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Affordable Care Act / ObamaCare

carlfense

By carlfense,
in Politics & Religion

Supreme Court Decision  

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Chaddyboxer Backup

Chaddyboxer

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This is interesting to me in the sense that we cannot even agree on the most fundamental facts. Every credible estimate shows that the cost of doing nothing exceeds the cost of the ACA. Something is better than nothing by virtue of not being nothing is a terrible argument for something, and there are ample reasons to be skeptical of the ACA achiving its objectives, but cost of the legislation being greater than no action simply is not one of them.

 

I think of this as a similar conundrum as someone who is poor and working, but cannot afford to obtain reliable transportation. Say they have a 78' Cadillac that gets 10 MPG, drive an average of 1000 miles / month, and spending $2,000 / year in repairs. That puts their base cost of ownership at around $500 / month if fuel is $3.50 / gallon. Now let's also say they could get a new compact car that got 35 MPG, would cost $150 / month to finance, another $50 in additional registration fees and insurance, and would cost $1,000 / year to maintain. That puts the base cost of ownership at about $380 / month. On top of the owner cost, there is also cost to everyone with the Cadillac with higher air pollution and higher chance of vehicle failure that could cause an accident or otherwise stop traffic.

 

It's interesting that you bring up the conundrum of a getting a new car versus keeping your old one, being poor, and having very limited options as to what you can do because I'm pretty much in that boat right now myself. I understand the comparison you're making and it sounds good initially. I don't want to get bogged down on the analogy but this is I believe relevant to the discussion. I think there are some serious issues which you are not taking into account. For example, over the Mermorial Day weekend I went to four different dealerships with the express purpose to buy a car. The interest rates for these four different cars were 36.9%, 29.9%, 41.9%, and 26.9% respectively. Basically what's happening is that these car dealerships generally own the finance companies and they collude together so that the consumer is literally left with no choice to go through them if they are unable to secure a lower interest loan through their bank or credit union. Correlating this to the ACA, health care facilities will also collude together to keep their prices artificially high essentially trying to gouge the government financially at every turn. Essentially the healthcare providers are the car dealerships in this analogy. I guess what I'm trying to say is that you car analogy seems to assume all players and circumstances are static and won't change. In reality people and the market will shift in response to what the goverment is trying to do through this ACA legislation. And that's the larger point, we simply can not take these saving projections or cost controls at face value and assume they are accurate because nobody knows exactly how the ACA, if upheld, will change the health care system. Further, one thing we do know for certain is that when government tries to set prices for healthcare services, providers will then charge people who want to pay cash substantially more than they charge someone paying with Medicare to try and make up for lost revenue. We see this happen everyday in healthcare facilities across this country. Add in the fact that same services cost different amounts depending on where you live, which facility you go to, and even what the business agreement is.

 

http://www.nhhealthc...ceServices.aspx

 

 

Just a very basic example of the cost of doing nothing being higher when it may seem antithetical for someone in poor financial shape to buy a new car. There may be other options too of course, but that doesn't make it untrue that a new car may cost less. Some of us believe that health care is a matter of national priorities in a fiscal sense. Germany, Austria, Switzerland, Denmark, the Netherlands, Belgium, Norway, Sweden, Finland, Australia, New Zealand, Taiwan, Singapore...all countries that have managed to do universal healthcare with a mixed market approach while maintaining acceptable fiscal policies, some far better than America. Why can't we?

 

One reason, because doctors, upon graduation from college, have huge school loans to repay. To a lesser degree so do nurses and everyone else along the health care delivery line. Back to doctors though, combine loans with insane malpractice insurance costs and doctors typically will start their careers 150-200K in the hole. Did you know that in Germany students go to medical school for free? People in other countries, like the ones you listed, have pretty much grew up with socialism their whole lives and so to them it is no big deal to do with less money charged for services. But that's not the American way is it? Why should an American company charge 1.00 for something that costs them .10 to produce when they can charge 4.50? That's slight bit of sarcasm by the way.

 

What really bothers me immensely, and it's a reason why I don't trust this legislation or the people who produced it, is that they crafted this legislation in secret, behind closed doors, with absolutely no one outside the liberal left having any input. There wasn't any discussion or consensus about this. This legislation was essentially the elite liberal left forcing multiple and rather probable bad laws on us simply because they could.

 

I will agree with you that something needs to be done to make healthcare more affordable. I'm just not convinced this Obamacare is it.

+1. Thoughtful post.

