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Author Topic: ACA  (Read 8916 times)

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Offline Kythia

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Re: ACA
« Reply #150 on: November 16, 2013, 01:26:30 PM »
Sorry I didn't realise I'd used "the south" at all.  Will have a quick scan through and look for it, and will explain what I meant by it when I find it.  I honestly wouldn't have been using it in a derogatory sense - the hillbilly view of the Southern US isn't a massive stereotype over here (or for me at least) and while I'm aware of it I wouldn't, you know, bring it to mind in writing.

But as I say, I'll check back through what I've written and put some context together.

Online The Dark Raven

Re: ACA
« Reply #151 on: November 16, 2013, 02:16:43 PM »
All I know is I have seen what it would cost me to float it every month is nearing 3x the monthy cost of what I pay now for about 1/2 to 2/3 of the coverage I get now of things I actually use.  Now, substance abuse coverage has gone up but I don't see myself needing any sort of detox at any point in the foreseeable future (I don't smoke nicotine anything and I barely drink.  I don't use other substances either.).

In my budget it is hardly affordable.  Other folks may have a different idea.  I know that if my insurance is not deemed valid under the ACA, I will become one of the uninsured because it is simply cheaper than paying for the monstrosity that is the ACA.

Offline Phaia

Re: ACA
« Reply #152 on: November 16, 2013, 05:20:19 PM »
Sorry I didn't realise I'd used "the south" at all.  Will have a quick scan through and look for it, and will explain what I meant by it when I find it.  I honestly wouldn't have been using it in a derogatory sense - the hillbilly view of the Southern US isn't a massive stereotype over here (or for me at least) and while I'm aware of it I wouldn't, you know, bring it to mind in writing.

But as I say, I'll check back through what I've written and put some context together.

i never thought you meant insult and at 2am in the morning i am not sure if t was you or someone else..i know I read the reference here at least once

no offense taken

phaia

Offline consortium11

Re: ACA
« Reply #153 on: November 16, 2013, 05:23:34 PM »
A quick search/read suggests it was kylie rather than Kythia who referenced the south.

Offline Phaia

Re: ACA
« Reply #154 on: November 16, 2013, 05:35:32 PM »
A quick search/read suggests it was kylie rather than Kythia who referenced the south.


eppp my bad i get thise K's mixed up sorry then kythia and *wags finger at kylie*

I was seeing squiggly lines trying to read through everything last day or so...

phaia

Offline kylie

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Re: ACA
« Reply #155 on: November 17, 2013, 01:35:27 AM »
As an example [and I am sure you did not mean offense] at least twice [I think] you have use the reference 'the south' as if to imply all those of us that live in the south are backwards, red neck hillbillies that do not know how the real world works. It is not just you but I often see in these political forums the term 'the south' used and nothing more.
   
          Last I recall  mentioning the South -- better big S, as a political bloc of mostly red states -- it was about the status of women there, which Val had skewered in a larger sense (he was talking about women generally) on the way to saying we can't possibly make everyone pay similar premiums and keep the business model we have ("That's not how insurance works" etc)...  But this rejoinder about 'don't generalize too much about my people like that' gets tossed around so much.  I wonder if it doesn't have its own thread somewhere, but I'll give you a response and try to be done with it.  I don't mean to hijack the whole thread. 

           I talked this way about the South a lot even when I lived there (and I did for a few years).  In fact when I was there, I was much more in a position to hear more about how upset some Southerners (often Black university students, as well as some Southern sociologists) were about racial prejudice in local politics.  Now granted I didn't grow up in the South so if that were someone's criteria, then I would say "whatever you think you're getting at by asking that" -- but at some point people are going to generalize for the sake of conversation.  Otherwise, it devolves into everyone "owns" the best understanding of their own little corner, and no one should have any logical or moral criticism of what happens anywhere they don't spend [insert minimum time and dues of each faction's choosing here]... 

          When you're much more likely to see a policy passed in a certain region that supports a certain view...  Or when in your personal experience it's easier to meet people in that region who do support a certain set of views than in other places...  Particularly views you find the view (and maybe policies) in question either simply counterproductive or downright prejudiced...  And -- perhaps again, if you live there when you used to live elsewhere -- you suddenly worry more than before about running into this day to day...  In both cases, then it's true that it applies to the South.  It's simply happening there.  It is a different place in the national experience. 

