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Why The Obamacare Exchanges Are Failing
Submitted by Devon Herrick via The National Center for Policy Analysis,
I reported earlier this week that the Obamacare Marketplace is slowly failing. Three days later the largest health insurer in America, UnitedHealth Group, announced it expects to lose $500 million on exchange plans next year and may exit the market in 2017.
The issue for many insurers is they were encouraged to participate in the exchange in return for a temporary risk sharing program called Risk Corridors. Under this program, all insurers paid into a pot of money and the firms suffering excessive losses were to share the funds based on a formula. However, a budget deal passed late in 2014, the ‘Cromnibus’ Spending Bill, required the program to be budget neutral. The losses far exceeded the pot of money collected by the program. Insurers have only received about $0.13 cents on the dollar of what they would have gotten under an opened-ended program.
The Centers for Medicare and Medicaid Services (CMS) has affirmed insurers will get their money. But the question is: where it is going to come from? CMS has $363 million to divvy up while insurers have requested $2.87 billion.
Why are insurers losing so much money? In my original article, I stated the exchange plans are suffering adverse selection due to the perverse regulations which drive up costs – making health coverage a bad deal for all but the sickest enrollees. The only people enrolling are those who are eligible for the most generous subsidies. Consider what Larry Levitt, a health insurance analyst with the Kaiser Family Foundation, told Bloomberg.
“The ACA marketplaces are not yet profitable for most insurers,” “It’s going to take enrollment growth, especially among healthy people, to make it an attractive market for insurers. If enrollment stagnates, we could very well see insurers thinking twice about their participation.”
The solution cannot be gouging healthy people so runaway costs are covered. The Affordable Care Act was support to slow the growth in health expenditures. Just about any economist will tell you the current system is not accomplishing that. Slowing spending requires appropriately-designed health plans with positive incentives among enrollees. The ACA’s cost-control mechanisms are the opposite of that; they’re akin to pouring gasoline on a fire in hopes it will put it out.
Why not scrap the perverse ACA regulations and admit it was a pipe dream to ever assume young, healthy people could be coerced into paying several times their expected costs to cover other people’s excessive spending. Young people already have a lower demand for health coverage because they don’t expect to need care. As I reported earlier in the week, healthy people also know they’re getting a raw deal when they are expected to pay $5,000 for health plans that require an additional $6,000 in spending before the plans will begin to pay claims. Justice Roberts called the penalty a “tax.” I know people spending $5,000 for health plans they get no benefit from. They certainly think in terms of their $5,000 premiums as another Obamacare tax they can ill afford.
* * *
In addition to this disaster, and on top of enrollment projections that are proving way off, perhaps the biggest immediate crisis facing the Obama administration's signature health reform measure, as Eric Boehm (via reason.com) notes, is the utter collapse of many of the so-called cooperatives that were set up by states as part of the 2010 law.
The Consumer Operated and Oriented Plan, or Co-Op, portion of the health care law established nonprofit health insurers that would receive federal funding and were intended to compete with private, for-private insurers on the exchanges as a way to lower prices. They were supposed to be small-scale single-payer systems that would be free from the profit motive; a progressive's dream solution to the problem of providing health insurance for all.
Instead, they've turned into a nightmare. So far, 12 of the 23 co-ops have failed, defaulting on more than $1.2 billion in federal loans. Only two have been able to break even so far, and most of the remaining co-ops are eyeing massive premium increases—as high as 40 percent in some cases—to stay solvent.
A government program being poorly run is nothing new, of course. But the co-ops established under the health care law were subject to a series of regulations that make you wonder how they were ever supposed to succeed in the first place.
"It should be no surprise that so many of them are going belly-up," said John Davidson, director of health policy for the Texas Public Policy Foundation, on the latest edition of the Watchdog Podcast. "The rules that they put on these co-ops almost set them up to fail."
For starters, the co-ops were barred from hiring anyone who had served at an executive level at any health insurance company in the country.
Think about that for a second. This was essentially a brand new business venture that was prevented from relying on the expertise of anyone who might have the slightest idea what they were doing.
Another regulation prevented the co-ops from raising any capital aside from what was provided via those federal loans. Other rules prevented the co-ops from being allowed to turn a profit, and if one happened to accidentally make money anyway, it wasn't allowed to use its profits to help it grow.
It's the kind of business plan that would be laughed out of a business school classroom. "The co-ops were essentially amateur exercises," said Davidson.
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Free shit is a civil right
Especially for corporations.
They seem to be missing from this article and the money they bring in to their investors at the destruction of the countries youth.
No wonder the millennials are such shit.
Their parents sold them out.
Go figure. Boomers selling out. Its like a national obsession.
Denying it that is.
I am not a boomer and your comments read like a marxist .
I don't know why anyone listens to what that asshole says. He is a living abortion.
Sure, the elites always make big bucks from social programs but those programs are sold to the public as free stuff for the little guy. That's what Gruber meant when he said the American voter is stupid. Folks have to stop asking the elites to take care of them. That's the problem.
Obesity
Sloth
Addiction
As a business owner, why do I have to get between you and your doctor and buy your health insurance? I don't get involved with buying your auto insurance, or your homeowners insurance. So why healthcare? I have to spend a small fortune just to print the damn paper---the 1095c's. I could have bought every employee and their family Thanksgiving dinner for the amount of money I have to spend generating paperwork. All of this busy work is drowning employers.
"The rules that they put on these co-ops almost set them up to fail."
Almost?
Failure was not an option, it was the plan.
#healthinsurerprofitsareallthatmatter
As long as Obamacare is around, I refuse to take on any health insurance. I operate under the assumption that I have cancer and heart disease, and take care of myself accordingly. Somehow this will all be the Republican's fault.
We're all victims. The only difference between us is that some of us know that we are victims.
And those who know that they are victims can be further separated into two groups: those who accept being victims, and those who fight being victims.
Guess which of those groups has a greater chance of recovering victimhood.
Thank you very much but I'll offer to pay cash for services needed, for a discount of course.
Not accepted? How about Ag or Au?
Then I'll take my business elsewhere.
I also refuse to pay the penalty for not buying health insurance.
Unfortunately, my income is so low that the government pays taxes to me, so they could simply deduct the penalty from my "refund".
Fortunately, because my state refused to expand Medicaid (for which I would have qualified), the government decided that I did not owe any penalty, so my chance to stick it to the Man was denied.
Insurance companies wrote the bill to elemininate conpetitive co-ops.
There is a very simple fix to this and I'm going to do my part.
By voting for Hillary Clinton.
That's right, Hillary!!
