News You hate Obama's health care penalty for the uninsured?

[TheStatutoryApe]

The law mandates that we have liability coverage for driving and in general, we just pay it and carry on. As long as we avoid tickets and accidents, we pay the lowest rate possible and have a choice of our carrier. Our rates stay competitive because the law requires everyone who chooses to drive to have liability insurance (and of course full coverage if financing the car).

If I get pulled over and it is believed that I am driving without insurance I will be given a ticket. I go to court and the court decides whether or not I broke the law and then fines me.
Apparently in a few years if it is believed that I do not have health insurance the IRS will simply tell me that I owe them more money. No court, no due process, just "fork it over pal". This allows congress to legislate de jure guilt for not doing what they want, you are guilty because their law (not a court) says so. It goes against the principles of the constitution and is, at the least, borderline illegal.

I'm for Universal Healthcare and do not mind the general aim of the bill, but they need to do it right.

 

[mheslep]

Yes, while naysayers point and accuse Obama of cutting dirty deals with the insurance industry, the reality is that by expanding the base significantly, companies can reduce rates for everyone. There is no way for insurance companies to survive if a good percentage of Americans only get insurance when they get sick or old. It doesn't take a genius to figure that one out.

There are of course limits on what we can hope to gain or save, but the goal was to contain the runaway costs. Broadly expanding the base of the insured was one strategy needed to achieve containment.

Real reality: Massachusetts has a mandate that attempts to pull in all state residents into the paying base, yet its rates are [STRIKE]by far the highest in the country[/STRIKE] far higher than the US average and continue to rise since implementation in 2006.

 

[Kerrie]

If I get pulled over and it is believed that I am driving without insurance I will be given a ticket. I go to court and the court decides whether or not I broke the law and then fines me.
Apparently in a few years if it is believed that I do not have health insurance the IRS will simply tell me that I owe them more money. No court, no due process, just "fork it over pal". This allows congress to legislate de jure guilt for not doing what they want, you are guilty because their law (not a court) says so. It goes against the principles of the constitution and is, at the least, borderline illegal.

I'm for Universal Healthcare and do not mind the general aim of the bill, but they need to do it right.

When you go to court to prove your innocence because you did have the required auto liability coverage (but perhaps the lack of proof on hand after getting pulled over earned you a ticket), technically you will get out of the fines imposed by court, correct?

If you prove to the IRS that you have health insurance, you should be able to get out of the fines the IRS collects, correct? IRS doesn't make the law, it only collects the fines and fees if the law is broken.

Both mandatory insurances (auto liability and health) stem from a law made our freely elected government representatives. Who collects the fines is not relevant in this thread, and in time the process of carrying out the law may be refined as needed. The lack of coverage for a portion of Americans becomes everyone's liability-whether we feel it today or not, it will become a disaster if government intervention is not taken today.

I think Americans in general take for granted and expect the best in a standard of living for next to nothing even as costs rise. Our government (that we as a free people have a choice in electing as many nations do not) must take action to ensure that American citizens have affordable access to adequate coverage over time; otherwise health coverage will become a luxury for the elite. Everyone having the ability to get heath care greatly benefits the nation as a whole.

 

[Kerrie]

Real reality: Massachusetts has a mandate that attempts to pull in all state residents into the paying base, yet its rates are by far the highest in the country and continue to rise since implementation in 2006.

Could it be that MA's population is roughly only 2% of the American population? The high costs are collective over the entire United States.

 

[mheslep]

Could it be that MA's population is roughly only 2% of the American population?

So? The theory on the table is that expanding the insurance base by mandating health insurance purchases will, without considering other factors, reduce premiums. If it did not lower premiums for the 6.5 million residents of Mass, why do you think it will somehow work for 300 million US residents?

The high costs are collective over the entire United States.

<shrug> The numbers say otherwise.
http://healthinsurance.about.com/gi/o.htm?zi=1/XJ&zTi=1&sdn=healthinsurance&cdn=health&tm=151&f=10&su=p736.9.336.ip_&tt=2&bt=1&bts=1&st=24&zu=http%3A//www.ahipresearch.org/pdfs/2009IndividualMarketSurveyFinalReport.pdf" :
Mass: $13,288.
Virginia: $6,383
Iowa: $5,609

 

[Kerrie]

So? The theory on the table is that expanding the insurance base by mandating health insurance purchases will, without considering other factors, reduce premiums. If it did not lower premiums for the 6.5 million residents of Mass, why do you think it will somehow work for 300 million US residents?

<shrug> The numbers say otherwise.
http://healthinsurance.about.com/gi/o.htm?zi=1/XJ&zTi=1&sdn=healthinsurance&cdn=health&tm=151&f=10&su=p736.9.336.ip_&tt=2&bt=1&bts=1&st=24&zu=http%3A//www.ahipresearch.org/pdfs/2009IndividualMarketSurveyFinalReport.pdf" :
Mass: $13,288.
Virginia: $6,383
Iowa: $5,609

Did you factor in the cost of living between Iowa and Massachusetts? I am sure a house in Des Moines Iowa is nothing in comparison to a house in Boston Mass.

