your electrical service at the house.   I get it; there are subsidies there that have to be accounted for, but if GE is paying me $1.00/hour, and providing benefits that cost them $0.50/hour, then certainly paying me $1.40 an hour and having me get it myself is more cost-effective for me, AND I get to leverage a pool of 325 million people as opposed to the 400,000 of GE employees (that's not exactly how it works, I know that, but the point is that we're cutting out layers and cutting out costs, and we can share those savings).
Lucky you. When my company was forced to stop providing insurance and pay that money out, it effectively amounted to raise for everybody else, and I really took it up the ass.

And I'm not dumping this on you. I didn't blame the people who got sizeable raises. I didn't blame my boss who really had no choice but to do this. I wasn't bitter about how it all shook down. It was all pretty reasonable, honestly. I was genuinely disgusted to find out how little regard there is for the sick in this country, though.

If we get to a point on a federal level where an employer no longer has to pay for medical coverage, I wouldn't mind seeing some verbiage in the legislation that states that your employer needs to compare your new and prior year's W2 and pay you the difference in the absence of coverage. It would offset the costs of the presumably more expensive single payer system.

Not a minor point:  I'm working on the assumption that a single payer system would ultimately be LESS expensive, and by a meaningful amount.  It might not be realized all in one fell swoop, and might not be realized by any one person picked at random, but part of the benefit is removing the layers of the current system* and by reducing some of the resulting administration that is duplicated, triplicated, and sometimes quadruplicated.

*  A couple years ago, I went in the hospital for what turned out to be diverticulitis.   I have insurance - rather good insurance, if you ask my ex-wife who is an executive in the healthcare insurance industry - and I have a reasonable amount of resources to pay for things like co-pays and what-not.  I ultimately got TWO letters threatening collection because the balances were unpaid. I had thought I paid them, but little did I realize that I got billed separately by:  the general I went to see when the pain started; the hospital, for emergency treatment when the pain didn't go away; from the specialist who was called in on consultation; the department that did the MRI/Cat Scan/Anal probe/whatever the hell the test was; the OTHER specialist that did the subsequent colonoscopy; and one other that I can't remember (I think it was the labs).  That's SIX - count 'em, SIX - different billing processes, six different administrative programs, six different payments I have to make... all with their own costs, their own overheads, and their own burden on the system.  And my problem was SIMPLE!   Imagine my dad, who has had acute rheumatoid arthritis since he was 35, had spinal fusion (unrelated), has a chronic thyroid condition that if untreated is life-threatening, but if treated is a simple pill every day, had non-Hodgkin's not once but twice, and has a recurring I-don't-know-what-it's-called-but-it's-basically-skin-cancer.   When I visit, he basically gets some mail from a doctor/medical service EVERY DAY.  I can imagine that Bart, and maybe some others here, are in the same boat.   

WHY?   Why are we paying for that?  Why are we not driving out that cost?  Even if it's 10% savings, in a $4 TRILLION industry, we're looking at $400 BILLION in savings.   Ballpark back of envelope calculations, you'd have to tax the top 1% at an additional 20% to even get close to that (and remember we're already taxing these people for free tuition, for student loan absolution, for the climate crisis, for the deluxe editions of the Rush Remasters, and for Peter Criss and Ace Frehley to rejoin Kiss for the final leg of the "End Of The World Tour".  Assuming they're even going to stand for this, it's a finite pot of money at the end of that rainbow.) 

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #712 on: February 28, 2020, 08:18:21 AM »
but I still donít understand why, if you donít oppose taxation then whatís the problem?

Because that's not what the current program is.  If it was just a matter of "taxation", then we wouldn't care about mandates.  We wouldn't have changed the flex program to under-incent wellness.  We wouldn't have forced people to use other doctors.  We wouldn't have had to cut $80 billion back room deals with Big Pharma to ram this past Congress.  We wouldn't have to punish Wall Street to make our point.     

Again, that's why I'm for single-payer. Just have government pay it, and have government balance the books as they always do (or don't).  Stop with the "beyonnaires" and the constant class warfare aspect of the proposals. 

