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Author Topic: ACA  (Read 8913 times)

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Offline Valthazar

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Re: ACA
« Reply #25 on: November 01, 2013, 07:00:54 AM »
I really don't think the economic climate would have mattered.  With Obama's original plan, he was planning to have a purely government healthcare exchange, that would essentially act like a competitor to the other private insurance companies.  So in other words, people would be able to purchase relatively cheaper healthcare through the government healthcare option - and if indeed this offered the "better bang for the buck," then naturally due to competition, all other private healthcare companies would need to lower their premiums.  Even if private insurance prices did not respond in this manner, the consumers themselves would prefer to join the government healthcare plan, since it would be cheaper, and offer relatively decent benefits.  As many people are saying here, this is the kind of policy that would lead itself to a single-payer system as found in Europe - which I can't really find too much fault in.  Granted, it's not my ideal situation, but it would certainly offer a solution to the current healthcare problems.

The ACA isn't doing that though, and saying that the ACA is a step towards that, or a step in the right direction, is misunderstanding what it accomplishes.  It's basically the government forcing private companies (health insurance providers) to offer lower cost products.  The economy doesn't work like that.  If it were that easy, the government could just step in and say, "Sorry, but colleges and universities are far too expensive right now, we think you should set your tuition prices to $3,000" and problem solved.

The Tea Party opposition to ACA is legitimate, but their arguments are not based on any substance.  They have totally misunderstood the issue, and nothing about the ACA suggests 'socialism' or a government-takeover.  I consider the ACA as more of a burden on business growth, similar to tax hikes on small business, that fails to accomplish its primary objective.
« Last Edit: November 01, 2013, 07:02:17 AM by ValthazarElite »

Offline gaggedLouise

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Re: ACA
« Reply #26 on: November 01, 2013, 07:18:10 AM »
Quote from: ValthazarElite
Even if private insurance prices did not respond in this manner, the consumers themselves would prefer to join the government healthcare plan, since it would be cheaper, and offer relatively decent benefits.  As many people are saying here, this is the kind of policy that would lead itself to a single-payer system as found in Europe - which I can't really find too much fault in.  Granted, it's not my ideal situation, but it would certainly offer a solution to the current healthcare problems.

Watching the U.S. debate from Europe, one does get the impression that anything leading towards a single-payer system (such as, mostly, in the UK, Germany or the Scandinavian countries) would have been a really hard sell with a big part of the American electorate at any time, both pushing it during a national election campaign and getting it worked through in congress. It somehow seems to clash with some baseline American ideas of limiting the state and of the people as a crowd of (real or potential) self-made men, ideas that are (I hazard) not even seen as political but just as part of being American.

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Re: ACA
« Reply #27 on: November 01, 2013, 09:01:02 AM »
You hit the nail on the head in that last post IMHO Gagged. Not to mention offered a much shorter and better explained reason of why here the government just does not pick up the tab for health care, than I did. *Offers a round of applause*

Offline kylie

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Re: ACA
« Reply #28 on: November 01, 2013, 09:39:11 AM »
Watching the U.S. debate from Europe, one does get the impression that anything leading towards a single-payer system (such as, mostly, in the UK, Germany or the Scandinavian countries) would have been a really hard sell with a big part of the American electorate at any time, both pushing it during a national election campaign and getting it worked through in congress. It somehow seems to clash with some baseline American ideas of limiting the state and of the people as a crowd of (real or potential) self-made men, ideas that are (I hazard) not even seen as political but just as part of being American.

          You'll have to say more than that to convince me, or risk jumping to the conclusion that anyone too liberal should simply be labelled "un-American."  Well, that works very nicely for the Tea Party I suppose.  (Though I do have plenty of times when I feel as a unit, the country too often acts that way.  Just...  I don't like taking it too broadly to the individual level.)

           Something like Val says, I was fairly happy with the overall sound of Obama's original proposal.  Now what I remember most of the "debate" (if it can really be called that when it comes to this) is that people like Fox News and company wouldn't stop screaming "Socialism?!" every other minute, while industry lobbies seemed to keep whining quietly that it would cut into their profits too much (or that is what I gathered they were opposing it for -- there was a lot of smoke and mirrors going on, at least in how I remember the news coverage of it). 

             The "Socialism" line is what really surprised me though -- they just seemed to keep repeating lines about how Europe must be weak, Europe must have terrible lines and lower quality care to boot (largely unsupported if I am not mistaken), ACA could mean some bureaucrats making vital decisions about your granny's life support (since it includes a provision for anything remotely like that --actually-- once in a blue moon), and just general rumblings about "isn't this the sort of thing we put all that trouble into fighting the Soviets over?  Why, yes!" Again with hardly any substantial detail to the discussion at all.  Simply, "Hey remember how riled up you were afraid of them and proving we must be better than them?  Look, here's a chance to say it again.  So vote how I say about this."  In other words, hysteria and fear-mongering.  Not sure that is really unique to American politics. 

