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

nytimes.com

371–380 of 383 posts

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

#371

Earlier quoted context omitted.

You have coverage , but having care is a little different. For each of those features, do you have local providers who are willing to take on new patients and provide that care at the offered reimbursement rates? In much of CA, the answer is no.

For me in SF, it hasn't been an issue. We are PPO blue shield which everyone takes.

SF proper has Healthy SF public coverage as well.

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

#372

Earlier quoted context omitted.

In CA, that's not the case. Our insurance went up maybe $50/person, but we got mental health care, acupuncture, and various other benefits we didn't have before. Oh and we have pre-existing conditions that would prevent us from being insured if we didn't have employer-based. And this is all PPO.

You have coverage , but having care is a little different. For each of those features, do you have local providers who are willing to take on new patients and provide that care at the offered reimbursement rates? In much of CA, the answer is no.

Here's an example of the concept just today:

Fecteau’s story illustrates a common complaint by health-care advocates here: Dental insurance doesn’t mean access to care. Part of the problem: Washington has one of the nation’s lowest reimbursement rates for dental care provided through Medicaid..."

http://www.seattletimes.com/seattle-news/times-watchdog/wash...

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

#373

Earlier quoted context omitted.

> "that's why you need to take the market out of it and have single payer." It's a consistent argument only if you believe that you'd be better off with single payer. No, it's a consistent argument for those who think beyond themselves; it's good for society as a whole. One doesn't have to believe one personally benefits, that's now how liberals work. > A good market would be one where you paid your doctor A good mar…

No, but it is the only answer to how much those services cost, which is a necessary question to answer if you intend to apply accounting to resource allocation and consumption.

> but it is the only answer to how much those services cost

No it isn't; and that which can be asserted without evidence, can be refuted without it as well.

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

#374

Earlier quoted context omitted.

> "that's why you need to take the market out of it and have single payer." It's a consistent argument only if you believe that you'd be better off with single payer. No, it's a consistent argument for those who think beyond themselves; it's good for society as a whole. One doesn't have to believe one personally benefits, that's now how liberals work. > A good market would be one where you paid your doctor A good mar…

other "socialist" civilized countries, you know, like the ones that regularly innovate and push the boundaries of science and attract millions of people each year because of a higher standard of living and less taxes. oh, wait... The "market" is just a synonym for individuals co-operating together for their mutual benefit. The "public" option is one where a faceless bureaucracy with a monopoly on power steps in and d…

> like the ones that regularly innovate and push the boundaries of science and attract millions of people each year because of a higher standard of living and less taxes. oh, wait...

Propaganda Americans seem always believe, as if the rest of the world were a third world country. The Nordic countries top the world standard of living, America, not so much. Quality of life, the U.S. doesn't even break the top 10. The U.S. isn't a shining city on a hill, it's a waning rotten empire slowly sinking back into 3rd world status for its average citizen.

> The "market" is just a synonym for individuals co-operating together for their mutual benefit.

That's a nice theory, it's just not true in the real world.

> I have lived decades with a single payer system and left in part because of it.

And which country would that be?

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

#375
post #347

Earlier quoted context omitted.

> but no compensation for their mistakes. You sue to get compensation.

You can sue them but it is a long process and you won't get U.S.-style amounts for payouts. That's if you can get that far. The staff cover for each other and use processes like the Ombudsman to delay and obfuscate. Also, the UK is not a litigious culture and my mother and other family members simply didn't want to go through more trouble.

You can't complain about not getting compensation if you didn't go through the process that would get you compensation.

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

#376
post #375

Earlier quoted context omitted.

You can sue them but it is a long process and you won't get U.S.-style amounts for payouts. That's if you can get that far. The staff cover for each other and use processes like the Ombudsman to delay and obfuscate. Also, the UK is not a litigious culture and my mother and other family members simply didn't want to go through more trouble.

You can't complain about not getting compensation if you didn't go through the process that would get you compensation.

Jut out of interest, do you know anyone who has claimed, and won, any decent amount of damages from the NHS?

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

#377

Earlier quoted context omitted.

To clarify, yes. After 2020, the federal government continues to cover 90% of the cost (compared with 60% normally) of the expansion indefinitely. So, for a state government, it is likely the cheapest way to ensure a large number of low income people are insured.

60% is not the normal federal share; the normal federal share varies by State, depends on state economic performance relative to other states, and is a minimum of 50% for certain populations, 65% for other populations.

What you said doesn't contradict the 60%. 60% is the normal federal share. I had a job that specifically involved forecasting state budgets (which obviously involved looking at historical trends) and forecasting the ACA's impact.

To clarify, these variations have historically averaged around 60%, and likely will continue to (sans ACA expansion): http://kff.org/medicaid/state-indicator/federalstate-share-o...

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

#378

Earlier quoted context omitted.

60% is not the normal federal share; the normal federal share varies by State, depends on state economic performance relative to other states, and is a minimum of 50% for certain populations, 65% for other populations.

What you said doesn't contradict the 60%. 60% is the normal federal share. I had a job that specifically involved forecasting state budgets (which obviously involved looking at historical trends) and forecasting the ACA's impact. To clarify, these variations have historically averaged around 60%, and likely will continue to (sans ACA expansion): http://kff.org/medicaid/state-indicator/federalstate-share-o...

There's a difference between 60% being the normal federal share, and a variable amount that, averaged across all states, averages to about 60%, being the normal federal share, particularly when addressing particular states policies, since the share for any particular state tends to be pretty consistent over time (e.g., the California regular FMAP has been the minimum, 50%, because of the states better-than-average economic health for long enough that I frequently have to remind who work on systems where it matters that that's not a fixed amount) and maybe be significantly different than the average.

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

#379
post #294
post #247

Earlier quoted context omitted.

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…

And why can't I buy antibiotics without a prescription. Don't I have a right to heal myself? Misuse and overuse of antibiotics is a huge global problem. Common bacteria are developing resistance, and the reason is the overexposure to antibiotics due to agricultural and medical overuse. If things continue like this, soon we'll have people dying of tuberculosis again in developed countries. If people can buy antibiotic…

This is a good point, but isn't it the agriculture which mainly drives the overexposure? Even if it isn't I doubt that this is a reason why antibiotics are prescription-only. Almost every other group of pharmaceuticals in the US is also restricted.

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

#380
I've heard that, based on how the ACA was written, the penalty is only weakly enforceable; if you refuse to pay it, the IRS cannot garnish your wages or seize assets for it, etc. They can subtract it from a tax refund if you are owed one, but that's about it. So I imagine more and more people will find ways to not have insurance and also not pay the penalty, as both continue to become more expensive over time.
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