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Many See I.R.S. Penalties as More Affordable Than Health Insurance

nytimes.com

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Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#251

Post by DrScump »

fpgeek wrote: post #153
lotsofpulp wrote: post #84

Earlier quoted context omitted.

Yes, it's funny to me how so many educated adults are in this conversation, when the problem is mostly political. On one hand, you have a population that believes that no one should be left to die if they show up at a hospital (probably due to their religion and whatnot). A significant portion of the same population also believes that everyone should stand on their own two legs and that offering healthcare to all via…

> On one hand, you have a population that believes that no one should be left to die if they show up at a hospital (probably due to their religion and whatnot). Or out of simple self-interest. Having health insurance doesn't guarantee you'll always show up at an ER capable of demonstrating to the hospital's satisfaction that you are insured, with the necessary documentation (e.g. after a car accident or a mugging).

by law, emergency care has to be provided without regard to the patient's proof of ability to pay.

This is part of why so many emergency rooms close.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#252

Post by zeckalpha »

Vendan wrote: post #175
stvswn wrote: post #133

Earlier quoted context omitted.

It's was pretty easy to predict: allowing enrollment after a diagnosis was politically popular but a terrible economic disincentive to not buy insurance (because at that point, it isn't insurance -- it's a subscription plan for your treatments). The young and healthy needed to enroll for the economics to work, but the individual mandate was delayed for years -- because coercion isn't popular politically, and there wa…

"I don't think the role of government is to take care of you, because it isn't the government taking care of you. It's the government coercing others to take care of you, against their will." The government does a lot of coercing people to do things against their will. That's why we have police, court systems, jails, and so on. Heck, we've had drafts! That's literally coercing young men to march headfirst into combat…

"... to secure these rights, Governments are instituted ..."

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#253

Post by peckrob »

yks wrote: post #247
peckrob wrote: post #231

Earlier quoted context omitted.

Random personal anecdote. When I was a teenager, my family took a trip to Europe. This was summer of 1999, IIRC. Anyways, near the end of the trip, when we were in Italy, my dad came down with a cough and sore throat. Rather than try to gut it out for another week and then have to fly back to the US sick, we decided to try to find a doctor. After consulting with the front desk at our hotel, we were directed to a smal…

When I first started reading about American health care being a foreigner I saw a persistent argument that in single-payer system "people will die in lines". Yet here in the United States the lines in medical institutions are greater than anything I've seen abroad, open slot for appointment with a doctor in one month is a usual deal. And why can't I buy antibiotics without a prescription. Don't I have a right to heal…

> When I first started reading about American health care being a foreigner I saw a persistent argument that in single-payer system "people will die in lines".

This is one of the reasons I really wish international travel was within the reach of more Americans. So more people could observe and experience these other systems - not having to be told about them secondhand by commentators with their own agendas. Not just healthcare, either. Just knowing a bit about how other people live their lives and how things work in other countries is enormously enlightening.

That trip to Europe was one of the most pivotal experiences of my life so far. I learned so much about the rest of the world that coming back to the US after spending a few weeks overseas, everything looked completely different to me. It ignited a lifelong love of travel - one that I hope to share with my daughter as soon as she's old enough to accompany us.

> Yet here in the United States the lines in medical institutions are greater than anything I've seen abroad, open slot for appointment with a doctor in one month is a usual deal.

I live in a mid-sized city. If I need to see a routine general practice doctor for a typical problem (coughs, etc.) I can usually be seen the same day, but I'll probably have to wait a 2-4 hours depending on when I go.

But if I need to see a specialist (allergist, dermatologist, sleep doctor, etc) and it's not a life-or-death emergency, it's usually a 6-week wait for an opening. My only other option is to drive 2 hours away to the next (bigger) city that has a medical school and a large concentration of doctors. Sometimes you can get an appointment in a few days if you're willing to drive.

> And why can't I buy antibiotics without a prescription. Don't I have a right to heal myself?

As someone who suffers from recurrent throat infections at least once a year, YES. Some people in the survivalist and "prepper" communities say you can take "fish antibiotics" but I've never been willing to risk my health over stuff I read on the Internet from questionable sources.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#255

Post by DrScump »

magicalist wrote: post #97
gscott wrote: post #2

I work with someone who has health insurance from the California exchange. His assigned doctor is about a 2 hour drive away. Maybe he has picked the cheapest plan but such a situation shouldn't really happen if this was well run.

FWIW as of 2015 California requires there be "primary care network providers with sufficient capacity to accept covered persons within 30 minutes or 15 miles of each covered person's residence or workplace", specialists within 60 minutes or 30 miles, and that there be sufficient capacity for doctors within those limits to accept new patients[1]. Getting that enforced isn't easy, but that situation not only shouldn't…

  Getting that enforced isn't easy
How is that even possible? How does the state mandate that some random provider step in and subsidize higher payments to providers in order to encourage them to take on more new patients?

