Quality of Life - Thoughts

[HikerGuy83]

As I've been working on my web-site, I've been thinking more about the Quality of Life and how it should be used in discussions around politics and community.

People often use the term to sell a concept or idea. Something I find distasteful and it always puts me on guard.

Most defintions will admit that both the definition and associated metrics are subjective and somewhat arbitrary. While I acknowledge that, I think it is still something we should include in our conversations.

I find that actively considering it has influenced my conscience thought (but I guess that is true in most instances).

As an example:

Health Care......

Because of my distrust of Washington D.C., I don't want our federal government in charge of anything to do with health care.

At the same time, I (having been blessed with great private insurance my entire working career) know that the lack of health insurance can be devastating to a family.

I want a conservative approach to it, but I would like to see a good public discussion on this and a conversation around what we desire as a national and as state communities for ourselves and what we are willing to do/not do to affect it.

There are many who seek to "measure it". I applaud those efforts if they don't have an agenda behind them.

 

[Grand Mal]

As I've been working on my web-site, I've been thinking more about the Quality of Life and how it should be used in discussions around politics and community.

People often use the term to sell a concept or idea. Something I find distasteful and it always puts me on guard.

Most defintions will admit that both the definition and associated metrics are subjective and somewhat arbitrary. While I acknowledge that, I think it is still something we should include in our conversations.

I find that actively considering it has influenced my conscience thought (but I guess that is true in most instances).

As an example:

Health Care......

Because of my distrust of Washington D.C., I don't want our federal government in charge of anything to do with health care.

At the same time, I (having been blessed with great private insurance my entire working career) know that the lack of health insurance can be devastating to a family.

I want a conservative approach to it, but I would like to see a good public discussion on this and a conversation around what we desire as a national and as state communities for ourselves and what we are willing to do/not do to affect it.

There are many who seek to "measure it". I applaud those efforts if they don't have an agenda behind them.

Make it more local then. In Canada the only federal involvement is the requirement that all Canadians have a right to access to health care. It's up to the province's how that is delivered.
You don't have to reinvent the wheel. There's dozens of government health care insurance schemes around the world- pick one that does what you want it to and copy it

 

[ttwtt78640]

Make it more local then. In Canada the only federal involvement is the requirement that all Canadians have a right to access to health care. It's up to the province's how that is delivered.
You don't have to reinvent the wheel. There's dozens of government health care insurance schemes around the world- pick one that does what you want it to and copy it

That (bolded above) assertion doesn’t seem to be true.

The provinces and territories generate 78% of the cost, with the federal government providing the rest through the Canada Health Transfer (CHT).

This split has been the subject of debate since Medicare was first established.

At that time, the federal share was about 35%.

In the late 1970s, it dropped to 25%.

Today, the Canada Health Transfer stands at about 22%.

Health care funding in Canada

It’s clear that Canada’s current health care spending is unsustainable. Rising costs are a reality. The COVID-19 pandemic and the recent wave of high inflation are stretching health care budgets. And relief is unlikely thanks to an aging population and an increase in the prevalence of chronic...

www.cma.ca

 

[BlueTex]

As I've been working on my web-site, I've been thinking more about the Quality of Life and how it should be used in discussions around politics and community.

People often use the term to sell a concept or idea. Something I find distasteful and it always puts me on guard.

Most defintions will admit that both the definition and associated metrics are subjective and somewhat arbitrary. While I acknowledge that, I think it is still something we should include in our conversations.

I find that actively considering it has influenced my conscience thought (but I guess that is true in most instances).

As an example:

Health Care......

Because of my distrust of Washington D.C., I don't want our federal government in charge of anything to do with health care.

At the same time, I (having been blessed with great private insurance my entire working career) know that the lack of health insurance can be devastating to a family.

I want a conservative approach to it, but I would like to see a good public discussion on this and a conversation around what we desire as a national and as state communities for ourselves and what we are willing to do/not do to affect it.

