Re: I spent most last evening listening to my "date" talk about politics.
I was in Canada a few years ago, and read an article in a Canadian newspaper. According to the article the Canadian health care system deals with women with problem pregnancies by sending them to the US for care, because Canada does not have doctors or medical facilities capable of providing care. You have to wonder what Canada will do when ACA causes US medical care to sink to its standards.
Re: I spent most last evening listening to my "date" talk about politics.
Quote:
Originally Posted by
Melonie
Again tossing in a couple of pertinent facts. Canadian taxpayers don't actually have to pay anything close to the actual cost for providing their National Health Care. This is because the Canadian gov't offsets a lot of those costs via money earned from royalties paid to the Canadian gov't for oil, natural gas, exported hydropower, mining of metals and minerals, lumber etc. The US gov'ts royalty earnings are just a tiny fraction of the Canadian gov'ts royalty earnings, and of course there are also 10 + times as many Americans as Canadians who would be consuming health care services.
U.S. per-capita gdp is approximately $53,000 compared to Canada, which is approximately $52,000, which includes income from oil, natural gas, and hydropower, so both countries have approximately the same amount of money per-person to spend on healthcare. The U.S. could just as easily afford a national healthcare system as Canada, or some other western country with universal coverage. The main issue in the U.S. is not the cost, but getting a consensus to agree on how to achieve universal coverage, and even if we should have universal coverage.
Re: I spent most last evening listening to my "date" talk about politics.
Quote:
Originally Posted by
eagle2
U.S. per-capita gdp is approximately $53,000 compared to Canada, which is approximately $52,000, which includes income from oil, natural gas, and hydropower, so both countries have approximately the same amount of money per-person to spend on healthcare. The U.S. could just as easily afford a national healthcare system as Canada, or some other western country with universal coverage. The main issue in the U.S. is not the cost, but getting a consensus to agree on how to achieve universal coverage, and even if we should have universal coverage.
That will be hard to do in this political climate. People have become accustomed to operating on the extreme ends of the two parties. Some smart people in my life are very willing to adopt the opinions of their favorite party without much thought. I consider myself to be conservative, but support universal healthcare paid by tax dollars, don't support how our military is being used (20 years USMC in MEU), and am pretty indifferent to gay marriage. My friends and family think I am a "lefty" lol. I think that is the bottom line, it's not about affording it it is about people don't want it because they don't.
Re: I spent most last evening listening to my "date" talk about politics.
Quote:
Originally Posted by
invibe
The topic aside, that is incredibly boring and lame lol. Props I guess for risking blowing it with you over an issue he has zero control or influence over? lol. What a player. Politics should go back on the list of impolite dinner conversation, ASAP.
Whenever someone wants to drag me into their $2 politics I can't resist poking holes in their beliefs. Don't try to convince me what the television told you is real and I won't question what the hell you mean by "supporting the troops", a.k.a don't question the foreign policy.
I hope I am reading this wrong but supporting the troops means you support the military NOT foreign policy. I don't support these wars but support the troops. I do this by collecting money and items for various military and just supporting. My brother is currently serving and I will admit I prefer military veterans over non veterans.
People that don't support the troops are assholes to be blunt. Often, the people who want to cut services for the military want to increase it for welfare and others. Those people are traitors.
Re: I spent most last evening listening to my "date" talk about politics.
Quote:
Originally Posted by
slowpoke
I was in Canada a few years ago, and read an article in a Canadian newspaper. According to the article the Canadian health care system deals with women with problem pregnancies by sending them to the US for care, because Canada does not have doctors or medical facilities capable of providing care. You have to wonder what Canada will do when ACA causes US medical care to sink to its standards.
That doesn't explain why they're #25 on best outcome after birth...while USA is down to #41. They're still doing better than USA overall.
Quote:
Originally Posted by
eagle2
U.S. per-capita gdp is approximately $53,000 compared to Canada, which is approximately $52,000, which includes income from oil, natural gas, and hydropower, so both countries have approximately the same amount of money per-person to spend on healthcare. The U.S. could just as easily afford a national healthcare system as Canada, or some other western country with universal coverage. The main issue in the U.S. is not the cost, but getting a consensus to agree on how to achieve universal coverage, and even if we should have universal coverage.
