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Why Paul Ryan Is Losing The Medicare Argument  
User currently offlineKen777 From United States of America, joined Mar 2004, 8329 posts, RR: 9
Posted (3 years 4 months 3 weeks 5 days 5 hours ago) and read 2564 times:

Another interesting article, suitable for discussions.

Quote:

It always gets back to health care.

That’s why 2009 and 2010 were so consumed by President Obama’s push for health-care reform and why Rep. Paul Ryan’s Medicare proposals are at the center of politics in 2011. Our long-term budget problem is primarily about two things: a shortage of revenue and rising health-care costs.

The revenue and health-cost issues are intertwined. The whole debate comes down to whether we want government to absorb a significant part of the risk of insuring us against illness, which means we’ll have to pay somewhat higher taxes, or whether we want to throw more and more of that risk onto individuals.

In that situation I think we first need to establish just how much the government is already paying out on health care.

Total current annual costs would include the basics like Medicare and Medicaid. Then add in Departments like BIA and VA that provide their own health care within their departments. Now add in the odds & sods, like money to help maintain indigent clinics and hospitals.

And a big one, all the money paid out for government employee and retiree health insurance. Even Ex Congressmen and women get very expensive health care, as do ex-Presidents.

That total dollar costs should be looked at. What else can we do with that total outlay that would deliver core care at a lower cost to everyone in hte country?

Quote:

Here’s the basic difference before us: Conservatives want government to play less of a role in paying for health insurance. Progressives believe that government will inevitably play a growing role in the provision of health insurance because if it doesn’t, more Americans will lose their coverage.

The progressive view is not a theory. It is what experience has taught in other wealthy democracies, and in our own country, too. The enactment of Medicare was an admission that most senior citizens simply could not afford health coverage without government help. What was true of seniors in 1965 is now also true of many non-elderly Americans.

The inflation rate of private health insurance continues to rise faster than the Cost of Living - that is basically sucking the middle class to a point were it will be unaffordable.


One of the core reasons for this abnormal increase in costs is that there is a continual increase in patients going to hospitals. We are running around chasing our tails with current games and a public option that provides core care can be very effective in reducing these costs without ending Medicare as we know it.

Link to quotes

http://www.washingtonpost.com/opinio.../06/01/AGqThkGH_story.html?hpid=z5

99 replies: All unread, showing first 25:
 
User currently offlineNIKV69 From , joined Dec 1969, posts, RR:
Reply 1, posted (3 years 4 months 3 weeks 5 days 4 hours ago) and read 2534 times:

Yet we will never have a public option or single payer so.......


Medicare has to be addressed. Vouchers are not the answer but something has to be done.


User currently offlineDreadnought From United States of America, joined Feb 2008, 8866 posts, RR: 24
Reply 2, posted (3 years 4 months 3 weeks 4 days 23 hours ago) and read 2500 times:

Quoting Ken777 (Thread starter):

One of the core reasons for this abnormal increase in costs is that there is a continual increase in patients going to hospitals. We are running around chasing our tails with current games and a public option that provides core care can be very effective in reducing these costs without ending Medicare as we know it.

One of the principle reasons for these continuous cost increases is the segregation between the consumer's pocketbook and the services requested. Let's say there was no such thing as health insurance - at all. Do you think that doctors would be charging you $150 for a 10-minute visit, or would their prices be adjusted to what people can afford (or are willing) to pay? The prices are that high because consumers think "what the hell, insurance will pay for it." It hits the pocketbook eventually but not in the immediate way that gets people's attention.

Adding the government as an insurer just makes it worse. Providers see insurers (and the government) as dupes to be fleeced, and set their prices accordingly.

It's a catch-22 situation. We want (and need) insurance, but insurance drives up costs as a natural effect.

Back to the OP topic. The reason the Ryan plan is being trashed is pure propaganda. Dems are intent of scaring the crap out of old people. Mediscare. Ads about grannies getting literally thrown off the cliff. It is a shameful indictment of how rotten politics have become when a serious proposition is put forward to solve a serious problem, and the opposition resorts to such scare tactics based purely on emotion and no facts. Republicans are fighting propaganda with facts, and history shows that facts lose every time - facts are so dull.

The more I look at it, the more I am convinced that Dems actually want and intend to cause the medicare/medical insurance system to collapse in the next decade, so that the only way out will be complete nationalization of the healthcare system. Obama and others said in 2007 and 2008 that was what they wanted in the end "but it will take a few years to get there".

The question is whether the American people - assuming that they are informed of the costs and consequences - are willing to go through that pain, or would they accept a deep reform such as the Ryan plan. Unfortunately I don't think the majority of people are educated enough to understand the problem.



Veni Vidi Castratavi Illegitimos
User currently offlineFlyPNS1 From United States of America, joined Nov 1999, 6639 posts, RR: 24
Reply 3, posted (3 years 4 months 3 weeks 4 days 22 hours ago) and read 2483 times:

Quoting Dreadnought (Reply 2):
It is a shameful indictment of how rotten politics have become when a serious proposition is put forward to solve a serious problem,

Ryan's proposal wasn't serious. It was a joke that dumped all the rising costs of healthcare on the poor/middle class.