There are many who seek to "measure it". I applaud those efforts if they don't have an agenda behind them.

During your career, has your private insurance company always been local? When you talk about health care, are you talking about providers or payers? For providers, I would agree..I do not want my primary care doctor to be 1000 miles away but fortunately have never heard anyone suggest such a thing. For the payer side, who care where they are located?

 

[ttwtt78640]

During your career, has your private insurance company always been local? When you talk about health care, are you talking about providers or payers? For providers, I would agree..I do not want my primary care doctor to be 1000 miles away but fortunately have never heard anyone suggest such a thing. For the payer side, who care where they are located?

That’s a good point. Many ‘Medicare Advantage Plans’ (usually HMO or PPO based) have their availability based on where the ‘applicant for coverage’ lives - often based on both the postal zip-code and county of one’s residence.

At one time, I lived in Maryland and worked in DC for an employer based in Virginia. I opted to get medical care insurance from a Virginia based HMO provider because their coverage was better and my (employee) share of the (employer subsidized) premium cost was lower than any Maryland or DC based insurance plans offered by HR.

 

[BirdinHand]

See, the ACA has been a game changer in my family’s quality of life.

If it wasn’t for the ACA, I’d likely have to work as an employee somewhere and maintain working for that employer to have health insurance for my family. And frankly, some employers I’ve worked for have had really bad insurance policies - because that’s what they chose. Even worse would be when they decided to change insurance providers/plans and then that meant I had to change doctors, etc because the new plan would be in a different network.

Now, I simply go online to the NJ Portal annually and renew our coverage (and I always see if there is a different option that’s better for us).

Our health insurance is now under our control. And I haven’t had to be an employee anywhere. I can have my own small business, I can offer consulting services, etc as fits my families schedule and lifestyle - and the worry isn’t there about health insurance.

But, from what I understand, my experience in NJ when it comes to the ACA is completely different than those in other states - because NJ is “all in”. We have numerous providers and tiers available and there are lots of plans to choose from. I’ve heard in other states, that isn’t the case.

 

[ttwtt78640]

See, the ACA has been a game changer in my family’s quality of life.

If it wasn’t for the ACA, I’d likely have to work as an employee somewhere and maintain working for that employer to have health insurance for my family. And frankly, some employers I’ve worked for have had really bad insurance policies - because that’s what they chose. Even worse would be when they decided to change insurance providers/plans and then that meant I had to change doctors, etc because the new plan would be in a different network.

Now, I simply go online to the NJ Portal annually and renew our coverage (and I always see if there is a different option that’s better for us).

Our health insurance is now under our control. And I haven’t had to be an employee anywhere. I can have my own small business, I can offer consulting services, etc as fits my families schedule and lifestyle - and the worry isn’t there about health insurance.

But, from what I understand, my experience in NJ when it comes to the ACA is completely different than those in other states - because NJ is “all in”. We have numerous providers and tiers available and there are lots of plans to choose from. I’ve heard in other states, that isn’t the case.

Yep, having competition among multiple choices is much better than having one (take it or leave it) option.

 

[BirdinHand]

Yep, having competition among multiple choices is much better than having one (take it or leave it) option.

I agree.

I’d like to see the states who do not have much choice have greater participation on their markets.

 

[ttwtt78640]

I agree.

I’d like to see the states who do not have much choice have greater participation on their markets.

The following (rather lengthy) link explains some differences in state policy which impact medical care insurance market competition and cost.

Making Choice and Competition Work in Individual Insurance in Health Reform Proposals

There are multiple areas where insurance design could promote efficient competition and consumer choice. Experiences with the ACA have shown that markets can deliver efficient premiums, access to care, and consumer satisfaction but only when they are carefully designed and actively managed...

www.commonwealthfund.org

 

[BirdinHand]

The following (rather lengthy) link explains some differences in state policy which impact medical care insurance market competition and cost.