           I think saying individualism and self-reliance are quintessentially American, is a little bit too broad.  A certain history of influences from Greek or Christian lore is also common to many (I wouldn't say all) Americans, but that doesn't mean everyone still buys into it as a gut reaction so much.  And Latinos may be thinking something rather different when they hear "family values" than precisely what rural Whites in the Upper Midwest and Mountain states, for example, are actually imagining -- though there may be certain resonances.    Many people take issue with signifcant parts of it, and particularly those versions hat the right has been appealing to of late. 

If it was simply "American" to buy into it, then well why hasn't the Tea Party been able to convince everyone to swarm the whole Congress over ACA or to push a national popular vote amendment against it?  They could use much the same rhetoric about it taking away too many individual choices, and that would be that if so.   
« Last Edit: November 01, 2013, 09:46:17 AM by kylie »

Offline gaggedLouise

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Re: ACA
« Reply #29 on: November 01, 2013, 10:20:48 AM »
You hit the nail on the head in that last post IMHO Gagged. Not to mention offered a much shorter and better explained reason of why here the government just does not pick up the tab for health care, than I did. *Offers a round of applause*

It's Louise. please. ;) *takes a bow*


Quote from: kylie
You'll have to say more than that to convince me, or risk jumping to the conclusion that anyone too liberal should simply be labelled "un-American."  Well, that works very nicely for the Tea Party I suppose.  (Though I do have plenty of times when I feel as a unit, the country too often acts that way.  Just...  I don't like taking it too broadly to the individual level.)

Mmm, I'm sort of liberal by American standards, even with a dash of socialist ideas and instincts. And supportive of this kind of thing myself. Just wanted to try to explain the near visceral negative response to ideas of the government taking charge of health care in a big part (like, half or sometimes even more?) of the U.S. voting public.



Offline Valthazar

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Re: ACA
« Reply #30 on: November 01, 2013, 09:05:04 PM »
I think saying individualism and self-reliance are quintessentially American, is a little bit too broad.  A certain history of influences from Greek or Christian lore is also common to many (I wouldn't say all) Americans, but that doesn't mean everyone still buys into it as a gut reaction so much.  And Latinos may be thinking something rather different when they hear "family values" than precisely what rural Whites in the Upper Midwest and Mountain states, for example, are actually imagining -- though there may be certain resonances.    Many people take issue with signifcant parts of it, and particularly those versions hat the right has been appealing to of late.

I don't think that is what Louise was saying.  It isn't to suggest that in order to be "American" in this day and age, that one has to be individualistic or concerned about the influence of the state.  It is simply a historical perspective, as to why the United States has a certain political discourse that is markedly different than the ones ongoing in Europe.

For the most part, all Americans had an ancestor that came independently (either voluntarily or involuntarily), or as a nuclear family - and in rare occasions, as an extended family.  The entire fabric of our society is almost entirely of largely autonomous families having to form communities.  In Europe on the other hand, people can trace their communities back for generations, upon generations - so there's far more of a deeply ingrained communal spirit.  The ultimate point being that self-sufficiency and individualism are deeply rooted within our cultural heritage as Americans - whether or not we ascribe to that philosophy ourselves.

Even many moderate left-leaning Americans believe that while the government can have significant benefits by having a very involved role in daily life, that it has the potential for trouble if unchecked.  After all, the US was founded as a means of escaping an oppressive government.  Hence the fact that almost all Americans acknowledge the beauty of the Constitution, and the separation of powers and checks and balances between the executive, legislative, and judicial branches.  Americans may disagree on the interpretation of the Constitution, but it's still universally valued.
« Last Edit: November 01, 2013, 09:41:18 PM by ValthazarElite »

Offline gaggedLouise

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Re: ACA
« Reply #31 on: November 01, 2013, 11:34:21 PM »
Well, I'm not saying ideas about the way you're supposed to think and act, because you're of a given country, couldn't change over time. Being British used to mean the stiff upper lip and knowing your place in life, it certainly doesn't these days.  ;)

Anyway, the "run your own business and don't wish for the state to come in" mindset (or however it's phrased) would be widespread with a big part of Americans, right? I never figured it'd have to be so overwhelming it defines, sort of objectively, what being a real American is about.