A healthcare system similar to the military could be implemented as a start up for a single payer system: administed at city/county level, managed by private entities, but with public funds. For those who complain about healthy people paying more, that could be balanced out by taxing certain things like junk food, soft drinks, tobacco, and other things people consume that can make their overall health worse, via progressive payroll taxes, a combination of the former and latter, and a tax credit to healthy individuals.
Quote:
Originally Posted by
Kellydancer
I hope I am reading this wrong but supporting the troops means you support the military NOT foreign policy. I don't support these wars but support the troops. I do this by collecting money and items for various military and just supporting. My brother is currently serving and I will admit I prefer military veterans over non veterans.
People that don't support the troops are assholes to be blunt. Often, the people who want to cut services for the military want to increase it for welfare and others. Those people are traitors.
There are plenty of areas in the defense budget that need to be cut. There is too much money wasted on defense that can be used elsewhere. Even if we cut about a third of the defense budget, our military will still be the #1 in the world by a huge margin, so wanting some sensitive cuts in the military budget is not being a traitor. The way a country treats their poorer and sicker individuals says a whole lot more about a country's outcome than ten Nimitz carriers, an upcoming Ford class carrier, and dozens of overseas bases, so yes, some money wasted in the DoD can go to fund things like colleges and research, and certainly to the underfunded VA...which is a different department from the DoD.
Things like golf courses and billion dollar contracts with the likes of Lockheed-Martin...not needed and should be cut. However, better training facilities for military personnel, more efficient healthcare software, a BAH reform based on time of service and not simply based on rank...are more needed than golf course #585993030.
Re: I spent most last evening listening to my "date" talk about politics.
Quote:
Originally Posted by
Jay12
There are plenty of areas in the defense budget that need to be cut. There is too much money wasted on defense that can be used elsewhere. Even if we cut about a third of the defense budget, our military will still be the #1 in the world by a huge margin, so wanting some sensitive cuts in the military budget is not being a traitor. The way a country treats their poorer and sicker individuals says a whole lot more about a country's outcome than ten Nimitz carriers, an upcoming Ford class carrier, and dozens of overseas bases, so yes, some money wasted in the DoD can go to fund things like colleges and research, and certainly to the underfunded VA...which is a different department from the DoD.
Things like golf courses and billion dollar contracts with the likes of Lockheed-Martin...not needed and should be cut. However, better training facilities for military personnel, more efficient healthcare software, a BAH reform based on time of service and not simply based on rank...are more needed than golf course #585993030.
I want to see things like wars cut and waste. However, things like pay for service people or things like that no I don't want to see cut. I believe that military are more important than say someone on welfare and would rather pay for medical for a private in the army than a welfare moocher who chooses not to work. Military are working, they deserve it.
I was referring to the people who think it's fine to attack military personnel and that they don't support the troops.Those people are definitely traitors and the military should be taken care of. Many people would rather spend money on people who don't work versus the military and that disgusts me. Contrary to what many think, those at the bottom of the pay scale don't make shit. Sure, everything is paid for but we can say the same about people on welfare. Those at the top are paid well but not talking about them. This is not the same thing as cutting money on weapons and tanks or things they don't need now.
Re: I spent most last evening listening to my "date" talk about politics.
Quote:
U.S. per-capita gdp is approximately $53,000 compared to Canada, which is approximately $52,000, which includes income from oil, natural gas, and hydropower, so both countries have approximately the same amount of money per-person to spend on healthcare
Again injecting some factual info ...
GDP has little to do with actual cash flows, since it includes the spending of borrowed money. Thus attempting to use GDP as a basis of comparison equates actual earnings with the taking on of additional debt ... which only 'appears' to be equivalent if that additional debt never needs to be paid back.
Canada's govt spent about $10 billion in borrowed money last year, comprising about 1/2% of Canada's total economy. Thanks to tax increases, the US gov't 'only' spent $492 billion in borrowed money last year comprising about 2.8% of the US economy. In recent years the US gov't spent from 4.1% to 9.8%, with the latter attributable to the 2009 'stimulus'.
