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You're describing a great argument for universal healthcare like other civilized Western democracies have. Unfortunately too many Americans have bought into the argument that getting rid of employer subsidized health insurance = socialism.
Actually, no. Universal healthcare just basically replaces the insurance companies with the government.
1.) You still PAY for the healthcare in your taxes.
2.) The government can determine what care you get and when you get it.
3.) Also, if there is a "government shutdown", your care might be cut as part of the budget.
4.) Unlike with insurance companies, you can't exactly switch to another plan with universal government-run care if you don't like your plan.
5.) The government can investigate the insurance companies if they commit fraud, but, if we have a universal healthcare plan, who is going to investigate the government if they cut corners or allow innocent people to die due to neglect? (See the VA) (Also, see investigation of Lois Lerner and her emails and investigation of Clinton and her servers and emails for examples of government investigating itself.)
Excellent analysis. Many people who support more health insurance treat it as a free lunch. The answer to this was supposed to be copays. The problem there is that the marginal dollar, or last dollar, is on the insurer's dime so once the patient has decided to go to a doctor and come up with the copay he or she no longer cares about cost. Very few patients or families of patients are going to say to a doctor or nurse "you're the reason my healthcare costs $26,000 per year."
Oh there was insurance, but it was far less extensive. My family had "major medical" capped at $10,000. And as I said normal visits were paid out of pocket. It was latter, in the "managed care/HMO/PPO" stage that physicals and other routine visits began to be covered for "wellness"purposes. It sounded good but it has morphed into a Frankenstinian monster.
I believe my parents paid for doc visits, too. And dental. Not feasible today, considering that a 15-minute office visit averages $150, and that's the low end. My last annual office visit with the cardiologist was nearly $300!
Well, there are also other factors responsible for this, some of which - for example - are some nurses that get paid darn near what doctors do, liability insurance, expensive services like MRIs and high costs in researches for medicine. Over-charged? You betcha'. Insurance companies can waste money, too. A major one here spent many millions of dollars to have it's name given to the local NBA arena, and now they are having problems and are getting rid of the private plans. Capital theft of the $ premiums businesses and people have paid in good faith!
I do not know if no health insurance would fly today, though. Only because we have become over-populated, newer life-extending procedures since "those days" (like my heart bypass), and Heavens knows what else.
Insurance is a risk-sharing scheme to spread concentrated clumps of cost out into smaller payments over more regular intervals. If this were not a net good, insurance companies would be failing all over town.
Insurance is a risk-sharing scheme to spread concentrated clumps of cost out into smaller payments over more regular intervals. If this were not a net good, insurance companies would be failing all over town.
But they are. Health Republic failed in New York recently. Most ACA-spawned cooperatives have failed or are in trouble. What has kept health insurance alive is that payments for health insurance are deductible to an employer but are not taxed as income to an employee. That's a great arrangement until it blows up because of the inherent distortions it creates.
The distortion starts from the fact that the insured loses all incentive to police the price at which he or she is purchasing medical care. This led to a series of attempts by insurers, with permission from regulators at the state levels to reign in costs. One, in New Jersey was called Diagnostically Related Groups or "DRG's." This effort quickly became unpopular with consumers and doctors when decisions about medical care were held up pending approvals from insurers, which were often not forthcoming. Bill Clinton as President deputized Hillary Clinton to come up with a solution. Her personal unpopularity spiked that solution as well, ultimately, her own presidential campaign, but I digress.
The ACA, also known as Obamacare was passed in 2010 only via a bizarre parliamentary maneuver after Scott Brown anomalously won election as a Republican in Massachusetts. It is in implosion mold.
Thus, I suggest going back to Square One except for the very poor (Medicaid) and the elderly. I'd scrap the deductibility of coverage at the employer level and make employer-provided benefits taxable as income to the employee. Wages would increase to cover at least part of the difference. I think life would get better, not worse, as they did after Reagan dumped prices controls on oil and gasoline.
What has kept health insurance alive is that payments for health insurance are deductible to an employer but are not taxed as income to an employee. That's a great arrangement until it blows up because of the inherent distortions it creates.
Stuff and nonsense. The rest of the developed world long ago left the US behind. Better overall health care at lower per capita costs. That's where we need to go.
