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How Ddoes Tthe Affordable Care Act Aaffect Yyou?

Hits: 2778 | Rating: (1.8) | Category: Misc. | Added by: auburnjunky
Page: 13 4 Next >   Jump to: Bottom    Last Post
Musuko42
Male, 18-29, Europe
 2850 Posts
Thursday, October 17, 2013 10:10:30 AM
@HumanAction

"First off, who would oversee such a system? An entirely new department would need to be created just to monitor doctors and healthcare providers."

Doesn't such a department(s) already exist? Surely doctors and healthcare providers are extensively monitored.

"Next, I suspect we would see a sudden drop-off of doctors. Either that, or, many would move to the private sector. People REALLY resent have their salaries decided by the whims of bureaucrats."

That already happens to an extent. But this is the same with every profession. The "CEOs will flee the country" effect.

We can't really be held to ransom by these people, can we?

Anyway, easy solution: government gives you a medical degree for free, you pay it off by working an agreed amount of time in the universal healthcare system. Nobody's forced to do it, it's a fair trade, everyone wins.

HumanAction
Male, 18-29, Midwest US
 2353 Posts
Thursday, October 17, 2013 9:58:20 AM
@musuko

In the example of healthcare: what if every doctor were responsible for a certain number of patients, and the higher the collective health of those patients (measured by how frequently they attend with ailments), the more the doctor gets paid?

Whoa. Now that is a scary thought.

First off, who would oversee such a system? An entirely new department would need to be created just to monitor doctors and healthcare providers.

Next, I suspect we would see a sudden drop-off of doctors. Either that, or, many would move to the private sector. People REALLY resent have their salaries decided by the whims of bureaucrats.

Musuko42
Male, 18-29, Europe
 2850 Posts
Thursday, October 17, 2013 9:58:19 AM
@HumanAction

"What of the rules our parents' government made? Our that of our grand-parents? We did not agree to those. Yet, we are still expected to abide by them."

Our parents didn't have to create us. We owe them our existence.

We live in their world by invitation. With that comes some measure of justifiably expecting us to respect the world they've built.

Within limits, naturally, and I see what you mean about the debt being passed on; nobody should be allowed to birth a child for the purpose of making them their slave.

Musuko42
Male, 18-29, Europe
 2850 Posts
Thursday, October 17, 2013 9:52:19 AM
@dang007

"And it still is, well except that it does not seem scary anymore. See we are already slowly sliding down the slope."

Depends on your view point. Some call it a slippery slope. Others call it progress.

I wouldn't worry too much. Scandinavia are much further down the slope, and their societies are fantastic.

HumanAction
Male, 18-29, Midwest US
 2353 Posts
Thursday, October 17, 2013 9:51:21 AM
@musuko

we've collectively chosen to group together and abide by the rules created by those we choose to rule us.

Ehh... grey area. What of the rules our parents' government made? Our that of our grand-parents? We did not agree to those. Yet, we are still expected to abide by them.

I think it was Jefferson who had what I consider one of the most valid points ever made regarding government: why should one generation be able to indebt another?

He argued that every generation should nullify any debts that the parent generation incurred. If nothing else, it would keep the budget honest as very few countries would lend to the US!

But alas, I am but a humble "fundamentalist, extremist, Constitution-loving, libertarian, idealist."

Musuko42
Male, 18-29, Europe
 2850 Posts
Thursday, October 17, 2013 9:50:54 AM
@HumanAction
@dang007

Okay, I'll correct myself: align the provider's profit incentive with the customer's goals.

In the example of healthcare: what if every doctor were responsible for a certain number of patients, and the higher the collective health of those patients (measured by how frequently they attend with ailments), the more the doctor gets paid?

This gives the doctor a profit incentive; but rather than profiting when patients are sicker, he profits when they are more healthy. This gives him a profit incentive to be more active with preventative treatment, early treatment, etc.

