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Guest Post: Obamacare's Fatal Flaw
Authored by Martin Feldstein, originally posted at Project Syndicate,
Obamacare, officially known as the Patient Protection and Affordable Care Act, is the health-insurance program enacted by US President Barack Obama and Congressional Democrats over the unanimous opposition of congressional Republicans. It was designed to cover those Americans without private or public health insurance – about 15% of the US population.
Opponents of Obamacare have failed to stop it in the courts and, more recently, in Congress. The program was therefore formally launched on October 1. Although it has been hampered by a wide range of computer problems and other technical difficulties, the program is likely to be operating by sometime in 2014.
The big question is whether it will function as intended and survive permanently. There is a serious risk that it will not.
The potentially fatal flaw in Obamacare is the very same feature that appeals most to its supporters: the ability of even those with a serious preexisting health condition to buy insurance at the standard premium.
That feature will encourage those who are not ill to become or remain uninsured until they have a potentially costly medical diagnosis. The resulting shift in enrollment away from low-cost healthy patients to those with predictably high costs will raise insurance companies’ cost per insured person, driving up the premiums that they must charge. As premiums rise, even more relatively healthy individuals will be encouraged to forego insurance until illness strikes, causing average costs and premiums to rise further.
With this in mind, Obamacare’s drafters made the purchase of insurance “mandatory.” More specifically, employers with more than 50 employees will be required after 2014 to purchase an approved insurance policy for their “full-time” employees. Individuals who do not receive insurance from their employers are required to purchase insurance on their own, with low-income buyers receiving a government subsidy.
But neither the employer mandate nor the personal requirement is likely to prove effective. Employers can avoid the mandate by reducing an employee’s workweek to less than 30 hours (which the law defines as full-time employment). But even for full-time employees, firms can opt to pay a relatively small fine rather than provide insurance. That fine is $2,000 per employee, much less than the current average premium of $16,000 for employer-provided family policies.
Not providing insurance and paying the fine is a particularly attractive option for a firm if its employees have incomes that entitle them to the government subsidies (which are now available to anyone whose income is below four times the poverty level). Rather than incur the cost of the premium for an approved policy, a smart employer can pay the fine for not providing insurance and increase employees’ pay by enough so that they have more spendable cash after purchasing the subsidized insurance policy. Even after both payments, employers can be better off financially. News reports indicate that many employers are already taking such steps.
But the biggest danger to Obamacare’s survival is that many individuals who do not receive insurance from their employer will choose not to insure themselves and will instead pay the fine of just 1% of income (rising permanently after 2015 to 2.5%). The preferred alternative for these individuals is to wait to buy insurance until they are ill and are facing large medical bills.
That wait-to-insure strategy makes sense if the medical condition is a chronic disease like diabetes or a condition requiring surgery, like cancer or a hernia. In either case, the individual would be able to purchase insurance after he or she receives the diagnosis.
But what about conditions like a heart attack or injuries sustained in an automobile accident? In those cases, the individual would not have time to purchase the health insurance that the law allows. If they are not insured in advance, they will face major hospital bills that could cause serious financial hardship or even cause them not to receive needed care. Anyone contemplating that prospect might choose to forego the wait-to-insure strategy and enroll immediately.
But private insurance companies could solve that problem by creating a new type of “emergency insurance” that would make enrolling now unnecessary and allow individuals to take advantage of the wait-to-insure option. Such insurance would cover the costs that a patient would incur after a medical event that left no time to purchase the policies offered in the Obamacare insurance exchanges. Emergency insurance might also cover the cost of care until the “open enrollment” period for purchasing insurance at the end of each year (if political pressure does not lead to the repeal of that temporary barrier to insurance).
This type of insurance is very different from existing high-deductible policies. Given the very limited scope and unpredictable nature of the conditions that it would cover, the premium for such a policy would be very low. It would not satisfy the broad coverage requirements that Obamacare mandates, forcing individuals to pay the relatively small penalty for being uninsured and to incur the subsequent cost of buying a full policy if one is needed later. But the combination of emergency insurance and the wait-to-insure strategy would still be financially preferable for many individuals, and the number would grow as premiums are driven higher.
Employers with a large number of full-time employees could encourage their existing insurance companies to create the emergency policies. They might even choose to self-insure the emergency risk for their employees.
The “wait-to-insure” option could cause the number of insured individuals to decline rapidly as premiums rise for those who remain insured. In this scenario, the unraveling of Obamacare could lead to renewed political pressure from the left for a European-style single-payer health-care system.
But it might also provide an opportunity for a better plan: eliminate the current enormously expensive tax subsidy for employer-financed insurance and use the revenue savings to subsidize everyone to buy comprehensive private insurance policies with income-related copayments. That restructuring of insurance would simultaneously protect individuals, increase labor mobility, and help to control health-care costs.
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duh!
ObamaScare is the second biggest clusterfuk of the century...right behind NINJA loans.
What about social security and medicare ? They are social programs too.
Mafia-Style Gangland Shakedown. You buy what we offer or we'll take the money right out of your account.
That feature will encourage those who are not ill to become or remain uninsured until they have a potentially costly medical diagnosis.
Thats my plan. Pay the 1% tax, and my once a blue moon doctor visit and screw it. I'll be damned if I'm going to pay for prescription drugs or a maturnity plan I dont want or need for $1k+/mnth, and I will not sign up into a government exchange until I HAVE to.
and if you are injured in auto accident you have separate health insurance as part of most full coverage auto policies.....
