Why the individual mandate philosophically is right/ or wrong

[ky54]

Is there a single payer proposal that you - or anyone else for that matter - support that I can read?

 

[soulcougher73]

If I want to protect myself, I should do it at my expense.

You're right. You should. And so should everyone else. But they arent. Thus it is becoming other peoples expenses to protect them.

 

[fskimospy]

The government ought not be allowed to require us to buy a private product simply because we are alive.

If I want to protect myself, I should do it at my expense.

Are you saying that you wish to repeal the law that requires emergency rooms to treat people regardless of ability to pay? If that is the case, are you comfortable with leaving the sick and injured to die in the streets?

If you are willing to do that then yes, we can implement your plan. If you are unwilling to do that it means that all of us are ultimately on the hook for medical expenses that others will incur. In light of that it is only reasonable for us to require that all people take a measure of responsibility for this.

 

[soulcougher73]

Really wish people who stop with the blatant lying about the public picking up the bill for the uninsured. The public picks up nothing, or least a very very small portion of that bill. The hospitals and insurance companies get the brunt of that cost. Unless someone is comming in with Medicare/Medicaid, the public as a whole is paying none of that cost. Only people with health insurance currently get hit with some of it through increased premiums but is minor since its spread across the board. The hospitals will collect if you are capable of paying but for some reason don't have insurance.

Obamacare will change none of this by the way. You still will have uninsured freeloading albeit in smaller numbers, people will still be getting subsidized healthcare, and the public will still be picking up more than their individual share of healthcare. So please stop lying about Obamacare being the solution to this problem. It's not going to be a pay you own way or pay as you go solution, so just stop.

So which is it? Nothing or a small amount? The fact that we are picking up any amount for them is the problem. I dont want my premiums to go up one cent because others are not insured (under the current crap system weve had for a long time now)

 

[dank69]

Really wish people who stop with the blatant lying about the public picking up the bill for the uninsured. The public picks up nothing, or least a very very small portion of that bill. The hospitals and insurance companies get the brunt of that cost. Unless someone is comming in with Medicare/Medicaid, the public as a whole is paying none of that cost. Only people with health insurance currently get hit with some of it through increased premiums but is minor since its spread across the board. The hospitals will collect if you are capable of paying but for some reason don't have insurance.

Obamacare will change none of this by the way. You still will have uninsured freeloading albeit in smaller numbers, people will still be getting subsidized healthcare, and the public will still be picking up more than their individual share of healthcare. So please stop lying about Obamacare being the solution to this problem. It's not going to be a pay you own way or pay as you go solution, so just stop.

I really wish you would realize that the hospitals and insurers pass those costs on to the rest of us through more expensive medical care and higher insurance premiums.

 

[xBiffx]

So which is it? Nothing or a small amount? The fact that we are picking up any amount for them is the problem. I dont want my premiums to go up one cent because others are not insured (under the current crap system weve had for a long time now)

It amounts to pennies to the public that actually does have insurance. Most of the cost is ate by the insurance company that recovers it with the small increase in premium that they then turn around and invest.

Again, Obamacare doesn't change this so stop trying to make it sound like a solution. If anything, it makes it worse because of all the extra mandates it puts on coverage for the insurance companies (no maximum benefit, required to cover pre-existing, etc).

 

[xBiffx]

I really wish you would realize that the hospitals and insurers pass those costs on to the rest of us through more expensive medical care and higher insurance premiums.

The hospital may charge more for services but then its negotiated with the insurance companies. The person paying insurance doesn't pay anything more than the deductible. That and along with everyone else they pay a tiny increase in premium. Again, in the case where you are able to pay but don't have insurance, its between you and the hospital, the hospital will collect and nothing is getting passed on.

The increase in premiums in not dollar for dollar. Its tiny, pennies, even fractions of pennies on the dollar. But they do this for a large number of customers and then invest that money as usual to cover the losses. And as I have said before, Obamacare changes none of this.