My point in my previous post was that only 2% of the entire US population is required to have insurance, therefore the costs will be "high" (partly due to cost of living?) and residents of MA won't see a decrease until the other 98% of the population of the country contributes to these costs as a whole. The larger the pool of insurance premiums, the more affordable it will become. Put in the other 300 million citizens contributing to these rates, and I have a good guess they will come down.

 

[mheslep]

[...]
My point in my previous post was that only 2% of the entire US population is required to have insurance, therefore the costs will be "high" (partly due to cost of living?) and residents of MA won't see a decrease until the other 98% of the population of the country contributes to these costs as a whole. The larger the pool of insurance premiums, the more affordable it will become. Put in the other 300 million citizens contributing to these rates, and I have a good guess they will come down.

Sorry I'm not sure what you mean. Clearly most of the rest of the US population does have insurance. About 85% of Americans have insurance of some kind. Maybe another 5-8% can afford insurance but choose not buy it, and they would be indeed forced to buy insurance with the new mandate. Even so, that won't change a thing about the current demographics of Mass., as all the insurers operating there only deal with Mass. residents, just like everywhere else in the US (unfortunately).

 

[Kerrie]

According to the Census Bureau, about 46 million people-more than 5-8% of the population-are uninsured, and those are just the citizens.

A family member of mine who is a nurse says she treats a lot of uninsured illegals everyday, which is also not helping our situation. Now, I don't have a suggestion for that fix, that is certainly a whole other topic, but the fact and reality is, the number of uninsured is growing, and it should make those who are insured concerned about the future of affordability of theirs.

What will happen when your health insurance premiums cost as much as your mortgage? Will you forgo your house or your health insurance? My entire family is currently uninsured because we cannot afford the $950 monthly premiums (I was laid off in January), I think I have more reason to be scared of this bill then those who are complaining about it and have excellent coverage. Am I going to forgo paying my rent to pay for those rates of health insurance? Absolutely not!

To clear up my last statement-if MA is the only state that requires health insurance, then that is just 2% of the entire US population. If, say 95% of the US population is putting in, then costs come down and competition is stimulated among health care providers and insurers. Hope that helps clear up my point.

 

[mheslep]

According to the Census Bureau, about 46 million people-more than 5-8% of the population-are uninsured, and those are just the citizens.

Yes, exactly so, about 15% of the population. But only half or less of those are in the group that can afford insurance but choose not to buy it - the ones effected by the mandate. The rest either can not afford insurance and don't qualify for Medicaid, can not afford insurance and don't sign up for Medicaid even though they qualify, can not get it for some condition, or are here illegally. None of those latter groups are going to 'contribute' to the base via a health insurance mandate. So as I said, the new federal mandate is going to add 5-8% more payers on the rolls, assuming those people go along, and they very well may not.

To clear up my last statement-if MA is the only state that requires health insurance, then that is just 2% of the entire US population. If, say 95% of the US population is putting in, then costs come down and competition is stimulated among health care providers and insurers. Hope that helps clear up my point.

Ok, I understand. Here's the problem. We won't have 95% of the US population paying in. That's not intended in this bill. The bill authors claim it will insure 95% of the population. We will theoretically have an increase from 85% paying to roughly 90-92% paying (via mandates), and then another 5% (10 million people) will essentially get coverage they don't have now for which they do not pay (pre-existing conditions, not quite poor enough for Medicaid, etc). Thus while some more people will be paying in, there will also be more people receiving benefits. That is what happened in in Mass (they're also 95% insured now), yet the premiums have gone up faster than the national average.

 

[Kerrie]

I don't believe the census can accurately count illegals, therefore that could be a bigger problem than what is actually visible, perhaps a problem blindly contributing to the rising costs.

As for your numbers, I see that is pure personal speculation unless you are citing a valid source? Isn't the health mandate intended to require everyone have insurance, with subsidies to those who cannot afford current rates? Therefore, if more are required to pay it, your premiums have a higher likelihood of not rising as quickly? Premiums everywhere have gone up faster than they should, not just in MA, which is why there is a growing percentage of those who are losing insurance everyday.

According to SCORE, small businesses employ about half of the American population. Small businesses are losing the ability to carry coverage for their employees due to rising group health coverage costs. If you are one of the lucky people who work for huge corporations or government establishments, you don't have to worry as much because of the purchasing power of group coverage that the large corporation or government can negotiate. And the bill specifically states that those who already have coverage will not have to change anything about their current plan, doesn't it?

So, really, those who are uninsured (such as myself) have a lot more to fear of this bill than most, yet I am relieved of the government intervention of the insurance reform itself. As for the actual health care quality we receive, do you speculate this quality will come down with the standard of living we demand in our country even with health insurance coverage as a requirement?

 

[turbo]

My last post was lost. Trying again:

We must acknowledge that many of the people that are "insured" are self-insured. There are countless people who choose to be "insured" but they are priced out of policies that pay for basic medical care, and have deductibles of $10-20K or more. If the "insured" come down with a really expensive disease, they are dropped like hot potatoes, and have NO coverage. This is a sick system, and it has to be stopped.