STACKERS. You SIR, have the CORRECT PLAN..................... I have been in the ins. bus for over 40 Years. Pocket the PREMIUMS or INVEST them. STAY HEALTHY and your plan will do WELL. This is not for the individuals that have BAD lifestyles.
been doin the same and i am proudly uninsured. fuk the fatties, lazy fuks and gmo tardos that refuse to be informed.
thousands saved and stashed-ready for the next once ina decade hospital visit...
<-- Ignore REAL human behavior
<-- Full of lie and deception
Of course, real problem is liberal is not understanding of simple math and build Utopia dream on illogical premise.
Insurance companies love to overcharge. Most of us get stuck paying for health coverage on our auto policies.
So really, the only thing you are insuring against is some acute, catastrophic calamity that you cannot sue someone else for. Pretty unlikely for 99% of us.
Nice body ya' git dere, pity if, a, something was to happen to it. Capice? Now, about our offer of protection....
FORWARD SOVIET!
@King_of_simpletons - Yes, they are social programs. And fiscal failures. Social Security has $16+ trillion in unfunded liabilities. Medicare has $87+ Trillion in unfunded liabilities. Medicare Part D, the drug program passed fairly recently under GW Bush is already $22 Trillion in debt. If you are keeping score that's a grand total $126 Trillion that these programs are unfunded. By any sane standard these programs are failures and the cost of that failure is going to be passed on to your children and grand children.
The program will be a failure but saying that the children and grandchildren are going to pay for it is false. These debts will never be paid back. They may as well run the deficit to five trillion a year and the debt up to 100 trillion. None of it will ever be paid back and anyone buying t-bills has to be out of their mind.
When the only purchaser of your debt is yourself, why ever stop buying?
They will pay for it through diminshed buying power because the dollar will be debased and increased taxation. Or they will live in an America that is a failed state. Any way you cut it they will be paying a very steep price.
The United States Inc. is already a failed state on life support and the plug is slowly being pulled. Game over. People voted for this.
I would say the wars occupy the top slots.
Wait. Where is the magic money tree that all white middle-aged men get their money from? The important part of the Obamacare law was taking that magic money tree away from the greedy white men and using it for the sick people, right?
The white men can complain all they want but they still have the magic money hole in the sky, so they can STFU. But I don't understand why they aren't using the magic money tree for Obamacare like they were supposed to.
Praise Obama from whom all blessings flow!
Your implicit attack on the fair and generous legacy legislation of "The One" proves that you are obviously racist. The fact that you attack "The One", proving that you are racist, negates any argument that you might make, and makes moot all facts that you might bring to the table. 'Obama Derangement Syndrome', aka racism, is an automatic political and rhetorical disqualifier.
La la la la la la la la la la ... I can't hear you, I can't hear you ...
"DHS, we got another one for FEMA re-education!"
Welcome to Year Zero.
akak said:
Never before have I seen such a stunning display of rationaldemocracizationalizing. Absolutely amazing.
Indeed, it is akin to MaxFischerUncivilCoatimundializing, but even more monolized in the retardational means.
Buckaroo has a point. From the average Joe's perspective, if the magic money tree can be used to pay for endless wars and bank bailouts and benefits for government workers and the well-connected then why can't it be tapped for health care?
The true fatal flaw of Obamacare is that there is no money to pay for it. But there is a hollow ring to all the cries for fiscal prudence when it comes to health care while simultaneously spending like a gang of drunken sailors for everything that benefits the corporate-military-government complex.
It's being spent for health care, too.
US governments (all levels) spend about $4,100 per citizen on health care. The UK government spends $3,300 per citizen. I say forget Obamacare and take the NHS and $250 billion in deficit reduction. Then individuals can use some of the money they currently spend on insurance to patch the holes in shitty socialized care.
Why isn't that ever on offer?
Because NHS is a shitty death-dealing clusterfuck. Because it is killing brain-dead British people, the word isn't getting out about how truly awful it is. Because the British are either brain-dead, or actually dead, you see.
Oh yes. About all that money they are "saving" compared to the US. Exterminating the brain-dead should be much, much, much cheaper than that. So they aren't "saving" any money at all, just wasting it.
Racist Amerika is opposition to Obamacare. Obamacare is socialist utopia dream, and is finally arrive! Other that irreconcilable math, Amerika should embrace, no?
Yes, a fairly large contingent of American adults still believe in some incarnation of Santa Claus. If it's from the gubmint, it must be free, right?
So will ambulance drivers and EMT's double as insurance salespeople?
They can sell health insurance to those people that get hit by a bus or go into cardiac arrest on the way to the hospital!
"Sir a bloody thumb print is all we need. If we start care before you sign, technically your are liable for th charges. But if you sign now, it is a preexisting condition"
Dr., No? Ya don't say... :>D
These ARE NOT FLAWS!!!
This is SPECIFICALLY DESIGNED TO FAIL to push everyone into Single payer, a.k.a. MedicAid
Why is this so hard for the "experts"?
Do you really think Obama & Co. are concerned about this website?!?!....they are throwing a party in the WH....they are getting what they want!!
+100 Lord Max. Always was and always will be about the total take over of healthcare in this country and making it a single payer system. You will be able to buy a supplemental private policy to proceed to the head of the line in this system. Otherwise you will take a number and await your turn. Nothing new here.
It always was and will be about a single payer system and then price controls on the medical system.
Free first world health care to unregulated numbers of third world unemployed.
This article is BULLSHIT. The author is full of SHIT. His solution is BULLSHIT.
Ok hot shot......let's do what you say. Let's scrap Obamacare.....(good start)....and let's end the tax subsidy for employer funded insurance and use that freed up money to subsidize everyone buying private insurance with copayments tied to income.
And you still have just a handfull of insurance companies and HMO's to deal with. These are akin to Mafia family syndicates. Yeah....right.....they're gonna cut us some slack.