Quoting Dreadnought (Reply 2):
The question is whether the American people - assuming that they are informed of the costs and consequences - are willing to go through that pain, or would they accept a deep reform such as the Ryan plan.

It leads to the fundamental question....do you want government care for all or a private system that leaves many without care?


User currently offlinepar13del From Bahamas, joined Dec 2005, 7382 posts, RR: 8
Reply 4, posted (3 years 4 months 3 weeks 4 days 22 hours ago) and read 2479 times:

Quoting FlyPNS1 (Reply 3):
It leads to the fundamental question....do you want government care for all or a private system that leaves many without care?

I would hope that many Americans would look at the full government systems in Europe and possibly the semi-private system in Canada to get a better understanding of what National Health Care is all about including the cost and new services that will be created, it is much more than folks being able to get prescription drugs at a reasonable cost.

A massive debate is presently ongoing in the UK on their health care system cost, makes for interesting reading.


User currently offlinemt99 From United States of America, joined May 1999, 6615 posts, RR: 6
Reply 5, posted (3 years 4 months 3 weeks 4 days 22 hours ago) and read 2469 times:
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Quoting Dreadnought (Reply 2):
Dems are intent of scaring the crap out of old people. Mediscare. Ads about grannies getting literally thrown off the cliff.

Wait - i thought fear was a GOP tactic.. do i need to remind you of the "Death Panels" Obama was going to institute?



Step into my office, baby
User currently offlineDreadnought From United States of America, joined Feb 2008, 8866 posts, RR: 24
Reply 6, posted (3 years 4 months 3 weeks 4 days 22 hours ago) and read 2469 times:

Quoting FlyPNS1 (Reply 3):
It leads to the fundamental question....do you want government care for all or a private system that leaves many without care?

Neither. I favor an individual mandate (authorized properly via a constitutional amendment, if we can get that passed) requiring everyone to have catastrophic health insurance which includes hospitalization for more than 24 hours, accidents, and chronic disease treatment such as Cancer, AIDS, etc. That way at least the rest of us are not on the hook when people spend a month in the hospital and can't pay.

For doctor visits for the flu, dental and other such stuff, that is up to the individual whether they want to insure for that.

For the basic package I would like to see some strong regulation around it, which I've described before in other threads. Government would police it, but not manage it.

That's what I want.

Quoting mt99 (Reply 5):
Wait - i thought fear was a GOP tactic.. do i need to remind you of the "Death Panels" Obama was going to institute?

Sorry, but the Dems are experts at the Politics of Fear. As soon as anyone says that we need to adjust Social Security, Medicare, Medicaid, Union Rights, or any other pet entitlement program, the immediate reaction is "Republicans want you to die!". They have been doing this for many years. Appeal to emotion, not reason.

[Edited 2011-06-02 06:44:32]


Veni Vidi Castratavi Illegitimos
User currently offlinemt99 From United States of America, joined May 1999, 6615 posts, RR: 6
Reply 7, posted (3 years 4 months 3 weeks 4 days 21 hours ago) and read 2458 times:
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Quoting Dreadnought (Reply 6):
Sorry, but the Dems are experts at the Politics of Fear. As soon as anyone says that we need to adjust Social Security, Medicare, Medicaid, Union Rights, or any other pet entitlement program, the immediate reaction is "Republicans want you to die!". They have been doing this for many years. Appeal to emotion, not reason.

How do you explain the "Death Panels" claims by the Right then?



Step into my office, baby
User currently offlineAGM100 From United States of America, joined Dec 2003, 5407 posts, RR: 17
Reply 8, posted (3 years 4 months 3 weeks 4 days 21 hours ago) and read 2460 times:

Quoting Dreadnought (Reply 2):
Unfortunately I don't think the majority of people are educated enough to understand the problem.

Good post ... and absolutely correct. The problem is our way is not easy ... it takes self disipline and self motivation . We can not expect that from Americans any more.

Quoting mt99 (Reply 5):
"Death Panels" Obama was going to institute?

I agree , "death panel" was a pretty direct way of putting it ., In the Bill it is called something like "cost containment panel". And frankly, if we are going to have single payer system (that is what they want) , I want death panels. I dont want my taxes going to keeping non productive citezens alive and costing the collective money . You cant have it both ways ...



You dig the hole .. I fill the hole . 100% employment !
User currently offlineAaron747 From Japan, joined Aug 2003, 8184 posts, RR: 26
Reply 9, posted (3 years 4 months 3 weeks 4 days 21 hours ago) and read 2452 times:

Quoting Dreadnought (Reply 6):
That way at least the rest of us are not on the hook when people spend a month in the hospital and can't pay.

Ryan's plan didn't address this issue adequately at all. Surprisingly enough, the rest of what you propose is highly practical and just might work, if it were a realistic political proposition.

