Appeals Court Upholds Healthcare Law

[Doc]

They'll have to bail them out. The "public" health coverage is private insurance purchased on a government exchange. Unless the government wants the public option to fail when the private insurers fail, they'll bail them out.

 

Of course, "bailout" in this context is more like "take over" or "nationalize". At which point, our socialized medicine program is in place.

That's what I'm thinking. You let the private insurers go bankrupt and have the government take over insuring non-Medicare or Medicaid people (Medicrap?).

Doc, your buffet analogy works well for some. For others (read: young people) I don't think it's quite as apt.

 

When I was paying for good health insurance (from 2004-2008) I really didnt ever use it. I guess I did for the dentist but I've never been a fan of the rush to the doctor mentality. Most of my young friends are similar in that regard.

 

But you're right, people do need to be more conscious of the consequences of their decisions to randomly go to the doctors/ER/urgent care because of a headache. And I would LOVE to see a focus on healthy lifestyles. I think American society has been trending that way for the last ten years or so, but its still a long way from being the dominant approach. I'd like to see the food stamps program take a more heavy handed approach at nutrition and even education. As someone who has been trying to get in better shape over the last few months, I appreciate the necessity of good food and how destructive an unhealthy diet can be, especially when its supplemented with a sedentary lifestyle.

 

The best thing this country can do to solve ALL of its problems is to get dialogue going, develop understanding of the assorted problems and try to reach an understanding on how to fix them. Thats why I get so mad when people participate in the demonization of liberal/conservatives. I am an unabashed liberal....but that doesnt mean I think conservatives are the devil. They hold a different approach...one with some merit. So lets talk and see how we can both accomplish goals.

Fine, get a dialogue going and tell people they need to live healthy. Don't create a massive-flawed new entitlement that will help sink the country faster than the already-established entitlements are.

That is why I stated other than people who are willing to make the "no treatment, this s my time" choice, most opt for extending their life.

 

We also live a society that values life, and in general we find it abhorrent to let people die who would prefer to live... And that is probably good policy...

 

Like you said, we have growing population that has increasing chronic conditions that live very long unhealthy lives... To pretend cost will decrease is absurd.... Cost will rise until there are less people, less chronic illness, cure for chronic diseases, or until be decide that we are willing to stop treating people at a certain age.... Maybe a combination of all of those.

 

I know someone who firmly believes that the US should spend no more than 6% of GDP on any kind of healthcare related outlays, and people can't afford to pay for it for themselves and they die, so be it.... He's a real prick

The problem is that you can't save everyone. Allocating resources to extend life just for the sake of "preserving life" removes resources that could be used better elsewhere. And at some point, if government takes over health care, they'll have to ration care because costs will continue to spiral out of control otherwise, +/- they'll tell you how you have to live.

Why are people crying over rising premiums? Is it that they weren't paying anything before? Where I work, the employer (federal gov't ) picks up around 60%. Always has been that way. My premiums have been going up every year since I started working 20 years ago. When I started on with family insurance (high option)... I was paying about well under 100 bucks every two weeks... That was in the mid-1990's... Now my premium is around 300 bucks every two weeks. You figure my employer kicks in over half... So that has got to be over 15k that Humana gets from the both of us a year. At my young age, I would be better off banking that into an locked account and go fee-for service while carrying catastrophic.

 

I am not sure what my threshold is... But it is getting closer where I will have to downgrade carriers... That and lack of service every year... And rising co-pays.

What insurance does the government offer you?

[Magox]

I did a lot of work on the health insurance bill....Is there any way I can retrieve it, the huge thread regarding the bill? I can't find it, if someone could post it I'd appreciate it.

[Dave_In_Norfolk]

Require that anyone who earns more than $50,000 a year must purchase health insurance or post a bond.

 

Whatever, what's the big deal?

[ExiledInIllinois]

What insurance does the government offer you?

 

All kinds of choice. The good thing, AS IT IS NOW, I can downgrade and go lower with less service and more co-pays... Not that hasn't been happening with my plan now. More premiums, more co-pays, less service for over 2 decades now. In the big picture, to benefit all better... The bad thing is that there is too many choices and too many insurance companies. I think benefits and service can be better if less choice was offered. I have been using Humana for a long time now and it has (like all the other choices) been steadily going up each year with constantly decreasing service and increasing co-pays on top of the highway robbery of the agency (employer) and employee.