And then you have the lawyers who drive up the insurance for doctor's and hospitals in the first place which trickles down to the cost of your insurance.
Then pretty soon, you're subsidizing more.....and you're trying to fight their lobbyists in Washington.
Remember......we're are in a full blown FASCIST state. Just because you take the government out of health care (Obamacare) you can never take health care out of the government.....for they have the politicians in their back pocket and many politicians leave and go to work for medical lobbies.
We're fucked either way. It is a FASCIST Gordian Knot you will never untangle with your libertarian free market utopian ideas.
Is that Kathleen Seblius performing an abortion on the pic?
No, just breaking some guy's heart.
The law is intended to fail. It will turn 1/6 of the economy into a national crisis - to which the only response government can provide will be single-payer. That will in turn cause much of actual health-care delicery in the US to morph into a cash-only system. Alot like a corrupt prison.
Cash only system is the ideal system. This way the market wins. Prices will come down. Tell me if you never get really sick and die at an old age health insurance was a waste of money for you. If you get really sick and need to take out a 100k healthcare loan to pay for treatment, was it worth it? Stupid broads go get fake tits and pay crazy loans to doctors at crazy rates, why can't we take out a loan for saving my life? That would make you try to take care of yourself by eating lots of fruits and veggies and exercising. This country hit the shit fan when it removed personal responsibility from the people.
A set of DD silicone jugs paid in cash is a fraction of the cost of a sprained ankle submitted through insurance.
That was the whole plan: Force premiums to skyrocket due to the "wait to insure" effect and forcing insurers to accept people with preexisting conditions. Then, the masses will scream bloody murder, "the government must do something!!!" After that, single-payer will be far more palatable and will go through in a few years, AS PLANNED. Fabian socialism at it's best. FORWARD, COMRADES!!
Agreed. Why this is so difficult for some people to comprehend is beyond me. And the insurance companies will be blamed, not government. Evil for-profit private industry once again failing the American People, blah, blah, blah. When they're put out of business (or sucked in to become part of the government) I don't want to hear any complaints from their CEOs. They pushed like hell for this.
"And the insurance companies will be blamed, not government."
I blame the government. They are the ones forcing this down our throats, not the insurance companies.
Take care of yourself, for that is all there is of you.
Obviously Martin Feldstein didn't watch Obama in Boston today...
i've got a great idea
how about those who want and can afford insurance buy it, and those who cant afford it or dont want it, dont buy insurance
Re: i've got a great idea
Git yer hands off my Medicare, that's not socialism, I'm ENTITLED to that 3rd hip replacement surgery.
(Let me know when the OldFarts stop living off of socialism. Then you can ask the rest of the population to do the same).
http://i1334.photobucket.com/albums/w657/Lil_Seminole1987/c6fab91c-cfb6-...
No comment and such, oh whatever, you know what....
Is Mr.Feldstein complaining because ACA give insurance companies wild profit margins at the cost of doctors?
Don't know. Who the fuck is the author? Can he be trusted?
Over.
"Martin Feldstein, Professor of Economics at Harvard University and President Emeritus of the National Bureau of Economic Research, chaired President Ronald Reagan’s Council of Economic Advisers from 1982 to 1984. In 2006, he was appointed to President Bush's Foreign Intelligence Advisory Board, and, in 2009, was appointed to President Obama's Economic Recovery Advisory Board. Currently, he is on the board of directors of the Council on Foreign Relations, the Trilateral Commission, and the Group of 30, a non-profit, international body that seeks greater understanding of global economic issues." - http://www.project-syndicate.org/contributor/martin-feldstein
So, a resounding no to your last question.
Shouldn't he be in charge of the criminals at the IMF or something?
SR , Thanks for the info. You saved me some time to research the name / Martin Feldstein. The CFR/TRI LATERALS connection is not a surprise.
Marty, Marty, Marty. The thing about taxes is... they keep going.... UP. Plan accordingly.
Plan your private + offshore health care thus: Pay your MD in cash for run-of-the-mill stuff and keep 100% privacy, and get big surgery done offshore. QED.
Dentistry in Mexico is 1/20th it is in US and rivals the US in quality.
How is the Canadian HC quality?
Wait to insure is a brilliant idea, and for those who can't cough up sign-up fees and faces serious problems, will likely opt for the 2 yr. (out in 8 mths) pinch after assaulting a law enforcement official...
Having been raped for years in the acknowledged "wild west" of the individual market...I have to say, I am thoroughly enjoying everyone else getting the serious wakeup call on just how criminal and greedy the health insurers are.
loving every minute. heard one guy having a meltdown today over a 5K deductible! rolled with laughter.....
the ONE monopoly insurer in my state has graciously sold we individual peasants policies carrying 15K deductibles minimum for the past five years.
I hope the whole damn thing collapses and takes the insurers with it. they are the problem.....
and every effort seems directed at making sure their right to "rape and pillage" remains intact right now.
the best thing in the world for all of us would be emancipation from the insurers thru a collapse engineered entirely by them ....and caused by their greed.
I agree with everything you said, but I'm concerned you might be one of those dopes that thinks that the Government can do a better job of running a health insurance scheme than private industry. You aren't, right?
There is a reason that health insurance costs keep rising, and health insurance companies are insuring fewer and fewer people: "health" is an uninsurable risk.
An infinitely expensive product offered to virtually no customers is a sign that THERE ISN'T A VIABLE MARKET FOR THAT PRODUCT. No matter WHO is offering it.
Re: No matter WHO is offering it.
Agree completely. And, that's where politics is at its best: creating bullshit for dumbasses about solutions taht don't exists.
