Healthcare... America and the rest

[Ayaan]

These things cost nothing. It's just a list of things you can sign up for. I think there is free insurance in business travel. You could get drunk and run over and be covered, world wide.

No one has lost a body part yet, but people have had to have stitches and have broken bones after encounters with machines. A few weeks ago, a compressed air line broke loose. No one was hurt, but judging from the gouge in the floor, if someone had been nearby, they could have been badly injured. This is not your typical pharmacy - you have conveyor belts moving things around (they go from near floor level to several feet overhead), robot arms moving things around, paper feeders dropping papers into packing machines, huge rolls of package film that have to be moved into place on the packing machines, that film has to be heated to form and seal the packages, there are blades to cut the packages apart, just to name a few hazards. Things get stuck or hung up all the time requiring human intervention. Some areas can only be accessed by crawling under conveyer belts. If you get too complacent or forget to pay attention to what you are doing, it would be easy to get hurt. Besides, it costs next to nothing, so why not have it, just in case.

[Tero]

Well the traveling sales rep would be covered off duty too. With your regular work place you have workman's comp by law.

[Ayaan]

True. The policy is just some extra coverage.

[Seth]

Seth, Republicans had 20 years or more to fix healthcare. They did...nothing.

That's because nothing is what was supposed to be done. Government has no place involving itself in the private medical affairs of the public. It was in point of fact the government that CREATED "health care insurance" way back during WWII. You see, before then, people paid for their own health care, and the free market for health care services kept prices reasonable. Knowing that they might face major medical expenses people actually saved money in an actual bank to be used for medical emergencies. During WWII, the federal government imposed controls on both wages and on hiring practices that made it illegal for one company to "rob" a competitor of their skilled employees by offering them higher wages. So companies began offering "benefits" packages as inducements to skilled employees to switch employers, the main one being company-paid health care. Not "insurance," just paid health care, sometimes provided by company doctors and clinics, sometimes by a physician or clinic of one's own choosing. This state of affairs continued for a good long time and most people were happy with the system. More and more companies offered health care as a perk and as a way of keeping wages down. Then in 1973 the government made it mandatory that companies with more than 25 employees, if they offered any health care insurance, had to offer plans that met a government standard. This was signed by Nixon.

The minute that the government set a standard, as it has done again with Obamacare, the shenanigans start.

The first problem with health care "insurance" is that it's not really insurance as much as it is pre-paid medical care, particularly when it's part of an HMO structure where the premiums are collected by the same organization that provides the actual care. This gives the HMO motivation to cut costs by limiting services and enforcing caps on the maximum amount of care that can be received. This motive applies to every patient when the care provider sets the premiums, rather than a traditional insurance structure where the actuary (insurer) carefully calculates the probabilities and costs and sets a premium, but is then obligated to cover the peril to the degree that the policy states. Insurers depend on the risk pool and the time value of money to make their profits. HMOs depend on cost-cutting and limiting of services to make their profits. The other way that HMOs differ is that they generally cannot (by law) increase the premium of an individual client based on that client's history of medical expenses. Insurers will routinely raise your premiums if you make claims. They will pay the claim, but for the next one you'll pay more. The HMO promises to provide whatever care you need at a fixed price, and like a buffet, it's a delicate financial balancing act between how much roast beef is available at a given price versus how many people will demand the "free" roast beef for dinner every night. This makes the market for medical services far more volatile than the typical insurance industry model where the insurer pays the claim, but also gets to audit the claim and adjust the payment based on the actual loss involved, and the customer gets to decide who does the work and whether to pay more for better service or simply keep the payout and not replace or repair the damaged goods. That paradigm doesn't exist with health care. You can't claim a cut finger and then get a check from the insurance company to reimburse for your out-of-pocket expense at the doctor...or skip the doctor and keep the check. You aren't paying for "insurance" at all, which is intended to make you whole FINANCIALLY for a covered peril, with the HMO you are paying for SERVICE, and you only get your money's worth if you actually USE the service.

The second, and really the biggest problem with "health care insurance" is that, being actually nothing more than guaranteed pre-paid medical care, the system induces clients to over-use the available resources. Most people figure, "Well, I pay a grand a month for this HMO coverage so I damned well better get a grand's worth of service from them even if I really don't need the service." That's why HMO waiting rooms are clogged with jackasses suffering from the common cold, which is viral in nature, demanding that the HMO dispense antibiotics. That's why every kid with a splinter in his finger ends up at the HMO because the parents figure, "What the hell, we've paid for it already we might as well use it."

This leads to over-use of precious medical resources, and any time there is a high demand for a product or service, the price is going to go up, especially with actual health care, because it's the source of great anxiety and angst to the public who are constantly bombarded with advertising about how dangerous life is and how expensive medical care is. Not only is the provider going to try to make more money but the suppliers who supply the medical equipment and supplies are going to jack their prices up because they too figure they have a captive audience, which they do. So, the suppliers jack their prices to what the traffic will bear, and the HMOs jack their premiums to compensate and preserve their profits.

