Liberal states impose new individual mandate ahead of ObamaCare rollback

[Moot]

As I understand it your state has its own healthcare plan why universal? Almost 330 million Americans 50 sovereign states with different cost of living, how do you implement anything universal with that diversity?

The same way they implement Medicare.

 

[Moot]

Taking jobs away from American dentists are you?

For shame!

Why that's almost the same as a company manufacturing product in some place with lower wages than the United States of Money just because it's cheaper.

Mr. Trump should impose tariffs on imported dental work.

LOL I thought the right hated taxes. So whose side are you on this week?

 

[nymillennial]

The funny thing about insurance schemes is that the larger the insured pool is the lower the individual costs are.

Let's assume that you are a fit, healthy, 20 year old male who is involved in an automobile accident, spends two weeks in ICU, then spends a couple of months in hospital and rehab while they are fitted with a prosthetic limb and learn to use it.

If you have insurance how much will you have saved in insurance premiums?

If you do not have insurance, how much will your medical, hospital, prosthetic, and rehab total bill be?

Would you like to bet that your insurance premium savings will be MORE than your medical, hospital, prosthetic, and rehab bill?

I sure wouldn't.

Except rates skyrocketed under Obamacare, even after the implementation of the individual mandate. Every time government programs have been privatized costs have gone down due to competition. There is no state where premiums went down (even adjusted for inflation) in any state since Obamacare was implemented and virtually no instance where privatization has increased costs to consumers. Obama took a system that worked for many and ruined it by turning insurance from competitive toward a Medicaid for all system (aka medicaid expansion) attempting to emulated the failed European health system.

 

[Renae]

The funny thing about insurance schemes is that the larger the insured pool is the lower the individual costs are.

Let's assume that you are a fit, healthy, 20 year old male who is involved in an automobile accident, spends two weeks in ICU, then spends a couple of months in hospital and rehab while they are fitted with a prosthetic limb and learn to use it.

If you have insurance how much will you have saved in insurance premiums?

If you do not have insurance, how much will your medical, hospital, prosthetic, and rehab total bill be?

Would you like to bet that your insurance premium savings will be MORE than your medical, hospital, prosthetic, and rehab bill?

I sure wouldn't.

Let's ask you this, you're 20 something and in good shape, you are told you have to pay for something or be punished by the government. How's that work out.

 

[HenryChinaski]

Rationing, long wait times, budgetary problems, and reinstituting private insurance in some cases.

Bull**** I have friends in Canada that utilize the healthcare system, including one pal who is a hypochondriac and goes to the doctor all the time. None of them have ever had to wait to see a physician and/or for medical treatment. Canadian healthcare is far superior to American in all regards

 

[ttwtt78640]

Except rates skyrocketed under Obamacare, even after the implementation of the individual mandate. Every time government programs have been privatized costs have gone down due to competition. There is no state where premiums went down (even adjusted for inflation) in any state since Obamacare was implemented and virtually no instance where privatization has increased costs to consumers. Obama took a system that worked for many and ruined it by turning insurance from competitive toward a Medicaid for all system (aka medicaid expansion) attempting to emulated the failed European health system.

The problem is that 'normal' insurance (a fairly high deductible and then pays a decent percentage of the balance) is not useful for those with below 'normal' incomes. Few poor folks can ever reach the deductible, and even if they did, could not pay their required percentage of the balance. IMHO, the Medicaid expansion was a good idea but implemented very badly - Medicaid has no premiums or deductibles and (allegedly) pays 100% of the bill. There is no reason that as folks get less poor (into the Medicare expansion range) that they are asked to pay no premium, no deductible and none of the balance.

 

[nymillennial]

The problem is that 'normal' insurance (a fairly high deductible and then pays a decent percentage of the balance) is not useful for those with below 'normal' incomes. Few poor folks can ever reach the deductible, and even if they did, could not pay their required percentage of the balance. IMHO, the Medicaid expansion was a good idea but implemented very badly - Medicaid has no premiums or deductibles and (allegedly) pays 100% of the bill. There is no reason that as folks get less poor (into the Medicare expansion range) that they are asked to pay no premium, no deductible and none of the balance.

Your point is fair, I can agree with that. That was a problem but the major issue was skyrocketing premiums for those who did have good insurance. Better access to medicaid is possible without Obamacare or the individual mandate.

 

[ttwtt78640]

The funny thing about insurance schemes is that the larger the insured pool is the lower the individual costs are.

Let's assume that you are a fit, healthy, 20 year old male who is involved in an automobile accident, spends two weeks in ICU, then spends a couple of months in hospital and rehab while they are fitted with a prosthetic limb and learn to use it.

If you have insurance how much will you have saved in insurance premiums?

If you do not have insurance, how much will your medical, hospital, prosthetic, and rehab total bill be?

Would you like to bet that your insurance premium savings will be MORE than your medical, hospital, prosthetic, and rehab bill?

I sure wouldn't.

