Author Topic: ObamaCare Implosion  (Read 64822 times)

mathlete

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Re: ObamaCare Implosion
« Reply #200 on: August 24, 2016, 03:49:59 PM »
I won't bother claiming that it's hypocritical to call something a "fundamental evil" but make exceptions when it benefits you... some things just don't deserve arguments. Let's just call that added humor.

Lol.

I'm not doing this. Everyone arguing with me is.

I'm at the very least, openly embracing the hypocriticalness of it. For a number of reasons. One being that it doesn't hurt me (and probably helps me) to be intellectually honest with myself. Another, more obvious one is that I'm in an extremely limited position to change anything about the way things work.

I'm not going to cut my "healthcare for all" nose to spite my "the government does a fundamentally wrong thing to do fundamentally egregious things and oh sometimes they also kick healthcare a nickle too and that's nice" face.

Jrr85

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Re: ObamaCare Implosion
« Reply #201 on: August 24, 2016, 03:52:07 PM »
It doesn't even cost these states to expand.  The Feds pay 100% in 2014-2016 and phases down to 90% in 2020 on out.  Once it is all netted out it costs them almost nothing.  But they will block it anyway.

It doesn't cost these state immediately to expand.  It does cost them.  Medicaid is already a huge part of many of these states budgets and has gotten larger just because of spillover effects from people who already qualify for medicaid enrolling.  I think states that didn't do the expansion made a mistake from a self-interested point of view, but you can't pretend that it was costless. 

dogboyslim

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Re: ObamaCare Implosion
« Reply #202 on: August 24, 2016, 03:56:11 PM »
<nevermind>  Already covered in prior conversation.
« Last Edit: August 24, 2016, 04:10:01 PM by dogboyslim »

Jrr85

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Re: ObamaCare Implosion
« Reply #203 on: August 24, 2016, 03:58:29 PM »
Republicans want America to be a totalitarian dictatorship where a small number of elites lord it over a large number of peasants. They hate when representative democracy is enacted. That's why they love Vladimir Putin so much.

.mRepublicans don't have a real strong progressive wing or technocratic wing of the party.  That's democrats.  They pretty much openly advocate for rule by elites/technocrats. 

Vladimir Putin and Russia was identified by the republican nominee for president as the U.S.'s primary geopolitical foe, and Obama made cracks about it, and then watched Russia invade Ukraine, bomb Kurdish allies, take a lead role in Syria, and help ensure that Iran embarrassed him.  Trump does have an unhealthy admiration for Putin, but that's because he's a wannabe dictator, but Trump is also basically a democrat, or at least want up until the moment he wanted to run for office.   

 
« Last Edit: August 24, 2016, 07:59:07 PM by Jrr85 »

bacchi

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Re: ObamaCare Implosion
« Reply #204 on: August 24, 2016, 04:09:58 PM »
Okay I'll break it down for you.

Ok, now let me break it down for you.

tl;dr Hyberbole much?

marty998

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Re: ObamaCare Implosion
« Reply #205 on: August 24, 2016, 04:11:25 PM »
Societies that do this have outcompeted the ones that didn't, hence all developed countries take money from their citizens to promote the common welfare as a matter of course. Philosophically, there's nothing different about taking money to use for everyone's health care than doing the same for roads or an army or whatever.

So in essence, there is not a "wrong" here, though you can disagree about how effective/practical different levels of taxation/service are.

-W

Joe Individual is under no obligation to care about how the society he lives in stacks up against its contemporaries, or any other society from history.

Sure, but that's not relevant here. If he chooses to remain a citizen of said country/take advantage of those services, he is agreeing to the terms. If he doesn't like the terms, there are plenty of other places on earth to live with much less government. They just tend to suck more.

-W

tend to agree with Walt on this one. If you don't like what your taxes are spent on, you can either vote for change, put yourself up as a candidate, or move somewhere else.


mathlete

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Re: ObamaCare Implosion
« Reply #206 on: August 24, 2016, 04:15:53 PM »
tend to agree with Walt on this one. If you don't like what your taxes are spent on, you can either vote for change, put yourself up as a candidate, or move somewhere else.