Offline kylie

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Re: ACA
« Reply #32 on: November 02, 2013, 12:01:56 AM »
           Maybe I'm just being fussy here...  I think it would have worked better to say, a particular take on a more general idealization of individualism could help explain why some, certain Americans are willing to buy into some angle on what Cruz, Tea Party, etc. are saying. 

           Sure it's there in the soup and the whole may be somewhat right of Europe (perhaps to the point that I don't really understand how it feels in some ways, on some issues to have more of the Euro, Swedish, what have you experience).  But left and right, as I understand it, don't quite translate wholesale across so many issues between the US and Europe. 

          Where they actually do translate, I can't quite believe that there are no concepts of self-reliance recognizable to most Americans to be found in Europe.  And I fully suspect on some things like healthcare, where there is some recognizable common field of discussion, people on the American left would sometimes be rather taken with what Europeans do -- even if they might have reservations about certain details.  I don't believe we're that different as whole groups.  So when you say self-reliance explains how America as a whole works, I want to hear something much more specific.  Otherwise, it does sound broad brush to me and too distorted for the issue at hand -- almost like one of those vague, shotgun, "socialism" bashing slogans the far right brandished during the health care debate. 
« Last Edit: November 02, 2013, 12:06:48 AM by kylie »

Offline gaggedLouise

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Re: ACA
« Reply #33 on: November 02, 2013, 01:11:07 AM »
           Maybe I'm just being fussy here...  I think it would have worked better to say, a particular take on a more general idealization of individualism could help explain why some, certain Americans are willing to buy into some angle on what Cruz, Tea Party, etc. are saying. 

           Sure it's there in the soup and the whole may be somewhat right of Europe (perhaps to the point that I don't really understand how it feels in some ways, on some issues to have more of the Euro, Swedish, what have you experience).  But left and right, as I understand it, don't quite translate wholesale across so many issues between the US and Europe. 

*nods* It's got a lot to do with national historical baggage I think. Also with hoiw the US political system is set up, to some extent, to limit the powers and abilities of the government, and to set the executive power and the parliament(Congress) against each other, competing for influence and agendas.


Quote
Where they actually do translate, I can't quite believe that there are no concepts of self-reliance recognizable to most Americans to be found in Europe.  And I fully suspect on some things like healthcare, where there is some recognizable common field of discussion, people on the American left would sometimes be rather taken with what Europeans do -- even if they might have reservations about certain details.  I don't believe we're that different as whole groups.  So when you say self-reliance explains how America as a whole works, I want to hear something much more specific.  Otherwise, it does sound broad brush to me and too distorted for the issue at hand -- almost like one of those vague, shotgun, "socialism" bashing slogans the far right brandished during the health care debate.

Oh sure, the idea of self-reliance and of "don't mess with my folks, Big Brother" is alive and well this side too. If anything, I think it's the "swim or sink!" take (as a moral standard) on getting through tough circumstances, or tough times afflicting all of a country, that's less accepted in many parts of Europe. And I think Valthazar has a point there, that most Americans (excepting pure Native American families) have a family history - however much it is known in detail, or just in a sketchy way -  that leads back on a couple lines to entering the country as small families or individuals, and joining up with/founding new towns, villages and communities in the U.S. Around here, the web of cities, roads and villages goes back many hundreds of years, even back to the Romans in some places (though not them here in Scandinavia, as it happens) and while most people haven't had their family living in the same place for six hundred or a thousand years, I guess local history and the local story of surviving and flourishing in good times and bad times will focus more on the city or parish itself than on your family or some leading local families.
« Last Edit: November 02, 2013, 01:21:22 AM by gaggedLouise »

Offline Phaia

Re: ACA
« Reply #34 on: November 02, 2013, 01:20:11 AM »
Normally I stay out of these discussions but the ACA has affected me directly so I would like to present what happened.

I am a 33 year old female, married with one child [4 year old boy] The company I work for is a well known international entertainment company with 1000s of employees.. I am considered upper mid management [kinda sorta in the scheme of things]

Anyway the company had offered me 250$  toward one of the health plans offered by the main insurance company...if my plan came to less then or equal to the 250 it was basically free for me.. Since I had the option I went with a family plan at 325 a month...so I was spending 75 a month on my family insurance. Until that is October 1ST.

By the ACA I have to pay at least 49% of my premiums and the whole family plan changed... the insurance company did not drop any of us but did implement the changes...and talk about the hollering by many of the ultra liberals I work with...yeesh

So now I have to pay 164 a month for my insurance...but it gets worst...