        Now, that is not saying "you" intend all of that personally...  If anything perhaps, it's saying, if you will:  As a collective, what are y'all thinking because between a few people shouting about "family values" and a few shouting about "self-reliance" you're ending up with some policies I just can't believe?  I don't know that much about how gerrymandering works, and I suppose it just might be possible that elections have been rigged so effectively in the South, it has nothing to do with overall popular opinion after all? 

          If in fact many people who have lived in the South longer do not really enjoy those views or those policies, then why don't they do more to change it?  Are they so concerned about other issues, or are they so constrained that they simply can't (incumbent advantage? gerrymandering? poverty? corruption?) ?  Or are they in fact somehow positively invested, if they could think about it, in some of the groups and values that do actively demand those situations go on as they are? 

... Although it's also possible to argue that at some level, much of the country (world? global economy?) has long been relying on some of the same positions -- and we just happen to see lots of them more for what they are when they manifest visibly in policies of the global South (whether it's visible institutional racism in Alabama or ethnic discrimination and child/generally abused labor in Filipino "free industry towns").  But yeah, if you believe some change has to start locally, then you have to ask, "Well whatever are people doing there?"  And sometimes a 'there' that crops up a lot in broader American politics as an obvious site of visible, rather extreme examples is the South.

         Also, I don't think one needs to be a hillbilly to be clueless about how the world works.  Wall Street and much of capitalism thrives on the premise of most people not knowing how it works, or being convinced not to care.  If I ask my students from rural China if it's ethical to sell investment based on real estate one knows is not worth much already (the financial crisis), or even to sell a necessity in a new market for exorbitantly more than it costs for the provider to pick up in another region ...  Some of them also will simply say in effect: ""Duh, yes, that's capitalism."  Likewise for Americans and Southerners included (city or rural), it's entirely possible to be connected and still be very clueless or a supporter of a sickeningly unequal, exploitative system.  The question is more, do in fact a lot of people in that region happen to buy into those ideas that stereotypical hillbilly political culture is famous for: that pursuing equality is a pipe dream and somehow bootstraps or big buddies business (I think the hillbilly version would be, getting on well with some "good" family) are the only way to go? 

          Back on topic, I do gather that people in some circumstances, perhaps too many of them, are finding the ACA impractical to say the least.  That's fine, but I'm not sure that is precisely what the Tea Party or even most Repubs were fielding as their reason for opposing it.  Do you vote for people who oppose something that should be opposed, even if their reasoning about why they oppose it are different or completely off?  Even if their prescriptions are likely to be dangerous, maybe?  I don't know.  I wouldn't, given the range of other things I see the Repubs generally leading toward -- including their obvious lean on business models, and for some their pretty outrageous representations of women.  But it seems all these red states keep electing these people and day to day, and I did have to watch out more often for very vocal and entrenched supporters of those views when I lived there.
 
« Last Edit: November 17, 2013, 01:49:37 AM by kylie »

Offline Valthazar

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Re: ACA
« Reply #156 on: November 17, 2013, 02:02:27 AM »
Last I recall  mentioning the South -- better big S, as a political bloc of mostly red states -- it was about the status of women there, which Val had skewered in a larger sense (he was talking about women generally) on the way to saying we can't possibly make everyone pay similar premiums and keep the business model we have ("That's not how insurance works" etc)... 

You have terribly misunderstood me.  My remarks were simply describing the realities of how premium rates currently work in a private healthcare model, where rates are determined by individual preference for coverage.

Regardless if it was a man or a woman, a person not planning to have kids would have a cheaper health insurance plan since they would not need maternity coverage.  However, a woman who is planning to have children would have a higher premium, all else being identical, since she would opt for maternity coverage.

This benefits women in their 20s, or women who have no intention of having kids.  They get cheaper premiums.

It's the same as saying, a man who participates in extreme sports might opt for additional coverage for sports related injuries, and thus have a higher premium.

The ACA attempts to resolve these issues by mandating maternity care and sports coverage, along with many other minimum coverage parameters for all individuals - man or woman.  It provides subsidies based on income (without the male/female issue coming into play).
« Last Edit: November 17, 2013, 02:09:02 AM by ValthazarElite »

Offline kylie

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Re: ACA
« Reply #157 on: November 17, 2013, 07:20:16 AM »
          Val, I seem to recall you comparing certain health conditions to regional disaster coverage, and at some point saying it was rather understandable that people might not want to pay for conditions that don't affect them.  And mentioning that women have certain needs men don't, which together with everything else sounded to me and at least one other person I know, as if you were saying women simply naturally have to pay more, why should men need to pay for it?  I know you are keen on dragging out various cases, but without getting into small corners... I don't really see how the principle changes or why certain amounts of money it would cost for this or that are clearly not feasible.  Cost relative to what? another carrier group? another bank bailout? Or simply relative to current health system costs? Another Iraq war?  Show me how it's impossible or socially irresponsible exactly to help more people who are already here needing it, and not just a cost that people (or corporations) in power now won't stomach. 