Because if anyone knows healthcare, It's Hillary!!
NOT.
Your correct of course, but, ironically it was businesses that began health care benefits attempting to attract qualified employees and keep them when the US government imposed wage controls in the 1940's.
Are we all to suppose that Canada,the U.K. and Australia do it differently because they are stupid?
I couldn't agree more, and that's why exchanges should work, rather than have the employer responsible. Employer provided healthcare is an artifact of the 2nd World War I believe when employers couldn't pay employees more so gave them health insurance.
The problem remains the cost sharing function as well as re astronomical increase in insurance rates.
" All of this busy work is drowning employers. "
That is the plan, Destroy small business and you destroy the American economy.
Maybe as an extension of the student loan program Obama could institute a Health Care Loan Program. People could borrow to pay for their Obama care.
Have you read Marx?
How does his comment sound like Marx, exactly? J/w
The millennials are the group that got Obama elected twice. They were hoping for promised free shit but O crossed them. Now, rather than blame themselves or Obama the morons blame boomers accusing them of doing exactly what they have just done.
The boomers are the ones who bought hook line and sinker into the progressive revolution and are running the country into the ground . Boomers in the 60's said trust no on over 30. Now boomer's want everyone under them to believe they have all the answers.
I gots to blame somebody else fors my problems...
Meet me in the alley at 25th & Main around midnight.
The reason O got elected was because he looked like a less bad alternative to the fascist clowns the Rep were offering.
And look what that got them.
0bozocare was written by the banks and major insurance companies. Tim Geithner bailed out Wall Street. GM was bailed out. Billions were given to sham scam "green" corporations that were looted by politically connected insiders and filed bankruptcy.
Then the left wing cretins and millenial sheep cry about corporate welfare after they put the corrupt clown prince into office.
Actually, the failure results from Government Failure to POOL and Provide Large Claim Risk Mgmt.
Pretty easy to run a self-insured plan with even only 50 particiapating families. Claims, Administration and Stop-Loss coverages for individuals and aggregate group members are easy to set and make function reliably. It is the unknown Large Claim that cannot be forecast; even with genetic analysis. Accidents happen, dread disease manifests without expectation.
Government could insure the large claims and manage them. Doing so would eliminate the great variables which drive the medical inflation model.
The pool expense for all plans could be affordable. The effect of removing the individual claim impact from plan budgeting would stabilize insurance costs and eliminate the game-playing Big Claims are for hospitals and insurers. Remove the gamed aspect and plans could easily be affordable and within short time frame, claims for pre-existing conditions of non-threatening nature would be covered.
Of course, you got to get the lawyers and MBAs out of Medicine; unless they can write a prescription.
How many dread disease and horrendous accident claims every year? Probably fewer than half a million.
With Government running ALL these claims, their management could be mandated in fashion like Medicare/Medicaid, and perhaps even combining this care nationally with the VA system; allowing all trauma and intensive care facilities to work under a real economy of scale.
Healthcare Reform can only work if the High-Dollar Claims are Insured/Assured and those claims worked through the healthcare system with an efficiency in cost and management control. Physicians in residence or early years in the surgical specialties could earn good money and Medical School expense refunding for a stint in the Large Claim Cost Health Services.
risk management: https://www.youtube.com/watch?v=laKprX-HP94
Who the fuck downvoted Lester?! I'm gonna kick your fuckin' ass!
"Each according to his ability each according to his need" has nrver worked and never will. With a withering middle class, don't expect grown in anything but destitution. If my company (United Health) just took a $500m hit, I wouldn't wait til 2017 to change course.
Seems you're running out of other people's money
see my comment below...
I am starting a new blog about the worst law ever passed. Watching this mf'er crash and burn is going to be fun.
http://myobamacarenightmare.blogspot.com/
Everything Obongo touches turns to sh!t.
Why should Obongocare be any different?
The situation always made me think of those who have shaky income, but then go out and buy a high end house and boat, knowing their going to end up in bankruptcy..
healthcare is a simple fix. if you show up to a hospital with a gunshot wound or arm hanging out of its socket, you don't get in without a healthcare card. period. do that and watch how fast people prioritize & NOT get that $500 new iphone with a $150 a month data package + monthly netflix + the new BMW they "had to have" +++.
that puts to bed the only other fix which is a mandate; you simply cannot have people wait until something bad happens and THEN they want to sign-up. its not the way insurance companies operate. EXACTLY like auto insurance, what insurer would FULLY insure a lamborghini for $500,000 if the owner just wrapped-it around a telephone poll for $250,000 in damage? the model makes ZERO sense. much like when obama FORCED insurance companies to accept those with pre-existing conditions.
The problem with your theory is that a law created in the 80's requires hospitals to accept you- and fundamentally although dwindling in number- there are decent health care providers that will fix you up pro bono because they still have an ounce or two of compassion.
The government has absolutely no BUSINESS telling you how to spend your money. Ever. Capiche?
The Medical Industrial Complex also gets a free pass on The Sherman Act (Fair Trade), thanks to the Congress-Critters with For Rent signs hanging over their asses.
They are simply allowed to use practices, that would land any other business people behind bars. (excluding banksters, but that's another thread).
" thanks to the Congress-Critters with For Rent signs hanging over their asses."
And,,, Instead of a target drawn on these signs there is just a well placed hole.
"healthcare is a simple fix. if you show up to a hospital with a gunshot wound or arm hanging out of its socket, you don't get in without a healthcare card. period. do that and watch how fast people prioritize & NOT get that $500 new iphone with a $150 a month data package + monthly netflix + the new BMW they "had to have" +++."
Not necessarily. In many neighborhoods where gun shootings are common, I suspect anyone without a medical card -- and who is injured and needs hospital care -- would hold up the first person they found with a medical card and use it. It's just simpler. Why pay those annoying premiums?
Should have went with the exact same system as Switzerland instead of trying to just adapt it.
We should stop making people who produce pay for those that choose to sit on their ass.
How kind of you. I'm sure you think that anyone sick enough to not be able to work is a "non producer." Let's hope you don't end up in that position....but, you will probably justify taking government money because you are entitled to it.
Let me guess, Canyon Wren.
You're a government employee of some sort -- education? You're sitting pretty, making a reasonable salary, knowing all your future needs will be cared for by the nanny state. You've got a pension, don't you? YOu've never made a dollar in the free market nor do you know how to.
You live in a house in the CO canyons, consider yourself to be a wren, a social little bird.
Just remember that those of us who actually WORK to pay your government salary have had it. We're tired. You're not. We're paying the taxes that keep you sitting pretty. We're risking our capital to make our small businesses work.