 

[dank69]

It amounts to pennies to the public that actually does have insurance. Most of the cost is ate by the insurance company that recovers it will the small increase in premium that they then turn around and invest.

Again, Obamacare doesn't change this so stop trying to make it sound like a solution. If anything, it makes it worse because of all the extra mandates it puts on coverage for the insurance companies (no maximum benefit, required to cover pre-existing, etc).

I notice you ignored the mandate for everyone to purchase the insurance in the first place. The one that many opponents of the law use to characterize it as a handout to the insurance companies. So for some opponents, this bill is a handout to insurers and to others like you it is a burden. What does that tell you? You guys can't have it both ways. Pick one and then stick with it.

 

[dank69]

The hospital may charge more for services but then its negotiated with the insurance companies. The person paying insurance doesn't pay anything more than the deductible. That and along with everyone else, tiny increase in premium. Again, in the case where you are able to pay but don't have insurance, its between you and the hospital, the hospital will collect and nothing is getting passed on.

The increase in premiums in not dollar for dollar. Its tiny, pennies, even fractions of pennies on the dollar. But they do this for a large number of customers and then invest that money as usual to cover the losses. And as I have said before, Obamacare changes none of this.

Tiny increase in premium? LOL you crack me up. :awe: I suppose you think medical care costs haven't increased substantially either?

 

[fskimospy]

It amounts to pennies to the public that actually does have insurance. Most of the cost is ate by the insurance company that recovers it will the small increase in premium that they then turn around and invest.

Again, Obamacare doesn't change this so stop trying to make it sound like a solution. If anything, it makes it worse because of all the extra mandates it puts on coverage for the insurance companies (no maximum benefit, required to cover pre-existing, etc).

So now you're agreeing that the public is in fact paying for this uncompensated care. Where did you get the figure that it is 'pennies'? According to the Urban Institute the cost of uncompensated care in 2009 was $62 billion.

http://www.urban.org/uploadedpdf/412045_cost_of_uncompensated.pdf

That's not pennies to me.

 

[Ynog]

I think the real danger of the individual mandate is the precedent it sets. IMHO it doesn't matter if it is in the best interest of the country or not. It opens a potential can of with further expansion of power for the Federal Government.

Do you trust the party you lean towards, to not abuse this power when they are in control? Do you trust that when the other party is in control, they will not abuse this power?

 

[blankslate]

Is there a single payer proposal that you - or anyone else for that matter - support that I can read?

Here is a an overview of how 5 different countries do it.

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/

I think Switzerland may be of interest to you because it has private insurance companies only they can't make a profit.

However, prior to the 70s and 80s I don't think that there were many private for profit insurance companies or hospitals in the U.S. either. That's something I should do more research on.

The person who is the main investigator of this piece, T.R. Reid is also an author on a book about it. He used to be a foreign correspondent and has had experience with 2 other countries health care systems as well as the U.S. I think he was in the military as well but I am not 100% sure of that anymore because it's been a while since I've watched the program or read his book.

Given the geographical sizes of the regions in question, in comparison to the U.S.A it may very well be up to states to follow the examples of Hawaii and Michigan and set up their own statewide programs.

I really don't have a program that I am advocating however. I just know that it is a drag on our economy, most specifically with our manufacturers who do face a disadvantage compared to other manufacturers based in other countries. In some part because of the health care issue.

Additionally given the state of the political climate and based on some of the more questionable sound bites surrounding "Obamacare" I really doubt any honest debate can happen on the national level....

 

[bradley]

I don't know what's more frightening, using: the Commerce Clause to mandate public citizens purchase a private product, Eminent Domain to grab private land for private corps, imperialism to start unilateral wars without an official Congressional declaration.

I can almost envision liberals/conservatives/libertarians aligning themselves to fight this 100yo progressive mindset in the next ten years, before it's too late. At least I'll get a laugh if conservative progressives figure out a way to mandate American-made Bibles next election.

