Discussion Let's Fix Medicare

[[DHT]Osiris]

Where did those "inherent rights" come from in the first place?

This is the digression I didn't really want to go into, but here we go:

The notion of those writing the Constitution was that they wanted to enumerate that certain rights exist for all peoples, regardless of who they are, where they were born, etc. Those are things that a government, any government, cannot take away. It was an expression of freedom, and a statement that everyone should have what Americans have, per this Constitution.

They don't 'come from' anywhere, they just are. If someone doesn't have them, it's because they were taken away.

That's the notion, anyhow.

 

[[DHT]Osiris]

I wouldn't say always. Slavery kind of flies in the face of the pursuit of life, liberty, and happiness, for one.

Yeah and it was later amended, there's some logical flaws in the original writing, such as slavery.

 

[fskimospy]

Look at all the various amendments...are those "god given?" Did the Jeezus come down from Mount Reagan with them carved into tablets of stone, or were they voted on by the citizenry and elected officials?

EVERYTHING in the US Constitution is given to us by "society" in one way or another...and don't forget...what has been given CAN be repealed. (21st repealed the 18th)

I think the easiest way to show that none of these things are rights is to look at the constitutions of the Soviet Union and North Korea. Both of them declare a right to free speech, for example. How did that work out?

No rights are inherent, no rights come from god, they are all things we give to ourselves and they have to be fought for, every day.

 

[soulcougher73]

Not according to the US constitution. I'd rather not digress the conversation, though.

That is what i meant technically. The people are in charge of the constitution though. It's not chiseled in stone to never be re-evaluated or questioned.

 

[[DHT]Osiris]

That is what i meant technically. The people are in charge of the constitution though. It's not chiseled in stone to never be re-evaluated or questioned.

True, but it should be regarded almost as such. There's far-reaching consequences for touching that document that a bunch of very smart people need to converse over, lest they throw the orphanage out with the thimble-full of bathwater.

 

[soulcougher73]

True, but it should be regarded almost as such. There's far-reaching consequences for touching that document that a bunch of very smart people need to converse over, lest they throw the orphanage out with the thimble-full of bathwater.

Yes and No. We are a lot smarter today than the founders ever were. We have more knowledge, understandings, experiences/history to draw upon than they did. We shouldnt change things willy nilly, but they knew they would make mistakes and times would change, thus the amendments. We just need to take advantage of that more often in my opinion and stop putting greed before good.

 

[[DHT]Osiris]

We are a lot smarter today than the founders ever were.

I'm having a very, very hard time with this. Our sphere of information is far more polluted now than then. We have more information to draw upon, but it's not all valid or even truthful. We're swiftly reaching a point where it's hard to even discern between fact and fiction, and a large percentage of our population doesn't really care one way or another. The notion that we could even recreate the Constitution is laughable at this point. Half our population sees it as a roadblock because it gets in the way of them disparaging people.

 

[dainthomas]

The fact that the majority of folks here are too incompetent to realize that you pay for Medicare in every paycheck - and that it isn't just your CURRENT cost of using it speaks volumes.

Plenty of people are just simply too stupid to understand costs that are out of sight.

Costs would plummet by eliminating the do-nothing medical insurance industry leeches. A million monkeys banging on keyboards could come up with a more efficient and logical system.

 

[ShookKnight]

1. Copy what [Name Of Country With A Successful Social Medicine Program] is doing. There are a few successful examples out there.
2. Paste.

More importantly, make it illegal to seek and strive for profits in the medical services space. Target what will cover your costs (everything from ops, salary to R&D). But, this nonsense of increasing stock value by sending your customers to their death and jacking up the costs 1,000 fold needs to stop.

Yes, that would be socialism and anti-capitalism... and that is a good thing. People's lives and quality of life are at stake here. This profit seeking and money making bullshit from medical services needs to stop.

Charge an arm and leg for cosmetic procedures. However, if you suffer a heart attack, get into an accident or are born with a serious illness - you should not go broke. And, we CAN cover that expense. And, we ARE. But, we are looking to make profits off of things that humanity is suffering over and it isn't always the fault of the patient.

 

[s0me0nesmind1]

One of the things that you and I agree with is that the majority of people are stupid, yes?