Offline XeRocks81

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Re: The ACA/Obamacare Thread
« Reply #713 on: February 28, 2020, 08:21:58 AM »
but I still donít understand why, if you donít oppose taxation then whatís the problem?

Because that's not what the current program is.  If it was just a matter of "taxation", then we wouldn't care about mandates.  We wouldn't have changed the flex program to under-incent wellness.  We wouldn't have forced people to use other doctors.  We wouldn't have had to cut $80 billion back room deals with Big Pharma to ram this past Congress.  We wouldn't have to punish Wall Street to make our point.     

Again, that's why I'm for single-payer. Just have government pay it, and have government balance the books as they always do (or don't).  Stop with the "beyonnaires" and the constant class warfare aspect of the proposals.

but isnít that what the democrats(or Obama,whoever) wanted in the first place? All the BS came later because they compromised. 

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #714 on: February 28, 2020, 08:33:30 AM »
but I still donít understand why, if you donít oppose taxation then whatís the problem?

Because that's not what the current program is.  If it was just a matter of "taxation", then we wouldn't care about mandates.  We wouldn't have changed the flex program to under-incent wellness.  We wouldn't have forced people to use other doctors.  We wouldn't have had to cut $80 billion back room deals with Big Pharma to ram this past Congress.  We wouldn't have to punish Wall Street to make our point.     

Again, that's why I'm for single-payer. Just have government pay it, and have government balance the books as they always do (or don't).  Stop with the "beyonnaires" and the constant class warfare aspect of the proposals.

but isnít that what the democrats(or Obama,whoever) wanted in the first place? All the BS came later because they compromised.

Not if you take "The Audacity Of Hope" at it's face.  He was all about wealth reallocation in that book. 

But you are right to a degree, and to the extent you are, I agree with you.  The compromise is what killed it.   No argument.

Offline XeRocks81

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Re: The ACA/Obamacare Thread
« Reply #715 on: February 28, 2020, 08:39:21 AM »
sorry,  I still donít understand why you get hung up on this wealth stuff if you truly support universal healthcare.  Again the very premise of it is to use the largest pool of ressources (wealth) to provide easier access to care. 

Offline El Barto

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Re: The ACA/Obamacare Thread
« Reply #716 on: February 28, 2020, 08:51:55 AM »
You lost me on the "something has to step in and replace that".    If we're doing single payer, then there's that.   You go transact the coverage that you're qualified for and that provider gets compensated by the government.  In the absence of that system, you go and transact the coverage you want the same way you transact your auto insurance or your electrical service at the house.   I get it; there are subsidies there that have to be accounted for, but if GE is paying me $1.00/hour, and providing benefits that cost them $0.50/hour, then certainly paying me $1.40 an hour and having me get it myself is more cost-effective for me, AND I get to leverage a pool of 325 million people as opposed to the 400,000 of GE employees (that's not exactly how it works, I know that, but the point is that we're cutting out layers and cutting out costs, and we can share those savings).
Lucky you. When my company was forced to stop providing insurance and pay that money out, it effectively amounted to raise for everybody else, and I really took it up the ass.

And I'm not dumping this on you. I didn't blame the people who got sizeable raises. I didn't blame my boss who really had no choice but to do this. I wasn't bitter about how it all shook down. It was all pretty reasonable, honestly. I was genuinely disgusted to find out how little regard there is for the sick in this country, though.

Ugh, I don't want to make this personal, Bart, I really don't.  I've already told you on the board and in person that your situation has enlightened me and made me change my point of view from 10 or 15 years ago.  So I come at this with the deepest respect.

Not everyone has the same choices in life, and I'm not sure how we get around that.  Sure, from a practical point of view, that scenario is a "raise" in that spot moment in time, but that's as much a function of timing and accounting than anything else.  They still have the RISK to deal with, and will have to possibly pay it out at some point. You're just paying it out now.  The point I was trying to make was that whether the amount is in dollars and cents paid in a check, or in risk value, the burden would be shifted to the person and in doing so the burden would - if done right - be smaller.    Presumably the system ought to be such that you can procure the same level of insurance coverage as you had before, but offset by 325 million people, and not the pool that your company participated in before they cut the coverage.  If that's not happening, that's a different discussion and a different solution.   I was asked "how I thought it should look" and to some degree that's the context of this discussion.  It should be clear that this is a system, and it's not enough to piece-meal some of these in and omit others (that's kind of one of my bigger beefs with the ACA: it wasn't a cohesive program and instead was a Frankenstein of competing interests.  Another reason I'm now an advocate for single payer.)
No explanation required. This isn't personal, and I know where we both stand here. And you did mention some subsidies would be in order, and presumably one of them would be to help people in my situation.