I understand that those are the practical options. Those + going to jail for refusal to pay taxes.

Doesn't mean that it isn't crappy that someone is limiting your options like that though.

mathlete

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Re: ObamaCare Implosion
« Reply #207 on: August 24, 2016, 04:18:41 PM »
Ok, now let me break it down for you.

tl;dr Hyberbole much?

k

I get it if you don't feel it is worth your time to read something and digest it enough to make an intelligent response. After all I'm nobody. It is very dubious that my posts hold something of value to you.

I'd appreciate it if you'd do me the solid of simply not responding at all next time though. It'll save me the time and effort, and it will save you from saying something dumb and obviously falsifiable.

Everybody wins ;D

stoaX

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Re: ObamaCare Implosion
« Reply #208 on: August 24, 2016, 04:23:55 PM »

It's not just this - 60% of bankruptcies in the US are due to medical expenses.  Of this proportion 75% HAVE HEALTH COVERAGE.  It's just that overall they have fight with their insurers tooth and claw.  It's a crappy, crappy system we have.  Unless you have a lot of money.   http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/index.html?_s=PM:HEALTH

That is possibly the most bullshitiest statistic of all bullshit statistics. 

I'm not criticizing you because it was put out there by two Harvard professors, one of whom was Elizabeth Warren, that were being intentionally dishonest about what they found.  What they really found was that a large percentage of bankruptcy claimants had medical bills.  They would basically take somebody who had a $400k house, $50k car, $60k in credit card debt and a $1500 medical bill and classify them as suffering from a medical bankruptcy. 

It doesn't sound that far fetched to me. I suspect a lot of CC debt in bankruptcy is actually medical debt people "paid". Even if the true number is 10 or 15% that are truly filing because of medical debt, that shows a huge flaw in our system.

It would be interesting to see how the bankruptcy stats have changed in 2015 and 2016 since those are the years that the full provisions of the ACA have been implemented.  A study from 2009 doesn't reflect the situation today.

bacchi

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Re: ObamaCare Implosion
« Reply #209 on: August 24, 2016, 04:31:36 PM »
Ok, now let me break it down for you.

tl;dr Hyberbole much?

k

I get it if you don't feel it is worth your time to read something and digest it enough to make an intelligent response. After all I'm nobody. It is very dubious that my posts hold something of value to you.

Where does this come from? I realize that you're being piled on but I never wrote nor implied that you're a "nobody" or that your posts hold no value for me.

Quote
I'd appreciate it if you'd do me the solid of simply not responding at all next time though. It'll save me the time and effort, and it will save you from saying something dumb and obviously falsifiable.

Dude, light up and chill. It's an internet forum.

Northwestie

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Re: ObamaCare Implosion
« Reply #210 on: August 24, 2016, 04:44:29 PM »

It's not just this - 60% of bankruptcies in the US are due to medical expenses.  Of this proportion 75% HAVE HEALTH COVERAGE.  It's just that overall they have fight with their insurers tooth and claw.  It's a crappy, crappy system we have.  Unless you have a lot of money.   http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/index.html?_s=PM:HEALTH

That is possibly the most bullshitiest statistic of all bullshit statistics. 

I'm not criticizing you because it was put out there by two Harvard professors, one of whom was Elizabeth Warren, that were being intentionally dishonest about what they found.  What they really found was that a large percentage of bankruptcy claimants had medical bills.  They would basically take somebody who had a $400k house, $50k car, $60k in credit card debt and a $1500 medical bill and classify them as suffering from a medical bankruptcy. 

It doesn't sound that far fetched to me. I suspect a lot of CC debt in bankruptcy is actually medical debt people "paid". Even if the true number is 10 or 15% that are truly filing because of medical debt, that shows a huge flaw in our system.

It would be interesting to see how the bankruptcy stats have changed in 2015 and 2016 since those are the years that the full provisions of the ACA have been implemented.  A study from 2009 doesn't reflect the situation today.

Well - it's always good to cast a critical eye on studies - but I don't see why you call this a BS study- especially since you provide no proof of this retort.