Why yes indeed

The point here is that this information needs to be fed to people monthly, bi-monthly or whatever. No one looks at this crap once per year on their tax forms, because it is never required to be filed anywhere--and of course, being a CPA, you know that plenty of people never file their own taxes, right? So the exact people that need to know this information--the ~wealthy folks with generally great healthcare and the accompanying ignorance of what it actually costs throughout their lives, thus leading to the type of post we get in the OP--will never see it.

The point is that no matter how much you want everything in life to be transparent - you want to present folks with MORE information so that they can overall better informed, right? It makes sense on the face of it. The problem is over the years, it only serves to continue to confuse people more. Just like terms and conditions - people just scroll and click Accept.

We tried this with mortgages and auto loans. People just kept saying "The problem is transparency - if we just introduce another form to the already 50 pages that clearly outlines their monthly payments then they will make sure to sit there and understand what they are signing, right? NOPE! Another page in a giant stack just serves to confuse people further. You ever see those pages? They clearly outline:
This is the amount you are taking a loan for:
This is the amount of interest you will pay:
This will be your monthly payment:
This will be your escrow amount:

You get the picture. All of that is never enough for the stupidity of Americans. Hell, just look at the types of folks that buy homes and cars. They don't ask the question "What do I NEED when buying a house?" they ask "How much can I afford in my house?"

Hell, majority of people don't even read their pay-stubs, which is why employers these days are doing things like automatically enrolling employees in their 401k because otherwise people are too stupid to figure it out for themselves.

It's like some of the very good regulations from Obama's Consumer Protection rules that mandate cc companies include actual interest payments and costs to the consumer if they only pay the minimum every month. This is actually a new thing and, knowing you, would generate the type of response "Well, dumb people should know how much they are paying, how stupid it is for them to carry a balance--ahahaha stupid morons!" etc...but people aren't going to do that. Plenty of people just don't get it, or also have very tight budgets where they can actually afford to float on paying those minimums on top of their bills, but they can't actually pay the lump sums each month (unless they visit @highland145 to help them out that month...then of course getting themselves in even more catastrophic debt. ).

Anyway, more information is always better. The fact that this piece of information exists on a negligible box once per year, that barely anyone ever sees, is as if it doesn't exist at all. If you think people benefit themselves from being better-informed, then the only solution is to provide more information.

I'm overall not against it, I think it's been completely proven by now though that it just doesn't make a difference. It would be one thing if everything was simplified on one sheet of paper - but it is not. It's always a stack of papers and people just look at it and say "How much longer do I have to be here, this is too much!".

Auto loans are still through the roof
Home Mortgage lending is still lending to practically anyone with a pulse
People still keep going to payday lenders regardless of the media and local governments warning people not to
Credit Cards have easily surpassed the debt load that they were pre-2008 crash.

So... no - I can't say your above statement is correct. They updated the credit card statements to include the stupid childish language of telling people how to calculate basic interest - and the problem is still there. A giant balloon that will inevitably implode once again.

 

[[DHT]Osiris]

The point is that no matter how much you want everything in life to be transparent - you want to present folks with MORE information so that they can overall better informed, right? It makes sense on the face of it. The problem is over the years, it only serves to continue to confuse people more. Just like terms and conditions - people just scroll and click Accept.

We tried this with mortgages and auto loans. People just kept saying "The problem is transparency - if we just introduce another form to the already 50 pages that clearly outlines their monthly payments then they will make sure to sit there and understand what they are signing, right? NOPE! Another page in a giant stack just serves to confuse people further. You ever see those pages? They clearly outline:
This is the amount you are taking a loan for:
This is the amount of interest you will pay:
This will be your monthly payment:
This will be your escrow amount:

You get the picture. All of that is never enough for the stupidity of Americans. Hell, just look at the types of folks that buy homes and cars. They don't ask the question "What do I NEED when buying a house?" they ask "How much can I afford in my house?"

Hell, majority of people don't even read their pay-stubs, which is why employers these days are doing things like automatically enrolling employees in their 401k because otherwise people are too stupid to figure it out for themselves.

I don't disagree with the above, there's a major issue of information overload among people and they don't seem to care enough to tamper it down to the point where they can digest it appropriately. Having said that, stuff like home documentation apparently has to be overtly obtuse because of wriggling little shits that insist on trying to steal money from people, either borrower from bank or bank from borrower.