Do you know what our biggest problem is, CW? the government. It's the regulations, taxes and demands, like Obamacare, that are killing us and the free way we choose to live our lives. If you want to be communistic, that's fine. Create a wee community or go live where others share your values. But don't ask us to pay for you. THat's all. You're free to create a small community within the larger community where you pool your money and dole it out to whomever you feel needs it. The rest of us would rather earn our own keep, give as we see fit, and take care of ourselves.
I'll trust my family and neighbors if I get sick. I prepare for my own future. I'm responsible for my own choices. If I smoke, have unlimited sex partners, become obese, take drugs ... I'll pay the consequences for my own behavior. But I'll be damned if I'll pay the consequences of your behavior.
Much of illness is preventable. Not all of it, but much of it.
I'll entertain your condescending and inaccurate perception of me because it's a holiday. I usually work on Fridays.
Actually, no, I'm not a government employee at all, and I'm not sitting pretty. I'm a college grad, self employed--living the "American Dream," so have to buy my own insurance--it isn't supplied to me by a corporation. I work hard--50 hours a week--to put food on my family's table. My daughter has to have after-school care so that my husband and I can work--it's expensive. I don't live in the canyons, I live in the burbs. I drive a Subaru. I live in a 1,200 sf house. I use coupons at the grocery store, and never buy anything unless it's on sale. My husband is a commercial fisherman in Alaska, so is "self employed" and isn't covered by corporate or small business insurance. It is up to us to find a plan that works for us, but all those plans will be serious hits to our life if we have to pay our deductible.
You're right--the problem is the government, but not the entire government. The problem is Republicans in Congress and the corporations who support them, who make sure most Americans don't have the ability to obtain affordable health care because they are in the pocket of the insurance lobby, who pays for their reelection campaigns. See, my family nearly went bankrupt several years ago because I had a medical condition that cost me $40K. My isurance cost me $700 a mont for only catastrophic coverage, and my family deductible was....wait for it.....$25,000. Blue Cross Blue Shield. I had to pay for everything up to that point to keep our monthly premiums "low" to where we could afford them.
How is health system remotely serving the average American's ability to make ends meet? It doesn't. And, it shouldn't be that way. People shouldn't go bankrupt when they get sick or in an accident. Anyone who thinks so is either a schill or is brainwashed by the elite who are making millions by the present system.
You have to understand, 80% of Zerohedge members are emotionally crippled, divorced, engineers whose only though is themselves. Herbs and vitamins can hold schizophrenia at bay and ward off cancer, auto accidents, and MS.
My doctor was like the above commenter. That is until his son developed liver faliure and need a transplant. Never seen a republican turn into a democrat so fast. They're broke now. One's a doctor and the other is a lawyer. But insurance has a $1 million cap. The flight to get him to the hospital the same day so he didn't die was $55,000. But hey, the insurance company paid $10,000 of it. The true cost of the flight? About $4,300.
Greed is good, right?
I'm all for a free market, but when it comes to health care, national insurance like Japan or Switzerland would be the lesser of the evils overall.
Red wing, blue wing, same turkey.
Thanks for your comment, much appreciated. I know I'm wasting my time here, but I care, so thought I'd give it a try.
Who is downvoting these commenters who are absolutely right? Once there is a very large,diverse population in a country, the only answer is a national healthcare system, with a single-payer. This determination is a simple matter of arithmetic, capitalism notwithstanding. Again, are we to suppose that Canada, the U.K. and Australia have single-payer systems because they are all stupid?
That would never work in 'Murica, the law is only about 30 pages long.... And since there is no official English translation, there is no way American lobbyists and Congress critters could understand it, because they can't even read it.
Unraveling the ACA and writing off the huge mal-investment is going to take some serious political capital, the progressive media will pillory any group that tries to make it so.
But take a look at what happen to those politicians who contrived and voted for the ACA. They are out, relegated to the dust bin of political inconsequence.
If it was an Apple CEO that promised what these guys were pitching, they would have been in jail years ago.
But Bam gets re-elected. It all makes little sense.
sschu
Identity politics at it's finest...
The slime oozes out of D.C.
The slime oozes out of the State Capitols.
The slime oozes out of my local county courthouse annex.
Same as it ever was. The slimeballs glue themselves to the wheels of power and everybody suffers until they get scraped off.
Strong AI can be our saviour or our destruction. It all depends on us not letting the bulletheads weaponize it.
Good luck with that...
Spoctor Din
My practice ((that means me, out of my pocket) has been informed that it must continue to provide care to patients of the now BK Nevada Health Co-Op until 12/31/15. It appears that I will lose about $30,000. No joke. Could take me and my practice down. I doubt I will see a penny. This is not just unpaid services but also drugs that I paid for that will not be reimbursed...most of the 30k falls into that category. I'm being forced to fund Obamacare.
Sorry to hear that. But did you imagine it would end any other way? This is right out of "Atlas Shrugged".
That's sickening. Doctors should organize and stage a walk-out of non-critical care. Political pressure would build so quickly that the govt would have to cave.
THAT is a huge problem. We are not allowed to 'organize' except in certain ways that most of us do not like (unions, corporations or other highly structured organizations.) Those who try to make it as solo practicioners or small groups are being kiled off. I'm told we'll be dead in year (by a group trying to organizes doctors).
I may not be able to afford my ZH dues next year.
I didn't know. It seems they've rigged the game in nearly every way. On the bright side, you've got a great education, and a skill set in demand the world over. If the Hildebeast is installed next Nov., you might want to look at another country. The U.S. is going to hell at an ever accelerating rate. One of my Dad's Docs bought a bug out home in Uruguay...
Try to cut your hours until January 1st. Go through your schedule and see if there are people who would not be harmed by having appointments delayed. Do this with an eye to limiting contact for the rest of the year if at all possible. Your staff members probably have plenty to do when you are out of the office. If not, post a schedule so that they can use some of their paid time off and decide among themselves who doesn't work those hours. At this time of the year, they'll probably be happy to be able to use some of their paid time to take care of other matters.
At the rate things are going, medical care in the US could end up like Vietnam right after the war. You could have surgery, but you had to bring your own suture and medications. The providers would give you a shopping list then you had to go shopping on the black market.
Banana Republic dead ahead.
Then again, that might be an improvement.
is it true that a lot of former usa doctors take up residence in places like thailand?
Obama and the US government appreciates your volunteering and funding ACA services comrade.
No, Thank you, commrade! My this glorious nation rise from the ashes and once again rule zee vorld miff our awesomeness.
unt ve vill if ze others will keep lending us money!!