 

[xBiffx]

Tiny increase in premium? LOL you crack me up. :awe: I suppose you think medical care costs haven't increased substantially either?

Over the years, yes. But that isn't due to the uninsured, its due to the cost to provide care. Most is due to overuse of the medical field because people go to the doctor for every little ache and cough. Some is also do the increase in pricing of equipment. Technology isn't cheap. The rest is due to a shrinking medical field because it doesn't pay like it used to to become a physician. Insurance companies have taken over.

http://www.cato.org/pubs/pas/pa211.html

Obamacare, yet again, fixes none of this.

 

[dank69]

Over the years, yes. But that isn't due to the uninsured, its due to the cost to provide care. Most is due to overuse of the medical field because people go to the doctor for every little ache and cough. Some is also do the increase in pricing of equipment. Technology isn't cheap. The rest is due to a shrinking medical field because it doesn't pay like it used to to become a physician. Insurance companies have taken over.

http://www.cato.org/pubs/pas/pa211.html

Obamacare, yet again, fixes none of this.

How does someone going to the doctor for an ache or cough drive medical prices up? I would think a doctor love a nice $500 take two aspirin and call my assistant, if you have the patience to get through the 15 minute robo operator, in the morning 5 minute visit.

There are two main factors driving up medical care costs. The biggest is malpractice. The other is providing care for the uninsured. Providing care for uninsured people is a problem. Trying to brush this one off as insignificant is ridiculous.

EDIT: I have been informed that malpractice is not one of the biggest factors driving up medical care costs. It also looks like providing care for the uninsured is also not in the top two factors, so I have reworded to correct my error.

 

[Atreus21]

Are you saying that you wish to repeal the law that requires emergency rooms to treat people regardless of ability to pay?

No, because those people will be required to pay for their care afterward. Just because they can't pay doesn't mean they're getting free care, and they will be billed.

 

[fskimospy]

No, because those people will be required to pay for their care afterward. Just because they can't pay doesn't mean they're getting free care, and they will be billed.

What makes you think that people aren't already billed for their care? It is only compensated if they have no capacity to pay. How would you go about collecting on these bills, and what do you do when someone with a net worth of 0 racks up $200,000 in bills?

 

[fskimospy]

How does someone going to the doctor for an ache or cough drive medical prices up? I would think a doctor love a nice $500 take two aspirin and call my assistant, if you have the patience to get through the 15 minute robo operator, in the morning 5 minute visit.

There are two main factors driving up medical care costs. The biggest is malpractice. The other is providing care for the uninsured. Trying to brush this one off as insignificant is ridiculous.

If you mean malpractice lawsuits, it is not true that they are the biggest cost driver of health care costs, or even remotely close to it. They are in fact one of the smallest drivers of health care costs.

 

[Atreus21]

What makes you think that people aren't already billed for their care?

Nothing. I'm sure they are billed. I'm just saying that immediate inability to pay doesn't mean you're not expected to find a way.

How would you go about collecting on these bills, and what do you do when someone with a net worth of 0 racks up $200,000 in bills?

The same way any institution does when it's owed a debt. Debt-collection agencies and whatnot. If that fails, you write off the debt. It's not perfect.

What you DON'T do is say, "Since there are a handful of people in a country of millions that are absolutely unable to pay no matter what, we should all be forced to pay for everyone else's health care."

 

[xBiffx]

How does someone going to the doctor for an ache or cough drive medical prices up? I would think a doctor love a nice $500 take two aspirin and call my assistant, if you have the patience to get through the 15 minute robo operator, in the morning 5 minute visit.

Simple, the patient is getting a service that isn't worth what they are paying for. They go to the doctor for a cough and get a prescription. Altogether they, or more importantly, their insurance is paying several hundred dollars for a visit not worth what they are paying for. The cough would have gone away or been easily treated with OTC medicine for $10 instead of several hundred.