 

[Choronzon]

My last post was lost. Trying again:

We must acknowledge that many of the people that are "insured" are self-insured. There are countless people who choose to be "insured" but they are priced out of policies that pay for basic medical care, and have deductibles of $10-20K or more. If the "insured" come down with a really expensive disease, they are dropped like hot potatoes, and have NO coverage. This is a sick system, and it has to be stopped.

I have one of those plans, and many of my friends and family do as well. Some of them have gotten seriously sick, and no one was "dropped like hot potatoes." I (and many like myself) was careful when I shopped for my health insurance, and I'm also not a push over—if someone breaks my contract I don't just whine about it—I take action.

I like having high deductible insurance. It allows me to talk to my doctor like a man—because when I need something done he isn't worried about getting paid by my insurance company. He works directly for me.

I understand that many people can't afford this—but so what? That's life. Poor people don't get to enslave the rest of us so that they can have health insurance.

I recommend high-deductible insurance to everyone—and if you can't afford it, there is a solution. It's the "stop being a loser and learn to make your way through life" method.

 

[Kerrie]

I recommend high-deductible insurance to everyone—and if you can't afford it, there is a solution. It's the "stop being a loser and learn to make your way through life" method.

Until you have to file bankruptcy due to medical collections garnishing your wages.

 

[Choronzon]

Until you have to file bankruptcy due to medical collections garnishing your wages.

Yeah, I have a pretty good method to avoid that situation—I pay my bills.

 

[Evo]

I recommend high-deductible insurance to everyone—and if you can't afford it, there is a solution. It's the "stop being a loser and learn to make your way through life" method.

I work, so I have a no deductible insurance that pays 100% after the first $20.

I'm not saying that you are a loser because you have to pay a fortune for your insurance. I'm just saying that one size does not fit all.

 

[mheslep]

Hi Kerrie -

[...]As for your numbers, I see that is pure personal speculation unless you are citing a valid source?

They're commonly available from quick googling, have been repeatedly cited by proponent legislators so I take them as public knowledge. Anyway:
http://dpc.senate.gov/healthreformbill/healthbill95.pdf"

The Congressional Budget Office (CBO) has determined that the two bills [...] ensure that more than 94 percent of Americans have access to quality, affordable health insurance

Breakdown of the 47 million uninsured figure you cited is http://www.nytimes.com/2007/11/04/b...773f35bd&ei=5090&partner=rssuserland&emc=rss" (Statement 2) which pulls from the Census:
o 10 million not US citizens, many illegal
o 18 million have household income over $50k (i.e. 6% of the population)
o 1/4 have been offered employer-provided insurance but declined it.

Isn't the health mandate intended to require everyone have insurance, with subsidies to those who cannot afford current rates? Therefore, if more are required to pay it, your premiums have a higher likelihood of not rising as quickly?

Yes everyone has a mandate to buy if they can afford it. Yes some more will get subsidies. But also, as I'm sure you've heard, the insurance companies will no longer be able to reject anyone with expensive pre-existing and chronic conditions - they have to suck all those people up into the system, paid for by the premiums of others. The CBO balanced those - the new payers vs the new chronic/pre-existing - and given the rules levied on the CBO they found on average that premiums would fall ~1%. That has not been the reality in Mass.

[...]And the bill specifically states that those who already have coverage will not have to change anything about their current plan, doesn't it?

The President has promised that several times. My read is he's wrong. You'll have coverage, but not necessarily the same. As the bill summaries above will show you, or some of the fact checker sites, the bill creates health insurance 'exchanges', which offer only 'Qualified Plans' specified by the government. For the moment everyone can keep their employer plans, but eventually all health insurance companies will be prohibited from offering anything but those plans on the exchanges.

As for the actual health care quality we receive, do you speculate this quality will come down with the standard of living we demand in our country even with health insurance coverage as a requirement?

I don't know. I have spent a lot of time looking at the quality issue, and I'm absolutely convinced that the US medical system on the whole produces the best or close to the best medical outcomes in the world, along with the highest costs per person. My speculation is that in moving closer to some of the European centrally controlled models either the costs will escalate, or the quality will decrease.

Here's what I think should have been done instead.
http://www.roadmap.republicans.budget.house.gov/Issues/Issue/?IssueID=8516

 

[mheslep]

I work, so I have a no deductible insurance that pays 100% after the first $20.
.

Holly smokes. No deductible for anything? Well that must be what they mean by Cadillac plan.

 

[brainstorm]

Here is your answer: There is an implicit contract between you and the government in which you demand that emergency and extended medical treatment be made available if you are sick or seriously injured. If you or someone else calls 911 for help, you expect someone to show up. If you are taken to a hospital, you expect treatment. And you don't expect to be tossed into the street if your credit card is refused. So, the only justification that I can see for an exemption to the insurance mandate is if emergency services, hospitals, and doctors, are given the right to refuse treatment. If your credit card bounces or your credit rating isn't good, or even if no one can find your wallet, instead of treatment, you are completely on your own. If that means that you are left to die on the highway after an auto accident, then that is your choice. The street cleaning crews can retrieve the bodies for the sake of public health and safety.

