ObamaCare - "Give up your phone to get it!!!"

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Re: ObamaCare: Permanent

Postby Metsfanmax on Thu Nov 15, 2012 11:20 am

thegreekdog wrote:
Metsfanmax wrote:
jj3044 wrote:Is having the first scenario better, only discovering 90,000 cases and having a lot of cases going undiagnosed? Or, is the second scenario better, even though some have to wait longer than 4 weeks?


That is pretty much the conservative playbook. Let people die because of undetected and preventable illnesses, and claim the free market is working.


Yes, because this scenario is the conservative playbook.

/sarcasm

The free market does not let people die because of undetected and preventable illnesses. You guys are fucking idiots. Seriously. How someone can be so smart and so fucking stupid at the same time is beyond me.


Your ad hominem arguments, while appropriate given the name of the forum, do nothing to advance the discussion.

It is certainly the case that many people die every year from illnesses that could have been prevented or treated, but were turned away because of insurance company polices precluding things like granting policies to those with pre-existing conditions. That is what happens when there is no government oversight on who can be insured. This is not an opinion. It is a fact, and has been well documented.
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Re: ObamaCare: Permanent

Postby Night Strike on Thu Nov 15, 2012 12:59 pm

jj3044 wrote:Just to play a little devil's advocate here, I have a hypothetical in regards to the Canadian story:

Say today in the current system we are at 90% capacity in the US from an operating room perspective, meaning there are some occasional openings, because we are catching and operating on about 90,000 cases of cancer (and total capacity is to operate on 100,000 cases within 4-weeks of discovery).

Now say that due to Obamacare, more people get preventive services, as the law is designed to do, and detect cancers in early stages. Say that it means that 120,000 cases are discovered after the law. The current capacity is 100,000 cases per year, and that is how many are serviced within 4 weeks. The other 20,000 will have to wait longer for surgery, but have at least had their cancer diagnosed and have started other treatments.

Is having the first scenario better, only discovering 90,000 cases and having a lot of cases going undiagnosed? Or, is the second scenario better, even though some have to wait longer than 4 weeks?


Let's assume that everything in your scenario is factual as to what will happen under Obamacare. Now, let's factor in the reality that because of the massive amount of payments to doctors that will be cut (the largest chunk of the cuts to Medicare that is supposed to be used to pay for Obamacare), enough doctors drop out of the practice to cause the total capacity of cancer operations to drop from 100,000 to 75,000 per month (a very plausible scenario given the number of doctors polled saying they will quit accepting new patients or will even quit such practices). So even though Obamacare might diagnose more people early, even fewer people than before will be able to receive treatments.
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Re: ObamaCare: Permanent

Postby GreecePwns on Thu Nov 15, 2012 1:17 pm

I wouldn't say it is a part of the conservative playbook, but its certainly a part of someone's playbook:

President Nixon: Say that I—I—I'd tell him I have doubts about it, but I think that it's, uh, now let me ask you, now you give me your judgment. You know I'm not to keen on any of these damn medical programs.
Ehrlichman: This, uh, let me, let me tell you how I am—
President Nixon: [Unclear.]
Ehrlichman: This—this is a—
President Nixon: I don't [unclear]—
Ehrlichman: —private enterprise one.
President Nixon: Well, that appeals to me.
Ehrlichman: Edgar Kaiser is running his Permanente deal for profit. And the reason that he can—the reason he can do it—I had Edgar Kaiser come in—talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because—
President Nixon: [Unclear.]
Ehrlichman: —the less care they give them, the more money they make.
President Nixon: Fine. [Unclear.]
Ehrlichman: [Unclear] and the incentives run the right way.
President Nixon: Not bad.
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Re: ObamaCare: Permanent

Postby Lootifer on Thu Nov 15, 2012 4:13 pm

Metsfanmax wrote:
jj3044 wrote:Is having the first scenario better, only discovering 90,000 cases and having a lot of cases going undiagnosed? Or, is the second scenario better, even though some have to wait longer than 4 weeks?


That is pretty much the conservative playbook. Let people die because of undetected and preventable illnesses, and claim the free market is working.

You're shooting at the wrong target there bucko. Did you see the bit where our resident fiscally conservative tax laywer said he'd prefer socialised HC over the incumberant?

This isnt a debate about left vs right; this is a debate around what makes sense and what is retarded.
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Re: ObamaCare: Permanent

Postby Metsfanmax on Thu Nov 15, 2012 4:24 pm

Lootifer wrote:
Metsfanmax wrote:
jj3044 wrote:Is having the first scenario better, only discovering 90,000 cases and having a lot of cases going undiagnosed? Or, is the second scenario better, even though some have to wait longer than 4 weeks?


That is pretty much the conservative playbook. Let people die because of undetected and preventable illnesses, and claim the free market is working.