To clarify about the risk component of value, most here were able to put part of that payout into insurance likely as good or better as what they had before, while still keeping extra bread. I was obviously the exception. For five or six years I'd been dragging the quality of insurance down for everybody. By buying into a spouse's plan, or just looking for a better solo plan, they all likely came out well ahead in both money received, money going out, and insurance quality.

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Offline XJDenton

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Re: The ACA/Obamacare Thread
« Reply #717 on: February 28, 2020, 09:36:37 AM »
Anything other than "universal healthcare as a clandestine vehicle for wealth redistribution".  It's not rocket science.   Some of you are acting as if I'm proposing that we cut off all our toes at birth, or require we walk through life with a bone through our nose.   It's not that hard; for me, it's baffling that we're even equating the two to begin with.   I'm not a huge fan of laws for morals or the like, but even just saying "we need universal healthcare because we're not dicks" is an argument that is wealth independent.

No offense, here, but this last page or so has basically confirmed I'm onto something here; the notion of universal healthcare has become SO intertwined with the concept of wealth distribution that it's now accepted as fait accompli, it seems.   For any of you that wonder why it's so hard to get this "simple" concept done, I offer that as the reason. 

By covering everyone, you are by definition committing to cover the medical expenses of people who can not and never will pay more into the system than they take out. Ergo, you ARE committing to wealth redistribution in some form. The two can not be separated in any practical/reality based discussion of the topic. The money needs to come from somewhere, and in a lot of cases its not the people actually using the resources.
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Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #718 on: February 28, 2020, 10:02:21 AM »
sorry,  I still donít understand why you get hung up on this wealth stuff if you truly support universal healthcare.  Again the very premise of it is to use the largest pool of ressources (wealth) to provide easier access to care.

I don't know that I can explain it any better that I already did.   Nominally, you're right, but I think - maybe, you tell me - that you're not bothering to distinguish "resources" from "wealth", and "wealth" from "the wealthy".    For me, "resources" just means the buying power of the federal government, and the ability to broaden the risk pool beyond a company, a state, or a demographic.  I've already said that one of the benefits of universal healthcare is in the removal of layers; that has ZERO to do with "wealth" or "the wealthy".   

I'm not in favor of "universal healthcare" because it let's the rich pay for the poor.  I'm in favor of "universal healthcare" because it's a simpler way of removing the obstacles in place now that result in higher prices and poorer outcomes.  It's simply a cheaper option to get more people covered.   Period. 

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #719 on: February 28, 2020, 10:21:04 AM »
Anything other than "universal healthcare as a clandestine vehicle for wealth redistribution".  It's not rocket science.   Some of you are acting as if I'm proposing that we cut off all our toes at birth, or require we walk through life with a bone through our nose.   It's not that hard; for me, it's baffling that we're even equating the two to begin with.   I'm not a huge fan of laws for morals or the like, but even just saying "we need universal healthcare because we're not dicks" is an argument that is wealth independent.

No offense, here, but this last page or so has basically confirmed I'm onto something here; the notion of universal healthcare has become SO intertwined with the concept of wealth distribution that it's now accepted as fait accompli, it seems.   For any of you that wonder why it's so hard to get this "simple" concept done, I offer that as the reason. 

By covering everyone, you are by definition committing to cover the medical expenses of people who can not and never will pay more into the system than they take out. Ergo, you ARE committing to wealth redistribution in some form. The two can not be separated in any practical/reality based discussion of the topic. The money needs to come from somewhere, and in a lot of cases its not the people actually using the resources.