Do we have any takers? What are the options? If you are not willing to agree to these terms, then please explain how you have the right to impose such a mandate on the public? Why do you expect to get something for nothing at my expense? What gives you the right to treatment that you can't possibly afford?

The problem is that medical costs are seen as fixed, and the assumption is that they can't be provided for less than the current fees. This simply isn't true. The reason why medical costs are so high is the large number of people who want to work and make good money in some aspect of medical service, administration, supply, etc.

The people who don't want to pay the high costs are those who make relatively little money in low wage jobs, for whom medical costs are a much higher proportion of their income than people who work in the medical field. Basically these people think they have a right to medical care without being slaves to medical personnel - which is probably true.

 

[Evo]

Holly smokes. No deductible for anything? Well that must be what they mean by Cadillac plan.

The way it works is that I have a $20 co-pay for my first visit and any tests done as a result are free. I had two cat scans, extensive bloodwork (3 times because of high results), x-rays and an MRI. All at no cost.

That's how insurance works for people that work for large companies. That's why you see so much opposition to universal healthcare. My plan covers unlimited dependants also, but my kids can't be covered after they turn 24, which is why there needs to be some sort of universal plan. I am willing to give up some of my benefits to cover these people, but I don't want to go broke either.

 

[mheslep]

Until you have to file bankruptcy due to medical collections garnishing your wages.

The bankruptcies don't (largely) come from high deductibles. They come from no coverage or loss of coverage.

 

[mheslep]

The way it works is that I have a $20 co-pay for my first visit and any tests done as a result are free. I had two cat scans, extensive bloodwork (3 times because of high results), x-rays and an MRI. All at no cost.

Hope all is well.

That's how insurance works for people that work for large companies. That's why you see so much opposition to universal healthcare. My plan covers unlimited dependants also, but my kids can't be covered after they turn 24, which is why there needs to be some sort of universal plan. I am willing to give up some of my benefits to cover these people, but I don't want to go broke either.

I work for a BigCo, and have what'd I'd call an excellent PPO plan. Much of the critical care coverage is also no deductible, but much of the rest - psych care, fertility, yaddah yaddah, has non trivial deductibles. I also provide health insurance to the employees of my partnership - its good but not as good as BigCo.

 

[mheslep]

..., and have deductibles of $10-20K or more.

I don't think there any plans with single coverage deductibles above $6k. $12k for a family, max.
http://en.wikipedia.org/wiki/High-deductible_health_plan

 

[Choronzon]

I work, so I have a no deductible insurance that pays 100% after the first $20.

I'm not saying that you are a loser because you have to pay a fortune for your insurance. I'm just saying that one size does not fit all.

I don't pay a fortune for Health Insurance. My premiums are actually quite low. As a matter of fact, I pay less for my Health Insurance than I do for my cell phone.

As for Health Care—I'd still rather pay for it myself. Even if I go over my deductible, I would pay for my care myself and then get reimbursed by my Insurance company. Even if I had to mortgage out my house. I want no one between my doctors and myself. No private corporation, and most certainly no Government.

 

[Evo]

I don't pay a fortune for Health Insurance. My premiums are actually quite low. As a matter of fact, I pay less for my Health Insurance than I do for my cell phone.

As for Health Care—I'd still rather pay for it myself. Even if I go over my deductible, I would pay for my care myself and then get reimbursed by my Insurance company. Even if I had to mortgage out my house. I want no one between my doctors and myself. No private corporation, and most certainly no Government.

I don't have anyone between my doctors and myself. I am not restricted to my choice of doctor, I do not need referals or pre-authorizations, I know this because the doctor's office calls me and tells me they checked with my insurance and I have no restrictions.

You must have sucky insurance. I feel sorry for you, but it's not unusual that people like you have to pay so much. Hopefully that will change.

 

[Kerrie]

The bankruptcies don't (largely) come from high deductibles. They come from no coverage or loss of coverage.

Or the co-insurance that the patient must end up paying, which can be 20-30% of the final bill. Regardless of the details, a lack of coverage and affordability drives up the bankruptcy tendencies, thus driving up costs to those who are still "in" the insurance circle.

From your link:

"The plan ensures universal access to affordable health insurance by restructuring the tax code, allowing all Americans to secure affordable health plans that best suit their needs, and shifting the ownership of health coverage away from the government and employers to individuals.

* Provides a refundable tax credit – $2,300 for individuals and $5,700 for families – to purchase coverage in any State, and keep it with them if they move or change jobs.
* Provides transparency in health care price and quality data, making this critical information readily available before someone needs health services.
* Creates state-based health care exchanges, so individuals and families have a one-stop marketplace to purchase affordable health insurance without being discriminated against based on pre-existing conditions.
* Equips states with tools like auto-enrollment programs and high-risk pools, so affordable health coverage can be accessed by all.
* Addresses health care’s growing strain on small businesses, by allowing them to pool together nationally to offer coverage to their employees.
* Encourages the adoption of health information technology and assists states in establishing solutions to medical malpractice litigation."

