The Affordable Care Act II - Because Mr. Obama Loves You All

[reddogblitz]

Baloney.

Please educate yourself on the difference between insurance and care.

Baloney my a$$

 

If suddenly everyone has INSURANCE, then the have money (INSURANCE payment to CARE providers) to pay for CARE.

 

If there are not enough doctor/clinics etc. and money is there (INSURANCE) not being collected, Some smart enterprising free market entrepreneur will build a clinic and hire doctors to fill the need (CARE).

[TakeYouToTasker]

I don't know about that.

 

If there were more people with insurance that could pay for care, don't for a second think that there won't be new doctors and clinics to meet the demand. Simple case of supply and demand.

Massive amounts of doctors won't accept Medicaid, and the list is growing every sigle day. That's because reimbursement rates very often don't cover the cost of care.

 

Under these circumstances, why in the world would you expect supply to increase? You think thousands of the country's best and brightest young minds will be lining up for 11 or more years of school and residency, living in relative poverty while doing so, working absurd amounts of hours, taking on crushing debt, for the ultimate reward of losing money and laboring under a massive bureaucracy which serves to limit the relationship between doctor and patient?

 

That's an absurd thing to believe.

[reddogblitz]

Which one?

2%? Or whatever?

Because I'm doing my budget for the next year, and if this needs to go into the whatever column, then I'll need to shift funds from my who knows account and transfer it to my anybody's guess account.

But otherwise...helluva plan you've got there.

Helluva plan.

I'm not the Congressional budget office. I'm just a scmuck on the sidelines thinking there's got to be a better way. Of course you would

Know the tax liability ahead of time.

 

Can you say equivically that 2% wouldn't do it? Please show your math.

 

What's your plan?

Massive amounts of doctors won't accept Medicaid, and the list is growing every sigle day. That's because reimbursement rates very often don't cover the cost of care.

Under these circumstances, why in the world would you expect supply to increase? You think thousands of the country's best and brightest young minds will be lining up for 11 or more years of school and residency, living in relative poverty while doing so, working absurd amounts of hours, taking on crushing debt, for the ultimate reward of losing money and laboring under a massive bureaucracy which serves to limit the relationship between doctor and patient?

That's an absurd thing to believe.

My plan is private insurance, NOT Medicare for all. what are these doctors going to do if they don't take the insurance everyone has? There would be no more bearacracy than we have now. See a patient, file a claim to PRIVATE insurance company.

[DC Tom]

I have a younger brother diagnosed with mitochondrial disease that effects where he had to quit work because of constant nausea and vomiting (food and stomach acid). and he sees about four specialists. Had no problem getting in with medicaid with any of the specialists so that may be a regional thing.

 

There are certainly regional effects, because even though Medicaid is a federal program, it's state-administered. And the state administration of it is hit-or-miss, at best - the two examples I mention cover four states, my niece in Florida, which was an atrocious mass of stupid regulation. And my SIL living with us, which involves a byzantine collision of three jurisdictions' regulations - or would, if there were more than one of the specialist she needs that took Medicaid.

 

But that still serves to highlight another issue: where is this "single payer" coming from? Currently, Medicaid and Medicare are "50+ payer" systems. Again...people advocating it as an example are living in a fantasy land where they fundamentally do not understand the country they're living in.

[TakeYouToTasker]

I'm not the Congressional budget office. I'm just a scmuck on the sidelines thinking there's got to be a better way. Of course you would

Know the tax liability ahead of time.

 

Can you say equivically that 2% wouldn't do it? Please show your math.

 

What's your plan?

 

My plan is private insurance, NOT Medicare for all. what are these doctors going to do if they don't take the insurance everyone has? There would be no more bearacracy than we have now. See a patient, file a claim to PRIVATE insurance company.

They aren't going to become doctors.

 

That's the whole point. Your plan will incentivize a decrease in health care providers, while at the same time increasing the demand for health care providers.

 

When this occurs, the quality of care decreases, and access to care decreases.

 

And this doesn't even begin to address other aspects of medical costs, such as R&D for new drugs and treatments.

 

When you suck the profits out of an industry, you destroy that industry.

[DC Tom]

I'm not the Congressional budget office. I'm just a scmuck on the sidelines thinking there's got to be a better way. Of course you would

Know the tax liability ahead of time.

 

Can you say equivically that 2% wouldn't do it? Please show your math.

 

What's your plan?

 

My plan is private insurance, NOT Medicare for all. what are these doctors going to do if they don't take the insurance everyone has? There would be no more bearacracy than we have now. See a patient, file a claim to PRIVATE insurance company.

 

Increased demand drives up cost well before it drives up supply. And when the supply is as inelastic as "availability of doctors," it drives cost because it reduces access to the resource.

 

You're basically arguing that the solution to high real estate prices is to subsidize everyone's real estate purchases to create more land through some sort of sympathetic voodoo.