LOL
The whole thing is stupid. I sometimes wonder if putting out individual practices isnt part of the plan.
You can close your practice through the end of the year.
Problem is that he still has to pay employees and overhead. With zero income coming in, that may be the worse option.
You can close your practice through the end of the year.
Here is THE fix for healthcare. First, all providers must list say, 4k-5k procedures and their costs. Second, all insurance companies must have coverage for all those procedures, and they must list the payout for each. Then, the person with the coverage is paid directly, whatever the payout is, and he gets to pay the difference or keep the difference, whichever way it is. 5 years, and this will fix it all.
Open pricing would go a long way toward fixing things. Healthcare is the ONLY product or service where the price is disclosed after the purchase.
Healthcare Insurers are not subject to anti trust statutes
but we doctors are...
Can't we just return to the pre-Obamacare, pre-HMO era of healthcare? It wasn't such a clusterfuck then.
Even before O'care, 40% of healthcare expenditures went to ADMINISTRATIVE COSTS. There are far too many parasites between the Doctor and the Patient.
Another 2 edged sword is the huge increase in highly effective treatments for serious illnesses. For example the biologicals in rheumatoid arthritis. Drugs like Enbrel, Orencia and Rituxin are all priced at about $15,000 per year and higher. If you need these drugs they can change your life. They can keep you employed. Look at Phil whatisname the golfer. Seriously, no way a guy is golfing at a professional level with bad RA. no way!
So I say these drugs properly used can be wonderful...but there is that cost. One in about 300 people will need them.
That is what insurance should cover. Most people can afford $90 per office visit 4 times a year. Almost no one can pay $15,000 out of pocket. Then there are the other costs of running a good office...think 20k to 30k per month. It is getting rough out here...really rough.
Yes, many of the new treatments are great, but Big Pharma gouges Americans on these drugs. Americans in effect, subsidize drug development for the rest of the world. Perhaps some sort of a price limit is in order.
I remember the proponents of Obamacare criticized 'Major Medical' plans, and yet that's what many O'care plans are essentially, only with less coverage and an even higher deductible.
Hundreds of thousands were going bankrupt with that system, and even more weren't covered because it was too expensive.
Many of the problems with Obamacare could have been avoided if the "public option" had not been killed by the big insurance companies. National health plans are not perfect. In England if you rely on the National Health for non-emergencies you might have to wait months for treatment, but if you can afford a private doctor or health plan you can be treated immediately.
From stay out of my womb to you own my womb.
Healthcare in the US is very expensive, not just because of the insurance companies
It is the way we run it as a whole
nobody wants to compromise so we could all have an affordable healthcare
We want everything, any suprise why it is so expensive
I work at the expensive end of it so I see the waste all the time
but it is in the hands of the politicians who are mostly lawyers.
If you work for it your should have the ability to buy it. it is not a civil right to have healthcare. There is no guarantee in the constitution. If people make bad life decisions I should not have to pay for them and neither should you .
Everyone has access to emergency healthcare. There were never 30 million people who did not have healthcare. The difference is preventative or not.
Well, you see, even if you have the money to buy it, you are gonna pay a hell of a deductable
So there really is no fail safe system for those in the mid income bracket
If you lose your job you are screwed if you don't qualify for cheap health insurance
A health care bill can be massive if something unfortunate came up.
How is getting sick, or getting in an accident, or being born with a life-threatening condition, or getting cancer a "bad life decision?" How are these people--you at some point most likely, since 1/3 of Americans will have cancer--RESPONSIBLE for the bankrupting health costs in this country?
It's amazing how brain washed people are to believe those that are sick shouldn't get help.
I am sure no one here objects to you helping them. They do object to you sticking your hand in their pocket, in the fatuous claim of healthcare, to rip out money most of which goes to bureaucrats, politicians, crony capitalists, and fraudsters.
Your hysterical caterwauling is just a specious attempt to disguise your desire for theft to benefit the thugs in life.
How is this "theft"? Misogynist cop-out name-calling aside.
CanyonWren, I agree with you, but many people are brainwashed on this issue and also can't be bothered to look at the numbers. What is coming is some sort of national sales tax or VAT, and single-payer healthcare. Prices and salaries in the medical profession will have to be subject to reasonable limits. Capitalism has some benefits but is simply inconsistent with proper healthcare.
Thank you, Canoe. I hope single-payer is coming....praying for it, in fact.
The exchanges are running out of other people's money.
presented with the authority of God, I will wait around for the responses and down arrows.
https://www.youtube.com/watch?v=4IjgBdjH7RA
just as i thought, down arrows, and crickets
I'm not hearing anyone fault Congress here AND they have NO SKIN IN THE GAME as they have their own Cadillac health care paid by us.
There's also the issue of the US citizenry electing two losers in a row - slam dunk torturer Bush and Zero-bama
Put Congress on O'Care and Social Security and things would change FAST
Except for the leadership, Congress is on O'care.
I have been throughout this entire thread. It's the Republican Congress who is making life miserable for millions of Americans, and shiny for the 1%, and people are too duped to see it.
Strange... that fucking cunt Gruber is nowhere to be found.
Living in a country with an almost free healthcare (minor participation payments) and already paid a whole bunch of money into the system (). Used it a few times only as I am young enough. Appendicitis, broken knee, few minor issues. Now if I lived in USA those two procedures would cost me some 100k. Here I got them for free. But what is the difference. In US hospitals are enterprises and they charge extremely expensive hospital stay and procedures while here they do not. Hence there is a much cheaper way of running these business than the current USA style. However hospitals in my country are full of queues of elderly. People who do not want to deal with that can go to private hospitals and pay for everything. I went once, took a nice chunk of my salary out, helped immediatly, however with a medicine I could have bought in any pharmacy. Got a few exams (ultrasound, etc) with the bill as well. I know for a fact that this system works better than US as most people I know had some sort of a procedure that would carry a life crippling debt in US.
Nationwide healthcare system can work. You just need to downsize the costs of medical expenses and medications. If a medicine is 10% less effective and costs 99% less than the better one is this not the medicine to take? Can't hospitals use older machines and repair them instead of buying new? There is a number of ways to reduce the bill, but few are taken. And yes, this will cause queues, but the ones that can, can just go to Mayo and pay for their services.