This sounds all similar to what has been passed with the exception of the tax credit vs tax fine. Perhaps however, the situation is dire enough to have to force people to purchase insurance because the incentive doesn't work for low wage workers-which are the majority of the under-insured. If I had the tax incentive to purchase insurance in my current situation, I wouldn't take it (and I have had health issues too). If I am being forced to, I am much more likely to do what is required to avoid a hassle with the IRS (especially being an accounting student!).

I am also in agreement with the medical malpractice problem, as I have read that doctors order all sorts of tests (which of course drive up costs) because they operate out of fear of getting sued over actually being a doctor. The transparency issue of what we actually pay for every little service, pill, or kleenix box definitely needs highlighting-Americans will stimulate competition when they are more aware of their options.

 

[Choronzon]

I don't have anyone between my doctors and myself. I am not restricted to my choice of doctor, I do not need referals or pre-authorizations, I know this because the doctor's office calls me and tells me they checked with my insurance and I have no restrictions.

You must have sucky insurance. I feel sorry for you, but it's not unusual that people like you have to pay so much. Hopefully that will change.

I'd say you were presuming a bit much—but I know you're not. You know for a fact that someone pays for your health insurance, and that even if it is entirely provided by your employer, it's just another type of wage that they're paying you, wages that you perhaps would have been paid directly if your employer values you enough.

Again, why am I telling you something I'm quite certain you already know? I 've had insurance policies similar to yours as well—including a posh plan provided by the government what I worked for the Department of Homeland Security. I'll admit, it was pretty nice having to pay only $20 dollars (I think mine was $35, it was years ago so I can't be sure) for a copay, but I think such ridiculous copays are what's wrong with health care in this country. People don't care what burden is being borne by others around them, they only care what has to come directly from their wallet, and eventually when they look around and there's no one else providing for them anymore, they get all indignant.

But, hey, maybe you do get a better deal then I do—you wouldn't be the only one in this country who does. Unlike most other people in this country, however, I don't feel like I'm entitled to a portion of your success. You enjoy it, and maybe I'll be inspired by your example and try and be more like you. Not today, though.

 

[TheStatutoryApe]

When you go to court to prove your innocence because you did have the required auto liability coverage (but perhaps the lack of proof on hand after getting pulled over earned you a ticket), technically you will get out of the fines imposed by court, correct?

If you prove to the IRS that you have health insurance, you should be able to get out of the fines the IRS collects, correct? IRS doesn't make the law, it only collects the fines and fees if the law is broken.

Both mandatory insurances (auto liability and health) stem from a law made our freely elected government representatives. Who collects the fines is not relevant in this thread, and in time the process of carrying out the law may be refined as needed. The lack of coverage for a portion of Americans becomes everyone's liability-whether we feel it today or not, it will become a disaster if government intervention is not taken today.

I think Americans in general take for granted and expect the best in a standard of living for next to nothing even as costs rise. Our government (that we as a free people have a choice in electing as many nations do not) must take action to ensure that American citizens have affordable access to adequate coverage over time; otherwise health coverage will become a luxury for the elite. Everyone having the ability to get heath care greatly benefits the nation as a whole.

The only reason the IRS has authority is because Congress can not legislate criminal guilt. So instead of saying that you are a criminal and will be fined for not doing what they want you to do they say you will be taxed. This allows them to side step the legal system and due process. Since you are not defined as a criminal you do not get your day in court. You will have to pay the tax. You get no defense. According to tax codes you must pay the tax and only then will you be allowed to dispute the taxation on the grounds that you do not owe it per tax code. You are only allowed to dispute the tax on the grounds that according to code you do not owe it. If you attempt to dispute a tax on the basis that you should not be made to pay it your hearing will be denied and you will be fined $5000 for submitting a frivolous dispute. There is no presumption of innocence and no right to a trial. You may only request, after the determination of your 'guilt', a hearing where you may attempt to prove that you have mistakenly been categorized as 'guilty'. In essence the law it self says that you are 'guilty' and will be 'fined'. It sidesteps the separation of powers on a technicality, denies due process, and comes incredibly close to being a bill of attainder.

 

[Evo]

I'd say you were presuming a bit much—but I know you're not. You know for a fact that someone pays for your health insurance, and that even if it is entirely provided by your employer, it's just another type of wage that they're paying you, wages that you perhaps would have been paid directly if your employer values you enough.

Again, why am I telling you something I'm quite certain you already know? I 've had insurance policies similar to yours as well—including a posh plan provided by the government what I worked for the Department of Homeland Security. I'll admit, it was pretty nice having to pay only $20 dollars (I think mine was $35, it was years ago so I can't be sure) for a copay, but I think such ridiculous copays are what's wrong with health care in this country. People don't care what burden is being borne by others around them, they only care what has to come directly from their wallet, and eventually when they look around and there's no one else providing for them anymore, they get all indignant.

