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Barack Obama Publishes Defense of the ACA in the New England Journal of Medicine

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Re: Barack Obama Publishes Defense of the ACA in the New England Journal of Medicine

#61

Post by dlp211 »

MR4D wrote: post #53
nyxtom wrote: post #31

Earlier quoted context omitted.

That's not a sustainable choice for our economy, it leads to too many people living like nothing could possibly go wrong until they need a doctor. The point of insurance is to distribute risk, not participating in that effectively negates the effectiveness of the industry.

That's not quite true. For instance, life insurance takes a varying times for it to kick in (varies depending on type and amount, as well as which state's laws apply.) It's quite possible that your health insurance could be limited at first, and grows to cover more things and higher dollar amounts. And before anyone says you can't do this, go look at your dental insurance. Odds are that your coverage increases each y…

And what happens when you're 18 and get cancer? Building up may work for dental because even in the most catastrophic case, the costs have a ceiling, but your overall health doesn't have these kinds of ceilings. Also, every dental plan I have ever had has lifetime maximums, something else that doesn't work with health insurance.

Re: Barack Obama Publishes Defense of the ACA in the New England Journal of Medicine

#62

Post by dlp211 »

maxxxxx wrote: post #41
thomasthomas wrote: post #28

Earlier quoted context omitted.

so i shouldnt have the right to choose?

You should have the right. But you also should not get any kind of treatment under any circumstances if you don't pay upfront.

While I don't disagree in principle, this is impossible to enact. Consider the case where this person who has chosen not to have insurance is in a car accident and render incapable of communicating. Responders and those at the hospital must act under the assumption that the victim has insurance and do everything in their power to save them.

In this situation the person in the accident can later claim that they didn't want to be saved and thus owe nothing. We, that is the rest of us who participate, are then forced to carry this cost and they free ride.

Re: Barack Obama Publishes Defense of the ACA in the New England Journal of Medicine

#63

Post by dlp211 »

Turing_Machine wrote: post #59
CamperBob2 wrote: post #42

Earlier quoted context omitted.

As long as the rest of us don't have the right to let you die on the sidewalk outside the ER, no, I'm afraid you shouldn't have the right to choose not to participate. If you want to go off the grid, you need to go ALL the way off the grid. Otherwise you're just another moocher.

This is a false dichotomy, which assumes that the only possible alternatives are Obamacare and no insurance at all. Not to mention that the majority of people who do have Obamacare are getting subsidized by the government (i.e., they're "moochers", in your terminology). How does making this public subsidy pass through more sets of pockets before it gets to the doctor make it any less "mooching"? Please be specific. A…

> This is a false dichotomy, which assumes that the only possible alternatives are Obamacare and no insurance at all.

No it isn't, the parent poster made no judgement about the system available, just that one must participate. What that system looks like is an entirely different debate to the "I should be able to not have insurance" debate.

> Also, what about the people with expensive preexisting conditions? Virtually all of those people are consuming far more resources than they will ever pay in. Are they also "moochers"?

That is the entire point of insurance. Some will pay more than they take and others will take more than they pay, but in the end, both sides of the ledger for the collective is balanced and both individuals had the same* access. *for some loose definition of same.

Re: Barack Obama Publishes Defense of the ACA in the New England Journal of Medicine

#64

Post by felipellrocha »

thomasthomas wrote: post #19

Thanks to the ACA, a larger share of Americans have health insurance than ever before because its compulsory. this shouldn't an argument for the ACAs effectiveness. I have to buy car insurance if i choose to drive a car on public roads. i have to pay income tax if i have income. now, by birth, i automatically owe the state. i'd like my freedom and right to choose back please. the fact this isn't the main argument fro…

If, you chose to gamble with your life, and end up not being able to afford medical treatment in the future one of two things ends up happening. You actually notify your doctors before hand that you don't have money, and will elect to not receive any treatment and follow through with your gamble, or someone else will pay for your treatment for you. Most likely every other person who can afford to pay for their treatment via raised prices (which will, in turn, remove more people from the market, more people will gamble, raising prices further in a spiral).

Which option do you think is more likely to happen?