OK, but look at the flip side (assuming, of course, that you were at fault for the auto accident) - even uninsured you are going to get the needed ICU and hospital care (see EMTALA) so any premiums paid are gone and thus not available for use to help pay for the non-EMTALA care (or even a BigMac) needed and you likely no longer have income or insurance (assuming that it was employer provided or you needed to pay premiums with your income). At that point you are unemployed, broke and disabled and can get Medicaid to pay for your rehab care. Having insurance (initially) helped to pay the ICU and hospital care providers but you are no better off since you end up broke, unemployed and disabled either way.

 

[Bullseye]

Bull**** I have friends in Canada that utilize the healthcare system, including one pal who is a hypochondriac and goes to the doctor all the time. None of them have ever had to wait to see a physician and/or for medical treatment. Canadian healthcare is far superior to American in all regards

Then take your profanity and move to Canada. Just wait until your "friends" try and see a specialist or requires more than a little cough syrup or a few aspirin. Even Canada recognizes they have problems with wait times and lack of facilities. I'd provide a link if you hadn't been such an asshole.

 

[Nilly]

Let's ask you this, you're 20 something and in good shape, you are told you have to pay for something or be punished by the government. How's that work out.

Ooh, I qualify for this, let me see: You have a quick think, recognize that a healthy population around you actually benefits you as a citizen, and go along your merry way, happy in the knowledge that if something happens to you you're covered. Next question?

 

[Nilly]

Then take your profanity and move to Canada. Just wait until your "friends" try and see a specialist or requires more than a little cough syrup or a few aspirin. Even Canada recognizes they have problems with wait times and lack of facilities. I'd provide a link if you hadn't been such an asshole.

Canada could easily choose to lower wait times by spending more money. They don't because they choose to be fiscally conservative. They weigh up 'getting good healthcare' vs 'having to wait 2 days to see a doc for a wart'. Its a choice, and one most are happy with. Wait times aren't a symptom of 'single payer', they're a function of how much money you want to sink into a system. When you need healthcare, you get it.

 

[ttwtt78640]

Your point is fair, I can agree with that. That was a problem but the major issue was skyrocketing premiums for those who did have good insurance. Better access to medicaid is possible without Obamacare or the individual mandate.

The problem is still who pays for the care of the poor and how. Premiums and deductibles don't come down unless care provider costs (thus prices) come down no matter how you shift who pays what. The myth seems to be that if the government was the single payer then care providers would simply have to charge less. See DoD contractors or public K-12 schools for how that works out.

If that were the case, then why not do that with SNAP? The answer is obvious - if SNAP paid 70% of 'average retail' then few (or no?) retail outlets would accept it - they simply do not make 30% (or more) in profit. It sounds wonderful to say that government will give everyone $2 foot-long submarine sandwich coupons until you try to find a $2 foot-long submarine sandwich store that accepts them.

 

[Greenbeard]

Except rates skyrocketed under Obamacare, even after the implementation of the individual mandate. Every time government programs have been privatized costs have gone down due to competition. There is no state where premiums went down (even adjusted for inflation) in any state since Obamacare was implemented and virtually no instance where privatization has increased costs to consumers. Obama took a system that worked for many and ruined it by turning insurance from competitive toward a Medicaid for all system (aka medicaid expansion) attempting to emulated the failed European health system.

Individual market premiums in New York were cut in half in real terms when the ACA went into effect. The reason being New York already had the protections but no individual mandate and implementing the latter (surprise) lowers premiums. And you can't "privatize" this insurance, these are already private insurance markets.

 

[Nilly]

The problem is still who pays for the care of the poor and how. Premiums and deductibles don't come down unless care provider costs (thus prices) come down no matter how you shift who pays what. The myth seems to be that if the government was the single payer then care providers would simply have to charge less. See DoD contractors or public K-12 schools for how that works out.

If that were the case, then why not do that with SNAP? The answer is obvious - if SNAP paid 70% of 'average retail' then few (or no?) retail outlets would accept it - they simply do not make 30% (or more) in profit. It sounds wonderful to say that government will give everyone $2 foot-long submarine sandwich coupons until you try to find a $2 foot-long submarine sandwich store that accepts them.

Can you please explain your DoD contractor/public K-12 school analogy in more detail? Under single payer the govt is bargaining for, say, a drug, which has limited customer base outside of medicine. K-12 public schools are trying to purchase stationary, which is of course used ubiquitously.

 

[nymillennial]

Individual market premiums in New York were cut in half in real terms when the ACA went into effect. The reason being New York already had the protections but no individual mandate and implementing the latter (surprise) lowers premiums. And you can't "privatize" this insurance, these are already private insurance markets.

New York had premiums skyrocket each year following the adopting of the ACA. And yes it is already private, my point was that privatization creates lower costs and better quality. That is why public programs have been privatized in the past for these reasons, not the other way around like Obamacare did.

