The Future of US Healthcare

[Sugetsu]

And speaking of conspiracy theories... does anyone here consider plausible the idea of paid hackers or paid contractors working under cover for the GOP sabotaging the website?

I am aware that the infrastructure is massive but they have had years to develop it, I just can't believe it is taking them this long to get the site up and running well.

[Drkz]

Originally Posted by Sugetsu

And speaking of conspiracy theories... does anyone here consider plausible the idea of paid hackers or paid contractors working under cover for the GOP sabotaging the website?

I am aware that the infrastructure is massive but they have had years to develop it, I just can't believe it is taking them this long to get the site up and running well.

Nah. The government has always had IT problems. Every few years you usually hear about a 8 year old who hacked the pentagon don't you? They prefer spending money on drones and planes no one will ever fly while sacrificing the science, math and technology department. I think it lies more with the fact they decided to hire over 40 firms to work on one website... Having two or three tech companies work together is already a headache, but over 40?! The problem is they don't have enough servers to handle the traffic. The smart thing to do would be to close down the site until they fix all these problems. The longer they leave it open the more the problems will get worse. I mean instead of wasting billions on a bunch of firms they could've of hired a company like amazon... their global how often you hear their servers crash?

Originally Posted by darkchibi07

I'd say there's one thing that is unanimous: that website needs to be fixed now!

Hmm, I wonder what happens to the people who's unemployed, uninsured, and still living at his or her parents' house.

Nothing. They can't really fine you if you have no income.

[GDB]

If I'm not mistaken, isn't the "fine" only applied to any tax rebate rather than actual money you have on hand?

[Drkz]

Originally Posted by GDB

If I'm not mistaken, isn't the "fine" only applied to any tax rebate rather than actual money you have on hand?

Honestly I got no idea. Because I can picture a lot of people still not getting health care either way. Its going to be up to BB to do it . I think the original intent for the fine is for the younger generation. The irony in this situation is the younger generation don't tend to have jobs anymore. They usually come out of college with enormous debt so that fine only works in the opposite fashion. People who have healthcare will still get it. Anyone with a better average income than others will have to fork over more. And a lot of the people who never got health insurance... well a lot of them won't sign up. Not to mention Obama isn't really helping the situation when he lets congress cut funding to schools and didn't stop them from lowering the interest rates for student debt. You can't plan on having a healthy economy if the working class your dependent on is debt ridden and can't find jobs. All they'll end up doing is borrowing more money and never paying it off. I think I mentioned this previously, but a on-going trend now is to not have kids as well as not paying off any debt you have. These are people in retirement age I'm talking about too . Man the future looks really bleak.

[SaintessHeart]

Across the world, universal healthcare is in poor health

Most Europeans don’t understand the U.S. healthcare debate. They don’t understand it because the opposition to it, and its breadth and depth, runs so counter to the experience of almost every European born since World War Two. It’s an experience so deep, so vigorously underpinned by government action and social teaching, that it has become a moral credo. They think healthcare is and should be a public provision. Most Americans don’t seem to.

The Europeans, who think of their unions as stubborn defenders of public provisions, don’t understand why a bunch of U.S. union leaders have come out against some of Obamacare’s central elements, arguing in a letter that it will “shatter not only our hard-earned health benefits, but destroy the foundation of the 40 hour work week that is the backbone of the American middle class.” (They worry that the thresholds for employers to provide health insurance will mean employers shift full-time employees to part-time work.)

The Europeans also don’t understand the visceral opposition of the right to the proposed system. Harvard economist and Obama advisor David Cutler looked at Mitt Romney’s 2012 campaign and said, “Never before in history has a candidate run for president with the idea that too many people have insurance coverage.” Yet Romney got a respectable vote. To oppose universal healthcare in Europe would be to guarantee instant political oblivion.

West European states have cradle-to-grave medical care for all of their citizens — and the residents of all the West European states go to their graves, on average, later than Americans, even if only by a year or two. This isn’t a direct measure of the quality of the medical care, and there’s a sizable debate about the connection between life expectancy and quality of healthcare. But Europeans believe in it, because they see it as a crutch in their sicker old age and believe that the U.S. system is heartless to the poor. In every West European country socialized medicine has become a matter of sentimental attachment as well as practical assistance. (Remember London’s tribute to the National Health Service during the Olympics?)

Now, though, that belief in socialized medicine is under strain, for the health services of the rich European states are in various kinds of “crisis.” I put the word in quotation marks because healthcare is ritually said by journalists to be in crisis: it’s the word that cries wolf. But this time there is a wolf.

In Italy, the UK, Spain and France, cuts of varying depths are now being introduced. In France, where the health system is usually seen as the best, the budget is exceded by billions of euros every year: the head of the association of French pharmacies says the system cannot survive more than six years without deep reform. In the UK, the new director of the Care Quality Commission that oversees standards, said after his appointment earlier this year that “the system is on the brink of collapse.”