And I've already addressed that.  To that level, sure, I'm in.  I'm not asking that every last person only take out dollar for dollar what they put in.  NONE of the government services operate that way.  I don't get the same benefit from FEMA that my dad or brother (both in Florida) do. So be it.  I don't get the benefit (knock on wood!!!!) from the military that, say, Texas does (assuming National Guardsman are on the border).   I've already mentioned education.   BUT... we are not ACTIVELY saying "hey, we need the 1% to cover the costs of police protection" in the way that we are for healthcare.  We're not demanding that Wall Street specifically fund FEMA.   But the very predicate of "Medicare For All" seems to come stock with the moral shaming of those that happen to earn more.   

If Bernie Sanders, in the next debate, says "I want Medicare for all as a basic human right, and we will pay for it by driving out inequities and inefficiencies in the system as it stands now, supplemented with funds from US General Fund." then you'd be right.  He's far more likely to say "I am the new touring drummer for Twisted Sister" than that, though.  You know it, I know it, we all know it. 

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #720 on: February 28, 2020, 10:25:13 AM »
You lost me on the "something has to step in and replace that".    If we're doing single payer, then there's that.   You go transact the coverage that you're qualified for and that provider gets compensated by the government.  In the absence of that system, you go and transact the coverage you want the same way you transact your auto insurance or your electrical service at the house.   I get it; there are subsidies there that have to be accounted for, but if GE is paying me $1.00/hour, and providing benefits that cost them $0.50/hour, then certainly paying me $1.40 an hour and having me get it myself is more cost-effective for me, AND I get to leverage a pool of 325 million people as opposed to the 400,000 of GE employees (that's not exactly how it works, I know that, but the point is that we're cutting out layers and cutting out costs, and we can share those savings).
Lucky you. When my company was forced to stop providing insurance and pay that money out, it effectively amounted to raise for everybody else, and I really took it up the ass.

And I'm not dumping this on you. I didn't blame the people who got sizeable raises. I didn't blame my boss who really had no choice but to do this. I wasn't bitter about how it all shook down. It was all pretty reasonable, honestly. I was genuinely disgusted to find out how little regard there is for the sick in this country, though.

Ugh, I don't want to make this personal, Bart, I really don't.  I've already told you on the board and in person that your situation has enlightened me and made me change my point of view from 10 or 15 years ago.  So I come at this with the deepest respect.

Not everyone has the same choices in life, and I'm not sure how we get around that.  Sure, from a practical point of view, that scenario is a "raise" in that spot moment in time, but that's as much a function of timing and accounting than anything else.  They still have the RISK to deal with, and will have to possibly pay it out at some point. You're just paying it out now.  The point I was trying to make was that whether the amount is in dollars and cents paid in a check, or in risk value, the burden would be shifted to the person and in doing so the burden would - if done right - be smaller.    Presumably the system ought to be such that you can procure the same level of insurance coverage as you had before, but offset by 325 million people, and not the pool that your company participated in before they cut the coverage.  If that's not happening, that's a different discussion and a different solution.   I was asked "how I thought it should look" and to some degree that's the context of this discussion.  It should be clear that this is a system, and it's not enough to piece-meal some of these in and omit others (that's kind of one of my bigger beefs with the ACA: it wasn't a cohesive program and instead was a Frankenstein of competing interests.  Another reason I'm now an advocate for single payer.)
No explanation required. This isn't personal, and I know where we both stand here. And you did mention some subsidies would be in order, and presumably one of them would be to help people in my situation.

To clarify about the risk component of value, most here were able to put part of that payout into insurance likely as good or better as what they had before, while still keeping extra bread. I was obviously the exception. For five or six years I'd been dragging the quality of insurance down for everybody. By buying into a spouse's plan, or just looking for a better solo plan, they all likely came out well ahead in both money received, money going out, and insurance quality.

And for me, that's the part of the system that needs to be fixed by ANY proposal.  It's baffling to me - and I recognize that sounds sort of inauthentic, but I promise you it's not - that it would be any other way. THAT'S the part that might actually be an "international disgrace", not the other class-based stuff.  If you can't even get appropriate coverage to begin with, it doesn't matter WHO'S paying for it, that needs to be fixed.