But, regardless of the REAL lack of solutions you can't have a society where one segment of entitled leaches lives off of a wonderful socialist medical scam and another segment of the same society doesn't; UNLESS you create enough bullshit about why the entitled segment is better than the unentitled segment.
1 reason for rising costs is always growing government meddling.
no, i am not one of "those dopes"....
i hope the entire system crashes thru the floor.....
and as they try -- in vain -- to put it all together again (in full rape the public mode)
the ACTUAL PROVIDERS start cutting them out,
and going to direct pay.
cash on the barrel head ...
amazing drops we'd see in pricing when we aren't paying the salaries of ten insurance people as well as doctor when we have an office visit
Here is one thing I've never understood. In my state insurers send out EOBs without any descriptions of the procedures -- they just include the CPT codes. That means, unless the person goes to the web to look up the codes, they never review the bill. The providers could bill the insurance company for anything (and many times, I'm sure they do) and nobody will be the wiser. It is stupid for insurance companies to trust providers. It is stupid for consumers to trust providers' billing practices, insurance companies, insurance commissioners, or anyone in government.
"I hope the whole damn thing collapses and takes the insurers with it. they are the problem..."
No, they're a big part of the problem, but there's another huge factor - government granted medical monopolies.
Don't forget: If the premium of the lowest priced Bronze plan on the Exchange exceeds 8% of one's AGI - there is no penalty. Given the premiums, particularly for middle-aged people, many will not incur a penalty even if they do not buy insurance.
I did not know that, Island --- thanks for that info!
Given that I live technically below the poverty line (by choice), that may be very meaningful to me.
That must be one of the mattering things, well hidden beneath the crustiest bits of Obamacare.
Obamacare is the final nail in the American standard of living.
Haha. Gotta love the loophole industry. This is more fun than income tax evasion.
Papa dollar is in trouble. The whole point of this boondoggle is to raise tax revenues and pretend it comes with a service.
its to bail out medicare. that thing is so fucking broke.....
Another strategy to consider: Buy the ridiculous Cadillac plans O mandated - but front load all your care. Drop the insurance in July if there is nothing wrong with you and then re-enroll for next January. That cuts the cost in half.
Yeah, I agree. Let's just give the un-insured the same Big-Gov socialist medical scam the duplicitous OldFarts have.
Why should one part of society get to live like welfare kings and queens while others don't.
"...use the revenue savings to subsidize everyone..."
Oh yeah, that will do wonders. Just subsidize everyone!
Marty wouldn't happen to be a ivy league economist, would he?
IMHO the fatal flaw is it requires young people to sign up, and most young people (the few who actually have jobs) don't have much disposable income. So it comes down to "do I party or do I pay for healthcare.. screw it give me the fine, I'm partying - YOLO"
As it should be. You are only young once, and it is immoral for older generations to use them as a donkey anyway.
2.5% of nothing is nothing. Anyone making enough to pay a hefty fine already has insurance. It can't work.
The best part of today's Sebilieus circus was her trying to justify why a single 32 year-old man must buy a policy that provides maternity services.
In addition, as has already been noted around here, a lot of those young folks under 26 are already under an insurance plan. My kids are covered already. Living on their own, having to buy insurance would bankrupt them so they'd just end up paying the tax anyways.
Just want to point out: ObamaCare is health insurance not health care.
Health insurance is a plan to pay for health care.
Health care is delivered by a doctor, nurse practitioner, etc.
Obama will get the web site and the insurance part "working" well enough for people to sign up.
But, ObamaCare is really going to crash and burn when people attempt to get health care, when they try to get in an see doctors, nurse practitioners, etc. for at least two reasons:
So, you have more sick people who aren't going to be paying trying to get into see fewer health care providers.
Think of it as a bunch of Chevy owners getting a free $1500 voucher to get their cars fixed and 30% of the mechanics walking off the job in frustration. Clearly, it will take longer for you to get your car looked at and fixed by a qualified mechanic.
That is when people will really start to get angry-when they must wait longer to see a qualified doctor after spending more money and having a higher deductable.
They'll just import "doctors" from foreign countries.
Re: many of these people have pre-existing conditions
A 64 yo OldFart becomes an entitled OldFart with socialist medical coverage at 65 regardless of pre-existing condition.
Re: so there less pressure for cost containment
Find me an entitled OldFart that wants ANY cost containment on their socialist scam?
Re: 30+% of doctors have said they will retire/quit rather than having the government constantly looking over their shoulder.
Doctors love free money as witnessed by their looting of Medicare. Obamacare will be happily looted by the doctors too.
The US has been one big socialist scam for 60+ years now, and the smart-n-savvy have gotten rich of their scams.
Yeah, those people without insurance weren't getting sick before they had insurance.
makes a lot of sense...
excuse me, but BS ... complete scare tactic BS......
look, the insurance industry is now parasitic to the point that it is killing the economy. We have a vast population with absolutely no access to healthcare.
we have doctors -- family practice guys -- making virtually nothing under the boot of the insurers.
Now, we're going to play the pretend game that there isn't enough healthcare or healthcare providers to go around? HELLO? Jesus the hospital group in my area just built two new wings and added huge numbers to staff (gotta put those non-profit profits somewhere)....
ONLY TO layoff people and "warehouse the space" due to empty beds.
Gimme a break. All the excess "skim" they've been extracting from the public, it has to go somewhere and the salaries of the administrators and insurance people are now in the embarrassing stratosperic zone......so they've been building space and facilities that they don't have customers to utilize (MRI anyone? $200 special sat afternoon special in little Maine hospital now...yeah) .......