Or put another way, attempting to use GDP as a yardstick attempts to equate 'affordability' for a person earning $49,500 per year who also borrowed $500 for credit card spending, with a person earning $45k per year who also borrowed and spend another $5,000 as down payment a new car. In the current year, they both 'spent' the same amount of money. But in future years, the $4,500 earnings gap is aggravated even further by the size difference between a miniscule credit card payment versus a sizeable car payment !!! Thus the person with higher actual earnings and lower actual debt is FAR better positioned to take on additional future expenditures.
The point is that of one takes the spending of additional borrowed money out of the equation, Canada has significantly higher per capita cash flow available to fund the costs of current year benefits.
Re: I spent most last evening listening to my "date" talk about politics.
This is off topic, but I just have to say that this is the most civil discussion of domestic policy I've ever seen on the internet between individuals who disagree. I love stripperweb. The people here are awesome!
Sorry for the interruption. Please return to your regularly scheduled conversation.
Re: I spent most last evening listening to my "date" talk about politics.
Quote:
Originally Posted by
Kellydancer
I hope I am reading this wrong but supporting the troops means you support the military NOT foreign policy. I don't support these wars but support the troops. I do this by collecting money and items for various military and just supporting. My brother is currently serving and I will admit I prefer military veterans over non veterans.
People that don't support the troops are assholes to be blunt. Often, the people who want to cut services for the military want to increase it for welfare and others. Those people are traitors.
Lol, this is so OT. Ah well. Your interpretation of what I meant is interesting. There was another similar reply, so I'll address it.
I am a recently retired Marine. I have done it all from humanitarian missions to the obvious combat missions. I have spent most of my adult life on deployment or getting ready for one. I don't need to elaborate further on that point.
The support the troops actually need is for the people to scrutinize how and why they are being used. Not that care packages and the appreciation that people show isn't great, it is. At the same time, the military doesn't need to be the target of a Facebook like fest campaign, or a subject for somebody's bumper sticker collection. It is sort of helping them through adoration, which is an empty gesture. We are talking real life and death stuff here, not about making people feel good.
What we really need is for people to wake up to the fact we are in the longest, most expensive war in U.S. history. We will have folks retire from the military having spent their entire career in this aftermath war of 9/11. I personally know a few. The original objective is complete, and was really most appropriate for strike groups and the special forces units all along (get in, hit the target, leave). Unfortunately by occupying and destabilizing the region for so long, we planted the seeds for a potentially worse group of scum that we are going to have to stick around and clean up our mess or worse will be back when our kids are 18.
Meanwhile people who just don't get it are eager for us to jump in with our military on any pissing match. Sometimes just because they are offended that we might look "weak", a strong president would send in the Marines! The problem with that slogan is that it means exactly that to a lot of people. Support using the troops. The 19yr old kid that gets his head blown in half on patrol by a pissed off uneducated goat farmer half way across the world in a place you can't pronounce or find on a map did not uphold your freedoms. He followed orders and made sacrifices every day that lead up to that point on your behalf, because that is his job. You owe him the dignity of using your freedoms to make sure his mission was worth it.
The condensed diatribe.
Re: I spent most last evening listening to my "date" talk about politics.
Quote:
Originally Posted by
invibe
Lol, this is so OT. Ah well. Your interpretation of what I meant is interesting. There was another similar reply, so I'll address it.
I am a recently retired Marine. I have done it all from humanitarian missions to the obvious combat missions. I have spent most of my adult life on deployment or getting ready for one. I don't need to elaborate further on that point.
The support the troops actually need is for the people to scrutinize how and why they are being used. Not that care packages and the appreciation that people show isn't great, it is. At the same time, the military doesn't need to be the target of a Facebook like fest campaign, or a subject for somebody's bumper sticker collection. It is sort of helping them through adoration, which is an empty gesture. We are talking real life and death stuff here, not about making people feel good.