Quote:
Originally Posted by jbgusa
The ACA, also known as Obamacare was passed in 2010 only via a bizarre parliamentary maneuver after Scott Brown anomalously won election as a Republican in Massachusetts.
LOL! The House simply passed the Senate version of the bill. Revisions were then passed by both chambers under reconciliation. The notion that reconciliation is some "bizarre parliamentary maneuver" is what's bizarre. Both of Bush's tax cut bills for instance were passed under reconciliation. Reconciliation is an entirely ordinary part of doing budget business.
Quote:
Originally Posted by jbgusa
It is in implosion mold.
No, it's not at all. 95% of PPACA is working just fine, and the small parts that are not can be easily adjusted and repaired. Wild-eyed opponents of course have exactly NOTHING on the table to replace it with. More than six years on now, and they've still got NOTHING. What does that tell you?
Quote:
Originally Posted by jbgusa
Thus, I suggest going back to Square One except for the very poor (Medicaid) and the elderly.
Horrible idea. PPACA was developed in a massive cooperative undertaking that brought everyone's best ideas into play. You would only have to retrace all that ground in pretending to start over.
Quote:
Originally Posted by jbgusa
I think life would get better, not worse, as they did after Reagan dumped prices controls on oil and gasoline.
Jimmy Carter began the phased deregulation of oil prices on April 5, 1979.
Stuff and nonsense. The rest of the developed world long ago left the US behind. Better overall health care at lower per capita costs. That's where we need to go. ....No, it's not at all. 95% of PPACA is working just fine, and the small parts that are not can be easily adjusted and repaired. Wild-eyed opponents of course have exactly NOTHING on the table to replace it with. More than six years on now, and they've still got NOTHING. What does that tell you?
The fairy Godmother at work.
Quote:
Originally Posted by Pub-911
LOL! The House simply passed the Senate version of the bill. Revisions were then passed by both chambers under reconciliation. The notion that reconciliation is some "bizarre parliamentary maneuver" is what's bizarre. Both of Bush's tax cut bills for instance were passed under reconciliation. Reconciliation is an entirely ordinary part of doing budget business.
First of all reconciliation is designed for budget and tax items, not fundamental policy. Second of all I don't recollect much if any in the way of fixes.
Quote:
Originally Posted by Pub-911
Horrible idea. PPACA was developed in a massive cooperative undertaking that brought everyone's best ideas into play. You would only have to retrace all that ground in pretending to start over.
More like an elephant by committee. Go on.
Quote:
Originally Posted by Pub-911
Jimmy Carter began the phased deregulation of oil prices on April 5, 1979.
My 22nd birthday. If they deregulated immediately on that date the horrendous gas lines of May-July 1979 and much of the price increases would have been avoided.
None of this discussion is answering the question as to why we are paying twice as much on a per capital basis for health care as other developed countries.
None of this discussion is answering the question as to why we are paying twice as much on a per capital basis for health care as other developed countries.
I firmly believe that a large chunk of the blame falls on time lost doing anything about it. It needed to start at least 30 years ago when employers started screaming to High Hell about the continual rise in insurance costs. This is not something that happened overnight in recent years. Heck, I can remember in the early 80's when the employer-paid premiums would have cost me around $1800 out of my pocket if I quit the job! This has been a climbing problem for well over a quarter of a century. Unfortunately, I really do think too much time has passed to EFFICIENTLY fix the problem, and all of us suffer for the laziness of the law-makers and politicians that pretended it didn't exist. The problem can get a little better, but I don't think it can get a LOT better.
None of this discussion is answering the question as to why we are paying twice as much on a per capital basis for health care as other developed countries.
Your own GAO answers that:
"As personal income increases, people demand more and better goods and services, including health care. This means that holding other factors constant, as higher personal income increases the quantity and quality of care demanded, overall health care spending increases as well. GDP is a good indicator of the effect of increasing income on health care spending."
Source: United States Government General Accounting Office GAO-13-281 PPACA and the Long-Term Fiscal Outlook, page 33.
"As personal income increases, people demand more and better goods and services, including health care. This means that holding other factors constant, as higher personal income increases the quantity and quality of care demanded, overall health care spending increases as well. GDP is a good indicator of the effect of increasing income on health care spending."
Source: United States Government General Accounting Office GAO-13-281 PPACA and the Long-Term Fiscal Outlook, page 33.
And other developed countries don't have increasing personal income?
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