         What I gather you are saying is that at some point, the current market operates by deciding some people are more risky than others and trying to get them to pay higher relative premiums etc. for it.  And when you get to the point of using examples like regional disaster insurance and going on about how this is just how insurance works...  Then I kind of suspect you'd go more than I would for a system that sooner or later, provides less benefit to those who may have more costs and socially fewer means available to deal with them.  If one is thinking "outside the box" when it comes to answering that, then fine, we need to change "how insurance works." 

For that matter, would it be such a shock for many US plans to cover maternity leave for fathers, as many European plans do...  Someone would probably scream "socialism" or "pinkies" all over Capitol Hill and Fox News again (notice how red scare and femininity scare have been tied together?).  I feel like you're going on about costs and Massachusetts, but if you don't admit that political will and priorities are an issue to begin with, then the whole conversation is silly from the get-go.  Of course health costs won't improve if the US is governed and de-regulated as it has been for the last generation!  Or that's my gut feeling.  And this idea that some people are not the responsibility of others, and 'anything else must be un-American or anti-business' -- that is part of the problem, I think.   

         I do agree it would make a lot more sense to have a single payer system where all the costs could be spread out.  You may just be demonstrating (without meaning to, I know) that it's leaning more toward a situation where the realistic options are actually single payer or bust?  But I'm not sure where you're going with all this.  If the point is simply that ACA is making the existing trend worse by giving insurance companies too much leverage to lump stuff people don't want into some plans to the point of being unaffordable, that's one thing.  I get that some people seem to want to make the thread nothing but one constant thumbs up or down rant on ACA as it is.  There, it sounds like as much a problem of whether the subsidies are actually the right size for the plan costs.  (Weren't Repubs attempting to defund this policy all along the way?  If indeed they were and made some success, then it isn't simply the idea that's wrong but more the lack of support that sabotaged it.  I'm not sure but I'd like to know.  Apart from that, simple lack of planning/will to pay could certainly be a problem.) 

But if the idea is more that no one should be stuck with any cost they don't want in principle because it may not help them so visibly and personally -- no matter how common or important that cost is across the whole population, and in exchange for other relationships across the country such as the country holds together -- then well we could go right back to the Whiskey Rebellion and say, 'Why should anyone pay the government for anything at all?'

   
« Last Edit: November 17, 2013, 07:24:11 AM by kylie »

Offline gaggedLouise

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Re: ACA
« Reply #158 on: November 17, 2013, 11:13:42 AM »
          Val, I seem to recall you comparing certain health conditions to regional disaster coverage, and at some point saying it was rather understandable that people might not want to pay for conditions that don't affect them.  And mentioning that women have certain needs men don't, which together with everything else sounded to me and at least one other person* I know, as if you were saying women simply naturally have to pay more, why should men need to pay for it?

*(read: one other woman)

*nods in agreement from the seating*

Quote
I know you are keen on dragging out various cases, but without getting into small corners... I don't really see how the principle changes or why certain amounts of money it would cost for this or that are clearly not feasible.  Cost relative to what? another carrier group? another bank bailout? Or simply relative to current health system costs? Another Iraq war?  Show me how it's impossible or socially irresponsible exactly to help more people who are already here needing it, and not just a cost that people (or corporations) in power now won't stomach. 

    What I gather you are saying is that at some point, the current market operates by deciding some people are more risky than others and trying to get them to pay higher relative premiums etc. for it.  And when you get to the point of using examples like regional disaster insurance and going on about how this is just how insurance works...  Then I kind of suspect you'd go more than I would for a system that sooner or later, provides less benefit to those who may have more costs and socially fewer means available to deal with them.  If one is thinking "outside the box" when it comes to answering that, then fine, we need to change "how insurance works." 

If the primary condition for driving an agenda of health care and insurance reform would be that you must have every major insurance firm who is already on the field willingly come on board beforehand, before you even draft any definite proposal and plan; must have them say without any political forcing: yes, yes, of course we think this is fine, we don't have anything against this and we'll pay according to the costs we can see coming, together with the state - then you'd never get anywhere. It would be like trying to get drinkable and healthy water, proper sewage and water cleaning, all across a city where there's never been any proper water sanitation except in a few suburbs where the rich people live, and under a local self-government that grades the voting power according to income. In that kind of situation, without any possible or legit leverage from those who demanded clean and safe water to their houses and to public buildings, nothing would happen.