The problem in the end is not the younger population, but the aging population. Our bodies brake down as they have an expiry date. Healing the young is an investment in our future. Healing the old however is a drain of resources. Like fixing a '68. Folkswagen Beettle. You could spend any amount of money to heal US baby boomers to be healthy and fit in their 70s with all the new drugs and breakthroughs, but all that money just goes to waste. This is why I believe we need a tiered system, one for the old that treats them with cheaper, yet marginaly less effective drugs, procedures, etc. And I accept the same for myself.
Yes, Hitler killing off the aged was way ahead of his time.
I did not say anything like that. I just identified a problem which is difficult to identify because of emotions, political correctness, etc. If you suggest that killing off everyone above 65 is good for sustainability of the healthcare system, it just is. But the question I ask myself when arriving to that thought is what do I do when I reach 65? For the benefit of future generations I accept to be treated with low tier drugs, I do not accept putting a rope around my neck.
I would agree only to the extent the elderly are given the opportunity to pay the difference for the better medicine or service, either in cash or through secondary coverage, without being gouged.
Fiction and reality:
http://finance.yahoo.com/news/market-response-unitedhealth-group-earning...
However, share prices of peer companies gradually rose on November 20, 2015, after these companies released statements assuring that their exchange businesses were continuing to perform as previously projected. These immediate responses helped to control the contagion effect that UnitedHealth Group’s announcement was having on other health insurance companies.
Compared to share prices on January 1, 2015, health insurance companies such as Aetna (AET), Cigna (CI), Anthem (ANTM), and UnitedHealth Group (UNH) have reported rises of approximately 17.6%, 28.5%, 4.6%, and 12.1%, on year-to-date (or YTD) basis.
Even United is projecting earnings growth from $6 to estimated earnings per share (or EPS) in the range of $7.1–$7.3 for 2016.
Obamacare drew from two halves. Neither was competently done. Actually, "incompetent" doesn't even begin to cover it, "Pass it to see what's in it", of course. Good grief.
The first was financial, like having policies from healthy people cover expenses of sick people. Now, that does not *have* to be done by age, after all, what else is insurance all about? But put that aside.
The thing that was supposed to "lower everyone's expenses by $2,500" was not financial engineering, it was technocratic expansion of scope - more preventative care to reduce expensive critical care, nutrition, "evidence-based" treatments, big data reductions, etc. All very academic. Maybe all good ideas but NOT something a rational person bets real money on, but Obamacare gathered dozens of these and put billions behind them.
And then, like everything Obama does, forgot about them entirely, what me worry, someone is going to see if it *worked*? How can it not work, when it was so well intended?
But in this case if they didn't ALL WORK, Obamacare was never going to make its numbers. The odds were 10000:1 against, Ms, Pelosi, I hope you're happy now.
I live in San Francisco in my van. Our country was on the verge of total collapse in 2008. Now, down on 3rd St., the medical industrial complex has a mile of brand new gleaming medical cathedrals which, I would imagine, were based on loans backstopped by the assurances of Fascist obamacare. It's a fucking joke.
I'm sorry you are in that position. How sad for you that you buy into the lie you've been told by the elites who are ruining Obamacare--the Republicans in Congress. They refuse to fund what would make your life easier, and they are making insurance companies richer by helping them increase premiums and reduce payouts to the sickest among us.
Total bullshit. It was the Republicans that changed the law to benefit insurance companies--you know, the ones who donate to their campaigns--and who rewrote the law to make the middle class pay for it. This is part and parcel of the Republican agenda--make the middle and lower classes shoulder the tax burden. It's no different for Obamacare. The original bill that Democrats wrote, and that Obama supported, would have placed a bigger tax burden on those who could afford it most and who benefit most from the "socialist" aspects of our society.
Please explain how the Republicans managed to change the law without Obama's agreement. Was he zonked that day and didn't know what he was signing and none of his staff bothered to tell him?
Well maybe you shouldn't let Republicans like Max Baucus ("D"-MT) into the Party, so he can't hire VPs at Wellpoint to come and WRITE THE BILL for him. Maybe you should also not elect Republicans like Obama who meet with the health insurers' trade groups on a frequent basis, yet rarely or never with patients' groups or other non-executive stakeholders.
Schizophrenic splitting can be very comforting, but ultimately, nobody else is bound to take it seriously.
As was already posted - they both did it. Two sides of the same coin, the elephant and donkey are the same.
The issue is managed care. Legalized price fixing and market allocations as well as ponzi scheme funding.
Managed care is not insurance and that is the root of the problem.
The HMO Act of 73, I believe, is the culprit and it was "bi-partisan" just as the Graham, Leach, Bliley Act.
Insurance is risk aversion, how does one insure against a 100% risk ?
Surprise all you readers who now weep! This was the way it was designed. We can now fix it by getting rid of the insurers and have Uncle Sugar pay - again with your money, sick or not and only those who can afford it will take out private insurance. The promise will be controlled costs but the reality will be thousands of new VA type dungeons all over the country with the same crowd running them, the same filth and the same fiscal care. Bend over people, here it comes, you elected them. As H.L. Mencken once quipped: "democracy is the form of government where to people get what they want. And they deserve to get it good and hard."
Everyone - no matter income or entitlement or benefit - should be required to pay $20 upfront. That would cut back on wasteful visits by those who think health care is a right.
What a surprise.
Not "enough" healthy people are signing up for $500+/month "insurance" plans that have $5,000+ deductibles.
I am shocked - shocked.
Maybe the American people are not quite as stupid as the drafters of this ridiculous monstrosity thought they were.
Oh, I guess we should all start paying only the taxes the are applied to things we actually use then, like the specific road we drive on to work, and the schools we send our kids to.
You're parroting what the elites are telling you and want you to believe.
Or, better yet, why don't we only pay for the things we ALL use, like roads, parks and national defense. Let communities decide education. Let individuals decide healthcare.
What a bunch of crap. The reason CoOp's are folding is because the Republican Congress has renegged on their promise to fund them. Gosh, I wonder why? Perhaps it is because Republicans are wasting millions in taxpayer dollars to ruin what Americans and the US Supreme Court have upheld as established law. But, I digress.
Take the Colorado Health CoOp, for example. They are closing Jan.1, 2016 because the state insurance regulator has determined the CoOp can't pay its bills--(even though there were committed donations of $30 million, more than covering projected payouts.) The cause of the money shortfall was the Republican Congress defunding more than $10 million to an agency set up to help fund "risky" business assessments.
