Obama: It's OK to borrow to pay for health care

[TomAiello 26]

Quote

If someone has the money to pay for a hip replacement when they fracture a hip, they get it. That won't change -- private doctors will not be outlawed.

The concern of the AMA is that the public insurance would crowd out private insurance, so that no one would be able to get insurance to cover that hip replacement in an older patient (because the insurance companies would fade out over time), and the public insurer would deny the operation due to age. Which would mean that the only people getting hips replaced would be the very wealthy (because the merely upper class couldn't afford it, and they couldn't buy health insurance to cover it, either).

I think we're likely to see a sharp reduction in the number of private, primary health insurance options, and the growth of a bunch of new "supplemental" insurance plans that cover things the government won't.

In this scenario, my worry is that the chronically or terminally ill (or even just old and sick) will be unable to purchase the supplemental insurance, and will be denied coverage under the public system (due to low odds of "recovery" making the spending "wasteful").

-- Tom Aiello

Tom@SnakeRiverBASE.com
SnakeRiverBASE.com

[kelpdiver 2]

We'll see a sea of supplemental plans, but then we'll replace battles between insurance companies and hospital over bills with battles between insurance companies and the feds over bills or preapproval process (leaving the patient waiting in pain).

[billvon 3,009]

>so that no one would be able to get insurance to cover that hip
>replacement in an older patient . . .

Why wouldn't the older patient just pay for it?

>my worry is that the chronically or terminally ill (or even just old and sick)
>will be unable to purchase the supplemental insurance, and will be denied
>coverage under the public system (due to low odds of "recovery" making
>the spending "wasteful").

Again - why wouldn't they just pay for it?

[Bolas 5]

Quote

In this scenario, my worry is that the chronically or terminally ill (or even just old and sick) will be unable to purchase the supplemental insurance, and will be denied coverage under the public system (due to low odds of "recovery" making the spending "wasteful").

Not to be cold, but that's how it has to be. We can't try and save everyone, it's just not possible. This is where the private options can and will come in to play if they can afford it.

Taking the human factor out, it doesn't make fiscal sense to give a hip replacement to an 85 year old person with government funding. If they can get their family, a charity, private insurance, etc. to pay, great.

Sadly there has to be acceptable losses or it has 0 chance to succeed. You think the whole "no child left behind" debacle is bad? It'd be nothing compared to a "We must save everyone, regardless of cost" government health care plan.

Stupidity if left untreated is self-correcting
If ya can't be good, look good, if that fails, make 'em laugh.

[Bolas 5]

Quote

We'll see a sea of supplemental plans, but then we'll replace battles between insurance companies and hospital over bills with battles between insurance companies and the feds over bills or preapproval process (leaving the patient waiting in pain).

Maybe. My guess is some of the pricier supplementals will just get the patient treated and cared for and then fight the gov't for the $$$, leaving the patient out of it.

Stupidity if left untreated is self-correcting
If ya can't be good, look good, if that fails, make 'em laugh.

[TomAiello 26]

Quote

>so that no one would be able to get insurance to cover that hip
>replacement in an older patient . . .

Why wouldn't the older patient just pay for it?

>my worry is that the chronically or terminally ill (or even just old and sick)
>will be unable to purchase the supplemental insurance, and will be denied
>coverage under the public system (due to low odds of "recovery" making
>the spending "wasteful").

Again - why wouldn't they just pay for it?

Because they couldn't afford to pay for it.

Some people really do carry health insurance as insurance against the unforeseen. It's is possible that one of them will have health insurance because they might need a hip replacement.

The concern is that you'll see private insurance (their option for paying for the hip replacement) crowded out of the marketplace. And that with no private insurance option to pay for it, they will be unable to pay cash up front.

It's going to be hard for private insurance companies to compete with the new government insurance company. Some of them will probably fail, since they lack the (virtually infinite) resources of their new competitor. Their failure could leave some people with the inability to acquire the private insurance they have now, but also unable to have a procedure approved by the government insurance (because it would be deemed wasteful to spend the money on someone with only 5 more years of expected life, or whatever).

-- Tom Aiello

Tom@SnakeRiverBASE.com
SnakeRiverBASE.com

[TomAiello 26]

Quote

Quote

In this scenario, my worry is that the chronically or terminally ill (or even just old and sick) will be unable to purchase the supplemental insurance, and will be denied coverage under the public system (due to low odds of "recovery" making the spending "wasteful").

Not to be cold, but that's how it has to be.

No it's not.

Under our current system, that (hypothetical) patient would have purchased private insurance, and be covered by it (hence they'd get there care).