You're shooting at the wrong target there bucko. Did you see the bit where our resident fiscally conservative tax laywer said he'd prefer socialised HC over the incumberant?

This isnt a debate about left vs right; this is a debate around what makes sense and what is retarded.


I'm not directly discussing Obamacare either. I believe that socialized healthcare ought to be the best system from an ethical perspective; whether it is the more efficient system in terms of generating the greatest good for the greatest number is not something I have the answer to.

Nevertheless, I wholly support a change from the status quo of 2009, where a large number of illnesses could be prevented by giving people access to health insurance. The fact that we couldn't achieve, for example, the single-payer system is not a reason to just abandon all hope of improving access to health care. Anyone who insists on either socialized healthcare or nothing may have a nice theoretical argument, but I can't see how it's morally justified to let people die from preventable illnesses because you didn't like the compromise we ended up getting.
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Re: ObamaCare: Permanent

Postby Lootifer on Thu Nov 15, 2012 4:28 pm

My concern as a left leaning observer is that Obamas plans for HC while look like theyre heading in the right direction is going to have far too many of the unintended consequences BBS harps on about for it to be anything other than worse.

Having said that; I would probably suggest that Obamas plan is about as "left" as you could hope to pull off considering the political landscape in the US. (full socialisation is not possible; see NS/PS for proof - that is they would dig their heels in and [successfullly] block any kind of socialisation).
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Re: ObamaCare: Permanent

Postby Metsfanmax on Thu Nov 15, 2012 5:02 pm

Lootifer wrote:My concern as a left leaning observer is that Obamas plans for HC while look like theyre heading in the right direction is going to have far too many of the unintended consequences BBS harps on about for it to be anything other than worse.


I agree that the unintended consequences are probably incredibly hard to evaluate for a policy as large and sweeping as this. That being said, unintended consequences aren't necessarily bad, and I feel as though we are morally obliged to not sit and do nothing while the unregulated insurance market permits people to die of diseases that can be treated easily using modern medicine. It is possible that we will end up with a worse medical system as a result, but it is also possible that we will end up with a better one. Without some systematic evaluation of where such consequences might lie, I do not feel as though they are a reason for inaction. Not when we're talking about thousands of cases of where human life hangs in the balance.
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Re: ObamaCare: Permanent

Postby Lootifer on Thu Nov 15, 2012 5:05 pm

Unfortunately I dant have the time nor the inclination to get into the details of Obamacare and its various supporting policies. So I cant comment.
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Re: ObamaCare: Permanent

Postby jj3044 on Thu Nov 15, 2012 5:35 pm

Metsfanmax wrote:
Lootifer wrote:My concern as a left leaning observer is that Obamas plans for HC while look like theyre heading in the right direction is going to have far too many of the unintended consequences BBS harps on about for it to be anything other than worse.


I agree that the unintended consequences are probably incredibly hard to evaluate for a policy as large and sweeping as this. That being said, unintended consequences aren't necessarily bad, and I feel as though we are morally obliged to not sit and do nothing while the unregulated insurance market permits people to die of diseases that can be treated easily using modern medicine. It is possible that we will end up with a worse medical system as a result, but it is also possible that we will end up with a better one. Without some systematic evaluation of where such consequences might lie, I do not feel as though they are a reason for inaction. Not when we're talking about thousands of cases of where human life hangs in the balance.

Mets sums up my position nicely as well... while I am sure there will be some unintended negative consequences, I am hoping that the intended positive outcomes far outweigh the negative. Considering the old system is/was unsustainable, the only unacceptable course, in my opinion, was inaction.
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Re: ObamaCare: Reactions

Postby stahrgazer on Thu Nov 15, 2012 5:52 pm

PLAYER57832 wrote: Illegally refusing coverage is perhaps rare, though you have to get technical there because Blue Cross (other than highmark, higher end Blue Cross plans) has a way of stone-walling and delaying approvals in such a manner that they are not technically denying coverage, but... they might as well be denying it.

These things all very much DID change. And far from what the Republicans are trying to claim, most doctors and hospitals are very happy about the healthcare reform act.

BUT.. it is far from perfect. We need true universal coverage.


Blue Cross isn't the only company who stonewalls and delays approvals. You're right, most doctors and hospitals are happy about the Affordable Care Act because when there was no one to pay, it was the doctors and hospitals who got shafted.

Personal experience: Auto accident. I had auto coverage, the guy who hit me had auto coverage as well.

The combined total coverage of both our plans did not cover my bills, plus the insurances were arguing about things. I had to hire a personal injury attorney to help figure out who would pay.

Fortunately, I also had medical coverage under a separate policy so was able to get treatment while things got ironed out.