The more socialized the U.S. system becomes, the more it will find itself facing the same dilemmas as the Europeans’. These dilemmas are all symptoms of the way we live now.

In nearly every country, people live longer than they once did. And in most countries, women give birth to fewer kids. In 2000, around 16 percent of Germany and the UK’s population was over 65 in 2000, while the U.S. had only 12.7 percent. But in the U.S., the proportion of over-65’s will increase to near 20 percent of the population in 2050, and over 80’s to around 8 percent. The UK will have over 20 percent of 65-plus citizens by 2050. Germany will have around 30 percent of 65-and-up by 2050; it will have around 15 percent of its population in their 80s.

So there will be fewer economically active taxpayers in North America and Europe while there’s a greater need for taxes to pay for socialized medical care.

Most of these older people will be healthier than previous aging generations and they may get relief from illnesses that others didn’t. Many fewer will smoke, because anti-smoking campaigns have meant that the diseases associated with smoking are down: the proportion of smoking Europeans is under 25 percent.

But they’re also likely to be fatter and some will be obese: within Europe the UK and Germany tend to lead in the obesity stakes, but France and even Italy, with its Mediterranean diet, are coming up fast. More will be prone to terrible degenerative diseases, of which Alzheimer’s is the most common — and most costly, at around $100 billion a year in the U.S.

Obamacare puts the U.S. closer to the Europeans in its generous universality, and closer to the Europeans’ budget problems. Behind the mendacious claim that the Affordable Care Act would create state-appointed “Death Panels” lurks the germ of an insight. Once medicine is paid by tax revenue, health becomes one of the government’s central concerns. It has little choice but to intervene directly to try to stop people’s bad habits that land them in the hospital. Governments have pressed harder and harder on smokers, and it’s working, if slowly. But if, for example, the obesity trends continue, the specter of Fat Panels may swim into view.

Making, and keeping, citizens of all income levels healthy is the biggest welfare challenge for the early 2000s. Socialized medicine always had a moral hazard tucked inside it: the healthy citizens subsidize the smokers, the drinkers, the food bingers, and the drug takers who occupy the emergency rooms every night.

Warnings of collapse now come often, with too much authority behind them to be dismissed. The creation of a system of medical services that is available free for everyone is a fine thing for a country to do for its citizens: but it needs citizens who won’t overload it by letting their appetites off the leash — for then everyone suffers.

[Vallen Chaos Valiant]

Socialized medicine always had a moral hazard tucked inside it

"Moral Hazard" is used to describe people not being punished for doing the wrong thing. Your link essentially argue that sick people deserve to be sick and should die, the same way sick businesses should die. That's the American way. Rich people deserve to be rich, and poor people deserve to be poor.

Screw that.

[Samari]

Hey this is my first trip into this thread. I know there is a lot of commotion regarding US healthcare and Obama's plan to move forward. I've heard on the radio that the website has been a disaster and the entire thing is going down the drain.

I am curious though, since I'm 26, live in California, don't make a lot of money (below the poverty line/my spouse makes way more) and I don't have healthcare at the moment, do you think it would still be a good idea to look into it? I've heard that some basic packages might be affordable with the way things are going. Perhaps even dentistry? I'm not certain what path I should take. One thing I can say is that I've heard from everyone under the sun to try and at least get some basic coverage even if it isn't much. I'm also in the process of trying to get another job so that makes things more complex.

[4Tran]

Originally Posted by SaintessHeart

Across the world, universal healthcare is in poor health

That's a pretty dumb article. It fails to consider that one of the main downsides to a non-universal health system is the danger that a productive person (and family) can become financially destitute because of medical costs.

Moreover, from an economical point of view, universal systems have been quite effective at reducing the overall health costs of any particular country. This is achieved by increasing the prevalence of preventative care, reducing payments to pharmaceutical companies through the use of collective bargaining power, and by reducing the abuse of emergency room visits. The writer also failed to look at how much the U.S. spends on health care and to compare that to its health outcomes.

Originally Posted by Vallen Chaos Valiant

"Moral Hazard" is used to describe people not being punished for doing the wrong thing. Your link essentially argue that sick people deserve to be sick and should die, the same way sick businesses should die. That's the American way. Rich people deserve to be rich, and poor people deserve to be poor.

Screw that.

Nevermind that the way insurance works in general is to take money from low-risk customers and to use those funds to pay out high-risk customers. Even from a purely logical point of view, this is s really stupid argument.

[SaintessHeart]

Originally Posted by Samari

Hey this is my first trip into this thread. I know there is a lot of commotion regarding US healthcare and Obama's plan to move forward. I've heard on the radio that the website has been a disaster and the entire thing is going down the drain.