As  a policy I take my son to see his doctor twice a year and our copay had been $30 ...last week I took him for his twice yearly and the copay was 60...well now I called the insurance office and talked to a nice helpful lady that explained all the changes mandated in my new approved ACA health care insurance... to keep the 325 a month they basically opted to follwed what is known as the silver plan as set forth by the government...this mandates certain payments... example...on the family plan we can have 4 visits to a doctor a year at a 60 dollar copay...it use to be any number of times...we use to be able to go one of the quick care clinics [as an example for an antibodic shot for my son when he got bit by a bunch of fire ants] that would cost us a 75 Dollar copay which considering an average visit could easy run 180 or more was well worth it...now we have 2 visit per year at 150 dollars copay but we do now have a 500 copay for any emergency room visit...once a year

but wait there is more... we had a 40000 dollar a year coverage plan... with a 1000 dollar deductable...by the new mandated plan [a silver plan to keep it at the same price I had before] there is now a 30% deductable which means that the first 12, 000 dollars we are now on the hook for....well there is good news though If I wanted to go for the platinum plan which is a 10% deductable It would only cost me 580 a month...with the company would of course have to pay half so I would ONLY have to pay 290 a month to get a plan that is similar but still worst then the one I had ....when i was paying 75 a month....and to answer those that are wondering what the 'fee's not to have insurance the first year is...it is 95 dollars...the second is 350 and the third I believe was 450..considering that a 20-30 year would have to pay something like 280 a month on the basic plan I can see why many are opting not to buy any insurance at all.

anyway my husband and I are weighing our options not sure yet what we will end up doing on this...considering we are rebuidling after a fire gutted our house we are very VERY tight and if we did not have a 4 year very well might have opted out ourselves

phaia 

Offline Phaia

Re: ACA
« Reply #35 on: November 02, 2013, 01:43:25 AM »
Also to answer the question as to why we in the US seem not to want to pay for a Europain system

lets look at some hard numbers...last year here in the US, I made a over 80K which makes me firmly middle class I had to pay 25% income tax and about 6% + in soical sercurity tax which meant I was taking home about 67% of my income...

In the netherlands [which i looked up] my income would translate to about 57000 euro on which is taxed 52%  hmmm and then there is a 7.1% health care tax...so if I was living in europe I would be working for the governement no matter the job i held [which also kinda explains why you all rent more then own]....i feel at times a straight tax on an item is better then more income tax....but then I would be one of those that would dig out my gun should the governemnet ever try taxing me at 50% of my income

phaia
« Last Edit: November 02, 2013, 01:45:25 AM by Phaia »

Offline gaggedLouise

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Re: ACA
« Reply #36 on: November 02, 2013, 02:32:29 AM »
Also to answer the question as to why we in the US seem not to want to pay for a Europain system

lets look at some hard numbers...last year here in the US, I made a over 80K which makes me firmly middle class I had to pay 25% income tax and about 6% + in soical sercurity tax which meant I was taking home about 67% of my income...

In the netherlands [which i looked up] my income would translate to about 57000 euro on which is taxed 52%  hmmm and then there is a 7.1% health care tax...so if I was living in europe I would be working for the governement no matter the job i held [which also kinda explains why you all rent more then own]....i feel at times a straight tax on an item is better then more income tax....but then I would be one of those that would dig out my gun should the governemnet ever try taxing me at 50% of my income

phaia

Well, it's not that bare-bones a story. I can't answer for the Netherlands specifically, but most middle-class people's tax rates in Sweden, Denmark or the UK is more like somewhere around 30-40% - and there are lots of specfied cut options to chip the taxes against specific expenses incurred on the job, just like in America.

Plus, most people here don't have to set aside the equivalent of hundreds of thousands of bucks to see their kids through decent colleges and universities or to put into their retirement schemes. Public responsibility. Sometimes it might be a moot question if a share of your earned money is more accessible when you have to keep it saved for your old age or for sending your children to a good university than when, more or less, a similar chunk is paid in taxes to the state...and education as well as retirement at a given age, with a good deal of flexibility, are free, or very subsidized, for all.

I don't feel particularly envious hearing of Americans who have lost a big part of their pensions savings over the last few years of recession - and not even getting to spend that money; it just shrivelled in their savings accounts or going into rocketing fees set by their banks and pension managers.

Let's not take this into a general taxation politics thread though.  ::)
« Last Edit: November 02, 2013, 02:35:01 AM by gaggedLouise »

Offline Valthazar

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Re: ACA
« Reply #37 on: November 02, 2013, 10:21:05 AM »
Plus, most people here don't have to set aside the equivalent of hundreds of thousands of bucks to see their kids through decent colleges and universities or to put into their retirement schemes. Public responsibility. Sometimes it might be a moot question if a share of your earned money is more accessible when you have to keep it saved for your old age or for sending your children to a good university than when, more or less, a similar chunk is paid in taxes to the state...and education as well as retirement at a given age, with a good deal of flexibility, are free, or very subsidized, for all.