Here's what the ironing did: The attorneys received a cut. My separate medical policy got reimbursed. Most of the doctors got 20% of what it cost to treat me (because the money was eaten up by the attorney cuts first, the reimbursement of the separate medical insurance policy second, the doctors last.) I got stuck with the bills, which I could not afford so had to bankrupt, so the doctors who got 20% were fortunate.

I understood the attorney cut from a business sense, although I detested that I had to go that route for a clear-cut claim. I did not understand why my other insurance got the second cut. The money from the auto insurances did not cover all the medical bills, but it was medical bills, so shouldn't my medical insurance have to pay the medical bills? If I'd fallen at home, they would have had to pay (anything over deductibles etc which I had already paid.) So why did they get reimbursed next?

I think it should have been: treatment paid by auto companies without having to hire attorneys to force it; leftover bills that were covered under my medical insurance paid for by the insurance. Not, "everyone gets paid but the docs who did the work."

The Affordable Care Act tries to ensure that the docs who do the work get paid some reasonable-and-customary amount for the work they did. That's fair.
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Re: ObamaCare: Permanent

Postby thegreekdog on Thu Nov 15, 2012 7:37 pm

Metsfanmax wrote:
thegreekdog wrote:
Metsfanmax wrote:
jj3044 wrote:Is having the first scenario better, only discovering 90,000 cases and having a lot of cases going undiagnosed? Or, is the second scenario better, even though some have to wait longer than 4 weeks?


That is pretty much the conservative playbook. Let people die because of undetected and preventable illnesses, and claim the free market is working.


Yes, because this scenario is the conservative playbook.

/sarcasm

The free market does not let people die because of undetected and preventable illnesses. You guys are fucking idiots. Seriously. How someone can be so smart and so fucking stupid at the same time is beyond me.


Your ad hominem arguments, while appropriate given the name of the forum, do nothing to advance the discussion.

It is certainly the case that many people die every year from illnesses that could have been prevented or treated, but were turned away because of insurance company polices precluding things like granting policies to those with pre-existing conditions. That is what happens when there is no government oversight on who can be insured. This is not an opinion. It is a fact, and has been well documented.


It's not fact. Sorry little buddy. When you make up some pretend land where health insurance and healthcare exist in a free market, you can't point to lack of access to health insurance and preventative medicine as the failure of the free market health insurance or healthcare system.

I mean, if I went around saying that Conquer Club was a horrible website for sports gaming, people would look at me weird.
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Re: ObamaCare: Permanent

Postby Metsfanmax on Thu Nov 15, 2012 7:58 pm

thegreekdog wrote:It's not fact. Sorry little buddy. When you make up some pretend land where health insurance and healthcare exist in a free market, you can't point to lack of access to health insurance and preventative medicine as the failure of the free market health insurance or healthcare system.


I didn't say this had anything to do with a completely free market. My post made it quite clear that I was citing a typical conservative justification of the current system, not my personal belief. The fact is, there was regulation of the insurance industry before Obamacare. But it was done on a state-by-state basis, and did not protect the people who most needed to be protected. The whole point of my post is that when there is no regulation regarding individual access to healthcare, which would be the default free market principle, people who need health insurance do not get it. That is a failure, if we believe that health insurance for all is a desirable goal.
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Re: ObamaCare: Permanent

Postby thegreekdog on Thu Nov 15, 2012 9:16 pm

Metsfanmax wrote:
thegreekdog wrote:It's not fact. Sorry little buddy. When you make up some pretend land where health insurance and healthcare exist in a free market, you can't point to lack of access to health insurance and preventative medicine as the failure of the free market health insurance or healthcare system.


I didn't say this had anything to do with a completely free market. My post made it quite clear that I was citing a typical conservative justification of the current system, not my personal belief. The fact is, there was regulation of the insurance industry before Obamacare. But it was done on a state-by-state basis, and did not protect the people who most needed to be protected. The whole point of my post is that when there is no regulation regarding individual access to healthcare, which would be the default free market principle, people who need health insurance do not get it. That is a failure, if we believe that health insurance for all is a desirable goal.


How do you know?

Unfortunately, health insurance is seen to be the solution to healthcare woes, when it is probably more of a problem. And yeah, there are the arguments that doctors getting paid in pumpkin bread or not getting paid at all won't work in our hustle bustle, technologically advanced world. But health insurance is a big business so won't go back to that.
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Re: ObamaCare: Permanent

Postby Metsfanmax on Thu Nov 15, 2012 10:05 pm

thegreekdog wrote:
Metsfanmax wrote:
thegreekdog wrote:It's not fact. Sorry little buddy. When you make up some pretend land where health insurance and healthcare exist in a free market, you can't point to lack of access to health insurance and preventative medicine as the failure of the free market health insurance or healthcare system.


