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Old 03-12-2017, 12:58 PM
 
29,789 posts, read 34,889,516 times
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Quote:
Originally Posted by NorthofHere View Post
It is called self-insuring. In other words you can afford to take the low risk of your house burning down or your car being wrecked. I laugh everytime I buy something and the clerk asks if I want insurance for it. I don't need to pay for insurance for something I can afford to risk losing. Why insure a car worth $5K if you can afford to buy a new one. Insurance is for risks you cannot afford. You don't insure a car for common maintenance, therefore I would hope to be able to buy insurance that doesn't include routine doctors visits. Yes I would like to insure in case I get in an accident or get cancer or some other costly disease but not for my routine doctors visits. This alone, would cut health care costs, because if you were paying for it you would ask the price and doctors would become competitive. I don't have dental coverage and when I do go looking for a dentist I will be sure to ask prices.
There are many of a different mind set who even if they can't afford a replacement they don't want insurance. It is part of a culture of independence that even rejects federal health insurance even if they can't afford it as they are responsible for themselves and not someone else/government giving it to them against the will of those government got it from.
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Old 03-12-2017, 01:07 PM
 
29,789 posts, read 34,889,516 times
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Quote:
Originally Posted by TwoByFour View Post
The analogy between health insurance and car insurance is not a good one though because with a destroyed car, it is your loss alone. But when someone without insurance gets injured or sick, he/she often ends up in the ER and gets treated. That is paid for with public funds, or by the hospital absorbing the cost and then passing it off to all its other patients with higher fees. The rest of us end up paying for those without insurance anyway, either through taxes or higher premiums.

It just does not work very well to have different insurance classes (private, Medicaid, Medicare) and different subsidies. Just pay for everyone with taxes and give everyone Medicare.
Ummm so you are making a argument for requiring major medical coverage to avoid those shared hospital cost. Hmm wasn't that available as a stand alone prior to the ACA? Didn't the ACA force men to give that up and buy a whole package of coverage including birth control and pre-natal?

So if required hospitalization was required which is a shared cost that would be ok with you? So if you can't afford a doctor for a check up or for medication you don't get and that is on you.

Ok bring back the major medical policy only option without having to subsidize the premium for others.
Remember auto insurance is based on your risk factors and goes up as they go up.

The ACA? A healthy single making 50k a year pays more than a sick welfare recipient and has a higher deductible. Does the welfare recipient on Medicaid have a deductible of much. So am I reading your right that under your system people would still pay different amounts based on income and not insurance needs? Could you imagine if low income folks were given free auto and home owners insurance?
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Old 03-12-2017, 01:10 PM
 
29,789 posts, read 34,889,516 times
Reputation: 11715
Quote:
Originally Posted by TwoByFour View Post
The analogy between health insurance and car insurance is not a good one though because with a destroyed car, it is your loss alone. But when someone without insurance gets injured or sick, he/she often ends up in the ER and gets treated. That is paid for with public funds, or by the hospital absorbing the cost and then passing it off to all its other patients with higher fees. The rest of us end up paying for those without insurance anyway, either through taxes or higher premiums.

It just does not work very well to have different insurance classes (private, Medicaid, Medicare) and different subsidies. Just pay for everyone with taxes and give everyone Medicare.
Problem as I recall is that much of Medicaid and all of Medicare is from the federal government and 47% pay not federal income tax and thus no contribution. Don't say they pay state and local taxes and try to make it seem like that contributes directly to Medicare. It does help cover part of the Medicaid state portion which is how much on average and how much in the way of state income taxes do welfare recipients pay?
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Old 03-12-2017, 02:10 PM
 