[reddogblitz]

They aren't going to become doctors.

That's the whole point. Your plan will incentivize a decrease in health care providers, while at the same time increasing the demand for health care providers.

When this occurs, the quality of care decreases, and access to care decreases.

And this doesn't even begin to address other aspects of medical costs, such as R&D for new drugs and treatments.

When you suck the profits out of an industry, you destroy that industry.

Ok, maybe.

 

But we have a private insurance model now, and we have plenty of doctors and medical schools are full.

 

I would not say that doctor compensation may go down some. Maybe it will. I'm not convinced it would.

 

But not all doctors are in it for the money anyway. I have a nephew in medical schools that's not in it for the money. He wants to help people. A lot of people become doctors for this reason and won't change thier mind if they make less.

[IDBillzFan]

Can you say equivically that 2% wouldn't do it? Please show your math.

You recommend a plan that you admit is not really a plan at all, and then need me to show you the math on why it's no plan at all?

 

Sometimes it's better to just sit back and be quiet.

Edited May 5, 2017 by LABillzFan

[TakeYouToTasker]

 

Increased demand drives up cost well before it drives up supply. And when the supply is as inelastic as "availability of doctors," it drives cost because it reduces access to the resource.

 

You're basically arguing that the solution to high real estate prices is to subsidize everyone's real estate purchases to create more land through some sort of sympathetic voodoo.

While simultainiously systematically making massive amounts of land uninhabitable by turning them into nuclear dumping sites.

[DC Tom]

Ok, maybe.

 

But we have a private insurance model now, and we have plenty of doctors and medical schools are full.

 

I would not say that doctor compensation may go down some. Maybe it will. I'm not convinced it would.

 

But not all doctors are in it for the money anyway. I have a nephew in medical schools that's not in it for the money. He wants to help people. A lot of people become doctors for this reason and won't change thier mind if they make less.

 

But how much time do they have to see patients?

 

Patients don't compete for doctors. They compete for doctors' time.

[TakeYouToTasker]

Ok, maybe.

 

But we have a private insurance model now, and we have plenty of doctors and medical schools are full.

 

I would not say that doctor compensation may go down some. Maybe it will. I'm not convinced it would.

 

But not all doctors are in it for the money anyway. I have a nephew in medical schools that's not in it for the money. He wants to help people. A lot of people become doctors for this reason and won't change thier mind if they make less.

So... You're willing to risk the delivery of medical care on a hunch that individuals in the medical field aren't profit motivated, but rather are monk like avatars motivated by pure altruism?

 

Sounds a bit utopian, don't you think?

[reddogblitz]

Increased demand drives up cost well before it drives up supply. And when the supply is as inelastic as "availability of doctors," it drives cost because it reduces access to the resource.

 

You're basically arguing that the solution to high real estate prices is to subsidize everyone's real estate purchases to create more land through some sort of sympathetic voodoo.

Ok, good point.

 

But when did I say anything about subsidizing real estate? Gheez

 

More doctors will be created because there's more money to pay them and more customers to pay them said money, not by voodoo.

 

It won't happen overnight, but thanks to America's free enterprise system and entrepreneurial spirit it would IMHO.

 

Sounds like the argument against is mainly we don't have capacity. So the answer is just to not treat everyone I guess.

So... You're willing to risk the delivery of medical care on a hunch that individuals in the medical field aren't profit motivated, but rather are monk like avatars motivated by pure altruism?

Sounds a bit utopian, don't you think?

It does, but it's not what I said.

[DC Tom]

Ok, good point.

 

But when did I say anything about subsidizing real estate? Gheez

 

More doctors will be created because there's more money to pay them and more customers to pay them said money, not by voodoo.

 

It won't happen overnight, but thanks to America's free enterprise system and entrepreneurial spirit it would IMHO.

 

Sounds like the argument against is mainly we don't have capacity. So the answer is just to not treat everyone I guess.

 

It does, but it's not what I said.

 

It's called an "analogy."

[reddogblitz]

You recommend a plan that you admit is not really a plan at all, and then need me to show you the math on why it's no plan at all?

Sometimes it's better to just sit back and be quiet.

Come on man. Congress doesn't even pencil this stuff out before they vote on it.

 

So what if its 10% or 15%? You won't be paying insurance premiums. No way your tax would be more than what you and your company are paying now.

 

Companies won't have to provide health insurance anymore. ZERO government regulations on that anymore. It would make it easier and cheaper for companies to hire people. I thought that part of it would have been a desirable outcome on PPP.

 

I'll decide when it's proper for me to get quiet thank you very much.

It's called an "analogy."

 

Sounded more like false equivilancy. Edited May 5, 2017 by reddogblitz

[Deranged Rhino]

What prevents someone from making the decision to purchase insurance prior to contracting a condition?

 

 

What they need to do is insure themselves before they become sick.

 

That's how insurance works.