In any case, the US is screwed on this issue for at least the next couple of decades with numbers like this:

http://topforeignstocks.com/wp/wp-content/uploads/2010/07/oecd-health-expenditure-gdp-per-cpita.PNG

Clearly, the US is doing something wrong. The conflated interests between providers covering inflated incomes, lawyers chasing malpractice suits, insurers delaying or deferring treatments to force providers into cost control corners, and employers and individuals stuck with massively increasing bills is a perfect storm of melancholy.



Maybe everyone back home should just start eating more fish and stop driving to work...



If you need someone to blame / throw a rock in the air / you'll hit someone guilty
User currently offlineStarAC17 From Canada, joined Aug 2003, 3387 posts, RR: 9
Reply 10, posted (3 years 4 months 3 weeks 4 days 21 hours ago) and read 2442 times:

Quoting par13del (Reply 4):
A massive debate is presently ongoing in the UK on their health care system cost, makes for interesting reading.

A lot of the issues about cost now are due to the aging population of all the developed nations, the same with things like social security. Older people require more health care and there is not enough younger people to support them, this has been on the horizon for decades and is now an huge issue.

Quoting Dreadnought (Reply 2):
Adding the government as an insurer just makes it worse. Providers see insurers (and the government) as dupes to be fleeced, and set their prices accordingly.

In countries with a universal healthcare even if the care is 100% private, the government in most if not all of these countries dictates what a doctor receives for a specific service. A doctor is unable to under OHIP in Ontario Canada as an example charge whatever they want for a check up because the government is going to pay them x.

Quoting Dreadnought (Reply 6):
Sorry, but the Dems are experts at the Politics of Fear. As soon as anyone says that we need to adjust Social Security, Medicare, Medicaid, Union Rights, or any other pet entitlement program, the immediate reaction is "Republicans want you to die!". They have been doing this for many years. Appeal to emotion, not reason.

Both sides do it and its done because it works.

Quoting Dreadnought (Reply 6):
Neither. I favor an individual mandate (authorized properly via a constitutional amendment, if we can get that passed) requiring everyone to have catastrophic health insurance which includes hospitalization for more than 24 hours, accidents, and chronic disease treatment such as Cancer, AIDS, etc. That way at least the rest of us are not on the hook when people spend a month in the hospital and can't pay.

For doctor visits for the flu, dental and other such stuff, that is up to the individual whether they want to insure for that.

That in a nutshell is the Canadian system (universal for general care, private for extended health usually provided by employers). Also the Australian system and the British systems are similar (public system with a private option available).

The right wing media in the US painted these systems as essentially commie systems where people were dying in the street.

Quoting Dreadnought (Reply 2):
One of the principle reasons for these continuous cost increases is the segregation between the consumer's pocketbook and the services requested.

I think one of the main reasons that care in the US costs nearly double what it does per capita than in other developed countries is the fact that uninsured people do not have easy access to general care where they can see a GP who can diagnose early signs of health problems.

Examples being things like high blood pressure, high cholesterol, high blood sugar etc which can be determined through a simple blood test. Because of this most people go to the ER which costs the most out of all treatments and often these issues have long been undetected and end up costing heaps more in the long run.



Engineers Rule The World!!!!!
User currently offlineFlyPNS1 From United States of America, joined Nov 1999, 6639 posts, RR: 24
Reply 11, posted (3 years 4 months 3 weeks 4 days 21 hours ago) and read 2432 times:

Quoting Dreadnought (Reply 6):
Neither. I favor an individual mandate (authorized properly via a constitutional amendment, if we can get that passed) requiring everyone to have catastrophic health insurance which includes hospitalization for more than 24 hours, accidents, and chronic disease treatment such as Cancer, AIDS, etc. That way at least the rest of us are not on the hook when people spend a month in the hospital and can't pay.

For doctor visits for the flu, dental and other such stuff, that is up to the individual whether they want to insure for that.

For the basic package I would like to see some strong regulation around it, which I've described before in other threads. Government would police it, but not manage it.

That's what I want.

And it's not a bad idea and I might be able to support it, HOWEVER the GOP (and particularly the Tea Party) would vehemently oppose it.

Plus, you'd have to come with a way of providing an affordable catastrophic plan for the poor which would be difficult without government providing it. No private entity is going to provide affordable catastrophic care to poor people since they are actually the highest risk group for needing catastrophic care to begin with. It would be like offering really cheap car insurance premiums to really bad drivers...no private company will do it.

Quoting Dreadnought (Reply 6):
"Republicans want you to die!". They have been doing this for many years. Appeal to emotion, not reason.

And Republicans are any different? Try making a cut to all the defense pork and the Republicans will scream that terrorists will kill us all if we do!!! We're spending $800+ billion annually on defense (and related functions) and Republicans have steadfastly refused to make any cuts even though it will be almost impossible to balance the budget with signficant DoD cuts.