 

[ttwtt78640]

Can you please explain your DoD contractor/public K-12 school analogy in more detail? Under single payer the govt is bargaining for, say, a drug, which has limited customer base outside of medicine. K-12 public schools are trying to purchase stationary, which is of course used ubiquitously.

Our military spends top dollar for everything and so do our public schools. This is where the 'look at how much other countries save' argument falls apart. We are not other countries so look at what US 'single payer' stuff costs when compared to its foreign equivalent.

https://www.military.com/kitup/2018...d-cost-air-force-450-million-slides-show.html

https://www.army.mil/article/131259/soldiers_to_get_new_camo_uniform_beginning_next_summer

 

[Nilly]

Our military spends top dollar for everything and so do our public schools. This is where the 'look at how much other countries save' argument falls apart. We are not other countries so look at what US 'single payer' stuff costs when compared to its foreign equivalent.

https://www.military.com/kitup/2018...d-cost-air-force-450-million-slides-show.html

https://www.army.mil/article/131259/soldiers_to_get_new_camo_uniform_beginning_next_summer

What does 'US single payer' stuff cost when compared to it's foreign equivalent?

Sorry but not sure how this holds up to scrutiny. Yes the military industrial complex is crazy and we spend far too much on the military, but that's not an argument against single payer. Military spending is as much a function of its ridiculous budget and lobbying as much as it is anything else. And as for public schools, like I said, they're buying items that are used ubiquitously. Everyone needs pencils, so the market drives costs up, the schools aren't the only buyers in the space. When the govt is the only drug purchaser in town then there are no other buyers to drive the market up, just competing sellers, which drives the market down. Why do you think everyone goes to canada for prescription drugs?

 

[Renae]

Ooh, I qualify for this, let me see: You have a quick think, recognize that a healthy population around you actually benefits you as a citizen, and go along your merry way, happy in the knowledge that if something happens to you you're covered. Next question?

Well if you ant to choose that, aces, what if you do NOT want to make that cost right now? You're paying for school, maybe saving for a house or other things. The point is, you lose that choice when Government and others who believe you owe them your hard earned money force you to do so.

 

[Checkerboard Strangler]

I get my dental work (other than routine check ups and cleaning) in Los Algodones, Mexico. I recently had a root canal with a crown and it cost $440 out of pocket of which my insurance company reimbursed me half and it all took place in a single weekend.

Your insurance reimbursed you for dental work done in Mexico???
Please give some more details. Is it dental insurance?
PM me if you want.
I need dental work and I'll drive to MX if need be.

 

[Bullseye]

Canada could easily choose to lower wait times by spending more money. They don't because they choose to be fiscally conservative. They weigh up 'getting good healthcare' vs 'having to wait 2 days to see a doc for a wart'. Its a choice, and one most are happy with. Wait times aren't a symptom of 'single payer', they're a function of how much money you want to sink into a system. When you need healthcare, you get it.

LOL, then why do they mandate wait times and then report failing to meet them? As for "being happy with that" you need to talk to a few Canadians who have to wait months to see specialists.

 

[CriticalThought]

LOL, then why do they mandate wait times and then report failing to meet them? As for "being happy with that" you need to talk to a few Canadians who have to wait months to see specialists.

Every Canadian I have met has been very happy with their healthcare system. It seems to be only right wing Americans who complain about it.

 

[azgreg]

Your insurance reimbursed you for dental work done in Mexico???
Please give some more details. Is it dental insurance?
PM me if you want.
I need dental work and I'll drive to MX if need be.

Yes, dental insurance. It was considered out of network, so the reimbursement was lower.

 

[HenryChinaski]

Then take your profanity and move to Canada. Just wait until your "friends" try and see a specialist or requires more than a little cough syrup or a few aspirin. Even Canada recognizes they have problems with wait times and lack of facilities. I'd provide a link if you hadn't been such an asshole.

They’ve all seen specialists for hernias and Crohn’s disease. Ya don’t know what your talking about.

 

[Conservative]

The same way they implement Medicare.

Medicare cost more than intended and is full of waste, fraud, and abuse. It is a forced contribution and when I lost my private healthcare I lost my doctor. Interesting how personal choice only exists on programs you like or want

 

[MTAtech]

Translation: adverse selection = higher premiums. Red states will figure that out eventually.

What the GOP hasn't grasp yet is that you can’t just support the popular pieces of the ACA, in particular coverage for preexisting conditions, and scrap the rest. As many others have said many times, reform is a three-legged stool that requires community rating, the individual mandate, and subsidies; take away any leg and it collapses.

If you don't have subsidies, then low income workers drop out, worsening the risk pool. If you take away community ratings, everyone has their own personal price and those who are sick will pay much higher rates. If you take away the mandate, you cause a rate spiral -- since you are encouraging people to sign up (e.g. because preexisting illness can't be refused) making the rate pool sicker and more expensive.

So, what blue states are doing is rational and reasonable and certainly within their power under federalism.