From the study methods:

Woolhandler and her colleagues surveyed a random sample of 2,314 people who filed for bankruptcy in early 2007, looked at their court records, and then interviewed more than 1,000 of them. They concluded that 62.1 percent of the bankruptcies were medically related because the individuals either had more than $5,000 (or 10 percent of their pretax income) in medical bills, mortgaged their home to pay for medical bills, or lost significant income due to an illness. On average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point.

So it's not as you stated - that they "just' had medical bills.  Rather - from interviews with the affected families and a review of their financial situations - it appears that medical costs were a major, if not defining element of bankruptcy.

BTDretire

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Re: ObamaCare Implosion
« Reply #211 on: August 24, 2016, 04:59:27 PM »

From the study methods:

Woolhandler and her colleagues surveyed a random sample of 2,314 people who filed for bankruptcy in early 2007, looked at their court records, and then interviewed more than 1,000 of them. They concluded that 62.1 percent of the bankruptcies were medically related because the individuals either had more than $5,000 (or 10 percent of their pretax income) in medical bills, mortgaged their home to pay for medical bills, or lost significant income due to an illness. On average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point.

 Don't know all the study criteria, but we all know many people on this forum are not spending 20% to 50%
of the income on stupid shit. Thus they could pay that bill instead of go bankrupt, which in effect, is making the rest of society pay for their stupid shit.
Quote
So it's not as you stated - that they "just' had medical bills.  Rather - from interviews with the affected families and a review of their financial situations - it appears that medical costs were a major, if not defining element of bankruptcy.

As it is, many of us have "savings cost that are major"  A medical bill that is 10 or 20% of income can be paid if
you have mustachian principals.
One of the stats, 38% that went bankrupt had less than $5,000 in medical bills.
« Last Edit: August 25, 2016, 05:27:21 PM by Qmavam »

doggyfizzle

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Re: ObamaCare Implosion
« Reply #212 on: August 24, 2016, 05:12:30 PM »
It doesn't cost these state immediately to expand.  It does cost them.  Medicaid is already a huge part of many of these states budgets and has gotten larger just because of spillover effects from people who already qualify for medicaid enrolling.  I think states that didn't do the expansion made a mistake from a self-interested point of view, but you can't pretend that it was costless.

The skeptic in me thinks that the refusal to accept the Medicaid expansion was more ideological in nature rather than a response to the possible cost of the expansion.  Unfortunately, there wasn't any back and forth between the D/Rs during the development of ACA Legislation, and that lack of willingness to work together extended to the state governments during the Medicaid roll-out and allowed for political opportunism on both sides of the political aisle which detracted from addressing the overly complicated nature of the medical insurance industry in this country.

Bicycle_B

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Re: ObamaCare Implosion
« Reply #213 on: August 24, 2016, 05:14:56 PM »
Well, our system might not be the best.  But our healthcare is.  Don't see too many people flying to Cuba to see a doctor.  If only we could get the two to both be great.

Not according to the world health organisation...  It's 37th.  Though you are right, people from Cuba probably do want to come to the USA for healthcare as they are ranked 39th.

http://thepatientfactor.com/canadian-health-care-information/world-health-organizations-ranking-of-the-worlds-health-systems/

Oh and here's another more recent one, though it only compares industrialised countries the USA came last (though spent nearly double per capita the other 6 countries did).

http://www.commonwealthfund.org/publications/press-releases/2010/jun/us-ranks-last-among-seven-countries


I do find the American perception of USA healthcare very interesting though, most other people I've met around the world have a fairly impartial view on their country in the global standings for healthcare.  Then every yank I've ever spoken to thinks the US healthcare is incredible (while statistically speaking this is incorrect by all data I've ever seen).  I know mustachians are generally immune to advertising and propaganda but this seems to be one area most people completely buy into.

As someone living in the "Yankee bubble", thanks for posting. 

Bicycle_B

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Re: ObamaCare Implosion
« Reply #214 on: August 24, 2016, 05:20:50 PM »
Great.  None of that solves the problem that none of my doctors are on the provider lists for any of the open exchange plans.  I feel fortunate that I can afford COBRA for now.