I don't feel particularly envious hearing of Americans who have lost a big part of their pensions savings over the last few years of recession - and not even getting to spend that money; it just shrivelled in their savings accounts or going into rocketing fees set by their banks and pension managers.

I think the main reason people like Phaia and myself hold such views, is because we trust our own judgment with regard to our finances, as compared to the government.  A government pension really isn't free money - it is essentially a portion of your monthly/annual income being siphoned away into investments decided by the government, with the returns being paid out systematically during retirement.  In other words, rather than the individual having control of how their money is invested, they are at the whim of the government's decisions.  Most pension plans that do exist are offered with salary-based jobs, so even if a pension plan doesn't exist, an employee can basically do the same thing on their own (taking a small portion of their paycheck, and putting it into a retirement account), and have more control over what is going on.

You may have heard that Detroit is facing bankruptcy, and many federal pension plans are under severe jeopardy, since federal pension plans tend to invest heavily in their own infrastructure.  In another thread, we were discussing how even though the American government has been making a lot of poor financial decisions as of late, and incurring heavy debts, that the fundamentals of the American private economy are still holding strong.  As a result, especially in this economy, I feel much safer knowing that I am receiving a more complete portion of my paycheck, and am able to allocate my money how I choose.

For example, a portion of all of our paychecks go to pay into Social Security.  I can guarantee you that by the time I qualify for Social Security, the system will be drained.  Instead of paying into this, if all Americans were permitted to keep this portion of paychecks going into Social Security, and all Americans simply invest that same amount of money, we would actually get real returns later in life - rather than funding a bankrupt system, with low probability of future pay-out.

But the reality is that most Americans don't have this kind of discipline over their finances/spending.  If most people get an extra $10 as a result of not having to contribute to Social Security, chances are they won't know how to go about investing it, and may not even know they are supposed to be saving it.  And as we had said in another thread, this goes back to a lack of personal finance classes in high school.  As a result, I can certainly understand how the European system might be favored by people who want to live care-free and have everything taken care of for them, through higher mandatory tax revenues.  Not an ideal place I'd like to live in (as someone who has lived in Europe in the past).
« Last Edit: November 02, 2013, 10:42:49 AM by ValthazarElite »

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Re: ACA
« Reply #38 on: November 02, 2013, 11:25:04 AM »
In the netherlands [which i looked up] my income would translate to about 57000 euro on which is taxed 52%  hmmm and then there is a 7.1% health care tax...so if I was living in europe I would be working for the governement no matter the job i held [which also kinda explains why you all rent more then own]....i feel at times a straight tax on an item is better then more income tax....but then I would be one of those that would dig out my gun should the governemnet ever try taxing me at 50% of my income

phaia

Just to expand on Louise's answer, we have progressive tax rates through most of Europe as well.  So take the UK as an example - our tax rates for income tax are:
0-35000 - 20%
35,001 - 150,000 - 40%
150,001+ - 50%

However, if I had an income of 160,000 I wouldn't be paying 50%.  I'd be paying 20% of the first thirty five thousand (7000), forty per cent of the next 115 thousand (46 thousand) and then fifty per cent of the final 10 thousand (5 thousand) for a total of 58 000 which is approximately thirty six percent.  The system is the same in the Netherlands, so you wouldn't be paying 52% on all your earnings, just on your earnings in the top band.

Offline Sethala

Re: ACA
« Reply #39 on: November 02, 2013, 07:51:46 PM »
Just to expand on Louise's answer, we have progressive tax rates through most of Europe as well.  So take the UK as an example - our tax rates for income tax are:
0-35000 - 20%
35,001 - 150,000 - 40%
150,001+ - 50%

However, if I had an income of 160,000 I wouldn't be paying 50%.  I'd be paying 20% of the first thirty five thousand (7000), forty per cent of the next 115 thousand (46 thousand) and then fifty per cent of the final 10 thousand (5 thousand) for a total of 58 000 which is approximately thirty six percent.  The system is the same in the Netherlands, so you wouldn't be paying 52% on all your earnings, just on your earnings in the top band.

It's the same in the US; you don't suddenly get a massive hike in taxes for just a small earning increase.  (Barring any sort of tax credit that reduces taxable income only for people in a certain earning bracket, at least.)  Only the dollar amount over the threshold is taxed at the higher rate.