I'm not saying that doctors deliberately let patients fester with illnesses until they become more serious and expensive and profitable to treat. I give them more trust than that.

But this would certainly incentivise them in the other direction.

dang007
Male, 30-39, Southern US
 594 Posts
Thursday, October 17, 2013 9:46:09 AM
>>>After all, the American people by and large came around to accepting mandatory seatbelt laws. Once upon a time that was a scary intrusion into personal liberty.>>>>

And it still is, well except that it does not seem scary anymore. See we are already slowly sliding down the slope.

HumanAction
Male, 18-29, Midwest US
 2353 Posts
Thursday, October 17, 2013 9:45:15 AM
@musuko

take the profit out of healthcare, and you get a doctor who benefits more from saying "do some exercise and eat fewer burgers"

How? The doctor will still make the same amount of money, especially if he's salaried.

"Non-profit" simply means that the company cannot take a profit. The employees (and CEOs), who are the companies biggest expense, can still receive ridiculous salaries. For example, the CEO of the American Cancer Society - a non-profit - made nearly $1 million last year.

dang007
Male, 30-39, Southern US
 594 Posts
Thursday, October 17, 2013 9:44:05 AM
>>>When healthcare is seen as a cost, rather than a profit oportunity, the incentive becomes reducing the cost, rather than raising the price.
<<<

This is silly. The provider will ALWAYS see the service as a profit opportunity. That is why they provide the service. The change that needs to be made is on the consumer side. Consumers need to be able to clearly judge if they are getting a return on there healthcare dollars. All insurance, especially insurance were the insurer directly pays the provider, limits the consumers ability to do this.

Musuko42
Male, 18-29, Europe
 2850 Posts
Thursday, October 17, 2013 9:40:13 AM
@HumanAction

PS: Besides, when the most you have to fear from your government is an extra 50c on a Big Mac, you're not in fear of much. ^_^

Musuko42
Male, 18-29, Europe
 2850 Posts
Thursday, October 17, 2013 9:38:47 AM
@HumanAction

You're correct: it is scary, and it can be a slippery slope.

But...that's true of government in general; we've collectively chosen to group together and abide by the rules created by those we choose to rule us.

You stop the slide down the slippery slope for this topic in the same way you do for everything else: keeping firm control over those we have chosen to make the rules we obey.

Consider this: Americans may traditionally shy away from such legislation. But what if the American psyche is changing? What if they are becoming more willing to accept such social contracts? Surely the re-election of Obama when he was flying the flag of Obamacare is a sign that, at least to some extent, this is happening?

After all, the American people by and large came around to accepting mandatory seatbelt laws. Once upon a time that was a scary intrusion into personal liberty.

HumanAction
Male, 18-29, Midwest US
 2353 Posts
Thursday, October 17, 2013 9:31:19 AM
@musuko

There's often been talk of taxing fatty foods the same way cigarettes and alcohol are taxed.

That's one of the really scary parts (to me, at least) about national healthcare. Once the government starts spending tax dollars on something, it becomes a blank check to regulate people in that regard.

Call it a "slippery slope" if you will, but there's little difference in the underlying principles of taxing unhealthy food and taxing unhealthy lifestyles; doing either would be "good" for the cost.

Possibly too much meddling for the average freedom-loving American.

Oh, yea. Definitely.

Musuko42
Male, 18-29, Europe
 2850 Posts
Thursday, October 17, 2013 9:30:22 AM
@HumanAction

One thing though: take the profit out of healthcare, and you get a doctor who benefits more from saying "do some exercise and eat fewer burgers", rather than a doctor who benefits from waiting until their patient needs a nice pricey heart bypass operation.

When healthcare is seen as a cost, rather than a profit oportunity, the incentive becomes reducing the cost, rather than raising the price.

So long as it's done legitimately (preventative treatment) rather than cheating (avoiding giving treatment, giving poor treatment, etc), then the incentive is in the right place.