In the good old days, like when I was a kid, going to the doctor meant that you had to put cash on the barrel-head right then and there. But it also meant that there were dozens or hundreds of independent physicians competing against one another for customers, so they had to provide better service at a lower cost in order to keep customers. Although patients tend to find a doctor they like and stick with them (I saw the same doctor for most of my life, from childhood until I was more than 45, when he finally retired) cost still makes a difference and someone could go find another doctor, or another hospital to provide the needed care at a better price. With the HMO, you are compelled to obtain your service from the premium-collector's "network" of facilities and doctors, which gives the HMO the advantage of controlling costs in many ways by not only controlling what care is provided, but using what supplies and resources. Their motive is, of course, to provide you with the LEAST expensive care that they can get away with, whereas with ordinary insurance you pay for X amount of coverage for loss Y, and you get a check for X if you suffer Y and then you get to decide what to do with the money...replace Y or keep the money or something else.

Since the insurer knows exactly how much they will have to pay out to an individual client if peril Y comes to pass, actuarial science can with reasonable accuracy predict cash flow and return on investment over large risk pools.

But no medical patient or provider actually knows how much medical care a particular patient will require in return for the premium paid. It could be $50 for a splinter or $50,000 for a heart attack. And since they cannot (by law) raise your premium in the future because you had a heart attack last year or you've been in 50 times in the last year for petty, niggling little things that you could have just handled yourself, the premiums for everyone in the HMO must reflect the reality of the expense of providing all the promised care to all of the clients, even though it's pretty much entirely unpredictable how much it will cost in any given year because of the random nature of health problems and health care costs.

And this situation, where the HMO is compelled to provide whatever care a client needs, regardless of cost, and now regardless of prior medical history, in addition to covering many mandated services that Obamacare deems are "required" coverage, it's perfectly obvious to anyone with even a rudimentary knowledge of economics that the premiums are going to go up and up every time some particular service is mandated by law. Take psychiatric care for example. It's mandated under Obamacare. But mental health treatment can be one of the most time-consuming and expensive things a patient can get into, and because it's not really objective in nature (ie: pathogen A causes disease B, administer drug C to cure patient) but rather is highly subjective (ie: this patient has daddy issues as the result of abuse that will take decades of intensive psychotherapy to resolve while that patient is malingering and claiming that "stress" is causing mental health problems) and therefore it's impossible to predict how much a HMO is going to have to pay out for such mandated services. But the client doesn't care about that because he's already paid for that coverage so he's damned well going to demand to see the shrink to help him with his "mental illness" driven obesity.

So the more mandated services the HMO has to provide for a fixed fee, the higher the premium is going to be. Even a confederacy of dunces like the Democrat party knows this.

To begin, Fleitman is wrong about the process of passing the Affordable Care Act. Republicans chose to obstruct the law at every turn instead of working to fix aspects they didn’t like or proposing a viable alternative. Fleitman claims Democrats “crammed” the law past Republicans, creating “enduring bitterness.” Hogwash.

We all remember the protest signs depicting Obama as Hitler or a witch doctor, town-hall screaming fits, lies about “death panels,” and shouts of “You lie!” at the president and “Baby killer!” at Democrats in Congress. Fleitman apparently doesn’t remember, but those displays of bitterness and incivility mostly predated the actual legislative process of passing the law.

And not one of those protests changed a fucking thing in the bill, which had been drafted years before by the Progressivists and had been stuck in a filing cabinet just waiting for a Democrat-ruled government to cram it through, which is factually exactly what happened. The Democrat party and Obama simply ignored all the protest and cautions given to them by people who knew whereof they spoke and "passed the bill so you can see what's in the bill." And THAT is how it happened, your revisionism not withstanding.

Republicans had plenty of opportunity for input as the law took shape, despite Fleitman’s revisionist history. In fact, many aspects of the law were originally Republican ideas they disowned when President Obama endorsed them. The “individual mandate,” for example, was proposed by the conservative Heritage Foundation as a personal responsibility provision. Republicans now act as though their idea is tyranny from a dictatorial Obama. As Republicans obstructed, Democrats compromised on single-payer, public option and even contraceptive coverage.

Whoopee. They didn't abandon single-payer, public option or anything else, they just created a Machiavellian bureaucracy that is guaranteed to destroy the health care industry entirely, at which point Obama will declare a national health care emergency and use it as an excuse to impose government-run socialized medicine by fiat. That's been their plan all along, and Harry Reid even said so publicly when he said in regard to Obamacare, "This is just the first step."

[Seth]

True. The policy is just some extra coverage.

Which may or may not ever pay out. You see, supplemental policies like that almost always have weasel-words in them that let's them escape paying you a fucking dime as long as workers comp is treating you, even if your workers comp treatment is inadequate.