What we really need is for people to wake up to the fact we are in the longest, most expensive war in U.S. history. We will have folks retire from the military having spent their entire career in this aftermath war of 9/11. I personally know a few. The original objective is complete, and was really most appropriate for strike groups and the special forces units all along (get in, hit the target, leave). Unfortunately by occupying and destabilizing the region for so long, we planted the seeds for a potentially worse group of scum that we are going to have to stick around and clean up our mess or worse will be back when our kids are 18.
Meanwhile people who just don't get it are eager for us to jump in with our military on any pissing match. Sometimes just because they are offended that we might look "weak", a strong president would send in the Marines! The problem with that slogan is that it means exactly that to a lot of people. Support using the troops. The 19yr old kid that gets his head blown in half on patrol by a pissed off uneducated goat farmer half way across the world in a place you can't pronounce or find on a map did not uphold your freedoms. He followed orders and made sacrifices every day that lead up to that point on your behalf, because that is his job. You owe him the dignity of using your freedoms to make sure his mission was worth it.
The condensed diatribe.
Like I said I don't support these wars but do support the military. I am out there everyday collecting food for homeless vets and actually doing something for them because our government does not. We have many current politicians (of both parties)who want to cut things like education for them or money to help them live. In fact many politicians have been wanting to decrease veterans benefits to help people undeserving, like illegals. That is wrong (and illegals deserve none of our money).
Re: I spent most last evening listening to my "date" talk about politics.
I still don't comprehend how the single biggest factor in this discussion, is always left out of the discussion. It was largely ignored during the years leading up to the creation of the disaster that is the ACA, and it's usually left out of discussions of the implementation and effects of said legislation.
Industry profit.
The ACA did almost nothing to curtail the idea that anything medical needs to cost a small fortune, and that companies in the field are somehow entitled to massive profits. To whit -
Health insurance companies are a drain on the whole system - they need to cover their own costs and make a profit, while taking money from people and paying it to hospitals. Do away with them and set it up so that everyone's contribution goes to the government, and the government pays for all healthcare - bam, you just freed up a few hundred billion dollars.
Big pharma - profits run into the TRILLIONS of dollars. if they posted a profit of ONLY a few BILLION a year, you just freed up a few hundred billion dollars.
Medical devices - an MRI costs $1,700 because an MRI machine costs $2 million+ and they want to recoup that expense. Look at the profits posted by the comanies that build these things. It's insane. And teh comissions that are paid to the people that sell them - they make as much as the surgeons that use them. There's a few billion more that could be pulled back into payers pockets.
Medical professionals - I'm not saying that they don't deserve to make good money. They do. But I know doctors that make over $400,000 a year working less than 25 hours a week. Surgeons at the top of their field make millions, and perform a few surgeries a month. Hospital administrators and other staff make exorbitant salaries and get huge bonuses. Again - I'm all for people making money, but there's a few billion more that can reduce premiums.
There are two sides to making care affordable. So far, all the plans have been to reduce the perceived cost to premium payers, while protecting the trillion dollar profits of the industry. This doesn't make sense,
Re: I spent most last evening listening to my "date" talk about politics.
I agree with that but there are many reasons for that. For example, a doctor spends lots of time in school and taking out debt so they should be paid a lot. The equipment costs a lot too. We could lower doctor fees by bringing in more foreign doctors but many come from countries with lower standards and even so they charge the same. We could make student loans cheaper and all of that but that'll take time.
Re: I spent most last evening listening to my "date" talk about politics.
^^^ again, sticking with the financial aspects of the discussion, your statements are true on the surface ... but ...
- Your claim about health insurance companies financing health care versus the gov't financing health care is a bit disingenuous. It's entirely possible for a particular gov't agency to operate at a 'profit' ... with the proceeds simply being thrown into the general gov't fund to offset some other gov't agency's loss. Both insurance companies and gov't run health care must pay interest to borrow money ( although the gov't can often get away with paying a few points less ). Both have overhead costs for evaluating health care need claims, for processing payments, etc. Thus in real world terms, the main differences between private sector health care versus gov't run health care are that A. with private sector health care 'consumers' have ( or had ) a choice regarding how much they wanted to spend versus how much 'coverage' they wished to receive, B. with private sector health insurance the investors lose if bad business decisions are made, whereas with gov't run health care the taxpayers lose if bad business decisions are made, and C. with private sector health insurance, gov't subsidies for poor and/or very sick Americans are 'transparent' ( covered under separate programs like Medicaid or 'High Risk Pool' subsidies ), whereas with gov't health care such subsidies are 'opaque'. A last difference is that with private sector health care, if a person chooses not to participate they aren't forced to pay a stiff 'penalty', only forced to pay 100% of their own uninsured medical bills ( or file for bankruptcy ).