Here is how it worked: the Centers for Medicaid and Medicare Services, a subset of the federal Department of Health and Human Services, did not obtain Congressional funding, so renegged on their promise to fund the "risk corridor program" set up by the ACA to make sure insurance companies were covered for "risky patients", ie, those with preexisting conditions or expensive health issues. You know, the most vulnerable of us that insurance companies would rather not cover. The ACA decided to help INSURANCE COMPANIES pay for these most vulnerable people that are not financially profitable in order to keep the insurance companies from denying them in the first place. But, Republicans in Congress decided to defund the Centers for Medicaid and Medicare Services by 88 percent for these "risk" programs because they would rather no one be covered and the system go back to bankrupting people than finding a solution. Clever. And, heartless. The Colorado Health CoOp was expecting to get $16.2 million by the federal government, and instead got $2 million, so the state Dept. of Insurance closed the doors.
The Colorado CoOp was going to be profitable in 2016, and was to have started paying back its federal loans early. But, without the money promised for the risk program, it will default on loans. It wasn't the fault of the CoOp, it was the fault Republican obstructionists in Congress who are bent on destroying affordable health care for Americans.
" Republicans are wasting millions in taxpayer dollars to ruin what Americans and the US Supreme Court have upheld as established law." LOL No comment needed.
Fund them with who's money again?
Yep, socialism/fascism is ripe in ameriKa.
Fund them with who's money again?
The apes' that are spending their money at Walmart during Black Friday, the same apes that pay for everything including your group health coverage that you think your coporate employer pays for.
Yeah, that pesky Supreme Court. Whenever it rules "for the people" ie, you, it's "socialism/fascism". By the way, you may want to check your dictonary--socialism and fascism are two different things. But, I wouldn't expect someone like you to know that.
Oh Jeez. You still believe in the old continuum with fascism on the right pole and communism on the left? That's such BS, you must know. Communism and fascism are tweedle-dee and tweedle-dum; two sides of the same coin. The opposite of fascism isn't communism, but libertarianism: similarly, the opposite of communism isn't fascism, but libertarianism.
From right to left is anarchism ... libertarianism (Trump)... uniparties D and R (Hillary/Bush) ... socialism (Sanders) ... communism/fascism.
I assume, from your comments, that you're somewhere between socialism and communism/fascism. Fine. That's your choice. Having said that, this is not the country for you and Colorado, though a purple state, isn't a good fit. Go to Sanders land (Vermont) or Scandanavia. Vote with your feet. Go where you fit, don't try to make the rest of us pay for your political delusions.
I hate to break this to you CanyonWren, since you are clearly a political naif, but the Democrats are just as corrupt as the Republicans. You don't want to see that, and so you won't see that, but it is true. There are many reasons that healthcare is overpriced, and the Democrats are just as big a reason for that as the Republicans. You live in a fantasy world with make-believe enemies. I envy you; it must be comforting to think you know the simple answer; just those old meany Republicans and ZHers and libertarians.
Just because 5 retards is black drag agree on something doesn't mean whatever they agree onis "established law.
Looks like a little wren is in la-la-land. "the Republican Congress has renegged on their promise to fund them". Since Obamacare was passed wholly by Democrats, who refused to consult and compromise with Republicans, there is no promise by a "Republican Congress" to fund them. This is wholly a Democrat disaster, like most.
Another practical tale for doom on this matter.
So my friend sets off to Quest (big lab company) for some quarterly blood work.
Hands in paperwork for Dr ordered test, has all insurance, is responsible for $20 co-lab co-pay.
Waits forever and is then ushered into the lab space for a blood draw.
Sits down with tech, puts tourniquet on arm.
Tech turns to patient and says; "I need to get your debit card on file and pay the estimated cost of this procedure - $112. We will bill your insurance, but we are not going to draw blood until we are paid.'
Will not accept "partial" $20 co-payment under insurance.
I shit you not.
Only told - 'It's our new policy.'
So the idea here is, lure the patient into care-space, separate them from the herd, acknowledge they have insurance, but ignore prior payment agreements, require pre-payment from patient sans insurance.
Hold patient hostage - shake all the cash out of them for de minimus procedures.
Creepy. Evil. Why have insurance in the first place?
After waiting a month for permission for the labs, the patient has no choice but to acquiesce to ANY demand the care-provider demands at time of treatment - insurance or not.
Mad as hell, my friend ask where other labs were to do future work.
There are none. Another Obama monopoly charging Turing Pharma prices.
The system is in free-fall.
It would be cheaper to train yourself to be a doctor than exist under this evil and expensive regime.
Fuck Quest Diagnostics.
Utter BS that your friend was not told of the clinic's payment policy upfront. Shame on them.
Just keep in mind that alot of these clinics are not being reimbursed in a timely manner by the insurance companies. My wife is a Doc, she processes insurnance for her patients and asks for co-payment up front. Same as she has done for the last 20 years. Whats changed is the S L O W N E S S at which they are processing those claims and sending the checks. It's always been bad but now, she has payment being held by 6 months. That's money out of her pocket that she needs to pay for the building and equipment, pays the staff, taxes, etc..
Again, total BS if your friend wasn't told before he stepped in the clinic that they expected payment up front. But shame on the insurance companies that are leaving these small businesses holding the bag when they don't pay in a timely manner.
You are 100% correct, the system is in free-fall.
"the patient has no choice but to acquiesce to ANY demand the care-provider demands at time of treatment"
No, just walk out. Then laugh at the $100 (a few years ago, probably more now) bill for "administrative services".
If you really want to watch them squirm, refuse to sign all their "get out of jail free", "not responsible for X,Y,Z,etc.." paperwork.
US "Health" care is a joke. More like "keep them dying" care.
Well you have one too big to fail health insurer in the US that has it claws into HHS and CMS and has for years. This is another one where you can bury Hillary on with hiring Lois Quam from United in the 90s and read about Lois's marriage to a Muslim last year too, who works for the State Department..lots of information here...
So while the dupes of hazard were graveling over the United CEO running his scare tactics on pulling out of exchanges, we had this big purchase going on by United..home infusion..pretty big but how many cared whether note their home infusion therapy drugs were now putting money to the bottom line of United Healthcare...obviously not enough. The big United scare last week made money for the short position stock holders at United and the next day we had a double bonus as investors got to buy the dip and the stock was back up next on Friday. Dupes of Hazard couldn't see this and nor would the press put it out either.
http://ducknetweb.blogspot.com/2015/11/optumrx-united-healthcare-buys-home.html
These are not stupid people over at United and they plot each acquisition with a method and have put other competitors out of business with subsidiaries that are not directly in the health insurance side. This company loves to see co-ops dive and probably helped design them so it would enable them to pick up more business as they have more Medicaid managed contracts than anyone else out there. Anyway if you like, see the United Cargill and Carlyle connections out there as well. United wants to be the contract holder of the single pay world, no doubt about it and they tried exactly that when Clinton was President. I have a few former CMS folks that keep me up to date from their experiences.