But, hey, maybe you do get a better deal then I do—you wouldn't be the only one in this country who does. Unlike most other people in this country, however, I don't feel like I'm entitled to a portion of your success. You enjoy it, and maybe I'll be inspired by your example and try and be more like you. Not today, though.

Funny the DHS is my customer.

My insurance is definitely a perk, on top of my pay. It's one of the things that you look for when you seek employment. But you say that "my" copay, the amount I personally pay is what is wrong. You're forgetting that as part of my contract that my company pays over $16,000 a year for my health insurance. They pay, not me, but it's paid.

That's why it's important to have a system in this country that takes care of those that don't have the ability to get insurance.

It also explains why many people that get free insurance now from their employers are upset. The government's plan to reimburse me $2,500 towards a $16,000 insurance plan is not a good thing. There has to be some way to allow for what people already have in place.

 

[mheslep]

Here again is Ryan's list:
* Provides a refundable tax credit – $2,300 for individuals and $5,700 for families – to purchase coverage in any State, and keep it with them if they move or change jobs.
* Provides transparency in health care price and quality data, making this critical information readily available before someone needs health services.
* Creates state-based health care exchanges, so individuals and families have a one-stop marketplace to purchase affordable health insurance without being discriminated against based on pre-existing conditions.
* Equips states with tools like auto-enrollment programs and high-risk pools, so affordable health coverage can be accessed by all.
* Addresses health care’s growing strain on small businesses, by allowing them to pool together nationally to offer coverage to their employees.
* Encourages the adoption of health information technology and assists states in establishing solutions to medical malpractice litigation.

There are a couple of similarities between Rep Ryans health roadmap and the current health reform law, but otherwise they are not alike, and approach the problem entirely differently. The similarities include, for example, a path to cover those with pre-existing conditions and an increased use of information technology. Otherwise, the current health reform law:

• Does not allow small businesses to pool, so that, for example, the US association of restaurants could set up a plan well suited for every waitor/waitress in the US. Instead the current law has the federal government set up a single pool, and even that eventually goes away.
• Does not enforce a policy that would allow you to buy and take your current policy to any new job, and to any state. The current law gives the states the option to set up cooperative agreements, which means nothing will happen.
• Does not do anything until 2018 (and then not much) to balance the current employer - self-employed tax law, as Ryan does in that first bullet with his tax credit, so that individuals get ~ the same tax breaks as those working for BigCo.
• Sets up a federally run health exchange which every health insurance company will eventually have to use. Ryan's plan sets up state exchanges.
• Uses the IRS enforced mandate to have everyone who can buy insurance. Ryan's plan has no mandate, but does do things that nudge the uninsured-but-can-afford-it to get insurance (auto-enrolment).
• Does almost nothing about malpractice costs. Ryan's plan does. It caps non-economic damages.

Long version
http://www.roadmap.republicans.budget.house.gov/plan/#Healthsecurity

 

[Choronzon]

My insurance is definitely a perk, on top of my pay. It's one of the things that you look for when you seek employment.

That's why it's important to have a system in this country that takes care of those that don't have the ability to get insurance.

I don't follow—how does the fact that your insurance is a perk which is given to you in exchange for your labor somehow imply that we should provide that perk to people who can't earn it?

 

[mheslep]

...

It also explains why many people that get free insurance now from their employers are upset.

Nobody gets free anything from their employer. For every benefit received, another one, probably additional salary, is taken away. If realized health insurance premiums are less because of the employer tax break, that break comes from the government and of course that's not free either.

 

[mheslep]

: I'll admit, it was pretty nice having to pay only $20 dollars (I think mine was $35, it was years ago so I can't be sure) for a copay, but I think such ridiculous copays are what's wrong with health care in this country.

Oh hell yes. You'd save the country a lot of trouble if you could convince some more folks.

 

[Evo]

I don't follow—how does the fact that your insurance is a perk which is given to you in exchange for your labor somehow imply that we should provide that perk to people who can't earn it?

You made the silly statement that insurance was paid by my company instead of wages. No, it was a perk on top of wages.

I'm saying that many people aren't able to get insurance from their employers and we need to do something about it. But we need to to do it in a way that doesn't hurt the companies that already pay for their employees. And poeple shouldn't have to pay through the nose for it as you suggested that people pay high deductables for insurance like you.

You said

I understand that many people can't afford this—but so what? That's life. Poor people don't get to enslave the rest of us so that they can have health insurance.

I recommend high-deductible insurance to everyone—and if you can't afford it, there is a solution. It's the "stop being a loser and learn to make your way through life" method.

Uh huh, American's that don't get employer benefits are losers. Nice.

 

[Choronzon]

You made the silly statement that insurance was paid by my company instead of wages. No, it was a perk on top of wages.

I'm saying that many people aren't able to get insurance from their employers and we need to do something about
it. But we need to to do it in a way that doesn't hurt the companies that already pay for their employees. And poeple shouldn't have to pay through the nose for it as you suggested that people pay high deductables for insurance like you.