- On the topic of big pharma profits, medical device maker profits, etc., the unmentioned 'joker in the deck' is R&D risk. Many drug companies invest heavily into the R&D of new drugs, and many medical device makers invest heavily into the R&D of new medical devices. Sometimes those investments pay off big time ( resulting in large company / investor profits ) ... but sometimes they don't ( potentially bankrupting the company and inflicting heavy losses on it's investors). The 'cost minimizing' approach favored by most gov't run health insurance systems is for particular drug companies and medical device manufacturers to stop investing in R&D, and to simply seek the lowest cost ( often offshore ) environment in which to produce already formulated drugs or already designed medical devices which can in turn be sold at the lowest possible prices. Yes this saves money from day one. However, it runs the risk that ... as 'germs' evolve ... today's already formulated drugs will no longer be effective in the future, but new drugs will not have been researched and developed to take their place. It runs a similar risk that, as technology evolves, that technology won't be applied to develop future medical devices ( which could potentially restore vision, potentially overcome paralysis etc. ) The alternative, of course, is for the gov't to fund drug and medical device R&D using additional taxpayer money. Arguably this doesn't result in any actual cost savings, but simply obscures total health care costs via spending taxpayer money to fund R&D out of a different 'gov't pocket' ( state university budgets, gov't agency grants, etc. ).
- in regard to medical professionals, indeed there are a few 'rock star' doctors out there who earn MAJOR bucks - thanks to extraordinary talent / skills. This is not going to change under gov't health care, because those doctors are simply not going to accept a gov't mandated X dollars per procedure as payment. Instead they will operate outside the system, charging as much as they want to 'self-pay' patients. The end result will be that the 'rich and famous' will be the only ones with the financial means to access such 'top shelf' doctors and facilities, while people relying on the doctors who are willing to accept a gov't mandated X dollars per procedure as payment will ultimately get 'their money's worth' ( as was pointed out earlier, typically foreign doctors who do not have student loan debt burden and who consider <= $100,000 per year to be 'good money' ). This 'two tier' medical system has evolved to a large degree in Europe already ... and has already started to evolve in regard to ACA health insurance partner 'network provider' doctors and hospitals in the USA. And beyond the 'two tier' system's doctors, you also have a significant number of competent doctors who don't have 'rock star' status thus can't cash in on rich and famous 'self-pay' patients, but who also have too much 'overhead' ( student loan debt, private practice equipment loans etc. ) to economically 'survive' on the gov't mandated X dollars per procedure payments. The future 'fate' of those 'middle class' doctors is unknown at this point ... as is the future 'fate' of many would-be US med students attempting to balance 6 years * $50k+ per year tuition costs plus 2 year's worth of 'slave labor' ( internship ) against a possible future scenario where their gov't mandated earnings potential will be limited to <= $100,000 per year.
- indeed it might be possible for the US to come up with alternate means to fund the tuition costs of future US educated doctors. Some of that structure exists already ... in the form of recently announced 10 year student loan forgiveness programs for graduates who ( directly ) work for the gov't. In the health care field, this provides a 'competitive advantage' for gov't run hospitals, and a strong financial incentive for new / recent med school graduates to accept positions as employees at gov't run health care institutions versus private hospitals or establishing their own medical practices. However, it also represents a significant health care related additional expense for US taxpayers ( who must pay for the 'forgiven' student loan amounts ) ... which again won't be directly accounted for as additional health care related costs since it will be spent out of a different 'gov't pocket' ( i.e. FAFSA ).