My concern is that under a (again, hypothetical) government insurance system, they'd be unable to find private insurance coverage (because private insurers have been crowded out) , but would be denied by the government insurance (because they don't have enough expected life left).

In this hypothetical instance (which has to be hypothetical because we don't have any details to work from), it's possible that the new system would actually provide less care to someone--even though under the current system that person could pay for it.

-- Tom Aiello

Tom@SnakeRiverBASE.com
SnakeRiverBASE.com

[Bolas 5]

Have you looked at how many Medicare/Medicaid supplemental plans are out there already to cover "the gaps?"

The majority of the money those companies make is in billing back the government. If anything, they prefer bein the middlepeople as they stand to make alot more $$$.

Federalized health insurance for all would be the same way.

Let's take our hypothetical old person. She goes to her insurance company and gets the procedure done, paying her deductible and whatever %age for the $50K procedure (Out of pocket costs for her: $1000. The insurance company discovers that she is part Albanian and then discover that in the National Health Insurance bill, a rider was added to exempt Albanians from the age limit in honor of (blah blah)

They then collect the $50K from the gov't for the procedure. That procedure only actually costs them $15K.

They just made $36K on one procedure without even touching what this woman pays per month.

Health insurance companies are going to make huge $$$ if things are federalized.

Stupidity if left untreated is self-correcting
If ya can't be good, look good, if that fails, make 'em laugh.

[billvon 3,009]

>Because they couldn't afford to pay for it.

Which suggests that a "backup" system makes a lot of sense.

Any insurance system operates on a profit. That means that they take in less than they pay out. That's why most companies charge high premiums for 50 year old smokers and lower premiums for 20 year old athletes - because the 50 year old is, on average, going to require more care.

Right now we have an unofficial national health plan - just show up, get care and don't pay. Yet insurance companies remain in business by following the above plan. Switching that to a (very basic) official national health plan won't change that. Smart 20 year olds will still get health insurance for catastrophic injuries; they will subsidize the sick 50 year old smokers. When they're old and sick, their kids will subsidize them, just as they do now.

[kelpdiver 2]

Quote

Taking the human factor out, it doesn't make fiscal sense to give a hip replacement to an 85 year old person with government funding. If they can get their family, a charity, private insurance, etc. to pay, great.

And yet you wonder why many people would prefer to leave things as is? The devil you know beats the one you don't.

Not replacing a hip is effectively the same as killing the person. Once you lose mobility, the rest of your body fitness quickly disappears and the quality of life is terrible. You'd be just as kind to put a gun to their head and pull the trigger.

[futuredivot 0]

Quote

Again - why wouldn't they just pay for it?

Because there's only so many pennies in the jar and the more of my pennies you take away from me to give to someone that didn't make their own pennies is less I have to take care of my family.


Social med people should reaquaint themselves with the story of the The Ant and the Grasshopper and get the fuck over this entitlement bullshit.

You are only as strong as the prey you devour

[mnealtx 0]

Quote

Quote

Again - why wouldn't they just pay for it?

Because there's only so many pennies in the jar and the more of my pennies you take away from me to give to someone that didn't make their own pennies is less I have to take care of my family.


Social med people should reaquaint themselves with the story of the The Ant and the Grasshopper and get the fuck over this entitlement bullshit.

Didn't you get the memo? When you spread the wealth around, it's good for everybody - especially the grasshopper.

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[lawrocket 3]

Especially the grasshopper? How dare you?

The ants hoarded all the corn for themselves and the grasshopper is but a victim of the racist, sexist capitaoist system that uses cheap ant labor at the expense the grasshoppers, only to benefit the wealthy.

The worker ant should join forces with Comrade grasshopper and demand a fair wage. The grasshopper was merely on strike. The grasshopper passed out cards seeking to unionize the ants and has offered to bargain for the ants in exchange for a mere 2% of the corn.

The ants eventually buy into the grasshopper's populist message. Grasshopper demands ant healthcare, a raise, a cut of the corn, as well as a retirement program and an 8 hour work day. An agreement is reached, and those ants with more than 3 months experience get what they request. Those of less experience are laid off.

Locust moves in (on the recommendation of grasshopper) and, speaking with the ants, states that their brothers and and sister were victimized by the queen ant, and that to take care of their fellow ants who were victimized by the fascist queen, that they should tax the queen her corn, and take care of the less fortunate. Such a programs is a resounding success, for the queen could not defend herself from the worker and soldier attacks!