Is this really a problem/concern people have? Why do people care so much who their doctor is? As long as they get the job done (and it's crazy or something) what's the difference? It's a person in a white coat that look at you for 45 seconds every few years, maybe. It's at least 4-5 years since I saw my doctor and I can't remember his name or what he looks like. I see my car mechanic way more often, and I don't care who that is as long as they do the job properly. This really seems like a non-issue.

It is. 

I know several people who care who their doctor is.  At some point, even a fairly healthy person can start to visit more often.  At that point, care varies in discernable ways among different doctors.  Some learn who you are and remember your case and pay attention to it, others don't.  Those who don't make mistakes.  People are not cars. 

At age 25, I wouldn't care.  At 50 and after caring for others during their final years, it makes a difference.  I am not alone in thinking this.  I personally know people who indeed have researched specific plans and discovered that their doctors don't accept the plans. 

Bicycle_B

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Re: ObamaCare Implosion
« Reply #215 on: August 24, 2016, 05:46:06 PM »
By the way, not many people know this, but the Government Accountability Office (GAO) was asked by congress to do a study on the feasibility of adopting the Canadian system of health care. The results:

http://archive.gao.gov/d20t9/144039.pdf

EDIT: Forgot to mention, this was back in 1991. NINETEEN NINETY ONE.

Thanks for posting.

2buttons

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Re: ObamaCare Implosion
« Reply #216 on: August 24, 2016, 06:18:23 PM »
How many years would you be willing to postpone FIRE to ensure everyone has universal access to healthcare?  We could do the math....

TexasRunner

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Re: ObamaCare Implosion
« Reply #217 on: August 24, 2016, 06:23:28 PM »
How many years would anyone be willing to wait for an MRI?...  The math has already been done on that one.  :/

That report isn't exactly glowingly positive...

ender

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Re: ObamaCare Implosion
« Reply #218 on: August 24, 2016, 06:33:14 PM »
How many years would you be willing to postpone FIRE to ensure everyone has universal access to healthcare?  We could do the math....

Healthcare subsidies should be means tested.

The way obamacare works, you could have $2M in retirement accounts and retire early but because you perfectly game your income for the year you get heavily subsidized healthcare.

Zamboni

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Re: ObamaCare Implosion
« Reply #219 on: August 24, 2016, 06:51:18 PM »
Wow that 1991 report on the Canadian system kind of makes us looks like incompetent boobs for not going that way at that time. But, if anyone remembers, Bill Clinton had overhaul of the healthcare system as a key piece of his platform when he was running for president the first time.

Mathlete, respectfully I think you just need to get outside of the US more. WW is right and your arguments just don't hold much water for people who have had an eyewitness view of much of what has happened in many other countries thanks to their govt (or lack of govt). Lack of infrastructure, oversight, planning, engineering . . . you just can't imagine it until you have lived it. These things are so painfully obvious just traveling around in developing nations, but often their taxes sure are low! It's painful to even witness it.

No one is holding a gun to your head and forcing you to do anything here in the USA. Unless you are wanted by the law we have an open border for you to leave, and plenty of places will welcome you and your literacy and your stash. Just don't expect structurally sounds buildings or security on the streets or education for your children or unfortunately even clean potable water. Don't expect your bank to be safe or ATM or credit cards to work (the place I just visited has so many fraud and corruption that it has been "permanently banned" by my American bank, so I couldn't even withdraw my own money while there which was a pain in the ass.) I hope you feel confident protecting that big pile of cash money you have all by yourself! And if you fall and need stitches . . . forget about it. Better take your own stockpile of alcohol, needles, bandages, medicine and disposable syringes with you to the nirvana you are imagining where no one makes you have insurance or pay any taxes!

forummm

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Re: ObamaCare Implosion
« Reply #220 on: August 24, 2016, 07:00:47 PM »
Obamacare would be doing swimmingly well if the GOP didn't purposefully set out to sabotage it because they hate poor people. (Sorry if that's blunt, but it's the truth.) It's amazing how spiteful some people can be when something threatens their self-proclaimed superiority. My state fully implemented all aspects of Obamacare and guess what? We have nearly no uninsured people and ACA health plans are super cheap. Imagine that.