So please, stop with the crap from Fox....we get that you don't want change. It is always good for the rapists....we get that. we rapees, we get that.
and excuse me, why not be correct? this is not a situation of the the dreaded government looking over their backs....
No, this is the insurers cracking the whips.
You are terribly terribly naive if you think the government has any say whatsoever in what care the insurers are going to allow the peasantry to have insured and actually get.
The insurers wrote the bill; they allowed their paid flunkies in Congress to pass it due to the extreme public pressure ... rape victims were screaming too loudly to ignore; and now, the insurers will decide what happens....
and what care you will actually get....
and, whatever they say, they choose, that's what their government flunkies will enforce.
let's stop pretending, shall we?
***the unraveling of Obamacare could lead to renewed political pressure from the left for a European-style single-payer health-care system.***
What an incredible dog's breakfast Obamacare has turned out to be. All of this just so a handful of large health insurance companies are allowed to loot billions from the health care system without providing any benefit. This is American capitalism at it finest. Get the government to make something mandatory then loot and rape Americans at will. Sooner or later Americans will realize that a universal single payer system like the rest of the world has is the only answer. But only after they try everything else.
Re: loot and rape Americans at will
And you think that the looters and rapers working for the insurance companes won't move to the government?
Is there something about monopoly that doesn't apply to government?
Or they'll realize they can just save money and pay for things when they actually consume the goods and services like everything else they buy.
"Buying" a major medical procedure isn't like buying a speed boat. You can save up to buy the speed boat or decide to put it towards your retirement. Whatever. You must have the the medical procedure or you die. Some people have $150,000 siting around for it. Most people don't. The principle of insurance is that you spread the risk around. Some collect some don't. Like with house insurance, you can pay in for years and get nothing back unless your house burns down.
For your education:
http://www.surgerycenterok.com/pricing/
I would sooner take a vacation trip to Oklahoma and pay $4,300 for a biopsy than pay $12,000 a year for insurance that requires me to pay the first $5,000 of a $45,000 procedure. Do the math.
That's why I advocate a universal single payer health system.
move to a country that has single payer.
Try Cuba! Its a paradise and FREE HEALTH CARE!!!!! You'll love their single payer plan.
¡ SOCIALISTAS SOVIÉTICOS HACIA ADELANTE !
My God, you are a fucking idiot.
Re: The principle of insurance is that you spread the risk around. Some collect some don't. Like with house insurance, you can pay in for years and get nothing back unless your house burns down.
I'm not against single payer, I'm again Federal single payer.
I see no reason the states can't accomplish the same thing. Having one Big-Health ensures it becomes like Big-MIC or Big-Road or any of the other scams the "Conservatives" and "Liberals" love so much.
Which part of "health care is an uninsurable risk" did you not understand???
HINT: "Uninsurable" means that THIS TYPE OF RISK CAN NOT BE SPREAD AROUND.
The concept of self-responsibility means that you quit smoking, lose weight, don't do skateboard tricks w/o a nut protector, etc. because you have to pick up the tab-financially and physically. It's your problem.
Catestrophic insurance pays for something catestrophic, and you pick up the rest. No money and no health insurance means Medi-cal.
I get that people want everyone else to pay for something they need, and they will fall for a fascist promising that, but fascist utopias always end badly.
Three things that could bring medical costs down:
1. Require providers to post prices for every procedure, and make them available before someone sees the doctor or agrees to a service.
2. Make all plans such that after the first $1000, there is $3000 that the patient will have to pay (i.e. a deductible). That will encourge prudent use of the system and comparative shopping.
3. Require each provider to charge their patients the same amount for the same procedure -- no more $1800 for you (uninsured person) and $500 for you (insured person). Charges could vary from practitioner to practitioner, but one practitioner can't charge different amounts to different patients.
Get the government out of the market place, and let people make their own arrangements and decisions.
Lasik went from $5000 -> $500, and the treatment is better now. If people have to pay their own health insurance, they will become informed, and the market will become competitive.
Government intervention raises costs and prices, destroys market competition thus destroying product quality and quantity.
Did "rent control" improve housing supply, quality and cost? HECK NO!!
Let people form their own contracts.
***Let people form their own contracts.***
You are dealing with an health insurance cartel. You can become as informed as you like. There is no competition, the cartel dictates prices. The "market place" you dream of doesn't exist.
Yes it does. Just find a doctor who only takes cash. There are more and more of them these days, and the more there are, the better the prices become and the more health insurance looks like a sucker bet.
4. Tort reform.
"That restructuring of insurance would simultaneously protect individuals, increase labor mobility, and help to control health-care costs."
Nice ! But how about the dent to profits of insurance companies that would ensue, later the loss of jobs in that sector, then decrease in consumer spending, then deflation,tbtf, then fed's printing,then lobbyists paying to politicians, and finally all the insurance stocks becoming whole & shoot to the moon! & the economy becomes stable again coz all will be well if stocks rise !!
enter the obamacare payroll tax, if your lucky to have a job.
Just remember what the original nationalized healthcare system and the current iteration aka Obamacare has in common they are run by people who are pro-eugenics.
https://www.youtube.com/watch?v=xdkrMdnrmPM&feature=youtu.be
German healthcare is often cited as an example that America should emulate. This is a video that provides some background on the German universal healthcare system that is relevant to the current debate on government control of the healthcare system in America. The question is not that the programs are currently the same, but why should this much power be given to the Government, which can so easily be abuse by such a messianic dictator that may gain power?