I am curious though, since I'm 26, live in California, don't make a lot of money (below the poverty line/my spouse makes way more) and I don't have healthcare at the moment, do you think it would still be a good idea to look into it? I've heard that some basic packages might be affordable with the way things are going. Perhaps even dentistry? I'm not certain what path I should take. One thing I can say is that I've heard from everyone under the sun to try and at least get some basic coverage even if it isn't much. I'm also in the process of trying to get another job so that makes things more complex.

Actually yes. Get the most generic one like an Accident Plan or Hospitalisation Plan, because going there will wipe out your savings.

I injured my back at work last month and had to shell out a couple of hundred for treatment because it went over my claim limit for work-insurance. My PA paid off the rest.

Just watch out for the small wordings. They can be lethal.

[Gamer_2k4]

Originally Posted by Vallen Chaos Valiant

"Moral Hazard" is used to describe people not being punished for doing the wrong thing. Your link essentially argue that sick people deserve to be sick and should die, the same way sick businesses should die. That's the American way. Rich people deserve to be rich, and poor people deserve to be poor.

Screw that.

Alright, then you pay for them. Charity is certainly your right. Just don't tell me I have an obligation to foot the bill for someone else's problems.

Any time longer than a century ago, if you got sick, you got sick, and that was the end of it. You didn't ask other people to pay for your costs, because you COULDN'T. You talk as though healthcare and wellness are rights, but they're not. The fact that we have the ability to save people that we couldn't before doesn't create an obligation to do so. These things still cost money, and money isn't infinite.

It's all well and good to preach about how everyone should have access to top-notch healthcare for every disease and impairment under the sun, and it sounds great to say "they're people, not businesses," but at the end of the day, this IS about economics. Good medical care isn't cheap, and while sick people don't deserve to be sick, they certainly don't DESERVE to be healthy, either.

[4Tran]

Originally Posted by Gamer_2k4

Alright, then you pay for them. Charity is certainly your right. Just don't tell me I have an obligation to foot the bill for someone else's problems.

That's describing insurance, not charity.

Originally Posted by Gamer_2k4

Any time longer than a century ago, if you got sick, you got sick, and that was the end of it. You didn't ask other people to pay for your costs, because you COULDN'T. You talk as though healthcare and wellness are rights, but they're not. The fact that we have the ability to save people that we couldn't before doesn't create an obligation to do so. These things still cost money, and money isn't infinite.

Just because things sucked a hundred years ago doesn't mean that they have to suck now.

Originally Posted by Gamer_2k4

It's all well and good to preach about how everyone should have access to top-notch healthcare for every disease and impairment under the sun, and it sounds great to say "they're people, not businesses," but at the end of the day, this IS about economics. Good medical care isn't cheap, and while sick people don't deserve to be sick, they certainly don't DESERVE to be healthy, either.

Economics is precisely the main reason why universal healthcare is superior to relying purely on private systems. Let's say that you have a condition that requires a $500 drug. If you were on your own, you'd have little choice but to cough up the entire amount. A universal system can order 1 million units of that drug, and use that purchasing power to negotiate the price down to $250 per unit, and everyone wins.

[Gamer_2k4]

Originally Posted by 4Tran

That's describing insurance, not charity.

Insurance lets me choose whether or not I want to take part. Insurance excludes people with pre-existing conditions to keep costs down. Insurance makes economic sense.

Universal healthcare isn't any of those things; it's forced charity.

Originally Posted by 4Tran

Just because things sucked a hundred years ago doesn't mean that they have to suck now.

Some things never change.

Originally Posted by 4Tran

Economics is precisely the main reason why universal healthcare is superior to relying purely on private systems. Let's say that you have a condition that requires a $500 drug. If you were on your own, you'd have little choice but to cough up the entire amount. A universal system can order 1 million units of that drug, and use that purchasing power to negotiate the price down to $250 per unit, and everyone wins.

I really don't think the insurance companies are the ones buying the drugs. Besides, hospitals already get drugs in bulk, and they jack up the prices anyway. Your point is based on the ideal - an ideal we'll never see.

[4Tran]

Originally Posted by Gamer_2k4

Insurance lets me choose whether or not I want to take part. Insurance excludes people with pre-existing conditions to keep costs down. Insurance makes economic sense.

Universal healthcare isn't any of those things; it's forced charity.

In the U.S., the price of health insurance is so low compared to the potential cost of any severe medical condition that insurance isn't really optional.

Originally Posted by Gamer_2k4

I really don't think the insurance companies are the ones buying the drugs. Besides, hospitals already get drugs in bulk, and they jack up the prices anyway. Your point is based on the ideal - an ideal we'll never see.