 

I do admit, I gotta piss or get of the pot about choice.

[Adam]

Keep the law, get rid of the law- all the same. Deny the health care lobby and force competition, that will lower costs and fix a lot of problems. Won't happen though, as politicians from both side will continue to take the dirty lobbyist money.

[Magox]

Keep the law, get rid of the law- all the same. Deny the health care lobby and force competition, that will lower costs and fix a lot of problems. Won't happen though, as politicians from both side will continue to take the dirty lobbyist money.

Bla bla bla my name is Adam and I never say anything of substance

[....lybob]

Bla bla bla my name is Adam Magox and I never say anything of substance

geeze you are so senile you forgot your name, it's Magox not Adam

[Magox]

geeze you are so senile you forgot your name, it's Magox not Adam

You sure can be original, not only can u not produce a thought not derived from a YouTube video, but u recycle quotes from ppp posters...

[Adam]

Bla bla bla my name is Adam and I never say anything of substance

The only thing that was insubstantial, is that it never will happen. Nobody can argue that competition would lower insurance prices.

[ExiledInIllinois]

Bla bla bla my name is Adam and I never say anything of substance

 

 

Why wouldn't you want to get rid of the health care lobby? One less lobby the better!

[Barack Obama]

Why wouldn't you want to get rid of the health care lobby? One less lobby the better!

 

Let me be clear. If we eliminate the health care lobby, that will also eliminate hundreds of thousands of millions jobs. Just think of all those poor unemployed lawyers.

[ieatcrayonz]

Doc, your buffet analogy works well for some. For others (read: young people) I don't think it's quite as apt.

 

When I was paying for good health insurance (from 2004-2008) I really didnt ever use it. I guess I did for the dentist but I've never been a fan of the rush to the doctor mentality. Most of my young friends are similar in that regard.

 

I don't really have anything to say about the main topic but would like to point out that this particular new guy is clearly NOT Canadian.

[Dave_In_Norfolk]

I see the Supreme Court has decided to rule on the mandate

[/dev/null]

I see the Supreme Court has decided to rule on the mandate

Was inevitable.

[B-Large]

That's what I'm thinking. You let the private insurers go bankrupt and have the government take over insuring non-Medicare or Medicaid people (Medicrap?).

 

Fine, get a dialogue going and tell people they need to live healthy. Don't create a massive-flawed new entitlement that will help sink the country faster than the already-established entitlements are.

 

The problem is that you can't save everyone. Allocating resources to extend life just for the sake of "preserving life" removes resources that could be used better elsewhere. And at some point, if government takes over health care, they'll have to ration care because costs will continue to spiral out of control otherwise, +/- they'll tell you how you have to live.

 

What insurance does the government offer you?

 

The question becomes this: "who do you want to make rationaing decisions?" Private Insurers ration care all the time, as does Medicare does through the ABN process. In the end do you want a company whose goal in the end if healthy margins, or a government who tends to produce cost overruns and is reliant on tax collections to make those decisions? as far as a paying adminstrator, they are basically the same, finiate dollars with decision to me made.

 

Costs are going to continue to rise either way, whether it is Government Care of Private Care. Americans do not like being told what to do (and that is their right), they general label any movement to increase health as preachy, and most have no intention to improve their lifestyle. Well, there is a cost to that freedom and the continued expansion of the Nation's waistline- higher costs do to chronic management of Diabetes, Health Disease and other related illnesses.

 

More reponsibilty for payment of care should be on every single American. I have always felt that decent size deductible plans for Americans is a great avenue in which to make people AWARE of costs- If you are fat and unhealthy, you will cover your deductibel pretty fast- no better way to change behavior that hitting people in the pocket, year after year. I addtion, lareg dedcutible plans force Americans to save for their expenses- that way dead beats can't shift onto others.

[Doc]

The question becomes this: "who do you want to make rationaing decisions?" Private Insurers ration care all the time, as does Medicare does through the ABN process. In the end do you want a company whose goal in the end if healthy margins, or a government who tends to produce cost overruns and is reliant on tax collections to make those decisions? as far as a paying adminstrator, they are basically the same, finiate dollars with decision to me made.