Offline Valthazar

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Re: ACA
« Reply #40 on: November 03, 2013, 09:38:24 AM »
To move the topic back to ACA, I am struggling to understand why people support the ACA as being affordable for those who need it most.

I am assuming that all of us can agree that people in their 50s and 60s will be the ones needing healthcare the most, since statistically, they are the ones facing the highest medical costs.  Currently (pre-ACA implementation), many people in their 50s and 60s were opting into health plans that suited their needs - meaning, for example, no coverage for maternity, elective psychiatric care, etc.  Many of these plans that were not employer-assisted, could easily run in the range of $900-1000/month.  Clearly very expensive, but still cheaper than complete coverage, which they did not want.

What the ACA does is basically tell these people that they need "complete coverage," without really making things any more affordable.  Someone in the example above, would still be paying in the range of $10,000/year for health insurance under ACA, that doesn't offer nearly as much choice as their existing plan.  In fact, they'll have to pay more than they are now if they want to keep the same deductibles.

http://www.nj.com/news/index.ssf/2013/10/obamacare_how_affordable_is_health_insurance_after_the_affordable_care_act.html

Even many Democrats are now pushing for an extension on the enrollment period, before the individual mandate provision goes into effect.  However, Obama and other ACA-insiders will never support further extensions for two primary reasons:  First, if there was no law requiring people to buy health insurance, they likely wouldn't buy it, given the cost.  Secondly, if there wasn't a mandate, the people who signed up would likely be those who are really sick, and thought they could definitely use the coverage.  This would cause premiums to spike up by a ridiculous amount, making it more difficult to sell the ACA as "affordable" for healthy people in their 20s and 30s.

Bottom line is, contrary to what many pro-ACA advocates say, most healthy people are perfectly happy without health insurance (even if their purely emergency care is taking a toll on tax-payers).  Suggesting that the ACA is a step towards a single-payer system like Europe is inaccurate, to say the least.
« Last Edit: November 03, 2013, 09:58:20 AM by ValthazarElite »

Offline consortium11

Re: ACA
« Reply #41 on: November 03, 2013, 09:59:11 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).

Looking at it from my own (very mildly libertarian) perspective, it seems to be one of the better systems around. Yes, the government is involved which will get the most fundamentalist libertarians fired up but it is not government run and hell, it's from Switzerland, a place that despite national service almost always comes at or near the top of those "freedom index" style reports, which should keep most centre-right thinkers happy. Yet it also offers a high level of universal healthcare that is comparable with or better than that found under "single payer" (or whatever the term is that is used for a British National health Service style) system. It, in short, is the best of both worlds... not so much a shoddy compromise or unholy alliance as a happy marriage.

Yet it seems despite aping a well respected and long established system, ACA has been a bit of a mess. Politically it was always going to be difficult simply due to obstructionism regardless of the actual content and while the website issues are clearly problematic they're also (hopefully) relatively short term. The real issue appears to be the flaws that Val and others have eloquently pointed out. It doesn't do what it says on the tin and may end up doing more harm that good with regards to insurance coverage, despite the best of intentions.

And that makes me sad... because with the Swiss system to work from, the US surely had a good chance to put together a system that, while not satisfying the more extreme left or right, delivers great results at a good cost.

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Re: ACA
« Reply #42 on: November 03, 2013, 11:02:01 PM »
Quote from: Val
Bottom line is, contrary to what many pro-ACA advocates say, most healthy people are perfectly happy without health insurance (even if their purely emergency care is taking a toll on tax-payers). 
        It's not just some accounting problem that vanishes into the general economy, and they all go on being happy forever as if nothing special happened.  (That is a privilege generally reserved for corporations and wealthy managers.)  Someone somewhere actually pays in lost opportunities of great importance.  Often it is the same young, and perhaps marginally employed person who thought they were doing just fine until they had one big bill to shell out (it may be originally mediocre in relative terms, but beyond their means) -- and suddenly financial recovery is nowhere in sight. 

          I am more or less healthy on the whole; I hardly visit facilities for much of anything.  However, if you hardly use health care and simply stay aloof with trust in your young age or fortunate constitution, then when stuff does blow up, you can land in big trouble.  I passed around two years of pretty much skimping on (also read: not getting) dental care.  This was partly because $100-200 for a cleaning here or there is a chunk of money when  "full-time" student loans are calculated at a somewhat below what you actually need for school fees plus rent, food, transportation and things like clothing in a major city...  And partly because even after school, the job market was not friendly to me and I often needed to keep my extra odd hundreds to tie me over for a few weeks between what shorter-term clerical jobs I could get.  And honestly, even had I gone in for regular checkups, I doubt that I would have felt secure enough to shell out for things like fillings before it became physically painful.  With my teeth, apparently that doesn't happen until I need some major treatment. 