Re: Barack Obama Publishes Defense of the ACA in the New England Journal of Medicine

#65

Post by rrock »

felipellrocha wrote: post #64
thomasthomas wrote: post #19

Thanks to the ACA, a larger share of Americans have health insurance than ever before because its compulsory. this shouldn't an argument for the ACAs effectiveness. I have to buy car insurance if i choose to drive a car on public roads. i have to pay income tax if i have income. now, by birth, i automatically owe the state. i'd like my freedom and right to choose back please. the fact this isn't the main argument fro…

If, you chose to gamble with your life, and end up not being able to afford medical treatment in the future one of two things ends up happening. You actually notify your doctors before hand that you don't have money, and will elect to not receive any treatment and follow through with your gamble, or someone else will pay for your treatment for you. Most likely every other person who can afford to pay for their treatm…

Which is, of course, exactly what happens: those with insurance subsidize those without. Why do you think a simple bandage or ibuprofen costs so much on insurance? To cover those that walk into hospital ERs, uninsured. It's a hidden tax, highly inefficient, but quite real.

Re: Barack Obama Publishes Defense of the ACA in the New England Journal of Medicine

#66

Post by rrock »

thomasthomas wrote: post #23
dlp211 wrote: post #21

Earlier quoted context omitted.

You pay for private insurance or you pay for public insurance via taxes. Any other solution is unworkable and you are a free rider.

i'd like the choice to not have any insurance

I'd like for you, along with everyone else, to pay an increased income tax to cover health care for everyone (the way every other industrialized country does it).

And before you reject that notion, try asking someone from one of those other industrialized countries if they'd like to swap their system for ours.

Re: Barack Obama Publishes Defense of the ACA in the New England Journal of Medicine

#67

Post by rrock »

maxxxxx wrote: post #40
projektfu wrote: post #27

Earlier quoted context omitted.

They might not, but they are probably lobbied by doctors, hospital administrators, and insurance executives, all of whom are likely to at least skim the top medical journals.

I don't think any of these groups care much about affordable Care.

Not so. Here's what one prominent hospital administrator (and academic physician) has to say about it.

http://www.chicagobusiness.com/article/20170124/OPINION/1701...

Re: Barack Obama Publishes Defense of the ACA in the New England Journal of Medicine

#68

Post by maxxxxx »

dlp211 wrote: post #62
maxxxxx wrote: post #41

Earlier quoted context omitted.

You should have the right. But you also should not get any kind of treatment under any circumstances if you don't pay upfront.

While I don't disagree in principle, this is impossible to enact. Consider the case where this person who has chosen not to have insurance is in a car accident and render incapable of communicating. Responders and those at the hospital must act under the assumption that the victim has insurance and do everything in their power to save them. In this situation the person in the accident can later claim that they didn't…

I guess he needs a tattoo?

Re: Barack Obama Publishes Defense of the ACA in the New England Journal of Medicine

#69

Post by runamok »

thomasthomas wrote: post #19

Thanks to the ACA, a larger share of Americans have health insurance than ever before because its compulsory. this shouldn't an argument for the ACAs effectiveness. I have to buy car insurance if i choose to drive a car on public roads. i have to pay income tax if i have income. now, by birth, i automatically owe the state. i'd like my freedom and right to choose back please. the fact this isn't the main argument fro…

They definitely did push back against the mandate and that was one of the arguments that went to the supreme court. http://www.nytimes.com/2012/06/29/us/supreme-court-lets-heal...

Furthermore all of us are consumers of health care at one time or another. I admit I am resentful against the many people that take terrible care of themselves but the fact is 40% of americans will get cancer. http://www.upi.com/Health_News/2010/05/06/41-percent-of-Amer...

Due to laws like this: https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an... and of course for ethical reasons hospitals can't turn you away when you can't pay.

I do feel it all needs urgent reform but I do feel the ACA was an attempt to expand competition and fairness while not leaving it completely unfunded like so many government plans seem to.

Re: Barack Obama Publishes Defense of the ACA in the New England Journal of Medicine

#70

Post by spoiledtechie »

anigbrowl wrote: post #20
spoiledtechie wrote: post #5

It's a wonderful idea. Free healthcare for all. Sadly, it simply isn't sustainable financially. I think in the next 10 years alone it was supposed to cost tax payers 10 trillion and that money can't literally be printed fast enough and the debt our country holds, extremely unsustainable. If they did it cheaper or more cost effective, I would say yes, but financially, you can't.

Other countries manage it fine, and the costs here are overblown. Aetna claimed last year that it was pulling out of the ACA over costs, but it has emerged that this was a purely strategic decision after the FTC or the SEC declined to support a merger the firm wanted to enter into. http://www.latimes.com/business/hiltzik/la-fi-hiltzik-aetna-... I reject the claim that 'we just can't afford it', and claim instead that…

They are not. With 50-70% income tax on It's citizens, they are not just fine. Do your research. Long waits, little access to specialised docs. People are dying waiting in line.
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