User currently offlinewingman From Seychelles, joined May 1999, 2290 posts, RR: 5
Reply 12, posted (3 years 4 months 3 weeks 4 days 21 hours ago) and read 2434 times:

Note the statement in the original opening which is the simplest of concepts, the issue is about revenue shortage and cost cutting. Those two things need to be addressed simultaneously. The last time they were, under Clinton and Newt, we were very quickly on our way towards becoming a debt free society.

The reason Ryan's plan is doomed to failure is that it targets cost cutting that impacts a MASSIVE voting block, OLD people. Republicans don't understand that until they raise revenue on a very SMALL voting block, RICH people, anything they say or recommend will NEVER work. Simple math folks, a bitter pill for 50% of the country to swallow but them's the facts Jack. The problem requires hard action on both ends of the equation where each party only wants to focus on one. It is a black and white issue and anyone who refuses to understand this third grade mathematical solution is either delusional or missing their thinking cap. I hope it doesn't take a default for our political leaders to see the light.


User currently offlineKen777 From United States of America, joined Mar 2004, 8329 posts, RR: 9
Reply 13, posted (3 years 4 months 3 weeks 4 days 20 hours ago) and read 2426 times:

Quoting NIKV69 (Reply 1):
Yet we will never have a public option or single payer so.......

If you want to get rid of the insurance mandate then you will need a public option financed with taxes. That is the only avenue of breaking our excessive medical inflation rate.

Quoting Dreadnought (Reply 2):
One of the principle reasons for these continuous cost increases is the segregation between the consumer's pocketbook and the services requested

And that is a never ending cycle. Has been for years now and it will only get worse as long as we stay on our current path of putting health insurance companies first.

Quoting Dreadnought (Reply 2):
Let's say there was no such thing as health insurance - at all.

Then the number of medical bankruptcies would explode and ERs would see even greater increases in people using them as a visit to their GP they can't afford.

Quoting Dreadnought (Reply 2):
Providers see insurers (and the government) as dupes to be fleeced, and set their prices accordingly.

Which is why Medicare pays set fees that avoid being fleeced. The real fleecing is the Medicare/Medicaid fraud. That needs more funding, more prosecuting and permanent expulsion from medicine if found guilty.

Quoting Dreadnought (Reply 2):
The reason the Ryan plan is being trashed is pure propaganda.

Or it is the fact that the Ryan Rape is to pay "vouchers" (there will be no paper voucher) directly to insurance companies, with no controls on how much care they deny. It is also a fact that the Ryan Rape is needed in order to drop the top tax rte to 25% - keeping the billionaires far healthier than the middle class who will have their assets stripped out by the Ryan Rape.

Quoting Dreadnought (Reply 2):
Ads about grannies getting literally thrown off the cliff.

I took that as a spoof. LMAO when I saw it.

Quoting Dreadnought (Reply 2):
Republicans are fighting propaganda with facts,

Republicans are fighting propaganda with propaganda

Quoting FlyPNS1 (Reply 3):
It was a joke that dumped all the rising costs of healthcare on the poor/middle class.
Quoting Dreadnought (Reply 6):
That's what I want.
Quoting StarAC17 (Reply 10):
I think one of the main reasons that care in the US costs nearly double what it does per capita than in other developed countries is the fact that uninsured people do not have easy access to general care where they can see a GP who can diagnose early signs of health problems.

Easy access to GPs would require universal care at the core levels and investments to train more GPs. We keep moving further away from that each day.


User currently offlineAaron747 From Japan, joined Aug 2003, 8184 posts, RR: 26
Reply 14, posted (3 years 4 months 3 weeks 4 days 20 hours ago) and read 2421 times:

Quoting Ken777 (Reply 13):
Has been for years now and it will only get worse as long as we stay on our current path of putting health insurance companies first

It is a pipe dream to end the influence of the big insurers and big pharma. Despite their occasional poor margins, they simply have more money to wield with both major parties than any coalition of physicians or patients could ever hope to.

Quoting Ken777 (Reply 13):
Rape

I'm pretty tired of witnessing how the current vein of political discourse has taken a word of considerable specific meaning and broadened it for use against any perceived injustice.

Quoting Ken777 (Reply 13):
Easy access to GPs would require universal care at the core levels and investments to train more GPs

Strangely this is more or less what Charles proposed, without using those exact words.



If you need someone to blame / throw a rock in the air / you'll hit someone guilty
User currently offlineseb146 From United States of America, joined Nov 1999, 11721 posts, RR: 15
Reply 15, posted (3 years 4 months 3 weeks 4 days 19 hours ago) and read 2398 times:

Quoting Dreadnought (Reply 2):
The prices are that high because consumers think "what the hell, insurance will pay for it." It hits the pocketbook eventually but not in the immediate way that gets people's attention.

Right. That is pure capitalism with no government control. I am all for capitalism to a point. But, when the common folk (read: We The People) can not afford basic health care, basic schools, basic fire protection, basic air traffic control protection, there is something wrong.

Quoting Dreadnought (Reply 2):
The reason the Ryan plan is being trashed is pure propaganda.