If the requirement for health care reform is that every company, every insurance provider of any weight in the market should say yes, without the least pressure from a political process that's been rolling on for years and which resulted in a signed package of laws three years ago, and which laws have been constitutionally tested, or else it would be those petty special interests (women, lower middle class, unions etc) shamelessly trying to push their game and exploitthe entrepreneurs...if that's it, then you'd have to wait two hundred years for the beginnings of any realistic change.

« Last Edit: November 17, 2013, 11:20:34 AM by gaggedLouise »

Offline Valthazar

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Re: ACA
« Reply #159 on: November 18, 2013, 03:20:33 PM »
For that matter, would it be such a shock for many US plans to cover maternity leave for fathers, as many European plans do...  Someone would probably scream "socialism" or "pinkies" all over Capitol Hill and Fox News again (notice how red scare and femininity scare have been tied together?).  I feel like you're going on about costs and Massachusetts, but if you don't admit that political will and priorities are an issue to begin with, then the whole conversation is silly from the get-go.

Requiring men to have maternity healthcare coverage is entirely different from maternity leave.  Maternity coverage refers to healthcare issues regarding pregnancy.  Forcing men to take maternity healthcare coverage has no influence on their employer paid time-off when they become a father.

There seems to be a lot of misinformation flying in this thread.  The ACA does not decrease or subsidize costs simply for being a woman.  Many women will actually see rate increases.  The subsidies are only provided based on financial figures - regardless of male or female.

The only clause in the ACA pertaining to women is the requirement that rates cannot vary between men and women.  On a functional level, we can all agree this is good in theory. 

However, it hurts women who are married, who now have husbands required to pay more for their insurance.  It also hurts women who just graduated from college and looking to get their first job.  It also hurts women who have no interest in having children, and women in their 40s and 50s.
« Last Edit: November 18, 2013, 03:21:36 PM by ValthazarElite »

Offline kylie

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Re: ACA
« Reply #160 on: November 18, 2013, 09:16:12 PM »
Requiring men to have maternity healthcare coverage is entirely different from maternity leave.  Maternity coverage refers to healthcare issues regarding pregnancy.  Forcing men to take maternity healthcare coverage has no influence on their employer paid time-off when they become a father.
         Bearing children is an event that has implications for the rest of the society far beyond whether the individual woman wants one at a given moment, in some hypothetical vacuum.  Just as in your regional disaster example, whether or not the whole insurance system actually does raise prices for everyone until it can cover people regularly getting washed off the floodbanks of the Mississippi (or whatever local emergency) has impacts across whole communities and even on the whole national economy. 

You can try an atomized, individual consumer choice model if you like, but it falls apart for me when we consider that actually, the whole society is organized around assuming that some people will positively take certain options and those choices are good for the nation as a whole.  It's not simply a matter of some personal "extra" or "privilege" that has no bearing on anyone else (and it has not been treated as if it were, where the government has been concerned historically).  The real question is what percentage perhaps the individual pays versus the collective -- but it is not whether the collective should reasonably pay a meaningful share at all to make things happen -- at least, not until you get into things like the One Child Policy or abortion debates.  This is a question of how the society or government (or is it now, corporation?) actually does regulate or encourage how many kids per family or how many houses per floodplain is a positively desirable (or at least a supportable) risk/investment. 

          Now, whether the whole business model has been rigged such that absolute prices are exorbitantly high to begin with (i.e. does the government reform this??), or whether the government plans and subsidizes a national plan in a way that people  can pay to get important stuff done at all and keep prices relatively low under whatever system is available -- those are separate questions. 

Quote
There seems to be a lot of misinformation flying in this thread.  The ACA does not decrease or subsidize costs simply for being a woman.  Many women will actually see rate increases.  The subsidies are only provided based on financial figures - regardless of male or female.
        I don't think I said the ACA itself was doing it all right.  I suppose now that the cost management could have been trashed the minute corporations were allowed to change the plans without consequences, and thus nullify the earlier estimates.  If that is not actually a runaway problem, then I also wonder if it's just not being funded properly for the intent. 