This is just completely uninformed. Obamacare was passed without any republican support. Democrats didn't have to do anything to cater to republicans and every compromise in the legislation was something to get democrats to agree on it. and since its been enacted, we've obviously had a democrat administration the entire time. And state administrations can only choose among the options permissible under the law.m, so there's not much of a way for them to sabotage it.

The ACA had over 700 amendments that Republicans asked for. And it was built on the model that the conservative Heritage Foundation championed in the 90s, that Republicans like Dole and Hatch also backed in the 90s, and that Mitt Romney passed in MA. The decision to vote against it was strictly political. When you ask Republicans what they'd replace it with, they say things like 'tax credits for health care, no exclusions for pre-existing conditions, competitive markets for insurance, etc', but then pretend like they are not describing the ACA.

MoneyCat

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Re: ObamaCare Implosion
« Reply #221 on: August 24, 2016, 07:05:10 PM »
Obamacare would be doing swimmingly well if the GOP didn't purposefully set out to sabotage it because they hate poor people. (Sorry if that's blunt, but it's the truth.) It's amazing how spiteful some people can be when something threatens their self-proclaimed superiority. My state fully implemented all aspects of Obamacare and guess what? We have nearly no uninsured people and ACA health plans are super cheap. Imagine that.

This is just completely uninformed. Obamacare was passed without any republican support. Democrats didn't have to do anything to cater to republicans and every compromise in the legislation was something to get democrats to agree on it. and since its been enacted, we've obviously had a democrat administration the entire time. And state administrations can only choose among the options permissible under the law.m, so there's not much of a way for them to sabotage it.

The ACA had over 700 amendments that Republicans asked for. And it was built on the model that the conservative Heritage Foundation championed in the 90s, that Republicans like Dole and Hatch also backed in the 90s, and that Mitt Romney passed in MA. The decision to vote against it was strictly political. When you ask Republicans what they'd replace it with, they say things like 'tax credits for health care, no exclusions for pre-existing conditions, competitive markets for insurance, etc', but then pretend like they are not describing the ACA.

The weirdest thing for me is how Kentucky has the largest percentage of state residents of any state in the Union on ACA health plans yet the very people on those plans are voting in favor of candidates who want to repeal it. They are literally so blinded by hate that they are fully willing to do away with their own health coverage. Completely blows my mind.

Metric Mouse

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Re: ObamaCare Implosion
« Reply #222 on: August 24, 2016, 07:28:48 PM »
Never underestimate how far people will go to do what they think is right.  Even voting against poor legislation that benefits them.

Telecaster

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Re: ObamaCare Implosion
« Reply #223 on: August 24, 2016, 08:32:50 PM »

The ACA had over 700 amendments that Republicans asked for. And it was built on the model that the conservative Heritage Foundation championed in the 90s, that Republicans like Dole and Hatch also backed in the 90s, and that Mitt Romney passed in MA. The decision to vote against it was strictly political. When you ask Republicans what they'd replace it with, they say things like 'tax credits for health care, no exclusions for pre-existing conditions, competitive markets for insurance, etc', but then pretend like they are not describing the ACA.

Great post.  The Republicans want all the treats in the ACA, but they don't want to each the spinach that is required to make it work.  Yes, for eliminating life time caps.  No for tax increases to pay for it. 

This is a little bit wonky, but the ACA including stripping $714 Billion of (mostly) waste out of Medicare, and spending that money in other areas.  A lot of that waste was overpayments for Medicare Advantage plans.   To me, cutting waste is the ideal way to pay for something.  You don't have to raise taxes and cutting waste is good in general.  Not so much for Republicans. 

Three things happened.  One is the Republicans screamed bloody blue murder that the Democrats were going to deprive our seniors of the good health care they deserve.  Basically, they claimed, unless the government continued to waste billions in areas Medicare Advantage in areas that didn't do anything, the Medicare Advantage would collapse.   

http://www.nationalreview.com/article/316375/medicare-distortions-james-c-capretta

Second was Paul Ryan who was then chairman of the House Ways and Means Committee running for Vice President, included the exact same cuts in his proposed budget.  But his cuts weren't going to deprive our seniors of health care because he had a magic plan that he would unveil in the future.  Trust him. 

