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#27 May 27 2016 at 7:37 AM Rating: Good
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gbaji wrote:
That's why it was a bad law.
Well, that and all the work to keep it broken because it's more important to make a political point than it is to actually fix things.
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#28 May 27 2016 at 12:31 PM Rating: Excellent
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Timelordwho wrote:

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Single payer would not solve this. Single provider, might, but that's an entirely different concept, with a huge amount of additional changes required. All a single payer system does is say that the government pays on your behalf (and you fund that cost via taxes rather than via insurance premiums). The problem is that this just adds another middleman to the equation. And frankly, a middleman that has even less desire or need to keep costs low than the insurance companies do now.


Single payer is not in addition to the various middlemen/billers, it is in lieu of.

It replaces the general health insurance system for routine & cato, but does not replace EoL, elective, and ultra premium care.
I could get behind something of this nature. Government provided health care that was limited in scope.

Basically there's a government option. They handle all the basic stuff, immunizations, yearly doctors visits, child birth (up to a limit), cover typical medication for common ailments, vision, dental care, birth control and a lot of similar things up until retirement age. This would be like the "public school" version of health care. It would be paid for by taxes much like public schools are. Along side of it private companies would be able to compete, offering premium packages and end of life care packages (we could put together an "end of life" savings account for medical care which could wrap into current 401k stuff), that would go above and beyond the government run package. They could offer what would likely be better service for those who were willing to spend extra to have things covered that didn't meet the government criteria, or didn't want to wait in the inevitable long lines at the government clinics.

Edit:

The reason for keeping end-of-life care separate is because I suspect people who can afford it won't want to give up their premium end-of-life care. The considerations there are different than throughout the working life, and people who were fine with the government minimum likely won't view a fight with imminent death in the same manner. There are going to be people who will want to pay that large extra amount of money to get another 6-12 months of life, and I see no reason to deny them that. On the other hand, that's not the kind of thing we can afford as a country for everyone. I suppose there's plenty of other ways to work it (i.e. the government option extended into old age), but there's still medicare and other things that would have to be meshed in together, and frankly I don't know enough about the ins and outs of that mess to be able to envision what a solution could look like.

Edited, May 27th 2016 12:25pm by someproteinguy
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#29 May 31 2016 at 6:36 PM Rating: Decent
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lolgaxe wrote:
gbaji wrote:
That's why it was a bad law.
Well, that and all the work to keep it broken because it's more important to make a political point than it is to actually fix things.


Failure was baked into the ACA from day one. It's a broken system by design. No one has to work to "keep it broken". It started out that way. Surely you can see why?
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#30 May 31 2016 at 7:04 PM Rating: Decent
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Timelordwho wrote:

Quote:
Single payer would not solve this. Single provider, might, but that's an entirely different concept, with a huge amount of additional changes required. All a single payer system does is say that the government pays on your behalf (and you fund that cost via taxes rather than via insurance premiums). The problem is that this just adds another middleman to the equation. And frankly, a middleman that has even less desire or need to keep costs low than the insurance companies do now.


Single payer is not in addition to the various middlemen/billers, it is in lieu of.


Already addressed this in my post. Those middlemen it actually replaces have at least some motivation to keep costs down today (well, less today than a few years ago, and less then than a few decades ago, so we can see what direction this has gone). Obviously, it depends on the specific implementation of your single payer system.

Quote:
It replaces the general health insurance system for routine & cato, but does not replace EoL, elective, and ultra premium care.


Again. This depends on the specific implementation. Honestly, it always sounds easy to say that "basic" care should just be paid for, but where's the boundary of that care? The devils in the details IMO. And this tends to creep into a larger and larger set over time as we find more cases of things that "should be paid for", but aren't.

For me it's less about how the care is covered as how it's paid for. I'm a firm believer in the principle that when someone has a direct out of pocket cost for something they receive, that they tend to make greater effort to be more responsible with all choices related to that thing. The more you abstract that cost, the less care will be taken. I know that one of the great arguments for free basic care is the concept of preventative care. If you make it free to get regular checkups, more people will get them, and they'll be healthier as a result, right? Except you can argue the opposite as well. If the care is free, then one might argue "why should I go to the doctor unless/until I get sick"? If me getting sick presents a major cost to me, I might take the responsible action to prevent it ahead of time. But if my illness will be paid for by the government, there's less of a need.