          It's the part where you seem to suggest people shouldn't have to pay for stuff they don't immediately use, where I start to ask, but are you sure they don't benefit from others having more reasonable coverage for those particular events (which might otherwise spread high costs of such events in cases of delay or non-coverage, i.e. stuff not getting done or costs of default on payments across the whole system anyway) and from more people having overall cheaper coverage for more things?  I just got the impression with your disaster and women's cases that you were picking situations where only a minority (errm, except there are an awful lot of women!) are commonly discussed as the immediate "agents" or "people involved" -- partly because yes, the society has taken it for granted that they would bear more burdens, rightly or not -- but in fact a lot of people are seriously really affected, sooner or later, by what happens?

          I do understand that people may be upset when they feel that charges for stuff they don't use "personally" are the ones that seem to break their budget, but to me that sounds more like a problem of how the funding was allocated or not.  That does not prove to me that there was no other way to allocate it, or even that the funding was proper or what was intended.  It may show that ACA as it stands has problems...  It doesn't necessarily show that it's better for everyone to let everyone, slice and dice plans for only what they use this moment.  That would be contrary to a single-payer system (which you say you support) anyway, right?  There would be no way to spread out the costs.

Quote
The only clause in the ACA pertaining to women is the requirement that rates cannot vary between men and women.  On a functional level, we can all agree this is good in theory. 

However, it hurts women who are married, who now have husbands required to pay more for their insurance.  It also hurts women who just graduated from college and looking to get their first job.  It also hurts women who have no interest in having children, and women in their 40s and 50s.
          So you're saying that in theory people are interrelated and should help each other, but "in practice" no one wants to.  No one cares if it is hugely expensive for some woman elsewhere in the society to have a child, or to have however many children you say is too many.  Only her immediate partner, you might say, should have any interest in that whatsoever.  It doesn't matter if she's someone else's neighbor or relative or teacher, or if one wing of the government is lamenting how domestic-born population is in decline for that matter... 

In that case, it's completely 'her problem' if she wants a child, and it has no relation to whatever else happens in the society?  Who is going to be the workforce when those women in their 30's are 60?  Why did the state perhaps, provide an easier financial environment for their parents to bear them, than it offers for them if they wish to have children?  No, it's completely their individual problem and if they can't afford children or proper maternity practices, that cost never goes anywhere else in the system.  Sorry, I don't believe that's very practical.  It's not empirically true.  Unless perhaps, you assume that the child she is contemplating is one the state and society are not at all interested in her having... 

Maybe it makes some sense in a scenario where you assume from the get go, that is one child too many and it couldn't possibly contribute anything good to have one more -- then, obviously, she should pay for everything.  No one else has any interest in that child then...  (Or it could be, in that guy's chronic condition being resolved so he can get back to work, or that house repaired after a flood that only happens in that region so that those people can focus on what they're doing while they drive buses of people across the country or build roads or inspect nuclear reactors...  What have you.)
« Last Edit: November 18, 2013, 09:41:18 PM by kylie »

Offline Valthazar

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Re: ACA
« Reply #161 on: November 18, 2013, 09:41:33 PM »
Bearing children is an event that has implications for the rest of the society far beyond whether the individual woman wants one at a given moment, in some hypothetical vacuum.  Just as in your regional disaster example, whether or not the whole insurance system actually does raise prices for everyone until it can cover people regularly getting washed off the floodbanks of the Mississippi (or whatever local emergency) has impacts across whole communities and even on the whole national economy. 

It may show that ACA as it stands has problems...  It doesn't necessarily show that it's better for everyone to let everyone, slice and dice plans for only what they use this moment.  That would be contrary to a single-payer system (which you say you support) anyway, right?  There would be no way to spread out the costs.

kylie, you are basing your understanding of the current state of American healthcare on inaccuracies.

You seem to be suggesting that the increased premium revenue from men being required to have maternity coverage, will now subsidize the healthcare costs of pregnant women who cannot afford health care.  This is fundamentally incorrect.  If you disagree, please cite your sources, because I have already outlined the specific implications of the ACA in earlier posts.

To add a bit more clarification, the insurance premiums are going to insurance companies, while the subsidies come from the government - meaning their origin is not from these new "minimum standards of care" instituted in ACA.  In other words, nothing is being done specifically for impoverished pregnant mothers.  What is being done is income-based subsidies, but that is for all individuals - male or female.

I know you also are not a fan of ACA necessarily.  And I know we both would be at least content with a functional single-payer system, since that would at least be better than what we have now.  However, the ACA is not a move towards a single-payer system.  It's actually just padding the pockets of the health insurance companies.

If you want proof, just look at the stocks for private health insurance companies.  Here's just a few.