 

What about those born w diseases that go undiagnosed until late adolescence? In my case, I was born w a disease that was not properly diagnosed until I was 20 though I was symptomatic since I was a baby. At that time I had insurance through my parents - then had my own insurance through my employer. From the time I graduated college and went on my own insurance until the ACA passed, my insurer went out of their way to create cause to drop me from their rolls. I fought them in court, spent literally tens thousands of dollars in legal fees to prove they were intentionally billing me late (or not at all) to force me off.

 

I could afford that because I was making good money, but plenty of others in my position would have been forced off coverage, which would have denied them the medicine needed to keep the disease under control and would ultimately cost the tax payer far more down the road.

 

I understand the point you're making, but it's overlooking a lot of people who either are not diagnosed until later (despite the disease being present since birth) as well as the lengths insurance companies will go to in order to NOT provide coverage to those who are the most at risk.

[Meathead]

I have a younger brother diagnosed with mitochondrial disease that effects where he had to quit work because of constant nausea and vomiting (food and stomach acid). and he sees about four specialists. Had no problem getting in with medicaid with any of the specialists so that may be a regional thing.

 

i think it is. i know several ppl on medicaid and theyve had surgeries and other conditions treated with nothing more than maybe a longer wait time

 

the biggest difference ive seen is the quality of drs. the best drs dont take medicaid so youll never see them, but medicaid drs are usually still competent to address common conditions. its the one-offs that you have problems with, the unusual cases

 

idk what kind of zoo abusive toms sister lives in but i expect hes exaggerating. i find it hard to believe theres only one pulmonologist in an area that has as many poor folks as wdc

[Magox]

 

If indeed that comes to pass, how long do you think it will be before those on the public system will resent the superior care received by those who can afford to pay their own bills? Will they begin to demand such care for themselves? Do you think that there will be a call to do away with private care in the name of fairness, or a call to do away with government provided health care services?

 

I ask that only half-facetiously, because I honestly do not think that the average American understands the can of worms they'll be opening with a centralized, socialized single-payer system. My wife's family lives in Madrid, and their access and treatment is appalling. That's exactly the same thing that we're going to end up with.

 

I'm not advocating for this, I've criticized that this idea would be a logistical nightmare and yes it would lead to rationing. Having said that, I think this would lead to two types of care, the Medicare-for-all coverage that would be for the majority of the population and then there would be boutique style coverage for the upper middle and higher economic class.

 

It's apparent to me that most people care about the total number of people that are covered as opposed to the quality of coverage.

yes. and as you have so effectively pointed out, it will be expensive

 

i was wondering, we say 'medicare for all' but what does that mean for medicaid? does medicaid go away? or could we make medicaid the default lowest rung (ie. poorest ppl), with standard medicare as the next rung (social security and default employed), and then have insurance companies sell policies above that for better coverage?

 

I'm not sure how the details would look. My guess is that Medicaid would stay on the books.

 

Medicare Advantage plans and Medicare supplements would be greatly expanded.

As expected, the Senate is going to rewrite the whole thing.

 

“We’re writing a Senate bill and not passing the House bill,” said Sen. Lamar Alexander (R-Tenn). “We’ll take whatever good ideas we find there that meet our goals.”

 

 

 

Rand Paul, Cruz, Lee and probably Cotton and maybe even Rubio will serve as the potential firewall to a deal not going through. I'm not sure how a bill gets through. It's gonna get interesting.

[GG]

 

 

 

 

What about those born w diseases that go undiagnosed until late adolescence? In my case, I was born w a disease that was not properly diagnosed until I was 20 though I was symptomatic since I was a baby. At that time I had insurance through my parents - then had my own insurance through my employer. From the time I graduated college and went on my own insurance until the ACA passed, my insurer went out of their way to create cause to drop me from their rolls. I fought them in court, spent literally tens thousands of dollars in legal fees to prove they were intentionally billing me late (or not at all) to force me off.

 

I could afford that because I was making good money, but plenty of others in my position would have been forced off coverage, which would have denied them the medicine needed to keep the disease under control and would ultimately cost the tax payer far more down the road.

 

I understand the point you're making, but it's overlooking a lot of people who either are not diagnosed until later (despite the disease being present since birth) as well as the lengths insurance companies will go to in order to NOT provide coverage to those who are the most at risk.

Then it is not a preexisting condition! The condition starts at the diagnosis.

[Tiberius]

 

Increased demand drives up cost well before it drives up supply. And when the supply is as inelastic as "availability of doctors," it drives cost because it reduces access to the resource.

 

You're basically arguing that the solution to high real estate prices is to subsidize everyone's real estate purchases to create more land through some sort of sympathetic voodoo.

You guys will say anything! As if doctors are the only part of health care. So many people get health care without seeing a doctor. Higher demand for doctors will lead to higher supply eventually.

[Gary M]

When you suck the profits out of an industry, you destroy that industry.

 

But they don't want health care to be an industry, they want it to be a right.