          I had a root canal which was already beyond my means (my insurance paid in lumps of around $400/semester, didn't include any dental at all).  I was able to pay for the operation with Care Credit, which gives you a year to (maybe, somehow?) sort things out but then starts whopping you with major credit card level interest rates.  I had no other way to pay.  The economy was still feeling the recession and I was then a full-time student, not willing to simply give up my chance of a career certification to commit to only full-time work at some unrelated entry-level job, that is if I could even get some (dubious). 

          A little ways down the road like that, I reached a point where it was obvious that  not only was I not keeping up with the rather staggering interest (and late penalty) payments on just that one, to me, rather whopping root canal bill...  It was also going to destroy my credit rating so fast that I wouldn't have flexibility to choose common options in location, transportation (say if I wanted to get a car), education, or job training.  More immediately, creditors come along afer a few months of missed payments and sue for the right to drain whatever is in your entire bank account -- and they can do this over and over if they feel like it -- possibly even ordering a bank to raid paychecks as they appear.  Voila, kylie says fuck this, I don't live to work multiple insecure jobs only to have paychecks ripped away as they come on terms I could never repay, and leaves the country.  Prices go up somewhere else in the world of insurance and credit, I suppose.  Or maybe the company could just afford to take a loss of a few grand now and it'd be done -- but really, as if they're ever satisfied with that.

         Lots of people may be perfectly "happy" at any moment with a situation that is likely to sooner or later either bite them personally, or shrink their economy indirectly, or harm someone else they know more visibly.  Maybe they shouldn't be, and maybe they wouldn't be if they looked into where all those costs for belated care go.  Granted, whether ACA will actually undo this pattern or not is another question.     
« Last Edit: November 03, 2013, 11:38:23 PM by kylie »

Offline ShadowFox89

Re: ACA
« Reply #43 on: November 04, 2013, 02:16:40 AM »
Bottom line is, contrary to what many pro-ACA advocates say, most healthy people are perfectly happy without health insurance (even if their purely emergency care is taking a toll on tax-payers).  Suggesting that the ACA is a step towards a single-payer system like Europe is inaccurate, to say the least.

 Happy until they need it. When they need it and don't have it? Then you have problems arising.

Offline Valthazar

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Re: ACA
« Reply #44 on: November 04, 2013, 05:26:19 AM »
Yes, I agree with both of you, but all the ACA is doing is mandating that people buy insurance - regardless of whether they can now afford it or not.  Sure, it attempts to reduce the price for certain plans, but because it is a 'forced' reduction, many others will be losing their existing health coverage.  A lot of people still can't afford insurance under this law, and it is not really doing anything to accomplish its mission of making healthcare "affordable."  So given all of this, I think it is actually doing more harm than good.

In addition, here is a snippet of Obama's word from his recent speech on Wednesday:

Quote from: Obama
"Now, if you had one of these substandard plans before the Affordable Care Act became law and you really liked that plan, you're able to keep it.  That's what I said when I was running for office. That was part of the promise we made. But ever since the law was passed, if insurers decided to downgrade or cancel these substandard plans, what we said under the law is you've got to replace them with quality, comprehensive coverage -- because that, too, was a central premise of the Affordable Care Act from the very beginning.  And today, that promise means that every plan in the marketplace covers a core set of minimum benefits, like maternity care, and preventive care, and mental health care, and prescription drug benefits, and hospitalization.  And they can't use allergies or pregnancy or a sports injury or the fact that you're a woman to charge you more. They can't do that anymore. They can't do that anymore."

http://www.cnn.com/2013/11/02/politics/obama-read-my-lips-moment/index.html?hpt=hp_t5

What he's basically saying, is that it is unfair for certain individuals to pay more, simply because they have greater needs. 

So apparently it is unfair that a woman who is married and actively trying to get pregnant pays more for a health insurance plan that covers maternity and pregnancy care, versus another woman who is single and not having sex, and pays less due to not having maternity or pregnancy care since she doesn't need it.

Or on that same token, it is unfair that an active 27 year old guy has to pay more in health insurance costs because of his desired sports injury coverage, versus a 60 year old man who doesn't play any high contact sports and thus opts not to get sports injury coverage, and thus has a lower initial primary coverage rate (before factoring in age, etc). 