 

Costs are going to continue to rise either way, whether it is Government Care of Private Care. Americans do not like being told what to do (and that is their right), they general label any movement to increase health as preachy, and most have no intention to improve their lifestyle. Well, there is a cost to that freedom and the continued expansion of the Nation's waistline- higher costs do to chronic management of Diabetes, Health Disease and other related illnesses.

 

More reponsibilty for payment of care should be on every single American. I have always felt that decent size deductible plans for Americans is a great avenue in which to make people AWARE of costs- If you are fat and unhealthy, you will cover your deductibel pretty fast- no better way to change behavior that hitting people in the pocket, year after year. I addtion, lareg dedcutible plans force Americans to save for their expenses- that way dead beats can't shift onto others.

Who do I want making rationing/health care decisions? How about...doctors?

 

As for "Americans do not like being told what to do (and that is their right)," you're saying that the insurance mandate is wrong/unconstitutional. We are in complete agreement there. And if it is correctly ruled as such, Obamacare crumbles because there is no way to pay for it.

 

Personally though, I would love to see a true "mandate." But take it all the way. Make no exceptions and make it mandatory until 70 years old, since people are living much longer than when Medicare was enacted. Make the penalty for not having insurance cost more than having insurance. And while we're at it, make people live healthier. The root cause of skyrocketing health expenditures starts and ends with people themselves. Obamacare is like spending money to protect the surrounds from a fire that keeps growing, and not attempting to put out the fire itself.

 

And as for HDHP and HSA, I'm all for them. I have one and love it, and I've saved $12K the past 2 years. The problem is, Obamacare is seeking to limit, and ultimately destroy, them. Why?

[B-Large]

Who do I want making rationing/health care decisions? How about...doctors?

 

As for "Americans do not like being told what to do (and that is their right)," you're saying that the insurance mandate is wrong/unconstitutional. We are in complete agreement there. And if it is correctly ruled as such, Obamacare crumbles because there is no way to pay for it.

 

Personally though, I would love to see a true "mandate." But take it all the way. Make no exceptions and make it mandatory until 70 years old, since people are living much longer than when Medicare was enacted. Make the penalty for not having insurance cost more than having insurance. And while we're at it, make people live healthier. The root cause of skyrocketing health expenditures starts and ends with people themselves. Obamacare is like spending money to protect the surrounds from a fire that keeps growing, and not attempting to put out the fire itself.

 

And as for HDHP and HSA, I'm all for them. I have one and love it, and I've saved $12K the past 2 years. The problem is, Obamacare is seeking to limit, and ultimately destroy, them. Why?

 

agreed, MD's do make the recommendations, but from what I have expereinced it is families that tend to extend life on a less than productive/quality of life basis (lets assume really old person). But alot of the rationing comes from payors, like not paying for unproven therapies in people who are really sick (lets assume a younger person)- will it save their life? don't know. But by not trying, we are in effect rationing.

 

It is interesting and one of my criticism of the ACA is this. If you are gauranteed to be able to purchase insurance, no matter what, why would anyone pay premiums until they get sick? Just pay the penalty- when you get sick, hop on the exchange and buy some insurance, which by LAW, you have to be able to get. Boom, insured and treated!

 

That is the biggest flaw in that legislation. It is a crap Law, but from a personal standpoint, I would rather whats on the books to protect my wife and I personally, where as prior to March 2010 there is no may my wife would be able to get individual health coverage. It sucks, but in life I think you weigh the options, and you tend to look "self-interest" first- it is the very reason I voted Democrat in 2008, and likely will again in 2012- my biggest risk, right now in life is COST of being unable to get health insurance- I have everything else covered, from Life Insurance to Disability.

 

As far as HSA's, I they are limited because the designers of the ACA were unsure Americans we able to budget and put money away. I think there is some merit to that, until recently US has had a negative savings rate- but for people like you and I, they work great beacuse the monthly premiums are low, and if you can cover 5-10K and have that saved, you are in good shape- it also a good way to get a feels for costs, etc.

 

I think the ACA has "less than transparent, managed care" versus a "consumer driven" feel to it, that is a big weakness as well. *for example, if someone has high blood pressure and diabetes attributed to weight, chances are they are on a bunch of Meds- if they only pay $10 copay for those meds, they have no idea of the costs. What if they had to pay cash for those Meds through a HSA? Do you think $400-500/ month until they met their dedcutibel woud be a motivator to make life changes? You bet!