It is already established that the Ryan deal would not be solvent until 2041. The Progressive Caucus plan would not be solvent until 2027, IIRC.

Quoting Ken777 (Reply 13):
Ryan Rape

Ken, I agree with 90% of what you say overall, but this is a bit much, don't you think?



Life in the wall is a drag.
User currently offlineCargoLex From United States of America, joined Apr 2010, 1275 posts, RR: 8
Reply 16, posted (3 years 4 months 3 weeks 4 days 18 hours ago) and read 2382 times:

Quote:
The reason the Ryan plan is being trashed is pure propaganda.

Ryan's plan is being trashed because it's a bad plan, pure and simple. It addresses the looming financial issues, but does so by basically dismantling medicare altogether and putting the costs on seniors - who in many cases would no longer be able to get medical coverage without medicare.

Medicare was created for a reason - because old people couldn't get health coverage, because it is not economical to provide coverage for people who routinely suffer serious illnesses and are statistically likely only to deteriorate - not get better. The concept of "health insurance" as a purely capitalist business doesn't work for people who are not good candidates for the business plan.

Health Insurers are out to make money - not to take care of people. They'll go with the customers who can pay and who cost less to take care of. Old people don't fit well into a model like that and so Medicare was created because the private market simply refused to cater to old people unless they were of extraordinary means.

It's businesses' right to not serve markets where they know they will lose money - but it's also the responsibility of society to make sure people don't die before their time.

Ryan's plan is an abdication of that responsibility, and that's why it gets (deservedly) derided as being bad for seniors. it is bad for Seniors.


User currently offlineDreadnought From United States of America, joined Feb 2008, 8866 posts, RR: 24
Reply 17, posted (3 years 4 months 3 weeks 4 days 18 hours ago) and read 2378 times:

Quoting CargoLex (Reply 16):
Ryan's plan is being trashed because it's a bad plan, pure and simple. It addresses the looming financial issues, but does so by basically dismantling medicare altogether and putting the costs on seniors

Considering that those over 55 would not see any change to their benefits, that's a load of bull, and you know that. That's why the Mediscare tactics are so nasty, because they are designed to frighten current seniors that Ryan wanted to change their benefits, which is a lie.

Quoting CargoLex (Reply 16):
The concept of "health insurance" as a purely capitalist business doesn't work for people who are not good candidates for the business plan.

Not if you require all persons over the age of, say, 25 years, all must be charged the same rate. Flat rates for all adults, regardless of age, prior history etc. Force the insurance companies to actually create a large risk pool rather than treating each individual as an individual risk/benefit calculation. This is what I have suggested for basic, minimum coverage (not for the optional extras).



Veni Vidi Castratavi Illegitimos
User currently offlineCargoLex From United States of America, joined Apr 2010, 1275 posts, RR: 8
Reply 18, posted (3 years 4 months 3 weeks 4 days 17 hours ago) and read 2373 times:

Quote:
Considering that those over 55 would not see any change to their benefits

That's only half the equation. The system of how those benefits would be paid for is fundamentally changed under the plan, and the burden of payment is shifted to the seniors with a declining amount of federal support.

Quote:
Not if you require all persons over the age of, say, 25 years, all must be charged the same rate.

So you are in favor of the government getting involved price fixing - e.g. telling private companies what they can and cannot charge and who they can charge it to?

Quote:
Force the insurance companies to actually create a large risk pool rather than treating each individual as an individual risk/benefit calculation

Well that's exactly what they need to do, you're right on that. But I don't think the current system, or really the system passed last year, will do that.

I can, however, see the merits in your argument - your proposed system would work something like the system in Belgium - which is very good and basically comprised of private companies that are heavily regulated by the government with, essentially, mandated pricing.

But if you tried that, you'd get alot of conservatives shouting about Socialism, and we'd be right back to where we were 12 months ago.

What you are proposing is not what Paul Ryan is proposing.


User currently offlineNIKV69 From , joined Dec 1969, posts, RR:
Reply 19, posted (3 years 4 months 3 weeks 4 days 17 hours ago) and read 2371 times:

Quoting par13del (Reply 4):
I would hope that many Americans would look at the full government systems in Europe and possibly the semi-private system in Canada to get a better understanding of what National Health Care is all about including the cost and new services that will be created, it is much more than folks being able to get prescription drugs at a reasonable cost.

We don't want the Euro or Canada system but allowing us to use Canada for prescription drugs and letting people go over state lines in the US for competition will lower prices is a good start.


User currently offlineDreadnought From United States of America, joined Feb 2008, 8866 posts, RR: 24
Reply 20, posted (3 years 4 months 3 weeks 4 days 17 hours ago) and read 2370 times:

Quoting CargoLex (Reply 18):
So you are in favor of the government getting involved price fixing - e.g. telling private companies what they can and cannot charge and who they can charge it to?

I'm not a libertarian. Simple, sharp regulation is not an evil.

Such a pricing policy should fall under the same logic as a restaurant not being allowed to charge different people different prices because of their sex or skin color.