The point is that there will always be people, who, left to their own devices will make poor decisions. So you really have two choices. You either allow them the freedom to make bad choices, but then hold them responsible for the consequences, or you cover the costs for their poor choices, but will almost certainly have to take some sort of coercive action to control their choices as a means of "reducing costs". He who pays for a thing controls that thing. And that's what bothers me the most about this. Ultimately, the only real cost savings methodology a single payer system has is to attempt to control the choices of those it covers. Which is problematic IMO. In the other direction, you save costs by just not paying for people's health care. It starts out costing "the people" nothing at all. Each person is responsible for their own actions and their own outcomes. Does that suck for the percentage of the population that will develop some illness or ailment that had nothing to do with their own choices? Sure. But it sucks to get hit by a car and killed through no fault of your own too. We live in an imperfect world, and bad things do just sometimes happen. I'm just not sure that giving up a massive amount of individual liberty is worth it to avoid that.

Hey. We're just one step away from Carousel. Logical conclusion and all that.
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#31 May 31 2016 at 7:25 PM Rating: Good
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gbaji wrote:
Each person is responsible for their own actions and their own outcomes. Does that suck for the percentage of the population that will develop some illness or ailment that had nothing to do with their own choices? Sure. But it sucks to get hit by a car and killed through no fault of your own too. We live in an imperfect world, and bad things do just sometimes happen. I'm just not sure that giving up a massive amount of individual liberty is worth it to avoid that.
I'm still trying to suss out if the altar in your condo is to Baal or Ayn Rand, so I'm going with "both".
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#32 Jun 01 2016 at 8:11 AM Rating: Excellent
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Friar Bijou wrote:
I'm still trying to suss out if the altar in your condo is to Baal or Ayn Rand, so I'm going with "both".
I figure Astaroth.
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#33 Jun 01 2016 at 5:07 PM Rating: Good
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gbaji wrote:
Surely you can see why?


This right here is an example of why no one can take you seriously. Posting your opinion as fact and then trying to make yourself superior because people don't agree with you.

Surely you can see this!
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#34 Jun 01 2016 at 5:17 PM Rating: Decent
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Professor stupidmonkey wrote:
gbaji wrote:
Surely you can see why?


This right here is an example of why no one can take you seriously. Posting your opinion as fact and then trying to make yourself superior because people don't agree with you.


If you disagree with my assessment, you're free to post your opinion if you wish. I don't claim my opinion is anything other than my opinion. But if you can't or wont counter it, then it kinda stands by default, right? Given that Obama himself said, fairly early in the process, that the ACA wasn't a great solution, but was a "stepping stone" to a better one (presumably single payer), I don't think it's wrong at all to say that failure was intentional. You don't get to single payer by creating a really great health care system that doesn't use single payer. Cause then people would be happy with that system. You get there by taking the existing system and making it so bad that people will clamor for "something better", and hope that at that future date, they'll choose to go with the single payer system you really wanted all along.

Is this really such a freaking stretch?
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#35 Jun 01 2016 at 5:34 PM Rating: Decent
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Here's a Forbes article on the subject. Even if you don't agree with the analysis, the facts are still quite damning. Heck. It's almost impossible not to find tons of evidence of failure (ok, the last bit was referenced in an earlier link, sue me).

Even those trying to find a silver lining in the law fall back onto weak talk about how it wasn't as bad as predicted. Um... Wait! So in 2013, 20% of small business owners said they would likely have to drop their employees from their health plans, but only 7% did, and that's a good thing? Talk about lowering the bar there! Oh, and apparently, the main reason they didn't was because the co-ops which were supposed to pick up the slack sucked so bad that employers felt bad dumping people on them? Wow. Um... Ringing endorsement right there. Oh. And lets not forget that employers largely just passed higher premiums and co-pays onto their employees anyway, and had to be coerced into doing so via government tax breaks. Again, not exactly a sign of a successful program. Gee! When we paid people to stick with the program fewer of them dropped it than predicted! Wow... Just wow.

I'll stick to my earlier statement. It was a terrible law and should never have been passed.

Edited, Jun 1st 2016 4:35pm by gbaji
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#36 Jun 01 2016 at 5:51 PM Rating: Excellent
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gbaji wrote:

That's not a "Forbes article"; it's an opinion piece written by someone representing a right-wing policy group.
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#37 Jun 01 2016 at 6:27 PM Rating: Decent
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Jophiel wrote:
gbaji wrote:

That's not a "Forbes article"; it's an opinion piece written by someone representing a right-wing policy group.