I didn't say this had anything to do with a completely free market. My post made it quite clear that I was citing a typical conservative justification of the current system, not my personal belief. The fact is, there was regulation of the insurance industry before Obamacare. But it was done on a state-by-state basis, and did not protect the people who most needed to be protected. The whole point of my post is that when there is no regulation regarding individual access to healthcare, which would be the default free market principle, people who need health insurance do not get it. That is a failure, if we believe that health insurance for all is a desirable goal.


How do you know?


I know because before the ACA, there was essentially no regulation preventing insurance companies from excluding individuals from coverage, and insurance companies did in fact exclude millions from coverage. The free market approach to this problem was the status quo before the ACA. Sure, there were plenty of other regulations on the industry, such as requiring them to retain enough money to actually pay out on claims, but this was the main one that the ACA was aiming to rectify.

Unfortunately, health insurance is seen to be the solution to healthcare woes, when it is probably more of a problem. And yeah, there are the arguments that doctors getting paid in pumpkin bread or not getting paid at all won't work in our hustle bustle, technologically advanced world. But health insurance is a big business so won't go back to that.


Health insurance is suboptimal for both sides, obviously. From a socialist point of view, insurance doesn't get at the root problem of why our health care system is inefficient and serves to exclude the poor. From a conservative point of view, we are now putting extreme regulation on the side of an industry that was previously unregulated. But that's the nature of political compromise. For me, the main point is that more people now have access to basic medical care. That has always been my stake in Obamacare. I'm really ok with accepting a suboptimal solution to this problem on economic terms if the alternative is no solution.
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Re: ObamaCare: Permanent

Postby thegreekdog on Thu Nov 15, 2012 10:48 pm

Metsfanmax wrote:I know because before the ACA, there was essentially no regulation preventing insurance companies from excluding individuals from coverage, and insurance companies did in fact exclude millions from coverage. The free market approach to this problem was the status quo before the ACA. Sure, there were plenty of other regulations on the industry, such as requiring them to retain enough money to actually pay out on claims, but this was the main one that the ACA was aiming to rectify.


There is no way that you can demonstrate to me that, prior to the Affordable Care Act, health care and health insurance were part of a free market system. You've identified a problem with health insurance: the exclusion of individuals from coverage. Two thoughts come to mind. First, and less important, health insurance providers are rarely engaged in fair competition. Second, and more important, why do people need health insurance in the first place? Healthcare is expensive, but why is healthcare so expensive? Why is it more expensive now than it was one hundred years ago? One of the least talked about, but most imporant, criticisms of the Affordable Care Act is that it does not solve the problem of healthcare costs and the reason for rising healthcare costs.

The easiest solution in the short term, politically and otherwise, to the problem of making sure people with preexisting conditions can get healthcare is to make sure they get affordable health insurance, which is ostensibly what the Affordable Care Act does (I'm not sure it makes healthcare affordable, so it may not do that). In my mind, the more effective solution, although much more difficult in the short term, is reduce the cost of healthcare itself.

Metsfanmax wrote:Health insurance is suboptimal for both sides, obviously. From a socialist point of view, insurance doesn't get at the root problem of why our health care system is inefficient and serves to exclude the poor. From a conservative point of view, we are now putting extreme regulation on the side of an industry that was previously unregulated. But that's the nature of political compromise. For me, the main point is that more people now have access to basic medical care. That has always been my stake in Obamacare. I'm really ok with accepting a suboptimal solution to this problem on economic terms if the alternative is no solution.


How many more people have access to basic medical care that did not have access to basic medical care prior to the passage of the Affordable Care Act? How much more, incrementally, will the Affordable Care Act cost? These are the two questions that must be asked that people who support and don't support the Affordable Care Act do not ask.

Here are the people that were uninsured prior to the passage of the Affordable Care Act:

- Illegal immigrants (8 million)
- Citizens not enrolled in Medicaid despite being eligible
- Citizens opting not to be insured (mostly young people)
- Citizens who live in states that opt out of Medicaid expansion

These are hardly wide swaths of people, with the exception of illegal immigrants and young people. So, in my opinion, you're accepting that a number of people, those indicated above, will now be insured and that is your reason for supporting the Affordable Care Act.

In supporting the Affordable Care Act, you are also now supporting government (read tax dollar) support of others' purchase of health insurance who could previously afford health insurance but will now choose, or be forced to choose by their employers, to purchase health insurance through exchanges where the price is not regulated. To me, this is worse than status quo, especially when a small fix to status quo, for example making Medicaid available to all of those listed above, would have cost less money. As a final word, the Affordable Care Act is very similar to health care fixes put forward by Republicans during the Clinton administration, which begs the question as whether this is an effective solution to an existing problem or an ineffective corporate boondoggle to insurance companies.
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