Veni Vidi Castratavi Illegitimos
User currently offlinenonrevman From United States of America, joined Nov 2001, 1302 posts, RR: 1
Reply 21, posted (3 years 4 months 3 weeks 4 days 17 hours ago) and read 2350 times:

Quoting Ken777 (Thread starter):
The inflation rate of private health insurance continues to rise faster than the Cost of Living - that is basically sucking the middle class to a point were it will be unaffordable.

This is why I am against any mandate to purchase insurance. Today, insurance is affordable through my wife's employer. However, this a limit to what we can afford if the rates continue to rise. Eventually, people are going to reach the point where they can no longer be able to purchase health care insurance without giving up the basics (food, clothing, shelter). Wages are clearly not going up, at least where I live. Under Obamacare, if we fail to buy insurance, we get penalized with a fine. When the cost of insurance gets too high, this is going to break the last straw that breaks the camel's back for many.


User currently offlineseb146 From United States of America, joined Nov 1999, 11721 posts, RR: 15
Reply 22, posted (3 years 4 months 3 weeks 4 days 13 hours ago) and read 2319 times:

Quoting Dreadnought (Reply 20):
Such a pricing policy should fall under the same logic as a restaurant not being allowed to charge different people different prices because of their sex or skin color.

But that is exactly what is happening with private insurance and what will happen under the Ryan plan: Seniors and those who can least afford it will be charged the most out of pocket. Why not have a system where everyone pays in and everyone gets care based on their needs? Especially so that things like boob jobs and Viagra are paid for out of pocket or through private insurance but things like knee surgery and cancer treatment are paid for by all of us.

Quoting NIKV69 (Reply 19):
We don't want the Euro or Canada system but allowing us to use Canada for prescription drugs and letting people go over state lines in the US for competition will lower prices is a good start.

We? Who are these "we" you are taking about? Prices have not lowered yet even with people going to Asia for major surgery and to Canada and Mexico for prescriptions and even across state lines for routine things. Prices are still going up. What a great plan!



Life in the wall is a drag.
User currently offlineDreadnought From United States of America, joined Feb 2008, 8866 posts, RR: 24
Reply 23, posted (3 years 4 months 3 weeks 4 days 12 hours ago) and read 2301 times:

Quoting seb146 (Reply 22):

But that is exactly what is happening with private insurance and what will happen under the Ryan plan: Seniors and those who can least afford it will be charged the most out of pocket

Firstly: I never said the Ryan plan is ideal. But it's better than the "everything is fine, don't worry about it" approach of the Democrats.



Secondly, you seem to be under the false impression that people should not have to pay for stuff. The argument that Seniors paid in the past for what they are getting now is bogus - taking into account what they paid in the past, plus interest, is on average only one third of what they receive today in benefits. I can't find the chart right now, but I saw it earlier today that the average contribution, including presumed interest for today's retirees over their careers is about $84,000, but they will cost, on average in today's dollars, $260,000.

This has to stop. People will have to pay more for themselves. There are a number of reforms that can help them do that (such as my suggestion to flatten all premiums), but the first step is to stop the hemorrhage.

And to repeat, Ryan's plan correctly does not affect those who are at or near retirement age who cannot make alternative arrangements. But those of us younger than 55 will have to face the fact that we will not get the incredible bargain our parents got.



Veni Vidi Castratavi Illegitimos
User currently offlineArrow From Canada, joined Jun 2002, 2676 posts, RR: 2
Reply 24, posted (3 years 4 months 3 weeks 4 days 12 hours ago) and read 2300 times:

Quoting NIKV69 (Reply 19):
We don't want the Euro or Canada system but allowing us to use Canada for prescription drugs and letting people go over state lines in the US for competition will lower prices is a good start.

Funny -- you think our system is bad (despite the fact that it offers better outcomes for about half the per capita cost) but you're eager to let US citizens get the benefits of cheap prescription drugs obtained through our "bad" health care system.

No thanks. You want cheaper drugs? Fix your health care system. Americans flooding across the border to raid our low-cost drug supply would probably wipe out our low cost drug supply. You want to make it legal in the US? I'll recommend we make it illegal here.

You need to go to a single-payer insurer and spread the cost and risk across the entire population. That's why everybody else's health care system is far far cheaper than yours. It's a fundamental tenet of all insurance -- spread the risk as widely as possible and you reduce the unit cost.