Third was that after the waste was cut out, Medicare Advantage became more efficient.  As it became more efficient, the plans got better.  As the plans got better, it got more popular, and enrollment has exploded.

http://www.nytimes.com/2016/02/13/us/politics/surge-in-medicare-advantage-sign-ups-confounds-expectations.html?_r=0






Telecaster

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Re: ObamaCare Implosion
« Reply #224 on: August 24, 2016, 08:33:18 PM »
Remember, the ability to vote yourself money is a sign of impending societal failure.

I didn't know that.  Can you give us some examples? 

randymarsh

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Re: ObamaCare Implosion
« Reply #225 on: August 24, 2016, 08:37:09 PM »
Never underestimate how far people will go to do what they think is right.  Even voting against poor legislation that benefits them.

That's not what they're doing. In polls, people say they don't like "Obamacare". Then when you ask them about the individual provisions, they approve. Even Republicans. https://www.washingtonpost.com/news/wonk/wp/2012/06/26/poll-republicans-hate-obamacare-but-like-most-of-what-it-does/


yuka

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Re: ObamaCare Implosion
« Reply #226 on: August 24, 2016, 10:41:59 PM »
Would you settle for "sociopath"? I mean...

That's a pretty serious charge. I'm honestly not sure where it's coming from. I'm a sociopath because I think a reasonable argument against universal healthcare can be made?


Society would break down...

..."fundamental evil" ...

...I'm really surprised that multiple people are struggling with this. This is <back-handed comment about parent>...


Jumping from the first page to last page of a mature (in terms of length) thread is like when your plane lands somewhere with crazy weather after being somewhere nice and sunny.

On another note, hopefully this has been mentioned with regards to performance of US healthcare: WHO reports will tend to value what the US system probably does best, which is raise the ceiling for how successful a complicated procedure can be, how well a crazy new drug can work, or anything else requiring huge piles of resources and skilled people. What we do poorly, and what is probably correctly weighted more heavily in rankings, are whole-population outcomes and general health. Our resources are allocated in terrible ways that encourage misuse of existing systems (ER as GP) and discourage use of the vast lever that is preventative care. So, if you're swimming in cash and trying to stay ahead of a really bad illness, it wouldn't surprise me to find that the US is #1. But for most of us, that's something we either don't see for ourselves, or which we would actively reject if placed in the situation; I know I wouldn't throw away hundreds of thousands to extend my last six months of life. That money should be going to my church and other charities.

It reminds me of school rankings. I sometimes try to explain to upper middle class parents that school rankings are nearly worthless for applicability to their children. It's most often just a proxy measurement for poverty rate in an area: given an environment that's not completely toxic, and a few good teachers, the parents themselves are the defining variable most of the time. Though I guess that may not be the case if you're taking the ivy league preschool route...

MoneyCat

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Re: ObamaCare Implosion
« Reply #227 on: August 24, 2016, 10:53:18 PM »
Never underestimate how far people will go to do what they think is right.  Even voting against poor legislation that benefits them.

That's not what they're doing. In polls, people say they don't like "Obamacare". Then when you ask them about the individual provisions, they approve. Even Republicans. https://www.washingtonpost.com/news/wonk/wp/2012/06/26/poll-republicans-hate-obamacare-but-like-most-of-what-it-does/

Yeah, it's mostly just dealing with the kind of very ignorant, easily frightened rubes that the Republican Party attracts. That's not counting the other type of Republican voter who purposefully behaves destructively out of spite.

MustachianAccountant

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Re: ObamaCare Implosion
« Reply #228 on: August 25, 2016, 01:20:37 AM »
If they are much cheaper, then why in the world do we not shift to them? Is it something other than profit motive?


Medical costs have only risen since 1991. If anything, the savings would be even more than that 1991 report states.
I too was wondering what the Republican resistance to universal healthcare is, and I did a little research a few months ago. I found this quote, which really makes sense to me:

Quote
The fundamental mythos of American culture is that no matter how poor or humble your birth, you can through grit, spunk, and hard work become wealthy and prosperous.