Hell, my first actual rental property I was in, I read through the full documentation, it had a line that said any payment more than 5? days late incurred a 300% charge, 300% of the rent. I brought it up and the person was all 'whoopsie doodle, that was a typo!' and corrected it to 15% or whatever. Yeah I'm sure. Mind you the two other guys I was renting it with didn't even want to read it, said I was wasting everyone's time.

All the things in our life I believe are intentionally complicated, and done so by wolves attempting to get another sheep.

 

[Chromagnus]

Costs would plummet by eliminating the do-nothing medical insurance industry leeches. A million monkeys banging on keyboards could come up with a more efficient and logical system.

This is completely false. Insurance companies do some bad things but they are the largest player in the game that is concerned with actually reducing costs. Most of the $hitty stuff that they do is in the name of reducing costs. Just cutting them out of the system doesn't reduce costs magically. One of the good things that the ACA did was regulate what percentage of premium has to go towards medical expenses which limits the profits that insurance companies can make. There is no such system in place for hospitals or pharma companies who make insane amounts of money.

 

[Vic]

Healthcare isn’t a right. It’s an entitlement we gave to ourselves. Or at least to some of us under certain circumstances.

Why do some people think it's wrong to expect to actually get what they paid for? If someone pays thousands and thousands of dollars for decades of their working life into Social Security and Medicare, then they have every right to be 'entitled' to receive the benefits that they paid for.

 

[Vic]

Don’t confuse “social justice” with rights. Our rights are in the constitution. We can pass a law to give everyone a pony and raise taxes to pay for it. But it’s not a right to have a pony.

Personally I’m willing to pay for healthcare for children. But it’s not right they have for being born. I’m not willing to pay for the results of adult choices like eating and drinking to excess, reckless behavior etc. if you choose ride a motorcycle without a helmet I shouldn’t have to foot the bill for your cracked skull.

And if you are planning your life so the government is going to take care of you in your old age then you have no one to blame but yourself for what you get.

So it's your opinion that rights exist only because they're written on a piece of paper?

It's weird how appear to think you're arguing for freedom, while preaching slave mentality.

 

[Vic]

Show of hands, how many people here know that Box DD on your W2 shows what your employer took out of your earnings to cover your health insurance?

Put it on the pay stubs.

To clarify, box 12 DD on a W-2 includes the total healthcare costs paid by the employer for that year, both the employee's contribution that was payroll deducted, and the employer's contributions, which were not deducted from regular earnings (but were part of the employee's overall compensation).

I don't know about putting it on the paystubs (as there is no standardized paystub format), but I'm sure most people would prefer more disclosure than a coded box on a W-2.

 

[BoomerD]

This is completely false. Insurance companies do some bad things but they are the largest player in the game that is concerned with actually reducing costs. Most of the $hitty stuff that they do is in the name of reducing costs. Just cutting them out of the system doesn't reduce costs magically. One of the good things that the ACA did was regulate what percentage of premium has to go towards medical expenses which limits the profits that insurance companies can make. There is no such system in place for hospitals or pharma companies who make insane amounts of money.

Insurance companies only care about reducing the costs they have to pay...leaving healthcare providers free to pass increased costs onto everyone else.

An example...in 2001, I got hurt at work, requiring an MRI. The work comp insurance company objected...claimed the injury wasn't work related. My union insurance said that since it was a work comp injury, they wouldn't cover it...I got billed nearly $1500 for the MRI and X-rays.
A couple of months later, the WC company accepted the injury as work related...they paid about $350...the provider wrote off the rest by contract. Insurance companies negotiate MUCH smaller reimbursement amounts...which sticks the uninsured with higher bills to make up the difference.

 

[Vic]

Why yes indeed



The point is that no matter how much you want everything in life to be transparent - you want to present folks with MORE information so that they can overall better informed, right? It makes sense on the face of it. The problem is over the years, it only serves to continue to confuse people more. Just like terms and conditions - people just scroll and click Accept.