Centralized government control of the healthcare system was already in place, when Hitler came along and wanted to use it for mass murder. German socialized healthcare was started in the 1880's by Otto von Bismarck, called the Iron Chancellor for his dictatorial style of governing. Socialized healthcare was applied to some segments of the society under Bismarck, but it was Hitler that expanded the system to the entire population and made it truly universal health care. Adolf Hitler is really the father of universal health care. He also expanded it to several other countries, such as France, Belgium and the Netherlands, after there were occupied by Nazi troops.
Few may realize it, but the Holocaust actually started in the national healthcare system of Germany with a project called the T4 program. Universal healthcare is based on the idea that the distribution of healthcare should promote the welfare of society, according to Government priorities. It is inherently redistributive. Hitler ordered the hospitals and mental institutions of his new universal healthcare system to euthanize hundreds of thousands of the handicapped and mentally ill, in order to save money. In any universal healthcare system the Government will be deciding at some level, who gets healthcare and who doesn't, that is, the government will decide who lives and who dies.
The old people and mental health being used against dissenters who want to carry guns are 21st century Obamacare equivalents of how the Germans perfected the methods on the retards in the mental hospitals before applying it on a grand scale against the joooos.
Re: Just remember what the original nationalized healthcare system and the current iteration aka Obamacare has in common they are run by people who are pro-eugenics.
Yeah, we should be so lucky as to somehow be able to get rid of some of the useless OldFarts living off Medicare. Maybe THEN there'd be some socialism left for the younger people to leach off of too?
Your broad brushed, totally out of line comments on the older generation leave a lot to be desired sonny boy.
Wow, that was very polite of you. I would have called him a despicable psychopathic fuckwit.
***the government will decide who lives and who dies.***
Sure, our system where the private health insurance cartel decides who lives or dies is so much better.
That is where you are wrong by law a hospital can't turn you away if you need care, insurance or no insurance. They will kill you with substandard care for not being able to pay at the end of the day. That doesn't change with Obamacare being the law of the land as long as that loophole exists.
I hate to break it to everyone we've always had "universal healthcare" it is called the fucking private nonprofit hospital system. This was never about care but getting someone else to foot the bill.
My wife's employer still offers a $50 a month insurance plan that has a $20 copay a $750 deductible and a maximum yearly payout of $500.
I looked at the plan and laughed. You pay more in premiums than you get in coverage.
I really thought it was a joke, but $600 is lower than the Obamacare penalty once it goes up for us.
As Rodney Dangerfield said in Back To School. If you want to look skinny hang out with fat people.
Great fkn movie! Prof wants to argue about Vonnegut's meaning? Fine. Here's Kurt Vonnegut!
The movement is toward public funding of healthcare. There will be no move back to private health insurance, or healthcare delivery.
We now have fully socialized medicine, and will soon have single payer, and a dramatically eroding medical care system.
You voted for this America. Great work.
Re: You voted for this America. Great work.
What's good for the entitled OldFarts is good enough for the young wipper-snappers.
Everybody loves the socialist scam they are living off of or got rich off of.
(That's not socialism, that's an invest in our children's future).
The entitled old farts are getting the better end of all of these programs.
Socialist Insecurity is a massive wealth transfer from the young to the old, as is Jokecare. The young consume very little by way of healthcare goods and services, and those costs rise dramatically with age.
The young unemployed whippersnappers are screwed.
You're pissed, I get it. Well, some of us OldFarts have been pissed since before you were born. The number is embarrasingly small, but we've been out here awhile.
The vast majority of people, no matter the age, are just too dim to realize that there's no such thing as a free lunch.
It doesn't matter what you think is fair, shit-for-brains. Reality's a bitch and she don't care if you're a boomer or an X-er. She don't care if you're America's first black president- the most entitled motherfucker on the planet, btw. She's gonna occasionally knock you flat on your ass and will not be considering your race or demographic predicament. Deal with it.
The flaw with Obamacare and Healthcare in the U.S. is that it is unaffordable.
$15,000/day is unaffordable for all but the Buffet's of the world.
Healthcare is for suckers... You pay perfectly good money for it and ur gonna die anyway someday. Plus why stay around longer just to get Butt fucked by the debtbased monetary system. All they want u to do is be viable enough to pay in, and die quickly enough so they don't have to pay out.
+1000
We all gonna die.
All the "HealthCare" in the World will not save anyone.
Enjoy life, friends, family, and a nice Port Wine.
Cheers
The biggest problem we have with US healthcare are all those who oppose single payer healthcare. Especially those who oppose it for "ideological" reasons, such as it's socialism. Who gives a damn what it is, if it provides better healthcare, for everyone, at half the cost? Criticism of the ACA is well warranted. But it's time for everyone including the right wingers, to get their shit together and do what's right.
A lot of people around here don't take kindly to someone talking non-ideological sense. Prepare for down arrows!
And who gets to define what is "right"? What is "right" for me is a little concept I like to call personal responsibility. Which means that if I choose to eat myself into a giant tub of lard, smoke two cartons a week, and down a fifth of liquor with my dinner, I deserve to pay the astronomical healthcare costs I incurred by being an irresponsible dipshit. I don't ask anyone else to pay for my mistakes, so why the fuck is it necessary for me to pay for everyone else's mistakes? If people can't pay for the enormous cost of the healthcare they caused themselves by treating their body like a disposable product, then they deserve to go bankrupt paying to fix it, or they deserve to die. End of fucking story.
+agawddamn trillion, CO. Sowell is right- we live amongst children in adult-sized bodies.
The biggest problem we have with US healthcare are all those who oppose single payer healthcare. Especially those who oppose it for "ideological" reasons, such as it's socialism. Who gives a damn what it is, if it provides better healthcare, for everyone, at half the cost? Criticism of the ACA is well warranted. But it's time for everyone including the right wingers, to get their shit together and do what's right.