You said

Your insurance is part of the compensation your employer pays for your labor--the same as wages. Your employer is still spending it's own resources to secure your employment, presumably because you have some value to them.

Why do we have to provide people insurance to people who can't acquire it on their own? I don't feel any particular obligation to subsidize other peoples lives.

And I'm not trying to be nice. I also feel no obligation to be kind to people who can't provide for themselves and thus believe that they are entitled to a portion to what I've earned. I don't think it's nice to be a burden to everyone else either.

 

[Evo]

Your insurance is part of the compensation your employer pays for your labor--the same as wages. Your employer is still spending it's own resources to secure your employment, presumably because you have some value to them.

Why do we have to provide people insurance to people who can't acquire it on their own? I don't feel any particular obligation to subsidize other peoples lives.

I get $250,000 salary, and they throw in free insurance. Does it matter if I pay it or my employer pays it? It gets paid. It just doesn't come out of my pocket.

What's your problem with that?

My problem with what you are saying is that less fortunate people shouldn't get compensated for insurance costs. I *do*, unlike you, feel responsible for people that don't get these perks and I am willing to help them out.

As long as I do not give up what I already have. That wouldn't be fair, unless the loss of insurance was paid back to me as an equal payraise to allow me to buy back that policy.

 

[NeoDevin]

I don't think it's nice to be a burden to everyone else either.

It's a bigger burden when people go to ER for frivolous things because they couldn't afford primary care.

 

[NeoDevin]

I'm also not a push over—if someone breaks my contract I don't just whine about it—I take action.

Now try doing that as a single person who's just been crippled by a disease or an accident.

 

[Choronzon]

I get $250,000 salary, and they throw in free insurance. Does it matter if I pay it or my employer pays it? It gets paid. It just doesn't come out of my pocket.

What's your problem with that?

My problem with what you are saying is that less fortunate people shouldn't get compensated for insurance costs. I *do*, unlike you, feel responsible for people that don't get these perks and I am willing to help them out.

As long as I do not give up what I already have. That wouldn't be fair, unless the loss of insurance was paid back to me as an equal payraise to allow me to buy back that policy.

I don't have the slightest problem with what you get—you've earned it.

Let me put it another way. The first thing I did after I left my parents home as a teenager was join the military. I had health my health care covered. When I left the Army, I worked for DHS—health insurance came with that. Then I worked for a small business in Detroit. I had to pay a pretty hefty premium with a bit higher premiums and my employer pitched in, but I had health insurance. Right now, I own a bar and buy my own insurance. From the age of my majority I've had health coverage in one form or another by working for it.

Now people want to give away for free what I've had to work for the past 10 years. Thats my problem. What was the point of going to war if all that I earned while there is what many people believe is a right that should be provided for everyone?

If you feel charitable and want to help someone else out, that's very commendable and I hope they appreciate it. I've done the same in the past, and I will do it again in the future. But if I feel like being a little less charitable this month and instead buy an IPad, that should be my right.

 

[Choronzon]

It's a bigger burden when people go to ER for frivolous things because they couldn't afford primary care.

Now try doing that as a single person who's just been crippled by a disease or an accident.

I'm unconvinced of that. While it is wasteful if an uninsured person takes advantage of ER services, it still doesn't entitle them to all the drugs, tests, and treatments they may need.

As for your second post—so what? Even if I had been crippled by a disease or accident, it doesn't mean that I'm then magically entitled to enslave doctors and force them to treat me, nor am I then entitled to take my neighbors property to pay for my needs. It's called life—we might die at any moment and we might waste our lives with bad decisions or fall upon bad fortune. How does that make your property mine?

 

[zomgwtf]

How does that make your property mine?

It doesn't, it just shows that you care for others well-being. (which I understand that you don't)

 

[NeoDevin]

As for your second post—so what? Even if I had been crippled by a disease or accident, it doesn't mean that I'm then magically entitled to enslave doctors and force them to treat me, nor am I then entitled to take my neighbors property to pay for my needs. It's called life—we might die at any moment and we might waste our lives with bad decisions or fall upon bad fortune. How does that make your property mine?

My reply there wasn't intended to support universal health care, but rather to point out that, in many cases, people who are dropped by their insurers are unable to fight back. This is a separate issue.

 

[Choronzon]

It doesn't, it just shows that you care for others well-being. (which I understand that you don't)

I care for plenty of people—like my friends and family. I work hard to provide for them, and I give to various causes that are important to me. And to be honest, I do think that some people should be given free health care—children with no one to support them, and the disabled, whether mentally or physically. But resources are in fact limited, and when it comes down to it I'd rather send my daughter to a better school or even buy her some meaningless luxuries than give my able-bodied neighbor health-insurance.

 

[zomgwtf]

@ Choronzon. I'm wondering exactly how much of what 'you earned' is being or will be taken away from you? It seems to me more or less that your 'angry' or 'jealous' over the fact that you've worked hard to attain what you have and other people will get it without working as hard as you. Is that really something to be angry over though?