Sorry. It's an op-ed on the Forbes site. Your point is?
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#38 Jun 01 2016 at 7:00 PM Rating: Excellent
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"Forbes article" suggests a level of editorial approval relying on Forbes' reputation that doesn't exist here. No reason to get defensive about it, you were just in error and the error is significant since it gives a misleading impression of your cite. Honestly, it's more an issue with Forbes' online policy of essentially being a collection of LiveJournals rather than a reflection of their magazine presence. I doubt you were aware of the difference.
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#39 Jun 01 2016 at 7:07 PM Rating: Good
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Well, uh, new Forbes is not as respected as old Forbes even when it's not an OP Ed.
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#40 Jun 01 2016 at 7:18 PM Rating: Decent
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Jophiel wrote:
"Forbes article" suggests a level of editorial approval relying on Forbes' reputation that doesn't exist here. No reason to get defensive about it, you were just in error and the error is significant since it gives a misleading impression of your cite. Honestly, it's more an issue with Forbes' online policy of essentially being a collection of LiveJournals rather than a reflection of their magazine presence. I doubt you were aware of the difference.


Ok. And? Do you agree or disagree with the op-ed? If so, why? Arguing about what we should label it is kinda silly, isn't it? I get that for liberals, who tend to place great weight in the fallacy of appeal to authority, whether a cite received editorial approval on the site it's posted on is massively important (cause apparently, you need someone else to tell you what is true and what is false), but for me, I care more about the actual content and prefer to assess it myself. Isn't that was matters?

Why not actually address the content contained at the other end of the link? Or any of the links I posted? Dunno. Just seems like a really strange response methodology to me. What's next? We argue about formatting? OMG! That guy used a terrible font! He must not know what he's talking about...
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#41 Jun 01 2016 at 7:32 PM Rating: Excellent
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I've little interest in debating health care with you tonight, I was just correcting an error. If you need to throw a hissy fit about it, that's on you Smiley: smile
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#42 Jun 01 2016 at 7:56 PM Rating: Good
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EDIT: Sometimes I don't know why I allow myself to get sucked in.


Edited, Jun 1st 2016 7:00pm by stupidmonkey
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#43 Jun 02 2016 at 1:18 AM Rating: Good
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gbaji wrote:
I get that for liberals, who tend to place great weight in the fallacy of appeal to authority, whether a cite received editorial approval on the site it's posted on is massively important (cause apparently, you need someone else to tell you what is true and what is false), but for me, I care more about the actual content and prefer to assess it myself. Isn't that was matters?
. And if someone links/cites some article from a writer known to be a member of the Communist Party of the United States from some normally relible website supporting some Democrat position you won't just slam/ignore/decry the source out of hand?


Riiiiiiiiiiight.Smiley: rolleyes


Edited, Jun 2nd 2016 1:20am by Bijou
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#44 Jun 02 2016 at 6:45 AM Rating: Excellent
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gbaji wrote:
it's posted on is massively important (cause apparently, you need someone else to tell you what is true and what is false), but for me, I care more about the actual content and prefer to assess it myself.

Unless he finds a book report that cherry picks what Gbaji wants to hear. Then he has no use for the "actual content" and will argue for pages that it's irrelevant because he read a column telling him all he needed to know.

Ah, Gbaji... you so Gbaji.
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#45 Jun 02 2016 at 10:12 AM Rating: Good
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gbaji wrote:
I care more about the actual content and prefer to assess it myself.
How can you claim to care about actual content when you've made it abundantly clear you don't read the actual content?
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#46 Jun 03 2016 at 6:03 PM Rating: Good
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Over the years I had health insurance through my parents, when my dad work for the State of MD, the military as a dependent, as family member of husband who work for the DoDArmy, No insurance so had to rely on a free clinic, Medicaid and ACA. The best health care I had was when my ex was working for the DoD. The worst was having no insurance many years before the ACA was passed. from best to worst, where are my rankings.

DoDArmy. - Not quite as good as what congress gets but close. Husband was paying $60 a month 410 or $20 co-pays
Medicaid - Free Government plan $1 or $3 co-pay for medications
State of MD. - I have no idea of what my parents were paying for the HMO. $2 co-pays in the '70's.
ACA Silver plan through MD. subsidized by Government my share was $14 and change a month plus co-pays that range from $0 to $90 for once medication that I ended up going without due to the cost.
Dependent of military member Free with no o-pays, but I had to pay for all meals while hospitalized and tthe navy food was barely edible compare to private hospitals I been in.
Free Clinic. Never the same doctor and hit and miss on care. I had to come up with money I didn't have to pay for tests and medications.

Notice that the top 3 are all run by government agencies. While there are some things I would like to be able to get, like Physical Therapy, I'm happy with the care I get on Medicaid. I can't get married without loosing my medicaid due to income levels unless I marry someone who can't work. We once asked what my medicine would cost if I married Jonwin. Our pharmacist told Paul we don't want to know. Since I often pick up Jonwin's medication, and had to pay for them I can imagine mine costing between $500 to $1000 a month, since the insurance he had through work was worst then the plan he had through the ACA, when they stop giving employees that didn't work 30 hours a week health insurance and then cut his hours to below 30 hours.
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#47 Jun 06 2016 at 6:50 PM Rating: Decent
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Friar Bijou wrote:
gbaji wrote:
I get that for liberals, who tend to place great weight in the fallacy of appeal to authority, whether a cite received editorial approval on the site it's posted on is massively important (cause apparently, you need someone else to tell you what is true and what is false), but for me, I care more about the actual content and prefer to assess it myself. Isn't that was matters?
. And if someone links/cites some article from a writer known to be a member of the Communist Party of the United States from some normally relible website supporting some Democrat position you won't just slam/ignore/decry the source out of hand?