[Tero]

That's because nothing is what was supposed to be done. Government has no place involving itself in the private medical affairs of the public.

The healthcare system is a monopoly, despite the appearance of many insurance companies.

According to the standard model, in which a monopolist sets a single price for all consumers, the monopolist will sell a lesser quantity of goods at a higher price than would companies by perfect competition. Because the monopolist ultimately forgoes transactions with consumers who value the product or service more than its cost, monopoly pricing creates a deadweight loss referring to potential gains that went neither to the monopolist nor to consumers. Given the presence of this deadweight loss, the combined surplus (or wealth) for the monopolist and consumers is necessarily less than the total surplus obtained by consumers by perfect competition. Where efficiency is defined by the total gains from trade, the monopoly setting is less efficient than perfect competition.

(Wiki)

By banning insurance, you would get competition, but many people would not use the healthcare system due to costs. They would just suffer and die. Health insurance is different from other spending in that way. Potential customers would die, the healthcare business would shrink.

[Seth]

That's because nothing is what was supposed to be done. Government has no place involving itself in the private medical affairs of the public.

The healthcare system is a monopoly, despite the appearance of many insurance companies.

Complete and utter nonsense. There are tens of thousands of individual medical service providers and thousands of insurance companies. Although Obama would LIKE there to be a monopoly on health care...under his control.

According to the standard model, in which a monopolist sets a single price for all consumers, the monopolist will sell a lesser quantity of goods at a higher price than would companies by perfect competition. Because the monopolist ultimately forgoes transactions with consumers who value the product or service more than its cost, monopoly pricing creates a deadweight loss referring to potential gains that went neither to the monopolist nor to consumers. Given the presence of this deadweight loss, the combined surplus (or wealth) for the monopolist and consumers is necessarily less than the total surplus obtained by consumers by perfect competition. Where efficiency is defined by the total gains from trade, the monopoly setting is less efficient than perfect competition.

(Wiki)

By banning insurance, you would get competition, but many people would not use the healthcare system due to costs. They would just suffer and die. Health insurance is different from other spending in that way. Potential customers would die, the healthcare business would shrink.[/quote]

Strange how the system worked quite well for hundreds of years before "healthcare insurance" came along.

[Tero]

No, you would just have the pre Obama situation. Middle class and rich would pay thru the nose. There is no budget care. Unless all you need is pills, the nurse practitionet at Walgreens can sign the Rx.

For hundreds of years there was no surgery other than the odd leg or arm amputation.

Modern life is incompatible with libertarianism.

[Seth]

No, you would just have the pre Obama situation. Middle class and rich would pay thru the nose. There is no budget care. Unless all you need is pills, the nurse practitionet at Walgreens can sign the Rx.

For hundreds of years there was no surgery other than the odd leg or arm amputation.

Modern life is incompatible with libertarianism.

Nonsense.

[laklak]

Does anyone here know if total assets are included when determining subsidy eligibility and amounts under Obamacare? I'm being told they do NOT look at total assets, only income. If that's the case then by shifting about 10K a year into the taxable column I can get the gummint to pay for about 90% of my insurance costs, and reduce my maximum out of pocket from 10,000 to just over 4000. Easy to do, just one online transaction. Minimum savings of almost $6,000 a year and a max of about $12K. I would be rather surprised if assets are NOT included, TBH. I know quite a few people worth multiple millions whose taxable income is under the Federal poverty line.

Maybe I've been looking at this all wrong. Maybe I just get other people to fund as much of my lifestyle as I can possibly manage. What thinkest thou?

[Tyrannical]

Gosh Seth, with these new $2500+ Obamacare deductibles it is cash on the barrel head when you go see a doctor.
I remember the good old days working part time in a grocery store, I had much better and cheaper insurance twenty years ago.

[Tero]

No, you would just have the pre Obama situation. Middle class and rich would pay thru the nose. There is no budget care. Unless all you need is pills, the nurse practitionet at Walgreens can sign the Rx.

For hundreds of years there was no surgery other than the odd leg or arm amputation.

Modern life is incompatible with libertarianism.

Nonsense.

Two nonsense. What have you got? I have an king (Obama) and a pair of nonsense.

[laklak]

I got two pair, Queens (Michelle Obama and Harry Reid) over Jackoffs (Biden and Boehner).

[Tero]

>>In less than 4 minutes, MSNBC’s Ari Melber reveals why the Republican Party’s worst Obamacare fears are coming true: no matter how hard they try to defund, obstruct, and sabotage the law, its main mechanisms are intact and working well.<<


http://www.occupydemocrats.com/ari-melb ... tle-video/

[Tero]

>>In less than 4 minutes, MSNBC’s Ari Melber reveals why the Republican Party’s worst Obamacare fears are coming true: no matter how hard they try to defund, obstruct, and sabotage the law, its main mechanisms are intact and working well.<<


http://www.occupydemocrats.com/ari-melb ... tle-video/