Making Choice and Competition Work in Individual Insurance in Health Reform Proposals

There are multiple areas where insurance design could promote efficient competition and consumer choice. Experiences with the ACA have shown that markets can deliver efficient premiums, access to care, and consumer satisfaction but only when they are carefully designed and actively managed...

www.commonwealthfund.org

I have to finish reading this. Thank you for sharing

 

[bongsaway]

As I've been working on my web-site, I've been thinking more about the Quality of Life and how it should be used in discussions around politics and community.

People often use the term to sell a concept or idea. Something I find distasteful and it always puts me on guard.

Most defintions will admit that both the definition and associated metrics are subjective and somewhat arbitrary. While I acknowledge that, I think it is still something we should include in our conversations.

I find that actively considering it has influenced my conscience thought (but I guess that is true in most instances).

As an example:

Health Care......

Because of my distrust of Washington D.C., I don't want our federal government in charge of anything to do with health care.

At the same time, I (having been blessed with great private insurance my entire working career) know that the lack of health insurance can be devastating to a family.

I want a conservative approach to it, but I would like to see a good public discussion on this and a conversation around what we desire as a national and as state communities for ourselves and what we are willing to do/not do to affect it.

There are many who seek to "measure it". I applaud those efforts if they don't have an agenda behind them.

So you distrust washington d.c. to be in charge of anything to do with health care? Two of the most consistent things the government does for us is medicare and social security, works every time I use it and my checks are NEVER late but sometimes early, like today. I get my check on the third of the month but because the third is saturday, I receive it today.

 

[Grand Mal]

That (bolded above) assertion doesn’t seem to be true.

Health care funding in Canada

It’s clear that Canada’s current health care spending is unsustainable. Rising costs are a reality. The COVID-19 pandemic and the recent wave of high inflation are stretching health care budgets. And relief is unlikely thanks to an aging population and an increase in the prevalence of chronic...

www.cma.ca

Well, a lot of funding comes from the feds but I pay my premiums to the B.C. Medical Services Plan and that's who my doctor sends his bill to. In Alberta it's the Alberta Health Services.
That's what I meant when I said it was up to the province's to deliver medical insurance.

 

[ttwtt78640]

Well, a lot of funding comes from the feds but I pay my premiums to the B.C. Medical Services Plan and that's who my doctor sends his bill to. In Alberta it's the Alberta Health Services.
That's what I meant when I said it was up to the province's to deliver medical insurance.

That was precisely my point. It’s hard to argue that paying for (or subsidizing) X is not having any involvement in X.

 

[Grand Mal]

That was precisely my point. It’s hard to argue that paying for (or subsidizing) X is not having any involvement in X.

Okay. The feds fund it for 30%. Or something. They have that much involvement.

 

[ttwtt78640]

Okay. The feds fund it for 30%. Or something. They have that much involvement.

Yep, but the idea that publicly subsidizing something automagically reduces it’s cost is BS.

For example, the cost of groceries purchased with SNAP funds is no less than that paid by any other grocery buyer. SNAP offers an over $100B/year federal subsidy to ‘grocery providers’ which charge full retail (including profit) price for SNAP grocery purchases.

https://www.cbpp.org/research/food-assistance/the-supplemental-nutrition-assistance-program-snap

 

[soylentgreen]

Yep, having competition among multiple choices is much better than having one (take it or leave it) option.

Who said it had to be a binary decision?

https://www.healthnavigator.org.nz/healthy-living/n/nz-health-system/

Healthcare in New Zealand is a mixture of free services and subsidised services (where you pay a fee to cover some of the costs). For example:

• most hospital visits and visits to the family General Practitioner (GP) for children aged under 13 are free
• GP's appointments for other age groups and picking up a prescription from the pharmacy do cost, even with a government subsidy (the government pays part of the cost).

 

[Donatello]

As I've been working on my web-site, I've been thinking more about the Quality of Life and how it should be used in discussions around politics and community.

People often use the term to sell a concept or idea. Something I find distasteful and it always puts me on guard.