The Six Degrees of Bob Rubin running HHS can't even support their own sub agency called the FDA!
http://ducknetweb.blogspot.com/2015/11/hhs-joins-optum-labs-as-research.html
They jumped in bed with Optum in Boston with their for profit Optum Labs deal. Of course you can't ignore that CMS is being run by one time Goldman banker Andy Slavitt and I covered the Elizabeth Warren Daughter McKinsey relationship at the the link as well..shocking..all this happening in plain sight as well as people don't read and some are just bliss and don't get complexities today.
That's for the specifics. I knew something of the sort had to be going on. It was obvious that the rules for the co-ops were Designed To Fail. As for owning the Home Infusion business -- see, this is TOTALLY an artifact of our current legal/regulatory regime. When I was a child that would have been ILLEGAL. Completely, totally, get your business wiped off the face of the nation illegal, and considered so fraudulent that your own best friends would be embarassed to have anything to do with you afterwards. What no one ever admits, is that we got ourselves into this mess from what WAS a "good place" in health coverage, a single-payer non-profit system called Blue Cross/Blue Shield, with community hospitals in almost every small city and laws in every state that prohibited kickbacks and self-dealing among medical professionals. We let it fall to pieces in the name of "efficiency", i.e., Holy Profits.
It's not just "young, healthy people."
Everyone I know in their 50s has annual medical expenses below their deductible and premiums that are rapidly closing in on 1K/month. If you have an income anywhere near the median, dropping insurance is going to result in a 20% increase in disposable income with no actual change in the health care you get since you're out of pockey anyway.
My premiums have gone from $249.00 per month to $863.00 per month in the past 3 years. Have never been to a doctor or spent a dime in that time. Now I opt out next year. Fuck Them, I should pay for illegals? BTW- my income has gone down during those 3 years
How do the people opting out then pay the resulting fines?
Death is preferable to life under Obummercare.
Zero Trust. Zero Confidence.
I would never risk my family's financial independence by becoming a victim of the USSA "Health Care" system.
However depending on the circumstances, I might consider leaving the country for quality medical care and pay a fraction of the USSA prices in cash or gold.
USSA "Health Care" is nothing but a bunch of quacks tapping away at their tablets, worthless turds all.
If I could not escape the USSA. I would trust a competent country veterinarian who can still use his or her brain over any MD or DO.
The USSA system sucks. I would rather die than be "treated" by USSA medical scum.
"Obummercare" has made health care affordable for millions of Americans who had no isurance, and also for Americans who were going bankrupt paying for junk insurance that required a $10,000 deductible for all but catastrophic benefits. You've been fooled into believeing Obamacare costs more for average Americans. It doesn't.
WHat planet do you live on? I can recount tens of friends who have had their insurance jacked up to the point where they're now uninsured.
Junk insurance? You mean catastrophic care insurance? That's what everyone should have ... no more. Insurance is supposed to be for emergencies, not for everyday care. Everyday care should be out-of-pocket, and Americans -- ALL americans -- should be self-reliant and forward-looking enough to pay for their own care.
Before the government, people received care. Charities took care of the indigent. Doctors charged a reasonable fee and generously waived it for those who couldn't afford to pay. Life was civil. People looked out for each other.
Now ... the nanny state takes from those who are responsible and gives to those who are irresponsible. It's ridiculous.
Precisely correct boodies +1000
One problem with the old way of paying doctors is that doctors are no longer independent professionals in charge of their own practices. They are all employed by large partnerships, where they don't have the power to waive fees on their own but have to get it approved by a bean-counter. Furthermore, they CAN'T be independent professionals in charge of their own practices, because the costs of setting up a practice are staggering due to 1) the fancy, expensive equipment they are supposed to have on hand, 2) the need to hire several office staff just to keep track of and communicate with fifty different insurance companies, all with their own ABSOLUTELY MANDATORY rules, and 3) the fact that even a popsicle stick is marked up by 1000% if it's labeled "for medical use" in this country, so supplies cost through the roof.
The Nanny State is only 50% responsible for the last of those causes. The others are fashion (including patient expectations) and the dominance of the insurance system.
So, you're saying that everyone should have junk insurance and no more--ie, we should have to pay for all health care costs out of pocket no matter how dire the healh problem is? In other words, you are saying those too poor to pay for health care should die? What a fucked up mindset.
Mine went up from under $400 a month to over $2,200.00. And the coverage is worse, the deductible higher. I am basically healthy, and have virtually no claims against my prior policies. I was always able to get insured with any company I wanted. I would like you to put your personal money on the line on this one, because I have bank statements, cancelled checks, letters from the government, and insurance records showing a payment history over 7 years, because by law I have to keep those records. By the way, the 30 million people it was supposed to cover: how many of those signed up? From what I've seen, there are still millions uninsured. How do you square that?
Now that the CoOp is finished (read this article: http://www.latimes.com/business/hiltzik/la-fi-mh-the-secret-swipe-at-oba...) our premiums, under the cheapest available plan, will go up $300/mo. and our deductible will go up $4,000 a person and $7,000 for the family. I feel your pain.
FUCK OFF LIAR!!!
Kinda with you on this. I have a blood pressure problem. It's linked to a bad MAO gene -- I can only deactivate adrenalin at about 20% the rate of a "typical" human. Any time I walk into a doctor's office, I get angry or frustrated with the way patients are typically treated (myself OR others), and my blood pressure goes up by about 50 points -- which puts me at risk of stroke, and terrifies the medical people to where it's even more impossible for them to pay intelligent attention to a Mere Patient. So I have to weigh the probability of dying from not going, against the possibility of dying because of running BP at 220/120. It's REALLY bad for my health to go to doctors' offices.
This is crap: "admit it was a pipe dream to ever assume young, healthy people could be coerced into paying several times their expected costs to cover other people’s excessive spending."
Maybe that is true in the USA, but there are all kinds of single-payer countries where this happens all the time. It is not a pipe dream in any sense of the word. People pay income taxes (including young people!) and income taxes pay health care for those who need it. For those who do not need it, we are thankful that our turn has not yet arrived, but we know the bell tolls for everyone at some point, and it is a comfort knowing we will never bankrupt ourselves or our families when our turn comes.
For those who are too self-obsessed or greedy or short-sighted to understand this, I feel sorry for your country. And for those who believe that insurance company executives should be making decisions about your health care, or that a significant portion of your personal health care expenses should go to insurance companies, I simply do not understand the thinking.