Never let the facts get in the way of a good story.
25 Post contains links Dreadnought : And here is a perfect display of the effect of the rhetoric and propaganda. http://www.pollingreport.com/health.htm CNN/Opinion Research Corporation P
26 Post contains links ImperialEagle : Glen Kessler who writes the "Fact Checker" op/ed for the Washington Post had some interesting things to say about Ryan in an article from a week or so
27 seb146 : No Democrat has ever said that. They all say we need to scrap the whole Part A/B/C/D thing and also put prices back in check. Actually, if you read w
28 NIKV69 : Sure after paying much more taxes to wait longer for a lower level of care. No thank you. We don't have to cross anything we could buy them on the in
29 RVV2011 : Lower level of care? Beats having no care at all, like many of your fellow citizens, or those that must go bankrupt. I have a solution: Dear American
30 Dreadnought : Do you even bother reading stuff?
31 Post contains images nwaesc : YES! I have a friend who was born and raised in Rwanda. He says that the system in place there for basic care (anything less than a broken leg, in hi
32 Dreadnought : That was not the question! There were other questions around that, but this question was: "Under the Republican plan to change Medicare, do you think
33 FlyPNS1 : Except that as Ryan's plan kicks in those seniors left on "old Medicare" will become pariahs. All the new seniors will be paying higher amounts via p
34 seb146 : Like Ryan's plan? Adding to the deficit? Putting high medical costs onto people who can not afford it? And giving private insurance the power to rais
35 StarAC17 : Much less in taxes that actually go to healthcare than your insurance premiums are. Also in the US you only get better care if you have money, and in
36 Flighty : Plenty. We already pay enough for a WONDERFUL 100% coverage health care plan for the USA. The problem is, corruption and duplication steal that healt
37 AGM100 : Because half or more of America believes Nancy Pelosi ..... its that simple. They believe nanny can save them ... and don't understand where the mone
38 Arrow : You need to read more -- and by that I mean some disinterested analysis of how the system works and what it costs -- not Glenn Beck's ravings.. Annua
39 Aaron747 : Total absurdity. This country spends 1/3 of the US per capita to look after 125 million people. My nominal tax rate is 20% here before deductions wit
40 Aesma : The government has to fix prices, of course. Here, it's currently 23€ for a doctor's visit. There are doctors that charge higher in rich neighborho
41 Ken777 : Bit less than the Death Panels hurled against Obama. And, as someone on Medicare it's easy for me to see that a lot of elderly people can be stripped
42 Arrow : That's the part of this US battle that mystifies me -- given the "free market" ideology that seems to drive all the conservative arguments against un
43 DL021 : It's very simple why he's having difficulty with his argument. Some people believe that they're entitled to the fruits of the labor of others without
44 windy95 : He is not losing the argument. We as a country are losing the argument. Our budget is not sustainable and if the system collapses under the weight of
45 sna752 : Right. That's exactly what they're supposed to do. Much like food stamps. It prevents the money from being used to pay the cell phone bill or somethi
46 seb146 : Why? Only in this country they do. Look at Africa. Look at South America. And, why do we the people have to support their lavish lifestyles just beca
47 Ken777 : The health insurance industry has sufficient funds for political contributions to avoid any common sense approach. Until employers grow the testicles
48 Post contains links dxing : That chart does not differentiate between elective and necessary care. The United States dominates plastic surgery alone. http://www.sherdog.net/foru
49 WarRI1 : Alright, he made, a proposal, a plan. Anyone in congress can offer a plan, Ryan's is deemed unacceptable, the death of Medicare. I do not think Repub
50 dxing : Ok, then the policy should be when you have spent what you paid in, you're done. Because anything spent on you after that is you collecting on someth
51 WarRI1 : Another version of death panels? You run out of Medicare benefits, you then go bankrupt, you then jump off bridge, or you then go on welfare. who pay
52 Post contains links Aaron747 : Source? Evidence? Virtually the entirety of contemporary literature in public health administration disagrees with your position, particularly as rel
53 sna752 : Pretty much. And adjust it for inflation annually. In effect, Ryan's subsidy/credit was ~$15,000/pp, which is roughly what we are spending per person
54 dxing : Take it up with Ken. He brought up the fact that he paid in, in response to DL021's comment about something for nothing. The logical conclusion to hi
55 Aaron747 : Boob jobs and tummy tucks do not treat any specific disease or condition. We're not talking about people getting skin grafts for third degree burns h
56 Post contains links dxing : Yes it does. According to what you qouted: boob jobs and the like would be considered "personal health care" since it compromised of a therapeutic go
57 windy95 : So take out what you put in. After that the checks end. Otherwise they are asking for something without paying for it.
58 Aaron747 : It is the best measure at this point in time, and if it's good enough for researchers at the NIH and contributors to NEJM, then that's enough for me.
59 Post contains images Ken777 : So a rich 15 year old can get a boob job while her mommy gets a tummy tuck. And that leaves us still at the same level as Cuba when it comes to infan
60 Arrow : I'd have a hard time believing ANY universal health care system pays for that. Ours certainly doesn't. Are you serious? How can any system, private o
61 Aaron747 : Generally over here it works like this: Employed people and pensioners pay premiums, usually around $200 for a family of four. Employers contribute a
62 dxing : None of that changes the simple fact that the United States dominates spending on plastic surgery. It would be nice to see a competing plan, but so f