Most defintions will admit that both the definition and associated metrics are subjective and somewhat arbitrary. While I acknowledge that, I think it is still something we should include in our conversations.

I find that actively considering it has influenced my conscience thought (but I guess that is true in most instances).

As an example:

Health Care......

Because of my distrust of Washington D.C., I don't want our federal government in charge of anything to do with health care.

At the same time, I (having been blessed with great private insurance my entire working career) know that the lack of health insurance can be devastating to a family.

I want a conservative approach to it, but I would like to see a good public discussion on this and a conversation around what we desire as a national and as state communities for ourselves and what we are willing to do/not do to affect it.

There are many who seek to "measure it". I applaud those efforts if they don't have an agenda behind them.

What is a "conservative approach" to Healthcare? What does that mean?

 

[ttwtt78640]

Who said it had to be a binary decision?

https://www.healthnavigator.org.nz/healthy-living/n/nz-health-system/

Your link addresses only publicly funded health care insurance.

The following link addresses the overall (public and private) health care insurance situation.

Healthcare and health insurance for expats in New Zealand| Expat Arrivals

Healthcare in New Zealand is a crucial aspect of the country's infrastructure, and fortunately, the nation boasts a robust healthcare system that offers both public and private care options to its residents.

www.expatarrivals.com

 

[soylentgreen]

Yep, but the idea that publicly subsidizing something automagically reduces it’s cost is BS.

For example, the cost of groceries purchased with SNAP funds is no less than that paid by any other grocery buyer. SNAP offers an over $100B/year federal subsidy to ‘grocery providers’ which charge full retail (including profit) price for SNAP grocery purchases.

https://www.cbpp.org/research/food-assistance/the-supplemental-nutrition-assistance-program-snap

That is not a reason I would choose to use.

Often in economic discussions the word "free' appears especially when discussing social benefits paid out by the government. That word " free' has a specific meaning in economics than just the normal dictionary meaning.

The idea that I would use it that those in most need, the poor, are able to have food.

 

[soylentgreen]

Your link addresses only publicly funded health care insurance.

The following link addresses the overall (public and private) health care insurance situation.

Healthcare and health insurance for expats in New Zealand| Expat Arrivals

Healthcare in New Zealand is a crucial aspect of the country's infrastructure, and fortunately, the nation boasts a robust healthcare system that offers both public and private care options to its residents.

www.expatarrivals.com

So yes, thank you or providing further evidence that you need not argue that it must be a binary decision.

 

[ttwtt78640]

So yes, thank you or providing further evidence that you need not argue that it must be a binary decision.

My point was that there are advocates for doing precisely that.

This bill establishes the Medicare for All Program to provide all individuals residing in the United States and U.S. territories with free health care that includes all medically necessary care, such as primary care and prevention, dietary and nutritional therapies, prescription drugs, emergency care, long-term care, mental health services, dental services, and vision care.

Only public or nonprofit institutions may participate. Nonprofit health maintenance organizations (HMOs) that deliver care in their own facilities may participate.

Patients may choose from participating physicians and institutions.

Health insurers may not sell health insurance that duplicates the benefits provided under this bill. Insurers may sell benefits that are not medically necessary, such as cosmetic surgery benefits.

H.R.676 - 115th Congress (2017-2018): Expanded & Improved Medicare For All Act

Summary of H.R.676 - 115th Congress (2017-2018): Expanded & Improved Medicare For All Act

www.congress.gov

 

[Greenbeard]

As an example:

Health Care......

Because of my distrust of Washington D.C., I don't want our federal government in charge of anything to do with health care.

At the same time, I (having been blessed with great private insurance my entire working career) know that the lack of health insurance can be devastating to a family.

I want a conservative approach to it, but I would like to see a good public discussion on this and a conversation around what we desire as a national and as state communities for ourselves and what we are willing to do/not do to affect it.

Over a decade ago, we had exactly this debate.