We tried this with mortgages and auto loans. People just kept saying "The problem is transparency - if we just introduce another form to the already 50 pages that clearly outlines their monthly payments then they will make sure to sit there and understand what they are signing, right? NOPE! Another page in a giant stack just serves to confuse people further. You ever see those pages? They clearly outline:
This is the amount you are taking a loan for:
This is the amount of interest you will pay:
This will be your monthly payment:
This will be your escrow amount:

You get the picture. All of that is never enough for the stupidity of Americans. Hell, just look at the types of folks that buy homes and cars. They don't ask the question "What do I NEED when buying a house?" they ask "How much can I afford in my house?"

Hell, majority of people don't even read their pay-stubs, which is why employers these days are doing things like automatically enrolling employees in their 401k because otherwise people are too stupid to figure it out for themselves.





I'm overall not against it, I think it's been completely proven by now though that it just doesn't make a difference. It would be one thing if everything was simplified on one sheet of paper - but it is not. It's always a stack of papers and people just look at it and say "How much longer do I have to be here, this is too much!".

Auto loans are still through the roof
Home Mortgage lending is still lending to practically anyone with a pulse
People still keep going to payday lenders regardless of the media and local governments warning people not to
Credit Cards have easily surpassed the debt load that they were pre-2008 crash.

So... no - I can't say your above statement is correct. They updated the credit card statements to include the stupid childish language of telling people how to calculate basic interest - and the problem is still there. A giant balloon that will inevitably implode once again.

Your elitist contempt for people sets off my Dunning-Kruger meter every time.

 

[hal2kilo]

Let's fix Medicare. Having only recently become eligible for Medicare I was disappointed to find out that after paying for Medicare for my whole working life that I now have to pay $142 (2020) a month to receive Medicare Part B benefits, the benefits you need if you want to be covered if and when you actually go to a doctor. Additionally you have to decide what level of coverage you want by picking from an alphabet soup of plans that vary greatly in benefits and coverage. And then there are penalties for declining Part B and Part D (drug coverage). This entire scheme by our government should constitute as cruel and unusual punishment. It shouldn't be the business of the government to reward Healthcare companies for taking care of it's obligations, nor should millions of Americans whose only income is SS. So what we should do is raise the percentage of a workers paycheck paid for Medicare enough so that when they turn 65 they are completely covered for everything. No additional payments ever. No alphabet soup to pick from. Of course this may also involve establishing strict cost structures for everything including procedures and prescription costs and possibly eliminating the private insurance sector from actually benifitting from Medicare at all (oh the horror). Due note I don't claim to be nearly as smart as all the idiots that instigated this system, but hey, you probably voted for them. Additionally I'm not running for office. Your voice may make a difference.

Welcome to American retirement. Yea, you get to find out all kinds of neat things about medicare, especially if they think you were rolling in money when you retired. I have had 2 SS adjustment letters since I retired in August, even though my projection of income for the year was not far off. Got my first SS deposit finally in November! First word of advise, don't retire in the middle of the year. Yea, the alphabet soup of plans is beyond confusing, and the mail offers never stop!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

 

[Chromagnus]

Insurance companies only care about reducing the costs they have to pay...leaving healthcare providers free to pass increased costs onto everyone else.

Insurance companies reducing the costs they pay helps their insureds by reducing their premiums. The ACA regulates this and so it is beneficial to their insureds for them to try and reduce costs. As I said, a lot of the $hitty things insurance companies do are in the name of reducing costs. I'm not arguing that they don't do some bad things I'm just arguing that removing them won't suddenly reduce costs like the post I was responding to claimed.

An example...in 2001, I got hurt at work, requiring an MRI. The work comp insurance company objected...claimed the injury wasn't work related. My union insurance said that since it was a work comp injury, they wouldn't cover it...I got billed nearly $1500 for the MRI and X-rays.
A couple of months later, the WC company accepted the injury as work related...they paid about $350...the provider wrote off the rest by contract. Insurance companies negotiate MUCH smaller reimbursement amounts...which sticks the uninsured with higher bills to make up the difference.

This is totally true and the reason I think we should aim for a fully insured population so there is no one to stick with higher bills. The bad thing is that the hospital is allowed to make an insane profit margin on the higher charges that they pass down to uninsured because they have little negotiation power.

People fighting over who pays for what isn't going to change. Even a government run health insurance program is going to try and reduce costs and could deny a WC claim because they think the WC insurance company can pay for it.