AETNA (AET)
$28 --> $65  (since 2010)

UnitedHealth (UNH)
$29 --> $71 (since 2010)

WellPoint (WLP)
$46 --> $90  (since 2010)

WellCare (WCG)
$24 --> $69  (since 2010)

Honestly, just look at these strong Health Insurance funds - some are getting 55%-60(!)% value growth in 1 year.
http://money.usnews.com/funds/mutual-funds/rankings/health
« Last Edit: November 18, 2013, 10:17:13 PM by ValthazarElite »

Offline kylie

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Re: ACA
« Reply #162 on: November 19, 2013, 04:42:13 AM »
kylie, you are basing your understanding of the current state of American healthcare on inaccuracies.

You seem to be suggesting that the increased premium revenue from men being required to have maternity coverage, will now subsidize the healthcare costs of pregnant women who cannot afford health care.  This is fundamentally incorrect.  If you disagree, please cite your sources, because I have already outlined the specific implications of the ACA in earlier posts.
        You seem to have the notion that anything I say is somehow obviously only about the ACA?  Well if that's all the thread can do, then you must enjoy going in circles...  I'm not wedded to the thing.  What I'm concerned about is people coming along getting the conclusion that ACA is some ultimate proof that government policy can't do anything right, and therefore all the effort and will should be scrapped rather than improved upon.  So granted your examples were apparently only concerned more with using what is in the prior industry as a precedent.  I didn't unerstand you were so interested in limiting the thread to bashing the ACA (and more btw but does that effectively mean, here bashing mainly the ACA/government and not so much business at large, I wonder?) for continuing or exacerbating what has been done in the past. 

          When I pick on those examples, I'm more concerned about what might be or should be, if there was only will to do it.  And yes, that is in general terms since I'm hardly in a position to be modeling every billion and every condition.  Nor to predict all the votes in the current nastiness of US politics to keep them in there, which was why ACA came out sooo problematic in the first place -- but I would appreciate if you said more to address a political situation where "pro-business" is generally code for "do what those big insurance companies [among other megacorps, who are also quite busy churning out and manipulating nifty figures] say we must."  Anyway...  What I can do is say, reorganizing in one direction or another makes sense to me or doesn't in terms of general process.   

         I've been saying maybe I'm more inclined to think we should subsidize those women.  At least to some reasonable extent -- I don't know if we can afford to subsidize 6 children per woman or not (not that everyone wants that many, but you get my drift).  However, I'm disinclined to believe that we couldn't afford to cover some lower average number...  The particulars don't concern me so much.  Rather I was responding against what sounded like a wave and nod to precedent, where it's a rather disingenuous understanding of even that precedent.  You may say "insurance doesn't work like that," but government does and here part of the question is will government get involved and make reforms or not.  If we're going to do better.  If nothing else, because people are concerned about the costs we have now

          Arguably the ACA itself no longer resembles what was originally intended; I think we agree on that.  So if we take the political will that originally went into ACA and try to do better...  If indeed people still want to, that is if they haven't come to believe it's simply impossible and if not too many of them believed it was "un-American" or somehow against the budget (however in the world that's figured) to do so in the first place...  If we are not hamstrung by those scenarios then this, status of so many conditions specific to so many groups, is something that could (and I think should) be considered.
Quote
To add a bit more clarification, the insurance premiums are going to insurance companies, while the subsidies come from the government - meaning their origin is not from these new "minimum standards of care" instituted in ACA.  In other words, nothing is being done specifically for impoverished pregnant mothers.  What is being done is income-based subsidies, but that is for all individuals - male or female.

I know you also are not a fan of ACA necessarily.  And I know we both would be at least content with a functional single-payer system, since that would at least be better than what we have now.  However, the ACA is not a move towards a single-payer system.  It's actually just padding the pockets of the health insurance companies.
            For the rest, I think I'm going to simply declare confusion, unless I can get a simple explanation of where this mess came from.  What I recall, by now and increasingly late from when it happened...  Is that some people were going on in the thread about how ACA forced them to pay higher premiums for conditions they didn't think were theirs to be worried about.  Roughly the same time, you said something about people have to pay different premiums for different situations and that is just 'how insurance works.' 

            I thought you were suggesting it was rather impossible, no matter what we do, to create a market where the costs will be spread more or less evenly.  I thought you were arguing that in effect, women etc. must pay more -- the economy or politics will bear nothing else no matter how good our intentions or any reforms.  Now, were you saying that is simply how it is under insurance companies and therefore under the ACA -- and if so do you in fact, you want to take those companies largely out of the decision process?   That isn't how it came across to me, but maybe there was some static in the air.  (Possibly static I sense, when I otherwise hear someone say so much about what is important "for business," but anyway.)
 