 

I don't love mandates, but I understand why the mandate mechanism was used. To me, humans are creatures who can be taught to engage ins favorable behaviors.... mostly, through the wallet.... I don't think the ACA accomplishes that.

[Adam]

Bla bla bla my name is Adam and I never say anything of substance

Allow me to clarify- given the choice between repealing the healthcare act and eliminating the barriers to competition, I think the choice is obvious. We save a lot more by creating competition. That said, I don't think much of the healthcare law.

[B-Large]

Allow me to clarify- given the choice between repealing the healthcare act and eliminating the barriers to competition, I think the choice is obvious. We save a lot more by creating competition. That said, I don't think much of the healthcare law.

 

Insurance companies were able to do business and compete for business anywhere in the country prior to 2010.... in fact, cities center usually had many competing providers....

 

the problem becomes, nobody competes for the business of sick people, or people with pre-exisiting conditions- competiton is for the low-risk, non resource using patients (money making pateints, let call it what it is). That and the the people who chose to not carry insurance, but then get care when they get sick and pass on the cost to the rest of paying premiums.

 

Now that I think about it, John McCain during the campaign suggested heavy expansion of HSA's, and using high risk insurance pool for people who were sick or prior condition. I think those were good ideas, but I voted Democrat because I believe they were the only ones that could get anyting accomplished. If McCain had outlined a plan that mandated every American carry insurance (with HSA, or without) OR sign a waiver acknolweding they could be turned away because they chose not carry insurance or have insifficient funds, I may have considered voting otherwise.

[Doc]

agreed, MD's do make the recommendations, but from what I have expereinced it is families that tend to extend life on a less than productive/quality of life basis (lets assume really old person). But alot of the rationing comes from payors, like not paying for unproven therapies in people who are really sick (lets assume a younger person)- will it save their life? don't know. But by not trying, we are in effect rationing.

 

It is interesting and one of my criticism of the ACA is this. If you are gauranteed to be able to purchase insurance, no matter what, why would anyone pay premiums until they get sick? Just pay the penalty- when you get sick, hop on the exchange and buy some insurance, which by LAW, you have to be able to get. Boom, insured and treated!

 

That is the biggest flaw in that legislation. It is a crap Law, but from a personal standpoint, I would rather whats on the books to protect my wife and I personally, where as prior to March 2010 there is no may my wife would be able to get individual health coverage. It sucks, but in life I think you weigh the options, and you tend to look "self-interest" first- it is the very reason I voted Democrat in 2008, and likely will again in 2012- my biggest risk, right now in life is COST of being unable to get health insurance- I have everything else covered, from Life Insurance to Disability.

 

As far as HSA's, I they are limited because the designers of the ACA were unsure Americans we able to budget and put money away. I think there is some merit to that, until recently US has had a negative savings rate- but for people like you and I, they work great beacuse the monthly premiums are low, and if you can cover 5-10K and have that saved, you are in good shape- it also a good way to get a feels for costs, etc.

 

I think the ACA has "less than transparent, managed care" versus a "consumer driven" feel to it, that is a big weakness as well. *for example, if someone has high blood pressure and diabetes attributed to weight, chances are they are on a bunch of Meds- if they only pay $10 copay for those meds, they have no idea of the costs. What if they had to pay cash for those Meds through a HSA? Do you think $400-500/ month until they met their dedcutibel woud be a motivator to make life changes? You bet!

 

I don't love mandates, but I understand why the mandate mechanism was used. To me, humans are creatures who can be taught to engage ins favorable behaviors.... mostly, through the wallet.... I don't think the ACA accomplishes that.

I agree that end-of-care life is needlessly extended in many cases. But whether an insurance company refuses to pay for an unproven therapy, or the government does it, it's still rationing. And both are doing it because it will save money/resources.

 

Many people tend to have a "what's in it for me" mentality. That's why the country is going down the crapper. But creating another flawed entitlement is the sure path to faster ruin of the country, and it will go from "well, it sucks for me" to "it sucks for everyone." And it can happen well within your lifetime.

 

Whether or not people have the ability to contribute to an HSA is not the government's concern. If I want a $10K deductible, I should be able to get one. I detest the fact that they will require me to get insurance and then remove my choices. But that's what happens when you have people with no business trying to run health care, trying to run health care.

 

And yes, I agree that HDHP/HSA's would make people better consumers and more willing to take care of themselves. But why would we want that?