So what's his proposed solution?  To make all women get maternity coverage, and everyone get sports injury coverage...
« Last Edit: November 04, 2013, 06:49:55 AM by ValthazarElite »

Offline Serephino

Re: ACA
« Reply #45 on: November 04, 2013, 08:39:29 AM »
What I don't get is why those insurance companies with substandard plans couldn't just change the plans instead of cancelling them.  They make changes to plans all the time, so why not now?  I honestly think they're just trying to help get people riled up.

Offline RetributionTopic starter

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Re: ACA
« Reply #46 on: November 04, 2013, 08:49:25 AM »
A lot probably depends on what you are calling substandard. As Val pointed out requiring someone in their 60s to have coverage for birth control in many cases might be a tad bit on the silly side.

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Re: ACA
« Reply #47 on: November 04, 2013, 09:37:53 AM »
A lot probably depends on what you are calling substandard. As Val pointed out requiring someone in their 60s to have coverage for birth control in many cases might be a tad bit on the silly side.

Granted, but if insurance companies get to be highly specific about what kinds of diseases and misfortunes are covered by the insurance for a particular person (as they may be in the US,  right?) they will very often have a major advantage over the customers they are negotiating with for their health insurance plans. Most people can't buy medical expertise to help them judge what kinds of illnesses they really should take care to keep under their insurance umbrella, to read the fine print of what their insurance provider is putting before them at a given point while talking about an insurance package, what kinds of illnesses will become more threatening to them over the next ten years, and so on. The insurance firm, on the other hand, is likely to have access to that kind of knowledge and can use it to its own long-term advantage.

If it were expected that any John Blow should have the grasp of medicine and health science that it takes to judge what kinds of diseases are more likely to strike them in a particular age band, all sorts of hidden lifestyle risks (not obvious stuff such as sugar-loving people risking to get obese) and what kind of damage any given illness could do to their working abilities (or to their children!), then you'd really have to send most people into the classroom for quite some time. People don't have that kind of overall pro knowledge about medicine, not even most people who have been to university.  On the other hand, if the state sets a number of central health areas and goals that *must* be met by any health insurance plan, for everyone insured under the system - and the ACA makes that requirement - then it protects everyone against going down the "parsimonious and stupid" path and negotiating away stuff that might prove absolutely essential when the bad hour strikes.
« Last Edit: November 04, 2013, 09:45:11 AM by gaggedLouise »

Offline RetributionTopic starter

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Re: ACA
« Reply #48 on: November 04, 2013, 10:14:51 AM »
I do not disagree Louise and actually I think forcing birth control coverage is a very, very, good thing. I feel that unplanned pregnancy and people having children with no reasonable means of supporting them in sight is one of the main causes of many of the issues of poverty and the like that are discussed on this board.

Having said that there are some things like birth control for 70 year olds that is kind of a "well duh" moment. It is one of my main issues with the way government does anything and pounds square pegs into round holes. For example my life situation is very similar to Phaia's.  I have stayed with government employ and not gone and cashed in on my experience over the years largely because the bennies are sweet. I have not had a large increase in expense under ACA because I already had good insurance and was more or less already paying the fees Phaia spoke of. Like I said government employ does have perks so my experience has been with minor things.

Having said that, insuring the uninsured costs and -someone- is going to have to pay for that. The bills are not just magically paid. Also insurance companies, large corporations, and other such entities are often many times draconian. Having said that as well I often see in these threads an almost sense of "they are evil since they make profit" and I would like to point out there is nothing inherently wrong with turning a profit.  The catch is there is a happy medium in all things and at some point someplace along the line someone has got to think. Just forcing all things into a one size fits none box does not really work.

Offline Valthazar

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Re: ACA
« Reply #49 on: November 04, 2013, 12:50:02 PM »
On the other hand, if the state sets a number of central health areas and goals that *must* be met by any health insurance plan, for everyone insured under the system - and the ACA makes that requirement - then it protects everyone against going down the "parsimonious and stupid" path and negotiating away stuff that might prove absolutely essential when the bad hour strikes.

Here's an analogy:

According to your logic, I am being parsimonious and stupid by not opting into windstorm coverage insurance on my home, even though I live in an area that has a historically negligible incidence of large-scale tornado damage.  On the other hand, floods are very common where I live, and thus, flood and water damage insurance is critical.

If someone is living in the midwest, it would be the exact opposite of my scenario.

According to what you are saying, as an analogy, all of us should pay more for all of these insurances, even though statistically, our needs are different.

edit:  Not positive on windstorm coverage - will need to look the specifics, it may be mandated by my state.  But I remember there was a couple of them that didn't apply to my region, can't remember right now, but my point is that people pick and choose insurance coverage based on their need.
« Last Edit: November 04, 2013, 01:00:37 PM by ValthazarElite »