Also, going way back to the OP's original questions, this tidbit hit the mainstream news wires today ... . As health care economist Dr. Gruber pointed out in the link story, funding mechanisms for the ACA are far from 'transparent', by original design.
Re: I spent most last evening listening to my "date" talk about politics.
^^
I heard about that. I want to punch that guy. That reminded me of the "47%" comment that Mitt Romney made in 2012.
Re: I spent most last evening listening to my "date" talk about politics.
Quote:
Originally Posted by
Melonie
Again injecting some factual info ...
GDP has little to do with actual cash flows, since it includes the spending of borrowed money. Thus attempting to use GDP as a basis of comparison equates actual earnings with the taking on of additional debt ... which only 'appears' to be equivalent if that additional debt never needs to be paid back.
Canada's govt spent about $10 billion in borrowed money last year, comprising about 1/2% of Canada's total economy. Thanks to tax increases, the US gov't 'only' spent $492 billion in borrowed money last year comprising about 2.8% of the US economy. In recent years the US gov't spent from 4.1% to 9.8%, with the latter attributable to the 2009 'stimulus'.
Or put another way, attempting to use GDP as a yardstick attempts to equate 'affordability' for a person earning $49,500 per year who also borrowed $500 for credit card spending, with a person earning $45k per year who also borrowed and spend another $5,000 as down payment a new car. In the current year, they both 'spent' the same amount of money. But in future years, the $4,500 earnings gap is aggravated even further by the size difference between a miniscule credit card payment versus a sizeable car payment !!! Thus the person with higher actual earnings and lower actual debt is FAR better positioned to take on additional future expenditures.
The point is that of one takes the spending of additional borrowed money out of the equation, Canada has significantly higher per capita cash flow available to fund the costs of current year benefits.
U.S. per-capita gdp is approximately 2% higher than Canada's, so even if you excluded what the government borrowed, there's still not much difference. Germany's per-capita gdp is approximately $45,000 and France's is approximately $41,000, and both countries are able to provide health insurance for all of their citizens. The state of Massachusetts is able to insure close to 100% of the state's residents. The U.S. easily has the means to insure all U.S. citizens, but there are a number of people who oppose this for one reason or another, which is why we don't have universal coverage. The ACA which significantly increases the number of Americans with coverage, but still doesn't cover everyone, just barely passed Congress.
Re: I spent most last evening listening to my "date" talk about politics.
It's really a question of cost. The government doesn't pay for healthcare in any country with universal healthcare. The taxpayers pay. And they pay through higher taxes.
As an employer, I lean toward the single payer plan deals where the employer pays a simple 8% of wages as a healthcare tax, just like I pay FICA, FUTA and SUTA taxes now. I could live with a system like workers compensation where each employer is charged a premium based on experience and risk. But, that would probably be more expensive. Still, It would work for my company. The current U.S. system is expensive and doesn't provide all that much result for the cost.
Z
Re: I spent most last evening listening to my "date" talk about politics.
The reason why many oppose it is because of the people who don't pay in or shouldn't be here. Let's not forget the countries with universal healthcare are also usually smaller.
Re: I spent most last evening listening to my "date" talk about politics.
I understand what you're getting at Melonie, but I must respectfully call shenanigans on your rebuttals.
- Private insurance companies serve no purpose in the system other than as a financial parasite. Sure, the government isn't exactly a paragon of doing things efficiently, but at least I'm not watching them drive off in Maybachs while dying of an ailment because my coverage cap for the year was reached. Of course there's overhead - but it can be minimized. As fucked up as medicare is, it's one of the best run medical systems on earth. Overhead is minimal and the system is run pretty well. Compare that to an HMO with massively increased overhead, that screws it's members every chance it gets because they run a CBA on every medical decision.
- R&D costs are largely offset with government grants already, lol. Researchers are some of teh few genuine people left in the world - research won't stop just because we reduce the ability of the executives to buy private jets. If R&D is such a risk, why does bug pharma post profits in the TRILLIONS of dollars, even after all these class action settlements?! Speaking of which, once we eliminate the ass-covering factor inherent in protecting stock values, maybe meds will start being prescribed correctly instead of abusively (antidepressants, anyone?).