What would work would be to understand the effects of government subsidies on supply and demand...
Subsidizing consumers increases demend, increasing the price at equilibrium, and perhaps quantity supplied, depending on elasticity. Have HHS pay insurers $2000 per insured (bounty?), and see how many uninsured are left after 6 months. Even the "I don't know and I don't care" crowd, typical of local zerO supporters in my neck o' the woods, will find themselves hounded to the furthest corners of the Earth, until they accept funds from insurers to accept minimum coverage. Increase bounty for insuring certain pre-existing condition. The gate keepers would have to guard against formerly uninsureds from accepting multiple coverages.
What would work would be to understand the effects of government subsidies on supply and demand...
Subsidizing consumers increases demend, increasing the price at equilibrium, and perhaps quantity supplied, depending on elasticity. Have HHS pay insurers $2000 per insured (bounty?), and see how many uninsured are left after 6 months. Even the "I don't know and I don't care" crowd, typical of local zerO supporters in my neck o' the woods, will find themselves hounded to the furthest corners of the Earth, until they accept funds from insurers to accept minimum coverage. Increase bounty for insuring certain pre-existing condition. The gate keepers would have to guard against formerly uninsureds from accepting multiple coverages.
I can hear the Revolving Doors from here...
The US should introduce a UK National Insurance tax, and call it what it is.
Legally, no man can be forced to accept a benefit ? So threatening and imposing fines on people who do not want to accept the benefit of health care violates their human rights.
Call it a tax. Else file you claims for damages for for having your human rights violated by being threatened and punished if you do not accept a benefit.
Just some thoughts, but looking from the UK, your health system is right royally screwed up.
Punished for not accepting a benefit ? Good lord , is your law system going backwards ?
Good luck America .
My premiums are going to nearly double according to my insurance broker, and that's with a $5,500 deductible.
Honestly I'll take the dumb and needless war in Iraq over this shit and QE to infinty. The shit we were complaing about during Bush was trivial compared to this tyrant.
Here's how to get a 75% discount on your ACA insurance plan, especially if your income is high enough that you don't qualify for a subsidy.
Fact #1: Under ACA you can cancel your plan at any time. You can then enroll at any later time. You cannot get a subsidy for the second enrollment however, you only qualify for subsidies once a year.
Fact #2: There is no tax penalty for having coverage gaps if your first gap in the calendar year lasts for less than 3 months.
Fact #3: There is a 90-day grace period after you stop making payments before your coverage lapses.
So...
Enroll in January. Pay one month.
Feb-Apr you are in your 90-day grace period.
Late April cancel your first policy and enroll in a second starting in May.
May pay one month.
Jun-Aug you are in your 90-day grace period.
Late August cancel your second policy and enroll in a third starting in September.
September pay one month.
Oct-Dec you are in your 90-day grace period.
Voila! Twelve months coverage for only three payments.
+1 and saved
I'm a 22 yr old making 35k a year and dont qualify for "subsidies(AKA the margin of your expensive premium)". This shit is getting me so mad that I'm being forced to subsidize birth control pills and babortions, hell if your going to hand out free pills then force girls to take them so I won't have to be paranoid about spending the night with random bar girls
ALPO,
Cheers for the tip.
Alpo,
if this shit is correct, then you should win a Noble prize in applied economics.
How did Obama's actuaries account for adverse selection?
Claim them as registered Republicans and raise their taxes
The Unaffordable Heath Care Act is unaffordable to all but the really sick.
It will financially collapse!
The potentially fatal flaw in Obamacare is the very same feature that appeals most to its supporters: the ability of even those with a serious preexisting health condition to buy insurance at the standard premium.
Legislated stupidity. This is like insuring a house after it's burned down; a boat after it's sunk; a car after it's totalled; a life after it's dead!
Its interesting that no one mentions the REAL fatal flaw of both Obamacare and all other forms of health insurance in the US.
THEY ARE NOT INSURANCE PLANS AT ALL.
All the health insurance schemes in the US run on a very short term basis where the premiums collected each month about match the amount spent on treatment. There are little or no reserves at all behind them. Indeed Federal and state regulations force them to run on that basis.
The current demographic disaster the US faces would have been forseen decades ago by any actuary. A real health insurance company would have set health insurance rates at a realistic level to build up sufficient reserves to carry them through. But NOOOO!!!! That would be seen as unfair. The young have to subsidize the old. Because the old vote.
Wait until we have a REAL public health disaster in the US. Something like the 1918 flu epidemic. Every health insurance company would be bankrupt overnight.
Any insurance company can be run with insufficient reserves and look profitable. Look at Berkshire Hathaway. But the law of averages catches up with them eventually. And don't get me started on what a "genius" Warren Buffet is.
"Wait until we have a REAL public health disaster in the US."
It is going to happen at this rate. They usually do when civilization breaks down and usually are somehow related to people living in filth and squalor.
The shame of it all is that those who do not work or contribute get. Those who do word get the shaft.
I would bet my bottom dollar that after Obama Care there will be more uninsured people than before.
As a Canadian, I once had a 3 month job in the USA. Plan was to eventually get a green card and retire in Florida. After I saw what living in the mid-west was like (Edwardsville, IL), came screaming back to Canada. Where health care is a socialist single payer system and where I erroneaously thought taxes were higher than the USA (they are). THe reality was that once the employee pay for health insurance was paid, and once the various "private" services were paid, my net on my pay cheque was pretty much the same in the USA as it was in Canada. But here there is NO deductible for health care. And yes, one may have to wait for some services. But the costs are a LOT lower for drugs, for medical procedures. Seems to me that in the USA it is all about the $$$$. FOr the medical system and the insurers. And the current plan is a total abortion (how much does one of them cost?) to cater to all the special interests of insurance companies, drug companies and other than can afford the lobbyists. Almost as many lines of legislation as there are lines of code on the website I would think!