There are two main factors driving up medical care costs. The biggest is malpractice. The other is providing care for the uninsured. Trying to brush this one off as insignificant is ridiculous.

Medical malpractice yes, but only somewhat. That is what I was partly alluding to when saying that the medial field is shrinking because it doesn't pay to be a physician like it did. The other being insurance companies nickle and diming the doctors for their services. Also the increasing administrative costs are much more of a driver. Providing care for the uninsured is a bullshit statement. This is a relatively tiny driver for the increasing of health insurance costs when you compare it to other factors. The other points I mentioned before far exceed this.

Yet again, Obamacare fixes none of this, especially the uninsured costs so I'm not sure why you keep bringing it up.

 

[dank69]

If you mean malpractice lawsuits, it is not true that they are the biggest cost driver of health care costs, or even remotely close to it. They are in fact one of the smallest drivers of health care costs.

What about when you include malpractice insurance? I swear I've read many articles with doctors complaining about this. :hmm: Please correct me if I am off base here.

 

[fskimospy]

What about when you include malpractice insurance? I swear I've read many articles with doctors complaining about this. :hmm: Please correct me if I am off base here.

Yes, including malpractice insurance. According to the CBO the total, cumulative cost of all malpractice insurance and malpractice judgments totals less than 2% of US medical spending. This cost can be highly unevenly distributed by region and specialty, however. Including the costs of 'defensive medicine' the CBO estimates that capping damages would reduce health care costs by about 0.5% going forward.

That can hardly be counted as the 'biggest issue'. It's a red herring used by the extreme right in order to provide a scapegoat for the failures of private health care insurance.

 

[dank69]

Simple, the patient is getting a service that isn't worth what they are paying for. They go to the doctor for a cough and get a prescription. Altogether they, or more importantly, their insurance is paying several hundred dollars for a visit not worth what they are paying for. The cough would have gone away or been easily treated with OTC medicine for $10 instead of several hundred.



Medical malpractice yes. That is what I was partly alluding to when saying that the medial field is shrinking because it doesn't pay to be a physician like it did. The other being insurance companies nickle and diming the doctors for their services. Providing care for the uninsured is a bullshit statement. This is a relatively tiny driver for the increasing of health insurance costs when you compare it to other factors. The other points I mentioned far exceed this.

Yet again, Obamacare fixes none of this, especially the uninsured costs so I'm not sure why you keep bringing it up.

The whole point of the mandate part of the law is to cut down on the number of uninsured. So you can stop saying the bill does not fix this, it's blatantly false.

 

[fskimospy]

Nothing. I'm sure they are billed. I'm just saying that immediate inability to pay doesn't mean you're not expected to find a way.

Actually that's what bankruptcy is for.

The same way any institution does when it's owed a debt. Debt-collection agencies and whatnot. If that fails, you write off the debt. It's not perfect.

What you DON'T do is say, "Since there are a handful of people in a country of millions that are absolutely unable to pay no matter what, we should all be forced to pay for everyone else's health care."

Hospitals and health care providers already do exactly this. Health care debt is one of the largest segments of the collections industry, including civil lawsuits and court enforced judgments. Hospitals already do try to collect, and in the case of failure write off the debt. I guess my confusion is that our system already works exactly like you want it to work, but there is no way that hospitals would be able to sustain that level of losses.

So again, it comes back to my original point. You need to be able to refuse care, or you need to have a mechanism to support that uncompensated care.

 

[dank69]

Yes, including malpractice insurance. According to the CBO the total, cumulative cost of all malpractice insurance and malpractice judgments totals less than 2% of US medical spending. This cost can be highly unevenly distributed by region and specialty, however. Including the costs of 'defensive medicine' the CBO estimates that capping damages would reduce health care costs by about 0.5% going forward.

That can hardly be counted as the 'biggest issue'. It's a red herring used by the extreme right in order to provide a scapegoat for the failures of private health care insurance.

Yes, I was just looking into this. You are right, I'm going to edit my original post to point out the misinformation...