63 Arrow : There are similarities there -- most employees here have their MSP premiums paid 50% by the employer, those with strong union contracts can get 100%
64 dxing : The chart that Aaron747 refers to references medical spending. It does not differentiate between out of pocket and insurance of any kind, or even pub
65 FlyPNS1 : You are desperately reaching. Being flat-chested is NOT classified as a medical condition. There is absolutely NOTHING medically wrong with small boo
66 dxing : Still does not change the fact that these are all medical procedures albiet elective ones. The chart that was referenced did not differentiate betwee
67 Aaron747 : Again, which only serves to aggregately highlight US cost disparities, since these procedures also occur in other OECD nations with smaller populatio
68 dxing : What it highlights is the disposable income of our nation versus some others. I guess you have to decide whether a person "feels" better after increa
69 Post contains images Ken777 : The Republicans blocked the plan that would have provided a public option. Once Ted Kennedy died there was no hope for that. But it can still be poss
70 Aaron747 : Despite the machines having similar unit costs and technicians requiring the same amount of training to utilize them, the costs are not on par. I hav
71 windy95 : Is their a comparison in salaries and insurance costs for providers Aaron? Or does the $600 price have a government subsidy? Cost is our problem but
72 Aaron747 : $600 is the total cost I assumed since I paid the standard 30% user fee deductible at about $180 and the NHS picks up 70%. I should point out I did t
73 dxing : Because they can. If the Japanese providers could they would as well. Yes it is as on my trips abroad to Europe and Japan I've noticed that Americans
74 Ken777 : It's health care in the US funded via private insurance companies. There are two factors that can move us towards a saner system. The first is when e
75 Post contains images Aaron747 : Maybe so, but I am acquainted with quite a few MDs here and they generally feel they are compensated fairly. Most don't graduate med school with $200
76 dxing : That also is a cultural difference between the two countries. What is left out of a lot of these debates which focus on economics is the cultural dif
77 Post contains links FlyPNS1 : Oh really? "Perhaps more jolting, the Republican budget would cut spending on Medicaid—health care for the poor—much of which goes to long-term c
78 Arrow : On a recent trip to Hawaii, I forgot to pack a simple thyroid prescription, and needed to get a doctor to write one up for me (got my own doc to fax
79 Ken777 : Which is why I use Australia as a solid comparison. There is very little difference in cultures when you get down to basics like wanting good health
80 Aaron747 : Yes, but not everyone everywhere with different systems deals with these waits. And unless you're a high roller, if you call up Mayo, Sloan-Kettering
81 Ken777 : Which is why I use Australia as a solid comparison. There is very little difference in cultures when you get down to basics like wanting good health
82 Post contains links and images Dreadnought : Good luck paying for it on your own. Nobody saw this coming... http://www.foxnews.com/politics/2011...ts-after-obamacare-fully-kicks-in/ McKinsey is
83 Ken777 : I paid for health insurance on my own when I had a small company. It's not cheap and, as an S Corp, the premiums were part of personal, not "company"
84 dxing : Short term memory loss? From January 2009 to January 2010 the democratic party had 60 seats in the Senate and an overwhelming majority in the House.
85 Flighty : Yes, those things happen. Most of that is pretty "small time" though. I think _most_ of the spending in health care right now is either wrongful, or
86 Post contains images Ken777 : Memory does fade with age. What I remember is Bush & Cheney (finally) leaving office in January 09, leaving Obama with the worst financial crisis
87 dxing : Since the stimulus bill was passed, over GOP objections, in February of 2009, that left 11 months to pass a public option health care bill, and no am
88 Post contains images Ken777 : It was unfortunate that Obama actually tried a bi-partisan approach. And somewhere the promise of "jobs, jobs, jobs" was tossed under the bus. Like t
89 Post contains links dxing : http://blogs.wsj.com/washwire/2009/01/23/obama-to-gop-i-won/ Challenged by one Republican senator over the contents of the package, the new president,
90 scamp : Wasn't it nice of the GOP to insert this little tid bit for the voting block that tends to vote the most...for THEM.
91 Dreadnought : That's only decency. You don't change the game for people who are already dependent on the program. That would be like passing a new tax that is retr
92 scamp : I'm doing nothing of the sort. Be careful when you jump to conclusions...you might hurt someone. That's rarely a term I would use to describe a conse
93 Post contains images Ken777 : The bi=partisan approach was when the nation lost the public option. Ad you get to pay fort that missed opportunity every month. Or are you on employ
94 dxing : Well that's a nice thought but since the democratic party had a majority in both houses plus the White House, its obviously an excuse for their failu
95 Post contains links NIKV69 : http://current.com/news/93288236_aar...on-social-security-benefit-cut.htm Uh oh, those times are a changing. Good to see these guys coming to their se
96 Post contains links Ken777 : Or an obvious demonstration of how to block legislation when in the minority. The GOPs only concern now is if the Dems remember how the GOP used the
97 dxing : Since the stimulus bill was passed without any GOP support in February 2009, and the make up of the Senate did not change until January of 2010, that
98 NIKV69 : I was pretty shocked myself. AARP is a major league defection.
99 Post contains links dxing : Some interesting quotes in that article. http://www.aarp.org/about-aarp/press...s-position-on-social-security.html “First, we are currently fightin
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