 

Malpractice insurance costs are so high primarily because there is so much malpractice. Approximately 195,000 people are killed by preventable medical errors each year in the United States. The number of malpractice lawsuits filed on average per year? Somewhere between 15,000 and 19,000. If anything, there should be more malpractice suits. Doctors should pay for their errors just like the members of every other profession.

I believe over 300,000 each year are killed, injured or impaired by incorrect diagnoses, drug reactions/incorrect scripts, and risky surgeries. THAT IS A HUGE number. Now....IMO, conventional medicine is AMAZING for acute trauma and crisis situations, ie if I get in a car accident or if I fracture my arm. However, it is poorly designed and implemented to treat "curable" ailments such as type 2 diabetes, heart disease, and various autoimmune disorders. The ironic thing about my post is that I am in the medical field, yet I will never EVER give someone a drug. Many people have stated that I should have become a male nurse....no thanks (I have plenty of reasons why I wouldn't take that career path). I went the other route and went into physical therapy. Lastly, in every profession, regardless if it is conventional medicine or not.....they're are great practitioners and they are poor ones. If you want to start taking care of your health, go read a book. Educate yourself. I rarely go see a doctor anymore...

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huKSer All-American

huKSer

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It strikes me as funny that the people who are going to complain and attack this the most are the people who have health insurance.

Well...health insurers wrote the bill....and I'm pretty sure my premiums will go up.

The "penalty" is a set number and less than premiums. If you get insurance through your employer - get ready to buy your own insurance.

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krill Five-Star Recruit

krill

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The "penalty" is a set number and less than premiums. If you get insurance through your employer - get ready to buy your own insurance.

 

The penalty + not receiving tax incentives for offering insurance, which is also in effect a penalty. I don't know how this can be interpreted as giving employers less incentive to offer insurance.

 

From a purely political perspective it seems to me like Romney now has the deck stacked against him aside from blind rage. Health insurance premiums in Massachusetts have gone down 5% two years in a row, the state ranks 48th lowest in health care expenditures, and 98% of residents are insured. When you're running for office those kinds of numbers should be headline accomplishments, rather than running away from the whole deal like bubonic plague.

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JJ Husker Head Coach

JJ Husker

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In a nutshell- the ACA was not upheld due to the commerce clause. That is a good thing. That would've been the most disastrous ruling the SC could've come up with, possibly opening up a huge can of worms and setting precedent for them to mandate virtually anything they might ever desire. However, the individual mandate was upheld because they read it as an activity (or rather lack of activity) that could be taxed. Just another tax in the long list of items that Congress and the SC have determined they could levy to cause us, the citizens, to act in certain ways. Want to reduce smoking? Tax the hell out of it. Want to try to reduce fossil fuel use? Tax the hell out of it. Want to encourage home ownership? Offer tax breaks to home owners. The list goes on and on. The scary part of this IMO is that it adds to the already precedented and prepared way for even more government over reach into our lives. As Roberts alluded to in his dissenting opinion; The example of healthy eating. So, even though the government may not mandate that we eat less fat & sugar and more vegetables, they apparently could, with little resistance from the current SC anyways, levy punitive taxes on unhealthy behaviors. Do you like fried foods? Ice Cream? Fast Food? Candy Bars? Salt? Well the yahoos in Washington can, anyday they wish, levy a penalty (err tax) on any behavior they want to modify. What if you don't purchase enough vegetables for your household size? Yes, they could levy a punitive tax on you. If I was one who claimed to be for liberty and freedom, I would sure as hell not rejoice in this ruling. Carl?

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carlfense Defensive Coordinator

carlfense

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The "penalty" is a set number and less than premiums. If you get insurance through your employer - get ready to buy your own insurance.

 

The penalty + not receiving tax incentives for offering insurance, which is also in effect a penalty. I don't know how this can be interpreted as giving employers less incentive to offer insurance.

 

From a purely political perspective it seems to me like Romney now has the deck stacked against him aside from blind rage. Health insurance premiums in Massachusetts have gone down 5% two years in a row, the state ranks 48th lowest in health care expenditures, and 98% of residents are insured. When you're running for office those kinds of numbers should be headline accomplishments, rather than running away from the whole deal like bubonic plague.

And there's the problem. Romney has to disassociate himself from his signature political accomplishment. He should be able to celebrate it! It seems to be working quite well! But thanks to the GOP's switch in time that coincided with Obama embracing their idea . . . he can't. He has to hide from it. Craziness.

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