I didn't see your reply to my other post. So with the resources that you're going to be losing you would be able to send your daughter to a better school?

 

[Choronzon]

My reply there wasn't intended to support universal health care, but rather to point out that, in many cases, people who are dropped by their insurers are unable to fight back. This is a separate issue.

Well I would absolutely support stronger consumer protection laws, both in health care and other industries.

 

[Choronzon]

@ Choronzon. I'm wondering exactly how much of what 'you earned' is being or will be taken away from you?

Well, I'll tell you. Out of every $10 of profit my bar brings in, the government takes $6.50 in various taxes and fees. If you're interested in my personal income taxes, I paid just over a third of it in Federal and State taxes. That doesn't include what I've paid in FICA and medicare, which I doubt I will see in 40 years.

As for sending my daughter to a better school, no, I just used that as an example. I was trying to illustrate that we all are at least a bit selfish. While my daughter goes to a public school (a good one!), I spent over $3000 last year so she could do various extracurricular activities (i.e. Dance, Gymnastics, Camp, Chess, etc..). I suppose I could have taken that money and used it help pay some of my struggling neighbor's mortgage, but I didn't. I expect others here have made the same choice. Should I be excited that the government may want to take another thousand of that next year?

To be honest, I don't know exactly how this bill will affect my tax bill. I don't believe those that say it will save money—the very idea that it will is absurd.

 

[zomgwtf]

Well, I'll tell you. Out of every $10 of profit my bar brings in, the government takes $6.50 in various taxes and fees. If you're interested in my personal income taxes, I paid just over a third of it in Federal and State taxes. That doesn't include what I've paid in FICA and medicare, which I doubt I will see in 40 years.

Ok but how much of this exactly do you suppose is going towards giving a helping hand to those that don't have insurance? Ball park figure if you can. Or are you just against paying taxes altogether and everyone should keep every penny of what they've earned? Maybe you live in the wrong country?

 

[Choronzon]

Ok but how much of this exactly do you suppose is going towards giving a helping hand to those that don't have insurance? Ball park figure if you can. Or are you just against paying taxes altogether and everyone should keep every penny of what they've earned? Maybe you live in the wrong country?

I've got no idea how much of my tax bill will go to this new health care program. To be honest, even if it lowered my taxes AND gave me personally awesome free healthcare, I'd still hate it on principle alone. To me, the very idea that health care is a right that should be provided to everyone is absurd.

And no, I'm not against paying taxes. I just wish our tax dollars were more localized. I absolutely hate it how the Federal Government takes such a large share of it that makes the sates and local government beg for it back on bended knee with hat in hand.

 

[TheStatutoryApe]

To me, the very idea that health care is a right that should be provided to everyone is absurd.

I believe in universal health care. I do not feel that it is a right per se but rather that doctors and those in the medical profession have a duty to their community and to do what they can to help those in need. I feel that the government ought to implement any possible means of supporting the medical community in discharging this duty as it is vital to the stability, health, productivity, and wellbeing of the nations citizens.

 

[brainstorm]

Your insurance is part of the compensation your employer pays for your labor--the same as wages. Your employer is still spending it's own resources to secure your employment, presumably because you have some value to them.

Why do we have to provide people insurance to people who can't acquire it on their own? I don't feel any particular obligation to subsidize other peoples lives.

And I'm not trying to be nice. I also feel no obligation to be kind to people who can't provide for themselves and thus believe that they are entitled to a portion to what I've earned. I don't think it's nice to be a burden to everyone else either.

I agree that I don't want to subsidize other people, but I don't think some people understand how prices are set economically that makes subsidies necessary for some people to get certain things. Here's a simple example:

Let's say I make 100k/year and you make 10k/year and, for simplicity's sake we are the only two people in our health care market with one physician. If I decide that my health is worth a lot, then I will be willing to pay higher cost. My doctor, of course, wants to make the maximum amount of money possible, so she will accept as much as I am willing to pay her. I decide 20% of my income is not extravagant, especially since that still leaves me with 80k/year for other things.

Now, the fact that I am spending $20k/year on healthcare means that my doctor's business managers and advisors need to set her fees to get the full $20k. Once these fees are set, they seem like "THE cost" of health care. No one remembers that it was the highest income in town that set the bar to make the fees what they are in the first place.

Then, because I feel bad for you making 10k/year and not having health care, I vote to subsidize your insurance so you can gain access to the same health care that I have. What a good person I am! Only, in order to get the insurance you have to fulfill certain criteria, the most important of which is that you get a job, because I need employees for my investments to keep my 100k/year income growing.

So the problem is that health care costs are relative to the highest incomes instead of the lowest. If they were indexed according to the lowest incomes, no subsidies would be necessary, and health care benefits would not longer be an incentive to work for businesses where people invest more money to make more profit so they can pay more for health care.

 

[Alfi]

$250,000

Holy crap !

I make 10% of that as a Electronics Technician fixing computer motherboards.
I guess I move in the wrong crowd.
Sure glad I'm Canadian and have nothing to do with this debate.It's been a very good read. Thanks to all who contributed to it thus far.