 

[dainthomas]

This is completely false. Insurance companies do some bad things but they are the largest player in the game that is concerned with actually reducing costs. Most of the $hitty stuff that they do is in the name of reducing costs. Just cutting them out of the system doesn't reduce costs magically. One of the good things that the ACA did was regulate what percentage of premium has to go towards medical expenses which limits the profits that insurance companies can make. There is no such system in place for hospitals or pharma companies who make insane amounts of money.

Their idea of reducing cost is to happily take your money and then not pay for a service you need. They dgaf how much you have to pay.

Single payer would eliminate them, and reduce costs further by the gov't negotiating with providers and drug/equipment manufacturers.

 

[Vic]

Hey guys, I know you've been paying 7.65% of your income (plus employer match, for effective tax rate of 15.3%) to Social Security and Medicare for decades, but you're stupid and a socialist if you actually expect to get the benefits you paid for. Because freedumb or some nonsense shit like that.

 

[BoomerD]

Insurance companies reducing the costs they pay helps their insureds by reducing their premiums. The ACA regulates this and so it is beneficial to their insureds for them to try and reduce costs. As I said, a lot of the $hitty things insurance companies do are in the name of reducing costs. I'm not arguing that they don't do some bad things I'm just arguing that removing them won't suddenly reduce costs like the post I was responding to claimed.



This is totally true and the reason I think we should aim for a fully insured population so there is no one to stick with higher bills. The bad thing is that the hospital is allowed to make an insane profit margin on the higher charges that they pass down to uninsured because they have little negotiation power.

People fighting over who pays for what isn't going to change. Even a government run health insurance program is going to try and reduce costs and could deny a WC claim because they think the WC insurance company can pay for it.

That last part is simple enough...do away with separate work comp insurance companies. Make companies buy coverage from the same government program everyone else does.

 

[fskimospy]

Why yes indeed



The point is that no matter how much you want everything in life to be transparent - you want to present folks with MORE information so that they can overall better informed, right? It makes sense on the face of it. The problem is over the years, it only serves to continue to confuse people more. Just like terms and conditions - people just scroll and click Accept.

We tried this with mortgages and auto loans. People just kept saying "The problem is transparency - if we just introduce another form to the already 50 pages that clearly outlines their monthly payments then they will make sure to sit there and understand what they are signing, right? NOPE! Another page in a giant stack just serves to confuse people further. You ever see those pages? They clearly outline:
This is the amount you are taking a loan for:
This is the amount of interest you will pay:
This will be your monthly payment:
This will be your escrow amount:

You get the picture. All of that is never enough for the stupidity of Americans. Hell, just look at the types of folks that buy homes and cars. They don't ask the question "What do I NEED when buying a house?" they ask "How much can I afford in my house?"

Hell, majority of people don't even read their pay-stubs, which is why employers these days are doing things like automatically enrolling employees in their 401k because otherwise people are too stupid to figure it out for themselves.





I'm overall not against it, I think it's been completely proven by now though that it just doesn't make a difference. It would be one thing if everything was simplified on one sheet of paper - but it is not. It's always a stack of papers and people just look at it and say "How much longer do I have to be here, this is too much!".

Auto loans are still through the roof
Home Mortgage lending is still lending to practically anyone with a pulse
People still keep going to payday lenders regardless of the media and local governments warning people not to
Credit Cards have easily surpassed the debt load that they were pre-2008 crash.

So... no - I can't say your above statement is correct. They updated the credit card statements to include the stupid childish language of telling people how to calculate basic interest - and the problem is still there. A giant balloon that will inevitably implode once again.

People often look at the nominal value of debt instead of the value of household debt as compared to GDP, which is a far more informative measure. When you look at that...

 

[Chromagnus]

That last part is simple enough...do away with separate work comp insurance companies. Make companies buy coverage from the same government program everyone else does.

Lets try and get single payer for health care before we worry too much about single payer for work comp I'm not arguing against it just think there are bigger fish to fry.

 

[hal2kilo]

That last part is simple enough...do away with separate work comp insurance companies. Make companies buy coverage from the same government program everyone else does.

It's called L & I in Washington State. It's no bed of roses either. They get to decide what doctors you go to and when you can go back to work.