The House, being the House, said let's set up a national marketplace with financial support to help people without offers of health care coverage at work buy coverage, and we'll make Medicaid a universal coverage program for the poor.

The Senate, being the Senate, said let's set up state-based and state-run marketplaces (with a federal backstop for states not interested in operating and setting policy for their own marketplaces) with financial support to help people without offers of health care coverage at work buy coverage, and we'll make Medicaid a universal coverage program for the poor.

("Conservative" Republicans largely boycotted the conversation).

The Senate won. And the SCOTUS subsequently said fine, but the Medicaid part requires states to opt in to making Medicaid universally available to poor people.

Red ("conservative"?) states largely said 'we're not interested in operating our own state marketplaces, we'll default to the federally-operated option.' The bluest states said 'we'd rather operate our own marketplaces at the state level ourselves, no thank you, federal government.' What a twist! (In Mississippi, the GOP governor and the GOP insurance commissioner feuded over this very question, before the governor won and the state defaulted to the federally-run option). So most red states ended up with federally-operated marketplaces for insurance and many blue states ended up with state-run marketplaces.

Meanwhile, virtually every blue state (and most red states) accepted the option to accept the expansion of Medicaid into a program of universal coverage for the poor. But some of the reddest states held out. But proponents in some deep-red states decided to ask voters at the ballot box and it turns out deep-red voters in Idaho, Missouri, Nebraska, Oklahoma, Utah, and South Dakota all thought Medicaid should be expanded to cover all poor people.

Maybe the moral is that "a conservative approach" to this question is completely meaningless at this point. And we should stop hiding behind labels and abstractions and just do what we think makes sense.

Certainly that approach has improved the quality of life for millions of people over the last 12 years or so with respect to their health care.

 

[rickc]

What is a "conservative approach" to Healthcare? What does that mean?

The best health care you can afford!

 

[ttwtt78640]

Over a decade ago, we had exactly this debate.

The House, being the House, said let's set up a national marketplace with financial support to help people without offers of health care coverage at work buy coverage, and we'll make Medicaid a universal coverage program for the poor.

The Senate, being the Senate, said let's set up state-based and state-run marketplaces (with a federal backstop for states not interested in operating and setting policy for their own marketplaces) with financial support to help people without offers of health care coverage at work buy coverage, and we'll make Medicaid a universal coverage program for the poor.

("Conservative" Republicans largely boycotted the conversation).

The Senate won. And the SCOTUS subsequently said fine, but the Medicaid part requires states to opt in to making Medicaid universally available to poor people.

Red ("conservative"?) states largely said 'we're not interested in operating our own state marketplaces, we'll default to the federally-operated option.' The bluest states said 'we'd rather operate our own marketplaces at the state level ourselves, no thank you, federal government.' What a twist! (In Mississippi, the GOP governor and the GOP insurance commissioner feuded over this very question, before the governor won and the state defaulted to the federally-run option). So most red states ended up with federally-operated marketplaces for insurance and many blue states ended up with state-run marketplaces.

Meanwhile, virtually every blue state (and most red states) accepted the option to accept the expansion of Medicaid into a program of universal coverage for the poor. But some of the reddest states held out. But proponents in some deep-red states decided to ask voters at the ballot box and it turns out deep-red voters in Idaho, Missouri, Nebraska, Oklahoma, Utah, and South Dakota all thought Medicaid should be expanded to cover all poor people.

Maybe the moral is that "a conservative approach" to this question is completely meaningless at this point. And we should stop hiding behind labels and abstractions and just do what we think makes sense.

Certainly that approach has improved the quality of life for millions of people over the last 12 years or so with respect to their health care.

Medicaid can‘t become ‘universal’ so long as Medicare exists. A huge flaw in Medicaid (aside from having variable state funding requirements) is that it’s longer term (nursing home) care benefit payments can become a lien on the estate of the covered person and recovered after their death.

 

[ttwtt78640]

The best health care you can afford!

Yep, just like housing, food, utilities, transportation and clothing.