On the face of it, and from the perspective of a class divided Europe, that seems incredibly noble and empowering. The idea that there is that much social mobility, that anyone can forge their own destiny is a powerful part of the American psyche. When it happens, it is an incredible thing. Something Americans can feel proud of.

However, there is a dark side to this mythos. Which is this: "If anyone can win through hard work and effort, anyone who doesn't win, therefore deserves to be poor."

At the core of all the anti-health care reforms is this attitude - "why should I pay for the healthcare of those losers."

And that, most often, is the base objection I hear. Maybe not in those words, but that is the attitude behind them.

MustachianAccountant

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Re: ObamaCare Implosion
« Reply #229 on: August 25, 2016, 01:50:14 AM »
How many years would you be willing to postpone FIRE to ensure everyone has universal access to healthcare?  We could do the math....

I don't think anyone would be postponing FIRE.

Read it again:
http://archive.gao.gov/d20t9/144039.pdf


Jrr85

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Re: ObamaCare Implosion
« Reply #230 on: August 25, 2016, 06:46:59 AM »
Yeah, it's mostly just dealing with the kind of very ignorant, easily frightened rubes that the Republican Party attracts. That's not counting the other type of Republican voter who purposefully behaves destructively out of spite.

Sure,  ~40% of the country consists of either very ignorant, easily frightened rubes or people who behave destructively out of spite.  That seems like a reasonable assumption for a country that, despite it's imperfections and setbacks, still has a roughly two and a half century streak of success, even while handing over control to the rubes and destructive people for years at at time. 

Jrr85

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Re: ObamaCare Implosion
« Reply #231 on: August 25, 2016, 07:00:55 AM »
That's not what they're doing. In polls, people say they don't like "Obamacare". Then when you ask them about the individual provisions, they approve. Even Republicans. https://www.washingtonpost.com/news/wonk/wp/2012/06/26/poll-republicans-hate-obamacare-but-like-most-of-what-it-does/

It's meaningless to ask people what they like if you don't give them the cost also.  Everybody would prefer that people not be priced out of the insurance market because of a health issue that arose when they were uninsured.  Everyone would like for low income people to have subsidies to make their insurance premiums more affordable.  But the answer is different when you ask, would you be willing to pay 30% more for health insurance so that uninsured people with existing health issues can receive the same price as people who sign up for insurance when they are healthy?  Ask someone making 250% of the poverty level (or whatever the cutoff is for subsidies) how much extra they are willing to pay so that people making 150% of the poverty level can have subsidized premiums.  Also, the poll in question asks about things that were already part of the law before Obamacare. 

And a lot of people will reflexively be against pretty much any program you propose if you tell them it will cost an additional two trillion dollars over ten years, which is obviously lacking in the analysis department but is not a terrible heuristic when we've already got massive unfunded liabilities associated with SS, Medicare, and state pensions. 

Jrr85

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Re: ObamaCare Implosion
« Reply #232 on: August 25, 2016, 07:29:16 AM »
Well - it's always good to cast a critical eye on studies - but I don't see why you call this a BS study- especially since you provide no proof of this retort.

From the study methods:

Woolhandler and her colleagues surveyed a random sample of 2,314 people who filed for bankruptcy in early 2007, looked at their court records, and then interviewed more than 1,000 of them. They concluded that 62.1 percent of the bankruptcies were medically related because the individuals either had more than $5,000 (or 10 percent of their pretax income) in medical bills, mortgaged their home to pay for medical bills, or lost significant income due to an illness. On average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point.

So it's not as you stated - that they "just' had medical bills.  Rather - from interviews with the affected families and a review of their financial situations - it appears that medical costs were a major, if not defining element of bankruptcy.