It's an ugly system where the healthcare system is happier when you're sick rather than when you're healthy.

Musuko42
Male, 18-29, Europe
 2850 Posts
Thursday, October 17, 2013 9:24:56 AM
@HumanAction

"Unfortunately, Americans sure do love their cheeseburgers."

There's often been talk of taxing fatty foods the same way cigarettes and alcohol are taxed.

I don't see why not, really. You still have the freedom to do it, but with it comes the responsibility of its consequences.

I suppose if it got the carrot and stick treatment, people might go for it; tax on unhealthy foods, subsidy on healthy foods.

Possibly too much meddling for the average freedom-loving American. But, if you could make it part of the social contract: we treat you if you get sick, in exchange you make a bit of effort not to get sick.

Musuko42
Male, 18-29, Europe
 2850 Posts
Thursday, October 17, 2013 9:20:31 AM
@HumanAction

Oh absolutely agreed. From what little I can understand of it all, it's an improvement of a bad system, rather than a replacement of the system.

It's probably the most that can be accomplished at the moment. I doubt your system could be overhauled and replaced in one go. There's far too much momentum in it.

How to switch it over? I couldn't say, personally.

Hmm...I wonder if the best way is a creepy kind of reverse of the norm: allow one insurance company to swell and take over all the others, becoming the sole provider.

And at the same time, tighten and modify legislation so that sole provider is very firmly under the control of the democratically elected government.

It sounds scary. But really...universal healthcare is basically a form of nation-wide single-supplier insurance.

HumanAction
Male, 18-29, Midwest US
 2353 Posts
Thursday, October 17, 2013 9:19:50 AM
@musuko

Kinda like...with your car.

I agree entirely with this premise.

Unfortunately, Americans sure do love their cheeseburgers. In all seriousness though, preventative care is great for things like cancer. That being said, from my experiences, I still think food is the number one culprit of poor health in this country. I doubt very much that any amount of lecturing via doctor/caregiver will change the eating habits of Americans.

Even the nutritional guidelines from the USDA - which hardly any Americans meet - are woefully inadequate.

HumanAction
Male, 18-29, Midwest US
 2353 Posts
Thursday, October 17, 2013 9:12:49 AM
@musuko

Shoulda, coulda, didn't...but one day might.

Sure, but it's still worth arguing about.

I think Obamacare is going to be nothing more than an expansion of our current multi-party third-party-payer system. Economically, it's about the worst possible system out there; it suffers from a lack of single-buyer leverage and it suffers from third-party payments.

Universal health insurance is cheaper. While it still suffers from third-party payments, and is therefore still susceptible to bubbling, it takes advantage of single-buyer leverage - as I call it.

Cheaper yet is directly subsidized healthcare. Public hospitals with public employees that charge a percentage of what the procedure actually costs.

That being said, without an Amendment, I'm against federal healthcare. I think the States and/or state conglomerates should make the decision to do so if desired.

Musuko42
Male, 18-29, Europe
 2850 Posts
Thursday, October 17, 2013 9:08:56 AM
@HumanAction

"I wasn't trying to prove whether or not it was "good/bar" or "right/wrong." I was only trying to show that quantity demanded will increase. XD"

Fair enough. Forget that part of the conversation (or treat it seperately) :)

Will costs increase, though? The whole "treat early, treat cheaper" thing, getting more people healthy and earning/taxpaying, etc?

Costs might increase...but savings (on avoided emergency treatments) might also increase. As might income (productivity and tax from people not languishing with untreated treatable health issues).

The net result might be a gain. Or at least...a smaller loss.

Musuko42
Male, 18-29, Europe
 2850 Posts
Thursday, October 17, 2013 9:05:26 AM
@HumanAction

PS: I missed a thought. Hospitals previously could refuse non-emergency care...and non-emergency illness if left untreated can often become an emergency illness, with all the additional risks and higher costs that come with it.