If your Soviet system is so great, why does it have to be enforced at the point of a gun?
You see, the difference is, you pay income taxes and get health care. We pay income taxes and get brown people bombed, open borders (and illegal immigrants who, surprise, get care for free that bankrupts local hospitals), and then are expected to fork over another $500-$1K/mo, per person, for insurance on top of the taxes.
It's not just insurance companies, it's the entire fucking system. We have pharma companies, that when their patents expire, pay the generic manufactureres to not make generics of their drugs, to keep prices high. We have hospitals continuously expanding ginormous buildings prone to MRSA outbreaks, while taking legal action to prevent cheaper, small community surgical centers from being built. We have legislators that get large portions of their campaign funds from pharma, hospitals, healthcare unions, and insurance.
We're not self-obsessed or greedy or short-sighted, we realize we're being fucked by the entire system, and Obamacare not only made it legal, they forced us to pay for being fucked over and fine us if we don't participate. On top of those same income taxes you pay.
So it is a pipe dream for single payer to ever work in the US unless the entire system is rebuilt top to bottom, and that will never happen because the system isn't intended to deliver healthcare, it's intended to extract money -- and the legislators are completely on board with the mission in spite of what their PR might say.
You don't understand the thinking because you don't understand the scale of the problem. This isn't about insurance.
Mostly true, with one quibble: Obamacare was tweaked by the Republicans in Congress to fuck over Americans to pay for higher drugs, higher deductibles, and higher prices per person who were healthy. The original bill had none of that, and actually had a sliding scale from poor to rich. Of course the Republican party--the party of the elite and greedy--didn't want to piss off their donors, so changed all the provisions that would have made Obamacare a fair system based on income; ie, a similar system we have today for infrastructure, schools, and basic living conveniences that rich and poor alike enjoy every single day of their lives, and that make our country one of the most desirable countries to live in.
The problem is that most Americans, like many on this thread, are being LIED TO to believe what is in their best interest is actually costing them.
Since Obamacare was passed solely by the Dems, and Obama has been in office ever since, and his signature is required to enact any law, how did those viscious Republicans manage to make these terrible changes? Was Obama asleep when he signed whatever law it supposedly was? Did he have the robosigner in use that day?
Obama and the Democrats totally own Obamacare, not anyone else.
You obviously don't know how Congress works. Obamacare was not passed by Dems--in fact, the Republicans joined on wholeheartedly with the condiiton that the health lobby got most of their concessions.
Obviously you're an idiot and don't understand how anything works.
Please post your links showing how the Republicans were involved in this process. Canyon, the Republicans suck like 1000 Hoover vacuum cleaners, but they were totally locked out of the Obamacare process. They weren't even allowed into the meetings. The Dems took it behind closed doors. And if the Republicans did what you said, and had something to gain from it, not a single Republican voted for Obamacare. So again, I ask you to post your links or site the specific passages added by the criminal group known as the Republicans, and please mention the legislator responsible so ZH'ers can research it. Thanks.
Silverer, perhaps I didn't explain clearly. Republicans and insurance lobbyists were heavily involved in tweaking the bill to further benefit insurance companies and remove some of the original provisions that were public-option in nature. Here is an interesting article:
http://billmoyers.com/2013/10/29/why-republicans-have-no-business-being-...
Nixon signed the HMO Act with all kinds of elephants in tow. The damn bill was authored by Teddy K
Graham Leaach Bliley was a marvel of bi-partisanship.
Bush instiled the prescription drug law to medi-whatever.
Anytime the debate centered around the flaws of the managed care system the elephants were more than willing to shill for their bankers.
For my money I would consult a Doctor on this issue.
https://www.youtube.com/watch?v=trQD9uW9gHs
Actually, although you'd think that, it was the Democrats. For that brief moment in Congressional history, they had an absolute majority. Unfortunately, at least a dozen members of that majority were DINOs/Blue Dogs, who might as well be Republicans except that they caucus with the Democrats. And they insisted on the changes to make sure that the bill 1) kept on-book government spending down, regardless of what it would do to the actual costs, and 2) kept insurance companies and health care providers in the drivers' seat, regardless of the fact that they would then proceed to suck us all dry.
Single-payer Medicare For All is the only system that will WORK in the short term (next 50 years). Obamacare was doomed from Day 1, because it wouldn't use the screws available to the State to eliminate gross fraud and profiteering. Only a monopoly can set prices and, frankly, put an end to frivolous and wasteful "treatments" that merely prolong the agony of the dying and unnecessary diagnostics that run up usage of expensive equipment for 0.001 chances of finding something that isn't there. (For reference, consider recent changes to guidelines for mammography and prostate testing, both of which tend to find and panic patients over benign slow-growing tumors -- and run up bills for additional testing and unnecessary treatments).
Nice. You managed to describe your own comment in its first 3 words.
Didn't you know? Insurance executives are millionaires, and therefore by definition godlike beings. Who better to make our life-and-death decisions? The ordinary American is the mud beneath Their feet. And of course, They must be compensated in proportion to Their superior worthiness, as must the administrative executives of the hospitals and health care practices which of course must make enough money to pay for that compensation, as well as the compensation for those illustrious individuals who manage the pharmaceutical companies, the medical equipment manufacturers, and the mail-in pharmacies.
Americans cannot afford healthcare, not just health insurance, because there are far too many pigs feeding in the government-regulated troughs. Even single-payer countries could not afford health care, if they allowed the level of profiteering in health care delivery that is the norm in America.
I neither have health insurance nor will I purchase it. I've put aside a small amount of money in case of emergencies, which thankfully haven't happened, and took a rider out on my auto insurance to pay medical bills if I'm in an accident. I go to a pay-testing place twice a year for blood tests -- I choose the tests I think I need. I get prescriptions filled in India.
Privacy is a huge issue, for me. I refuse to give the government my medical information as I consider it invasive, and dangerous, to have the government decide what/when I can have medical services. If I'm independent of the system, and take care of myself, I'm not only self-reliant, but I retain my autonomy and control my personal information. I have nothing to hide, by the way, but still, why give the government my ... estrogen prescription, for example. Why do they need to know this?
I was beyond pissed when I discovered that I cannot reinstate my driver's license without giving the government my fingerprint (Colorado). I've never had any sort of issue with the police or state, so why do they need MY fingerprint. It's not like I'm a felon or terrorist or illegal immigrant.
It's votes vs. fines. Democrats would rather have votes. Once they totally corrupt the election process, then they stick the stupid freeshitters with fines and force them in.
Because it is designed by Shylocks