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#256

Post by nickff »

humanrebar wrote: post #170
stvswn wrote: post #133

Earlier quoted context omitted.

It's was pretty easy to predict: allowing enrollment after a diagnosis was politically popular but a terrible economic disincentive to not buy insurance (because at that point, it isn't insurance -- it's a subscription plan for your treatments). The young and healthy needed to enroll for the economics to work, but the individual mandate was delayed for years -- because coercion isn't popular politically, and there wa…

> This would be politically disastrous -- "we know the plans are expensive, but it will be even more expensive to not get one!" isn't a great selling point. IANAL but it's my understanding that the individual mandate only passed Constitutional muster because it was not punitive. If it were a penalty or crime instead of a tax, the legal interpretation might change. Then again, the Supreme Court had been all over the p…

It passed constitutional muster because the Supreme Court (specifically the Chief Justice) is unwilling to wade into this particular political morass. This was not the first decision which has been made by post-hoc rationalization because of magnitude, political significance, side effects, and judges' policy preferences, but it is one of the most notable.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#257

Post by nateabele »

jhulla wrote: post #4

Personal experience with ACA: As of 2016, we're onto our 3rd insurer. Each prior one has dropped our local doctors, physicians groups and hospital. With each insurance change, our deductible has gone up, our premium has increased and our co-pay, co-insurance has increased. In effect, our ACA plan has become an extremely expensive catastrophic insurance plan.

From mid-2014 to early 2015, my premiums went up from ~$450 to over $1400, and the deductible increased from $5000 to $10k. This was with a single provider (BlueCross) in Pennsylvania. After the final increase I switched to an ACA-tax-exempt insurance alternative, and I no longer carry regular insurance.

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#258

Post by Vendan »

nickff wrote: post #188
Vendan wrote: post #175

Earlier quoted context omitted.

"I don't think the role of government is to take care of you, because it isn't the government taking care of you. It's the government coercing others to take care of you, against their will." The government does a lot of coercing people to do things against their will. That's why we have police, court systems, jails, and so on. Heck, we've had drafts! That's literally coercing young men to march headfirst into combat…

And many people believe the draft is morally equivalent to slavery (which they do not support either).[1] [1] http://gregmankiw.blogspot.ca/2006/11/rangel-and-friedman-on...

That's fine, I personally don't support the draft, but still. What about the legal system? Don't you see there is a problem with forcibly locking a portion of our population away behind bars? After all, that's what the government does, "for your own safety". Do you really feel safe in a country where the government can decide that murder is a "crime" for which you should be inhumanely LOCKED AWAY FOR LIFE?

P.S. Extreme sarcasm above...

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#259

Post by Vendan »

zeckalpha wrote: post #252
Vendan wrote: post #175

Earlier quoted context omitted.

"I don't think the role of government is to take care of you, because it isn't the government taking care of you. It's the government coercing others to take care of you, against their will." The government does a lot of coercing people to do things against their will. That's why we have police, court systems, jails, and so on. Heck, we've had drafts! That's literally coercing young men to march headfirst into combat…

"... to secure these rights, Governments are instituted ..."

it's almost like our government is supposed to "establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare", right?

Re: Many See I.R.S. Penalties as More Affordable Than Health Insurance

#260

Post by dzeanah »

mgkimsal wrote: post #76
Frondo wrote: post #67

Earlier quoted context omitted.

When I read this stuff, I'm a little astounded about how bad the situation must be in other states. Here in the Pacific Northwest, my premiums have actually been going down and the plan offerings are getting better. The provider I was on did go out of business so I had to switch, and I'm now paying less for more services. And, to be totally frank, having had a pre-existing condition that kept me from buying any insur…

Yeah, it's pretty crappy in NC. First year of ACA we only had one company even offering any insurance in my county. And yeah, it's county-based for some reason - if I lived 2 miles in another direction I'd have had multiple options about 10-15% cheaper than what I had available. Second year we had another option in our county which was about 15% higher than BCBS (which had gone up about 25% from the year before). App…

> Apparently some/much of this has to do with our state choosing to opt out of dealing with increased medicaid funding, so... yay... I guess they get to show obama how bad ACA is by... digging in their heels while we all just pay insanely increasing pricing?

Let's be fair here. The ACA said that the feds would match the expanded medicaid enrollment for a few years, but after that the states would need to continue to sustain the larger enrollment on their own. Medicaid is a significant chunk of state budgets, and doing that meant raising taxes, or lowering expenses in other areas, or taking on debt.

It's not as simple as "screw obama, and screw poor people we ain't doing it." In the post-crash years, while money was scarce, there was some real concern over where the money would come from, how much it would need to cost, and how states would cope.

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