- So the "rock star" doctors go do what they do. Big deal. There are plenty of people willing to become doctors for $150k/year instead of $300k/year. The governemtn is already full of VERY talented lawyers making a fraction of what they could make in the private sector - I know, my father is one of them. Top 5 in the nation in his field, makes a comfortable living on his governemnt salary but less than 1/4 of what he'd make in the private sector. He took a couple years off a while back and made double his normal salary on one consulting gig. Went back to his government job to retire anyway. He's not alone. The jobs would get filled. Besides - many of those rock star doctors are ALREADY catering to wealthy private pay clients. Now let's talk about those million dollar per year administrators, lol. Plenty of very efficient government bureaucrats willing to take that gig for a fraction of the money.
On a personal political note, I'm completely against governemtn run anything. I believe not in small government, but in TINY government. But in this case, the private sector has had their chance, and shown their desire to put profit above the public well being (literally). Time to take away their allowance.
Re: I spent most last evening listening to my "date" talk about politics.
^^^ and for the record, I'm not attempting to defend insurance company execs with 7 figure paychecks. But in terms of overall use ( or misuse ) of health care funds, between payroll and employee benefit costs, there's no question that 100,000 gov't workers administering health care benefits are going to cost more than 100,000 private sector workers. So in the end, even though a comparative handful of insurance company higher-ups are knocking down huge paychecks, the total dollar situation probably isn't much different.
In regard to 'dying of an ailment because an annual coverage cap was reached', in fact the ACA provides for something similar. However, instead of a hard and fast dollar limit ( which the ACA has now outlawed ), decisions regarding whether or not particular expensive treatments will be covered will be made by an Independent Payment Advisory Board consisting of political appointees. While mainstream media reports of the IPAB have been vitriolic, the fact remains that the IPAB has the authority to approve expensive treatments for some, while denying expensive treatments for others, based on criteria that are as yet unpublished.
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It's really a question of cost. The government doesn't pay for healthcare in any country with universal healthcare. The taxpayers pay. And they pay through higher taxes.
Certainly true for the USA. However, certain countries like Canada, Denmark etc. do receive a large amount of funds by mechanisms other than taxing their citizens ... i.e. sales of oil, gas, minerals etc. from gov't lands. The additional funds certainly don't cover the costs of national health care by any means, but they do reduce the amount of tax burden their citizens would otherwise have to bear.
Quote:
The reason why many oppose it is because of the people who don't pay in or shouldn't be here. Let's not forget the countries with universal healthcare are also usually smaller.
Actually, the key issue isn't the size of the country, but the proportion of the country's residents who are 'productive' ... thus actively contributing toward the costs of national health insurance. As previously discussed in regard to the Scandinavian countries, besides high individual tax rates, a key component to funding their national health care system is the fact that these countries do not have a significant proportion of 'non-productive' residents, and will not allow 'non-productive' residents of other countries to enter their countries and subsequently collect national health care benefits.
This is an area where the USA faces major problems, given that 47% of 'working age' Americans are not required to pay income taxes ( net of tax credits ). It is expected that a similar situation will develop in regard to not paying the new IRS 'tax penalty' for failure to purchase ACA 'qualified' health insurance ( since the amount is ratio-ed to income, and since other 'tax credits' can be used as offset ). A Rand Corporation study of 2014 ACA sign-ups showed that ~80% of sign-ups were by residents who were either eligible for 'free' health insurance coverage under expanded Medicaid, or were eligible for low income based 'discount' insurance premiums, or had expensive to treat pre-existing conditions thus making all ACA premium levels a 'discount' ... all of which must be funded by healthier, higher earning taxpayers. Simple logic then dictates that, given the 47% who aren't 'paying their own way', each higher earning US taxpayer must essentially pay the costs of their own health care, PLUS pay the costs of health care for another 'non-productive' / low income / seriously ill resident.
Ironically, for higher earning American dancers, camgirls, escorts etc., there is another option. They can elect NOT to pay for their own ACA health insurance coverage. However, via the new 1-2-2.5% IRS 'penalty tax', they will still be required to pay ( some portion of ) the costs of health care for a 'non-productive'/ low income / seriously ill resident !