« Last Edit: November 19, 2013, 04:52:55 AM by kylie »

Offline Valthazar

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Re: ACA
« Reply #163 on: November 19, 2013, 11:50:10 AM »
I thought you were suggesting it was rather impossible, no matter what we do, to create a market where the costs will be spread more or less evenly. 

No, I am suggesting that the measures necessary to implement the healthcare model you are describing is increasingly becoming further and further away from our reach, as the ACA implementation gets further underway.  In other words, your proposals are far more attainable without ACA, and nearly impossible now that ACA is implemented.  I do not find fault with the insurance companies themselves, but with violations - such as business corruption, fraud, and illegal practices - such as government-business collusion and inter-business collusion.  I explained this further in an earlier post in this thread.

This is an outstanding 8-minute video that discusses just the facts of ACA.  It is non-partisan, and just discusses the actual clauses of the law, and clearly describes how it is making it even more challenging to find a functional solution.

As I have been saying, the ACA was a closed-door, wall-street orchestrated initiative.

I highly recommend investing in healthcare funds, to make a killing in a year or two.  The individual mandate penalty is going to be over $695 or 2.5% of taxable income in 2016, so I can assure you that an increasing number of people will be enrolling in private healthcare (and thus paying them premiums) progressively from 2014-2016, and onwards.  It's doing nothing but making insurance companies and investors richer.

« Last Edit: November 19, 2013, 12:08:51 PM by ValthazarElite »

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Re: ACA
« Reply #164 on: December 17, 2013, 11:39:26 PM »
I'm just gonna throw this up here cause it made me LOL really hard.


Offline IStateYourName

Re: ACA
« Reply #165 on: January 01, 2014, 11:14:14 PM »
I'd an American who like to emigrate to a nation that doesn't have such enormous difficulties doing common-sense things like providing health insurance for all citizens.  And that isn't trying to run the world (not trying to derail the thread, but there's a definite correlation between the expense of administering a global empire and "oh noes we can't afford universal healthcare it's TOO EXPENSIVE we'll go BANKRUPT!"

Re-reading this...yes, I can see where it would be perceived as a thread derail.  So if you want to speak to the issue of other countries and better systems, I created a new thread.  http://elliquiy.com/forums/index.php?topic=193399.0

Back to the ACA--I think it's going to fail.  Too much complexity in something already drowning in complexity.


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Re: ACA
« Reply #166 on: February 10, 2014, 04:42:39 PM »
Found this pretty interesting:

The Obama administration is giving more time for employers to comply with ACA guidelines for their workers.  Companies with 50-99 employees will now have until 2016 to provide coverage under Obamacare, and larger companies will only need to cover 70% of full-time workers by 2015, instead of 95% as previously stated.

It is surprising to me that the Democrats are now granting this provision via executive action, when it is almost exactly what the Republicans were asking for in Congress several months ago, which was blamed for causing the government shutdown.

I support the Obama administration's decision, but I am perplexed why they did not feel this way earlier.
« Last Edit: February 10, 2014, 04:52:38 PM by ValthazarElite »

Offline Zeitgeist

Re: ACA
« Reply #167 on: February 10, 2014, 05:38:41 PM »
Found this pretty interesting:

The Obama administration is giving more time for employers to comply with ACA guidelines for their workers.  Companies with 50-99 employees will now have until 2016 to provide coverage under Obamacare, and larger companies will only need to cover 70% of full-time workers by 2015, instead of 95% as previously stated.

It is surprising to me that the Democrats are now granting this provision via executive action, when it is almost exactly what the Republicans were asking for in Congress several months ago, which was blamed for causing the government shutdown.

I support the Obama administration's decision, but I am perplexed why they did not feel this way earlier.

I would suggest it might be because it was more politically expedient to point fingers and blame Republicans for this administrations poorly executed and thought out program.

Offline ShadowFox89

Re: ACA
« Reply #168 on: February 10, 2014, 06:12:21 PM »
 It's almost as if anything anyone in the gov't or media can do is point fingers....

Offline IStateYourName

Re: ACA
« Reply #169 on: February 10, 2014, 08:19:56 PM »
It's almost as if anything anyone in the gov't or media can do is point fingers....

For all the angst and wrangling there's been over this, we could have just created a single-payer system.  But no.  This is America, so if a reform or change doesn't help the rich get richer, then by golly it's COMMUNISM and we'll have none of it, no matter how much sense it makes or how well it works elsewhere.