Ideal? When we're discussing potential benefits, of course, we're going to be bringing up ideals - they're what we're trying to achieve after all. Besides, it's common for drug prices to be cheaper outside of the U.S., and bargaining power is one of the main reasons why.

[Vexx]

Alright, then you pay for them. Charity is certainly your right. Just don't tell me I have an obligation to foot the bill for someone else's problems.

Then gtfo out of society. You live in it. You cost other people money, time, and labor because you exist in a community. You are not "an island", that's delusional.

We can argue about the lines in the sand between individual responsibility and group/social/community responsibility but they're lines in sand. Use the public roads? Use the fire department, police? Do you have auto insurance? (required to drive, shared pool reduces the cost and risk)

More to the point - do you plan on never catching a disease or having an accident that bankrupts you and leaves your medical costs to the rest of us to absorb without you contributing to the community? That's the situation at present.

edit: if that sounds angry, it's because I'm tired of hearing the same indefensible assertion. it only tells me someone doesn't understand how it all hooks together or what the ramifications are.

[Anh_Minh]

What they said.

Also, before deciding that universal healthcare is "charity", you must agree to kill uninsured people as they come to the ER. If you can't do that, well, you end up paying for it anyway. In a less efficient, more expensive way.

And then, there is the question of what happens as you turn ER into slaughterhouses for the poor. I'm pretty sure the effect on society isn't going to be pretty.

[maplehurry]

Originally Posted by Gamer_2k4

Alright, then you pay for them. Charity is certainly your right. Just don't tell me I have an obligation to foot the bill for someone else's problems.

"Forced charity" doesn't start, nor will it end with healthcare, even in US.

"Some things never change" indeed, as you said so yourself.

Insurance excludes people with pre-existing conditions to keep costs down. Insurance makes economic sense.

Universal healthcare isn't any of those things;

Actually, UH IS cheaper than the US system. It's just a different perspective of economic sense (or politics).

[Irenicus]

Originally Posted by Samari

I am curious though, since I'm 26, live in California, don't make a lot of money (below the poverty line/my spouse makes way more) and I don't have healthcare at the moment, do you think it would still be a good idea to look into it? I've heard that some basic packages might be affordable with the way things are going. Perhaps even dentistry? I'm not certain what path I should take. One thing I can say is that I've heard from everyone under the sun to try and at least get some basic coverage even if it isn't much. I'm also in the process of trying to get another job so that makes things more complex.

Yes, it is worth it.

Here is why:

Uninsured people in the USA pay more for the same procedure.

I don't just mean out of pocket vs copay. I mean the dentist will literally collect $3,000 from the uninsured person and $1,500 from an insurance (with copay included in that) for the same procedure and even lower if the doctor is in the insurance network or something.

Don't ask me what the fuck is wrong with America, but it is how it is.

The previous problem is that even if you wanted to have healthcare insurance, if your employer doesn't offer/you weren't rich enough to pay for super expensive, anti-preexisting condition individual insurance plans, you were out of luck. Obamacare, for all of its messes, will change all that. There's enough teeth in that thousand-page marvel of a modern American governmental mess that basically forces insurances to play ball and create real, affordable alternatives to employer-based healthcare.

Young, presumably healthy, uninsured and with low income, you are the prime market for this reform project. You are one of the core reasons why it exists. Take advantage of it. Insure yourself. Your payment will be even less than anticipated if your income is enough (there are some levels of subsidies offered). At the very least, you will have access to preventative care and examinations, likely free of charge, which will prevent nasty "cancerous" surprises being sprung up on you.

[Sheba]

Originally Posted by Gamer_2k4

*snip*

I am fucking glad to not live under your health system because I would be FUCKING DEAD three years ago if I did.

PS: I got appendicitisis back then, it went south and I was unemployed.

[aohige]

Originally Posted by Gamer_2k4

Alright, then you pay for them. Charity is certainly your right. Just don't tell me I have an obligation to foot the bill for someone else's problems.

Do you realize you just invalidated funding schools, fire fighters, law enforcement, fixing roads and infrastructure, building highways, and disaster relief?

I don't think you even understand how much your luxury of living owes itself to the existing of society?

[SaintessHeart]

I think he means solely in the face of healthcare. Given that obesity is a major health issue in the US, there might be valid concerns about "paying for morons".

Then again, given the availability of "healthy" food as compared to "quickly done preservative trans-fat laden" food, that might be the cause of the concern, giving it is probable irrationality.

Perhaps crashing the corn/wheat/soy market for a couple of days, or enforcing a "direct public consumption" into the farm subsidy contracts might help with the issue.

P.S : I live under universal healthcare and I am not against it because it saved my life twice. But I am against "paying for morons", so I support the higher premiums chain smokers pay. Obese people too, unless they produce a valid doctor's statement stating a hereditary cause.