No, I won't. I will read what was written, and respond to the content contained within. Why would you do this any other way? I suppose I might take someone identity into account when assessing *why* he might write something or take a specific position, but my argument against that position will consist of actual argument against the position itself, not the person who wrote it.

I find it odd that anyone would do this any other way. Hence my comment earlier.
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#48 Jun 06 2016 at 7:07 PM Rating: Default
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ElneClare wrote:
Notice that the top 3 are all run by government agencies. While there are some things I would like to be able to get, like Physical Therapy, I'm happy with the care I get on Medicaid. I can't get married without loosing my medicaid due to income levels unless I marry someone who can't work. We once asked what my medicine would cost if I married Jonwin. Our pharmacist told Paul we don't want to know. Since I often pick up Jonwin's medication, and had to pay for them I can imagine mine costing between $500 to $1000 a month, since the insurance he had through work was worst then the plan he had through the ACA, when they stop giving employees that didn't work 30 hours a week health insurance and then cut his hours to below 30 hours.


I'm sure I'm going to come off like a jerk here, so I'll apologize in advance, but you do realize that the existence of Medicaid is impacting your freedom to marry the person you love, right? I get that the world presents you choices and you have to make the best ones you can, but this is a classic example of government benefits creating opportunity costs which affect and influence the free choices of the citizens. And, intentional or not, the rules regarding those benefits often result in restrictions on people's lives.

I've often stated that the least free people in our society are those who receive the most government benefits. Those benefits always come with strings. And that one's a biggie. But not unusual either. In your case it's health related, but the same rules apply to people receiving all sorts of broad public assistance. Single moms, for example, find it extremely difficult to get out of their condition because if they marry someone, they lose much of their benefits. Heck. Even having a live-in boyfriend can be a violation and result in them being convicted of welfare fraud (if they're receiving housing assistance, or in subsidized housing, they can't provide that to anyone not themselves or a dependent). It sometimes seems as though the system is rigged to make it nearly impossible to get out.

Obviously, that's not the exact same thing as your situation, but I do find the concept troubling. And while I suppose the obvious argument would be "let's just provide a free basic living level for everyone", and then remove the restrictions on such things, I just have this terrible suspicion that it wont work out that way. They'll still find ways to use the benefits as a means of control over the population receiving it. The power over the dependent population is just too great not to use and over time it *will* be. And in the course of applying such a solution, the total percentage of the population now dependent on a significant amount of government assistance will grow dramatically. Making the temptation to use that power even greater. I just can't get past the fact that those running the system are human too. It's nice to imagine this grand utopia where we can provide for everyone and everyone will live happy content lives, but I just don''t believe that will happen. I think that once the people are dependent on the government to provide them with food and housing and transportation, the government will use those things to enforce control over them.

Never intentionally, of course. And always out of a necessity to do the most good for the most people. But it'll happen anyway.
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#49 Jun 06 2016 at 8:28 PM Rating: Good
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gbaji wrote:
But not unusual either. In your case it's health related, but the same rules apply to people receiving all sorts of broad public assistance. Single moms, for example, find it extremely difficult to get out of their condition because if they marry someone, they lose much of their benefits.
Maybe change the system to differentiate someone like Elne who through no fault of her own needs the assistance from someone who made "bad choices" (your personal "moral" reason to not help people)?

Haha, just kidding; you don't want there to be any assistance. People like Elne are disposable to your ideology.

People like me, too, I might add...
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#50 Jun 07 2016 at 6:30 AM Rating: Good
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I'm sure I'm going to come off like a jerk here, so I'll apologize in advance, but you do realize that the existence of Medicaid is impacting your freedom to marry the person you love, right?


This is why we should move from welfare system to a UBI system. Provide support and flexibility to those who need it, but let the market correctly price goods and services, remove a large chunk of bureaucratic apparatus, and remove edge effects in the process (welfare cliffs) that inhibit growth.
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#51 Jun 07 2016 at 7:49 AM Rating: Excellent
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gbaji wrote:
you do realize that the existence of Medicaid is impacting your freedom to marry the person you love, right?
And we all know just how deeply you believe in the freedom of people marrying the person they love.
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