Location: Haiku
4,144 posts, read 2,591,176 times
Reputation: 6099
Quote:
Originally Posted by TuborgP View Post
The ACA? A healthy single making 50k a year pays more than a sick welfare recipient and has a higher deductible. Does the welfare recipient on Medicaid have a deductible of much. So am I reading your right that under your system people would still pay different amounts based on income and not insurance needs? Could you imagine if low income folks were given free auto and home owners insurance?
Yes, you are reading me right. Again, the analogy with auto insurance is not valid - owning a car is not a basic human right. Health care is. At least it is in most of the developed world. The US is the exception where we treat health care as a luxury item - you only get it if you can afford it.
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Old 03-12-2017, 02:18 PM
 
29,789 posts, read 34,889,516 times
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Quote:
Originally Posted by TwoByFour View Post
Yes, you are reading me right. Again, the analogy with auto insurance is not valid - owning a car is not a basic human right. Health care is. At least it is in most of the developed world. The US is the exception where we treat health care as a luxury item - you only get it if you can afford it.
For how much of history was it a basic human right and is it sustainable
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Old 03-12-2017, 02:36 PM
 
Location: Haiku
4,144 posts, read 2,591,176 times
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Quote:
Originally Posted by TuborgP View Post
For how much of history was it a basic human right and is it sustainable
Well, it may well not be sustainable but that does not negate the fact that it is a human right. This is like the AGW debate - people cloak the fact that it will be expensive to fix by arguing that the science is BS. In both situations it is important to get the fundamentals worked out and then figure out a practical public policy. I would much rather hear a politician say "I believe in AGW but it is too damn expensive so we are not going to do anything about it", or, "UHC is a basic human right but it is too damn expensive so we are going to officially limit who gets healthcare". Perhaps people will then work on getting both of these issues to cost less.
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Old 03-12-2017, 02:39 PM
 
Location: Wisconsin
21,542 posts, read 44,060,337 times
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Quote:
Originally Posted by snowtired14 View Post
Sorry, but that doesn't add up, I think you misunderstand, the situation is worse than you think. Taxes on $30K/yr are less than $4K. I think they're proposing a tax credit, meaning the taxes you would have paid on $4K which would be only $600.
No, the legislation isn't THAT draconian. The tax credit is refundable - similar to the EIC or child tax credit - which means the amount is fixed whether or not you have a tax liability and, if your tax liability is less, the difference is refundable to you.

March 8th draft per Thomson Reuters Tax Accounting:
Quote:
Replacement. The main feature of the AHCA’s ACA replacement is a new refundable tax credit for health insurance, described below. The AHCA would also make a number of significant changes to strengthen HSAs in addition to those described above.

Health insurance coverage credit. The AHCA would create a new Code Sec. 36C refundable tax credit for health insurance coverage—generally, state-approved major medical health insurance and unsubsidized COBRA coverage. (Repeal and Replace of Health-Related Tax Policy, Sec. 15(a))

The credit would generally equal the lesser of: (i) the sum of the applicable monthly credit amounts (below) or (ii) the amount paid by the taxpayer for “eligible health insurance” for the taxpayer and qualifying family members. (Code Sec. 36C(b))

Monthly credit amount. The monthly credit amount with respect to any individual for any “eligible coverage month” (in general, a month when the individual is covered by eligible health insurance and is not eligible for “other specified coverage,” such as coverage under a group health plan or under certain governmental programs, like Medicare and Medicaid) during any tax year would be 1/12 of:

A. $2,000 for an individual who has not attained age 30 as of the beginning of the tax year;
B. $2,500 for an individual age 30 – 39;
C. $3,000 for an individual age 40 – 49;
D. $3,500 for an individual age 50 – 59; and
E. $4,000 for an individual age 60 and older. (Code Sec. 36C(c)(1))

Income-based phaseout. The Code Sec. 36C credit would phase out at higher levels of income. Specifically, it would be reduced by 10% of the excess of the taxpayer’s modified adjusted gross income (MAGI, as specifically defined) for a tax year over $75,000 (double that for a joint return). (Code Sec. 36C(c)(2)) The $75,000 amount, as well as the dollar amounts in (A) through (E), above, would be adjusted for inflation.

https://tax.thomsonreuters.com/media...lacement-bill/
So, the tax credit will be at least the $$ amounts listed above unrelated to the individual's actual tax liability, or the actual cost of the health insurance, whichever is less.