The brothers and sisters are offered jobs by a new queen. Convinced by grasshopper that there is no way that they can make a decent wage because of their inexperience, he gathers what corn he can from them and presents an offer to the queen for a New Deal to build the great society.

The queen, emaciated, has nothing left to give. The workers, however, are okay, though the economy is suffering from a shortage of corn. There is plenty in the fields, but the agreements provide that they shall only be collected during twilight hours. But not anymore - grasshopper has hired desperate ants on the side to collect the corn.

The grasshopper points to the policies of the queen that caused the environmental devastation. The ants, fed up with the queen, destroy her. The ants quickly die out.

Grasshopper, shaking his head at the supply of corn that will now last decades, mutters, "just like Europe..."

My wife is hotter than your wife.

[mnealtx 0]

The ant works hard in the withering heat all summer long, building his house and laying up supplies for the winter.

The grasshopper thinks the ant is a fool and laughs and dances and plays the summer away.

Come winter, the shivering grasshopper calls a press conference and demands to know why the ant should be warm and well fed while others are cold and starving. CBS, NBC, PBS, CNN, and ABC show up to provide pictures of the shivering grasshopper next to a video of the ant in his comfortable home with a table filled with food.

America is stunned by the sharp contrast. How can this be, that in a country of such wealth, this poor grasshopper is allowed to suffer so? Kermit the Frog appears on Oprah with the grasshopper, and everybody cries when they sing, 'It's Not Easy Being Green.'

Jesse Jackson stages a demonstration in front of the ant's house where the news stations film the group singing, 'We shall overcome.' Jesse then has the group kneel down to pray to God for the grasshopper's sake.

Nancy Pelosi, John Kerry & Harry Reid exclaim in an interview with Larry King that the ant has gotten rich off the back of the grasshopper, and both call for an immediate tax hike on the ant to make him pay his fair share.

Finally, the EEOC drafts the Economic Equity and Anti-Grasshopper Act retroactive to the beginning of the summer! The ant is fined for failing to hire a proportionate number of green bugs and, having nothing left to pay his retroactive taxes, his home is confiscated by the government.

The story ends as we see the grasshopper finishing up the last bits of the ant's food while the government house he is in, which just happens to be the ant's old house, crumbles around him because he doesn't work to maintain it.

The ant has disappeared in the snow. The grasshopper is found dead in a drug-related incident and the house, now abandoned, is taken over by a gang of spiders who terrorize the once peaceful neighborhood.

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[lawrocket 3]

Jesse Jackson? His racket is finished. I haven't heard a damned thing from or about the guy since I saw him sobbing on election night when Obama won.
We all knew why he was sobbing at seeing that a black man was elected. "My racket is over. I'm ruined. What will I do now?"

My wife is hotter than your wife.

[Bolas 5]

Quote

Jesse Jackson? His racket is finished. I haven't heard a damned thing from or about the guy since I saw him sobbing on election night when Obama won.
We all knew why he was sobbing at seeing that a black man was elected. "My racket is over. I'm ruined. What will I do now?"

He's only half black, it doesn't count...

Stupidity if left untreated is self-correcting
If ya can't be good, look good, if that fails, make 'em laugh.

[Zach 0]

I'm not taking a side (its actually kind of entertaining - you guys should argue using parables and nursery rhymes and shit more often) but aren't there both ants and grasshoppers somewhere in the middle who work hard and still end up disadvantaged? Sorry if my bug-talk isn't as clear as yours.

Zach

[billvon 3,009]

>Because there's only so many pennies in the jar and the more of my
>pennies you take away from me to give to someone that didn't make
>their own pennies is less I have to take care of my family.

Agreed. They're taking a lot of pennies from you now - we should make that system work a little better. However, letting that old woman die, to me, just isn't an option.

>and get the fuck over this entitlement bullshit.

If you can honestly tell me that you would let a friend of yours die instead of calling 911 - because you knew they couldn't pay their medical bills - I'll take that statement seriously.

[lawrocket 3]

Very few end up disadvantaged after merely working hard. I've known many (myself included) who worked hard and played hard - blowing what I had. People have a strange way of putting themselves at a disadvantage.

Or, failing to prepare. My wife and I have 19 insurance policies between us. What if I am in a car wreck. Vehicle and health insurance. What if I'm hurt really bad? I've got an umbrella policy. What if I can't work? 80% of my income is insured with a disability policy. If I die? Well, then, my family will have no debt and will have plenty left over.

It's meant that there has been a lot of fun I've missed out on. It's meant a lot of fun with my family.