Americans love the rich more than they love themselves.  It's sad...but it's only the truth.

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Re: ACA
« Reply #170 on: March 31, 2014, 06:55:52 PM »
From an outside perspective looking in, what's surprised me about the ACA, its implementation and its flaws is that it is essentially a clone of the Swiss health care system, which is likewise based around compulsory "basic" medical insurance with complementary plans on top of that. Under that system, Swiss health care spending is just over 10% of GDP (roughly in line with most western European countries) and does very well in comparisons with regards to the quality of care, as well as coming out well in efficiency tables (top 10 according to Bloomberg).

Just checked this thread since today is the deadline for purchasing health insurance, and saw that I missed this post.  The Swiss healthcare system was the model for the ACA, and I really like theirs.  But there are some specific clauses which make the Swiss healthcare system successful.

Health insurance is only offered privately in Switzerland as well.  All citizens are required to purchase a 'basic package' health insurance, just like with the ACA.  All health insurance companies in Switzerland must offer a version of this basic coverage if they want to stay in business, which includes basics such as sickness insurance, maternity insurance, and accident insurance.  However, health insurance companies are NOT permitted to make a profit off of this basic coverage.  They can, however, make a profit off of supplementary coverage which goes above and beyond the basic coverage.  Because these companies cannot make a profit off of the basic coverage offerings, they naturally tend to offer plans with HIGH deductibles and HIGH co-pays, in addition to premiums.  This naturally creates incentive for consumers to be cost and value conscious, which keeps their overall cost of healthcare down (less services are being used unnecessarily).

In addition, if someone cannot afford to pay the premiums for their basic coverage, the citizen is only required to pay 10% of their income towards their premiums.  The government will subsidize the remainder.

It's a pretty good system, and it works for Switzerland, since they are a relatively wealthy country to begin with, given their population of only 8 million.  Health insurance companies in the US are making huge profits off of the ACA already.

Source
« Last Edit: March 31, 2014, 06:57:10 PM by Valthazar »

Offline mj2002

Re: ACA
« Reply #171 on: April 02, 2014, 12:26:54 PM »
That's why a single payer system would have been better.
Health insurance companies in the US are making huge profits off of the ACA already.
Single payer solves that.

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Re: ACA
« Reply #172 on: April 02, 2014, 02:30:11 PM »
That's why a single payer system would have been better.Single payer solves that.

Assume that widespread access, low cost, and high quality are the three attributes we value in a health policy system.  Policy experts generally agree that any healthcare system can strive to achieve only two of the above.

The ACA seeks to have high access and maintain high quality, while promising 'affordability.'  Naturally, increased access and high quality comes at the caveat of higher costs - which people are seeing now. 

A single-payer system seeks to have high access and lower costs, at the caveat of providing lower quality on an individual level (as compared to what many currently holding private insurance experience in the US and Switzerland).  This is not necessarily a bad thing at all, however, for those who currently have no healthcare.

The reason this issue is so contentious is that those currently with private insurance in the US have different priorities than those without insurance.  And neither view can be faulted for having their perspectives.

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Re: ACA
« Reply #173 on: April 02, 2014, 02:49:39 PM »
Assume that widespread access, low cost, and high quality are the three attributes we value in a health policy system.  Policy experts generally agree that any healthcare system can strive to achieve only two of the above.
The good/fast/cheap rule. Actually applies to pretty much everything in one form or another. The thing is, the pre-ACA system achieved none of those for the overwhelming majority of the population - rather the opposite. If we're comparing to that benchmark, it is indeed possible to hit all three - because it's entirely possible to have, for example, widely-available solid coverage that, while not cheap per se, doesn't bankrupt entire families the moment anything serious goes wrong (and is therefore considerably cheaper than the old version).

The American healthcare system has an administrative overhead of 30%, plus the inefficiency of profit. A typical single-payer system runs at ~3%. You really think there's absolutely no way to decrease costs while maintaining quality of care?

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Re: ACA
« Reply #174 on: April 02, 2014, 03:02:42 PM »
You really think there's absolutely no way to decrease costs while maintaining quality of care?

I do think there is a way, but with lower costs, and higher quality of care, we must accept potentially lower access as well.

I outlined the Swiss healthcare system above, which I'm a huge fan of.  That's the most realistic direction the US can progress in at this point, given how similar the ACA is.

They've achieved 99.5% coverage through an entirely privatized, mandate-driven approach, and the government subsidizes premiums for those who cannot afford it.