And to all the commentators above that want private care, pay cash, etc.. I hope you never get ill. I hope you never are unemployed between jobs (and coverage) and are forced to sell all to keep alive. Good luck to you all as you get older....
As just another brainwashed apologist for statism, you fail to ask WHY medical care is so expensive in the USA today, whereas before the heavy government involvement in medical care circa the 1960s it was not. Like most simplistic and short-sighted sheep, all you can see is the obvious --- you ignore, or are incapable of grasping, the deeper issues and secondary effects of the heavy hand of government involvement in, and distortion of, this particular market.
Government (and the crony corporatism that it enables) creates a problem, so .... by your 'logic', we 'need' government to solve the problem, is that it? Yeah, sounds like a winning strategy to me.
And I bet you believe that university tuitions and fees have become overly onerous, and have FAR oustripped the general trend of rising prices over the past three or four decades, merely because of the 'greed of university administrators', again neglecting to grasp the role that federal subsidization of student debt has played in that similarly distorted market as well.
This whole issue of overly expensive medical care in the USA is just another classic demonstration of the maxim that "government is a disease masquerading as its own cure".
I would posit that it is GREED that has become cultural in the USA that had more of an influence. As to needing government, how else to set up a single payer system? Via the government is the only way. I am not saying the system is perfect - but the statistics do tend to indicate it works better than what you have now or when ACA comes into effect. Yes, perhaps YOUR government has its problems - but don't tar ALL governments with the same brush.
I do agree with your comment re tuition. And car sales. And real estate. Good intentions have skewed these three items in unintended ways I will admit.
Jusman,
I agree with your take on greed running the healthcare biz, but you better understand that the greed is the reason you have healthcare in Canada at all.
We suckers get to pay for advances in pharmacy, technology, etc.
Your socialist gov gets to buy in bulk, while our own anti-competitive laws screw us over.
Enjoy it while it lasts.
" As to needing government, how else to set up a single payer system? "
You stupid fucking tool.
WE DON'T WANT A FUCKING SINGLE PAYER SYSTEM. IT'S FOR RETARDS.
Jusman, you are looking at this very simplisticly. As someone who has been in the medical field for almost 30 years let me state emphatically this has NOTHING to do with greed, sorry. The sad truth is simply massive government intervention in healthcare has caused the dramatic rise is costs coupled with an obese, sickly population that has no inclination or motivation to personally improve their health.
Regulation and compliance has radically changed my job. I spend a vast amount of time in nonproductive activities to maintain compliance. The new thing on the horizon is readmission fines. So I have a 400 lb person with a 800 glucose come into the ER with a raging MRSA infection in their central line. We work for 2 weeks to put this person back together and release them with a 180 glucose. Not great but stable. 4 days later that person is back in the hospital with the same labs. Because this readmission is shorter than Medicare mandates this persons costs are not reimbursable. This is deemed the hospital's fault! Now we eat the costs. This type scenario plays out multiple times a day. I'm not saying hospitals are perfect and shouldn't be fined when egregious errors are made but this situation today is grossly unfair and economically unsustainable.
I know it is popular for people to hear the cause of this is the evil insurance companies. My father made his living insuring unions. He had a small insurance company he created himself and we lived modestly as middle class. Insurance works incredibly well if used catastrophically. Premiums were affordable in the 60-80s for this style of insurance. People paid for their day to day medical expenses and the coverage was only for situations that were beyond the financial means of the average citizen. Believe me it worked. My father has no problem getting underwriters and used actuarial
tables. It's basic math. The more government intervened the more costs increased and,therefore, plans increase in cost. Now catastrophic plans,which should be very affordable to the young, are being used to subsidize more costly plans. Insurance pools have been warped. To assess risk correctly on my fore mentioned patient word require thousands of dollars a month in premiums. I highly doubt this man is paying remotely the true cost for the care he received.
Single payer is not the panacea. Unless you consider restricting access to care to solve the problem by reducing the population of the very ill.
Miffed;-)
No, you stupid fuck. It's the influence the corporate oligarchy that has been allowed to run amuck in gov't that is the culprit. If it was de facto because a gov't was involved France for example wouldn't have one of the best medical systems in the world. One that far surpasses or own. Stupid brainwashed fuckhead.
I am an American living in Canada and have for many years. At the age of sixty-four I went in for tests and ended up with triple coronary bypass surgery. They told me without the surgery I would be dead in days. With all the pre-op tests and all the post-op procedures, the total cost could have easily been $150,000 in the U.S. All decisions about treatment was decided by doctors, no government bureaucrats in sight. The only thing I paid for was the rental TV in the hospital. No worrying about per-conditions. No reading the fine print in the contract. No co-pays. Sure Canadians pay for this system through their income taxes. But for the average guy, this is the best system in the world. Cost per person is far lower then in the U.S. Americans are, for the most part, in denial about their health care system. Let's hope they wake up before it's too late.
North Korea and Canada have much in common.
The United States and Zimbabwe have much in common. Health care and the currency.
Lets face the facts, you didn't build that system in Canada, you just went up there to suck off it because you didn't want to come off some cash for past "transgressions".
Alternately, your brother rat, who did help "build that" system is perfectly fine with 20-30 year olds being forced through taxation to pay for his.
Which one do you think I have more respect for?
Yeah, but Canuckistan doesn't spend $1.2T per annum blowing shit up and policing/terrorising the wprld
BINGO!