My family will not be disadvantaged from ANYTHING because of me. They will have advantages I did not. This, however, gives me pause - my childhood of disadvantage and watching my parents work gave me an advantage. Will I deprive my kids of that?

Most adults who are disadvantaged end up that way through their choices. Not all. Most. And many will put their kids at that disadvantage.

Kids have no choice. Adults DO have a choice. With freedom comes responsibility. And we've perverted that concept to freedom being care-free. The responsible are enslaved to the will of others.

My wife is hotter than your wife.

[Bolas 5]

Quote

>Because there's only so many pennies in the jar and the more of my
>pennies you take away from me to give to someone that didn't make
>their own pennies is less I have to take care of my family.

Agreed. They're taking a lot of pennies from you now - we should make that system work a little better. However, letting that old woman die, to me, just isn't an option.

>and get the fuck over this entitlement bullshit.

If you can honestly tell me that you would let a friend of yours die instead of calling 911 - because you knew they couldn't pay their medical bills - I'll take that statement seriously.

Once again a bad example.

If a friend hurt themselves, you call 911, get them the ambulance or helicopter ride they need and to the hospital for treatment.

Many a skydiver without insurance has been hurt and his friends, family, and charities pitch in to help. Then again, they are generally much younger and probably have many productive years left.

In the case of the hypothetical old person, they'd have supplemental insurance, charities, family, or friends. If they've got none of those, sounds like they aren't going to be missed by anyone...

The other thing that needs to be looked at is quality of life. Personally, if I was in a really bad accident and permanently mentally and/or permanently severely physically injured, just let me go peacefully.

These are difficult calls to make but basic care criteria and goals need to established before any nationalized basic plan can even become a reality.

Stupidity if left untreated is self-correcting
If ya can't be good, look good, if that fails, make 'em laugh.

[SkyDekker 1,465]

Quote

That's supposed to make us want a Canadian style system?

People there have poor enough care that they go to another country to seek care if they are able to.

If that's not an indictment of the Canadian system, I don't know what is.

Silly argument. Medical Tourism is quite popular among Americans as well. Mostly because they can get a better level of care for a lower price.

[billvon 3,009]

>If a friend hurt themselves, you call 911, get them the ambulance or
>helicopter ride they need and to the hospital for treatment.

OK. So you call 911. You know your friend won't pay; he's told you this. He's going to use the current "health plan" of just going to the hospital and then not paying his bills.

Who should pay for his care? You? You're the first one who could deny him care (by not calling 911) and you said you wouldn't; most people along that chain, from first responder to ER doctor, are the same way.

>Many a skydiver without insurance has been hurt and his friends, family,
>and charities pitch in to help.

That's great! But often, those charities will not cover his bills. Again, who should pay for his care?

[Bolas 5]

Quote

>If a friend hurt themselves, you call 911, get them the ambulance or
>helicopter ride they need and to the hospital for treatment.

OK. So you call 911. You know your friend won't pay; he's told you this. He's going to use the current "health plan" of just going to the hospital and then not paying his bills.

Who should pay for his care? You? You're the first one who could deny him care (by not calling 911) and you said you wouldn't; most people along that chain, from first responder to ER doctor, are the same way.

>Many a skydiver without insurance has been hurt and his friends, family,
>and charities pitch in to help.

That's great! But often, those charities will not cover his bills. Again, who should pay for his care?

This is where payment plans come in. Not everyone skips out in their bills.

A neighbor of mine when her granddaughter was born there was complications and she was in the NICU for an extended time. No insurance. They worked out a plan with the hospital that the final payment would be made when she was 18.

Stupidity if left untreated is self-correcting
If ya can't be good, look good, if that fails, make 'em laugh.

[lawrocket 3]

I can't think of a better example of irresponsibility and an example of CHOOSING not to get health care.

20 jumps per month is a minimum of $500 just in lift tickets and commuting costs. Add gear, etc. And the costs get higher.

And people will spend money on jumps but not health care. Then they femur in. And get hit hard by costs.

We all end up paying for it. It just doesn't seem fair or just when someone who can afford skydiving (which aint cheap) won't get health insurance.

My wife is hotter than your wife.

[billvon 3,009]

>This is where payment plans come in. Not everyone skips out in their bills.

I agree. But even here in this forum, we had a poster suggesting just not paying hospital bills so they could better afford rent, food etc. This is common, and is the unofficial "national health care" plan that many people use nowadays.

You said you would call 911 for a friend of yours who couldn't pay. So would I, and I think most people would as well, even if they knew the guy would never pay, and would do whatever he could to "skip out" on his bills. Who pays for him?