If they now have to treat the non-emergencies, they might in doing so avert some of the emergencies from ever developing. Not all, obviously. But perhaps enough to give balance.

Kinda like...with your car. Getting that oil change for £50 now means you're not spending £5,000 on a new engine later.

HumanAction
Male, 18-29, Midwest US
 2353 Posts
Thursday, October 17, 2013 9:05:25 AM
@musuko


That can only be a good thing, surely; both for the individual, and for the nation.


I wasn't trying to prove whether or not it was "good/bar" or "right/wrong." I was only trying to show that quantity demanded will increase. XD

Sure, it's certainly good by most measures that sick people will get care. Absolutely! I couldn't agree more. However, that doesn't absolve us of our responsibility to assess the cost of such things.

Cost will increase. Whether or not it is going to be worth it is an entirely different argument.

Musuko42
Male, 18-29, Europe
 2850 Posts
Thursday, October 17, 2013 9:02:46 AM
@HumanAction

"If we really want to do universal healthcare, it should be subsidized healthcare pegged to a percentage of cost per procedure - not universal health insurance."

Shoulda, coulda, didn't...but one day might.

What you have now is kinda like civil partnerships in the UK: it wasn't gay marriage, but it was part of the way there (most of the way there, really).

And guess what; we have gay marriage now. It came along later.

Who knows, maybe Obamacare will work out great, people like CrakrJak will see that the sky didn't fall and the world didn't end, and they might be a little more willing to hear out the idea of true universal healthcare if it gets floated a few years down the line.

Musuko42
Male, 18-29, Europe
 2850 Posts
Thursday, October 17, 2013 9:00:51 AM
@HumanAction

"Quantity demanded will go up. The person who could not pay for the carpal tunnel procedure will now get it."

That can only be a good thing, surely; both for the individual, and for the nation.

If you have any sick person going without treatment, then it's personal suffering, and also a weakening of the nation: that person is either suffering, or risking, ill health. And a person in ill health is not going to be working and paying taxes and generally making the nation better off.

So it's good for both sides: the wishy-washy emotional side, and the pragmatic side.

HumanAction
Male, 18-29, Midwest US
 2353 Posts
Thursday, October 17, 2013 8:52:44 AM
@musuko

But demand isn't going up: there is still the same number of sick people needing treatment.

Ah, OK, I get what you're saying. No, hospitals may not refuse emergency care. They can (and occasionally do) refuse all other forms of care though.

Quantity demanded will go up. The person who could not pay for the carpal tunnel procedure will now get it. In an attempt to be less dramatic, I'll just say 'so on and so forth." XD

In addition, we have to consider the consequence of rapidly injecting the insurance market with "extra" cash. As we have seen with all universal health insurance systems (Europe, Canada, US...), we get a bubble. I can discuss why this happens if you're interested.

If we really want to do universal healthcare, it should be subsidized healthcare pegged to a percentage of cost per procedure - not universal health insurance.

Musuko42
Male, 18-29, Europe
 2850 Posts
Thursday, October 17, 2013 8:50:08 AM
@HumanAction

"In other words, I don't think we can honestly say that the 30-40 million people will use more, or less, services than the average. At very least, we should not form an entire argument around such a baseless assumption."

Exactly. And it's not worth trying to guess it. We'll soon find out.

HumanAction
Male, 18-29, Midwest US
 2353 Posts
Thursday, October 17, 2013 8:46:34 AM
@musuko

The average cost for all Americans, which is what you were saying

Exactly.

Look, I don't suppose that the people now entering the system will be any more or less sickly than those already in the system. There's simply no data to support either claim, at least none that I've come across. That leaves me with what I consider the most likely assumption - that they'll use about the same amount per person as everyone else. Any other argument relies on an assumption that is drastically different from the average and is completely untestable, and therefore, indefensible.

In other words, I don't think we can honestly say that the 30-40 million people will use more, or less, services than the average. At very least, we should not form an entire argument around such a baseless assumption.

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