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I heard about that. I want to punch that guy. That reminded me of the "47%" comment that Mitt Romney made in 2012.
I'm reluctant to 'touch' this observation with 'someone else's 10 foot pole'. However, in fairness, they do share a couple of things in common. Both were intended for a very specific audience ( in Gruber's case a room full of politicians and academics, and in Romney's case a room full of political donors ). And both cited economic 'truths' ( in Gruber's case the fact that young, healthy, higher earning Americans must bear the brunt of ACA insurance costs on behalf of older / sicker / low income beneficiaries, and in Romney's case the fact that spending campaign funds for outreach to black / low income communities was not going to result in significant additional votes for Romney ) that don't 'play well' with mainstream media.
The pertinent issue where Gruber and this thread are concerned, of course, is his acknowledgement that the economic realities of the ACA were 'deliberately' obscured ... because if those economic realities had been fully disclosed the ACA could never have been passed. And, as also mentioned earlier, 2015 will be the first time that most American individuals will actually begin to 'discover' the ACA's personal cost consequences ... either via having to pay the new IRS 'penalty tax' for the first time, or via having to pay notably higher ACA or employer provided health insurance premiums.
Re: I spent most last evening listening to my "date" talk about politics.
... and, by sheer coincidence, USA Today just published an example of some 'indirect' economic effects of the ACA ... from
(snip)Since the beginning of 2010, 43 rural hospitals — with a total of more than 1,500 beds — have closed, according to data from the North Carolina Rural Health Research Program. The pace of closures has quickened: from 3 in 2010 to 13 in 2013, and 12 already this year. Georgia alone has lost five rural hospitals since 2012, and at least six more are teetering on the brink of collapse. Each of the state's closed hospitals served about 10,000 people — a lot for remaining area hospitals to absorb. ***
There's a "golden hour" after heart attacks, trauma and stroke in which treatment is needed to prevent loss of heart muscle and brain tissue, says Janis Orlowski, chief medical officer for the Association of American Medical Colleges.
With just two ambulances, which are often tied up making the average 90-mile round trip to the nearest hospital [ since the local rural hospital closed - sic ], "We're pretty much shot around here with the golden hour," says Ed Lynch, Stewart County's director of emergency medical services.***
But rural hospital officials and others say that federal regulators — along with state governments — are now starving the hospitals they created with policies and reimbursement rates that make it nearly impossible for them to stay afloat.
Low Medicare and Medicaid reimbursements hurt these hospitals more than others because it's how most of their patients are insured ***
County and town council members, hardly health care experts, are faced with life or death (or least injurious) decisions on whether to raise taxes in poor towns and counties that depend on their hospitals for care as well as good jobs. ***
Change, including a move to costly electronic health records required under the ACA, can be difficult, and Burwell says HHS will "work to incorporate feedback" from rural hospitals on how it's going.
"Transition takes time," she said.
But the $1 million or more it was going to cost to change over to electronic records was one of the last straws for Randy Stigleman, former owner of Stewart-Webster. Efforts to sell the hospital never panned out ***
Even if they aren't regularly filling their beds, rural hospitals are typically among the largest employers in their areas. Stewart-Webster, with its 75 employees, was only topped by a large immigrant holding prison. Once a hospital closes, it usually takes other businesses with it — and thwarts efforts to attract more, city and county officials say.
Richland Mayor Adolph McLendon says two dollar-type stores in town closed, and the local Subway shop left, since the hospital shut down. ***
officials repeatedly describe a "perfect storm" of cuts in reimbursement and tougher regulations under ACA, especially those that penalize them when they have to re-admit patients and require them to use electronic health records. ***
The day before USA TODAY visited Elbert Memorial Hospital in Elberton, Ga., this fall, the hospital had to borrow $200,000 from a hospital partner so it could make payroll. A month earlier, after contentious debate — and an ER visit for heart attack symptoms by a council member — the county council voted to pass a $500,000 property tax increase to fund the hospital. (snip)