Last edited by Ariadne22; 03-12-2017 at 02:55 PM..
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Old 03-12-2017, 02:41 PM
 
29,789 posts, read 34,889,516 times
Reputation: 11715
Quote:
Originally Posted by TwoByFour View Post
Yes, you are reading me right. Again, the analogy with auto insurance is not valid - owning a car is not a basic human right. Health care is. At least it is in most of the developed world. The US is the exception where we treat health care as a luxury item - you only get it if you can afford it.
Lets get a common understanding. I have been in this forum a long time and have always said folks are crazy if they think Medicaid will be there to pay there LTC down the road. I have said folks need to be prepared to get a lump sum for Medical insurance as part of their Medicare and to provide the difference themselves for what they want over basic coverage. I say this not out of ideology but out of a lack of ideology. It is a matter of fiscal sustainability and debt accumulation and dog is about to bite the royal hair off our butts as interest rates rise and Medicare and SS get closer to their sustainable expiration date.

I was with reservations a fan of the ACA and my reservations were valid. There are not enough doctors for everyone and that is at the core of the VA hospital problem. A shortage of medical practitioners in some areas. The ACA is collapsing not just because of cost but because service providers are pulling out of markets and how good is insurance with no doctors? Capital didn't as hoped for flow to the markets and service providers are leaving.

Let me pause and ask you are if you are familiar with Thomas L. Friedman NY Times journalist and Pulitzer prize winner author. He wrote the World is Flat among other books and his newest best seller is Thank You for Being Late. He is fantastic thinker and is often on the news type shows. He is very clear on the impact acceleration of technology is having on people and the challenges society faces collectively coping with. I say collectively because individually we may be able to but as a society maybe not.

The solutions to health care have to play out in the market place as that is the best vehicle to keep up with change and that needs to be done without overbearing regulations that are rapidly outdated as things change exponentially.

We currently spend 18% of GDP on health care and that is a crippling percentage that chokes capital flowing to other uses etc etc etc.
http://www.pbs.org/newshour/rundown/...her-countries/

The solution will not be written in congress but will be for better or worse as the ACA has found out determined by free markets.
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Old 03-12-2017, 03:09 PM
 
12 posts, read 9,822 times
Reputation: 68
Quote:
Originally Posted by TwoByFour View Post
Yes, you are reading me right. Again, the analogy with auto insurance is not valid - owning a car is not a basic human right. Health care is. At least it is in most of the developed world. The US is the exception where we treat health care as a luxury item - you only get it if you can afford it.
But yet the govt wants to tax my health insurance plan as if I bought a luxury item, that is what the Cadillac tax will do.
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Old 03-12-2017, 03:20 PM
mlb
 
Location: North Monterey County
3,194 posts, read 2,861,612 times
Reputation: 4890
Quote:
Originally Posted by NorthofHere View Post
Personal experience. Husband retired early I stopped working years ago. Current health care is a joke, though we are healthy we pay over $15K a year for basic medical coverage (currently COBRA but cost is similar to what we could get on the open market). Cobra will expire before he hits 65 and I have a year or so afterwards. I would love to get coverage for catastrophic events only paying out of pocket for doctors visits etc. at a reasonable rate but can't. I have to get health coverage that covers pregnancy, birth control pills and other things I do not need but I pay twice or more as those who are younger and will most likely utilize pregnancy benefits. Before Obama care my husband looked into what health care would cost and it was half the amount we currently pay. Our health hasn't changed, in fact, retirement has probably made us healthier. As to subsidies, quite frankly unless you are retiring early for health reasons you aren't retiring on an income that qualifies you for subsidies. As to the proposals of the current administration we aren't so happy with that either. Would we change retiring early? No way. My husband is healthier and happier not working and is enjoying retirement very much.
It's like saying I don't want to pay for any man's viagra - or prostate cancer.

Ridiculous.
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