You are referring to a later study that also was designed to be misleading.  1st, they looked at filings in 2007, when bankrtupcies were still way down from their historical trend.  When the 2005 bankruptcy reform law was coming down the pipe, lots of people rushed to file Chapter 7's before the law changed because they didn't want to get stuck with the new law's onerous requirements.  So a lot of potential bankruptcies from the latter part of the 2000's were brought forward.  That combined with the deterrent effect of the new bankruptcy law resulted in many fewer filings, and the ones that did file were more likely to be sudden onset.  So for people truly thrown into bankruptcy by a medical issue, you would expect the percentage to be higher in 2007 than 2001 because so many "optional" bankruptcy filings didn't take place because of the new law.  That is what Warren et all found even using their bullshit definition, and they screamed and hollered about this huge spike in medical bankruptcies, from 50% of filings in 2001 to 62.1% of filings in 2007.  Even if you accepted their bullshit numbers as accurate, the 62.1%in 2007 still means a much smaller number of medical bankruptcies were filed in 2007 than in 2001 because that is 62.1% of a much smaller number of filings.  So if you were worried about medical bankruptcies and the impact of insurance, Warren's study would indicate the problem was getting better not worse. 
 

Of course the 70% number is still bullshit.  Probably the best indication of that is taht the people filing bankruptcy disagreed with it.  The people that filed would presumably be pretty down and would love to point to something out of control as causing their bankruptcy, but only 30% claimed they filed because of medical reasons. 

Another good indication taht they are doing advocacy and not research is that if you really wanted to use this study to argue for gov't subsidized or provided health insurance (as Warren did), you wouldn't include people who"lost significant income due to an illness."  If anything, you would use that to argue for more/broader short term disability insurance.  Including people who went bankrupt because they coudln't work makes the study mostly useless for arguments about health insurance, which won't stop the loss of income.

They also still have laughably low limits to qualify as a medical bankruptcy.  $5k or 10% of gross income in medical bills?  Someone making $100k a year having $5k in medical bills is not bankrupt because of medical bills.  Neither is somebody making $50k.  And while a $2500 medical bill while earning a $25000 salary would be tough, it can't be the cause of a bankruptcy if they also have a $15,000 car note. 

The average debts is also probably chosen to be misleading, as median would give a much better indicator, as each person with a true medical catastrophe is going to influence the average disproportionately to each person with a manageable medical issue.       

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Re: ObamaCare Implosion
« Reply #234 on: August 25, 2016, 09:49:18 AM »
That's not what they're doing. In polls, people say they don't like "Obamacare". Then when you ask them about the individual provisions, they approve. Even Republicans. https://www.washingtonpost.com/news/wonk/wp/2012/06/26/poll-republicans-hate-obamacare-but-like-most-of-what-it-does/

It's meaningless to ask people what they like if you don't give them the cost also.  Everybody would prefer that people not be priced out of the insurance market because of a health issue that arose when they were uninsured.  Everyone would like for low income people to have subsidies to make their insurance premiums more affordable.  But the answer is different when you ask, would you be willing to pay 30% more for health insurance so that uninsured people with existing health issues can receive the same price as people who sign up for insurance when they are healthy?  Ask someone making 250% of the poverty level (or whatever the cutoff is for subsidies) how much extra they are willing to pay so that people making 150% of the poverty level can have subsidized premiums. 
You're pretending that all costs went up for everybody polled. There is no way that's true. And my point wasn't even talking about cost. It's talking about how people like what the law does. They don't like the word Obamacare because of a smear campaign.


Also, the poll in question asks about things that were already part of the law before Obamacare. 

Now you're just making stuff up. We did not have insurance subsidies before ACA. Now we do. We didn't require companies with more than 50 employees to provide insurance. Now we do. Insurance companies weren't required to keep children up to age 26 on a parent's plan. Now they are. Insurance companies used to be able to deny based on preexisting conditions. Now they can't.

It's clear you don't even know what the ACA/Obamacare is so it's pointless continuing this conversation.

And a lot of people will reflexively be against pretty much any program you propose if you tell them it will cost an additional two trillion dollars over ten years, which is obviously lacking in the analysis department but is not a terrible heuristic

Still making stuff up. Repealing the ACA would increase the deficit. Therefore, it doesn't add 2 trillion over 10 years. Stop repeating GOP talking points that have been proven false hundreds of times.

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Re: ObamaCare Implosion
« Reply #235 on: August 25, 2016, 10:15:58 AM »
Well - it's always good to cast a critical eye on studies - but I don't see why you call this a BS study- especially since you provide no proof of this retort.

From the study methods:

Woolhandler and her colleagues surveyed a random sample of 2,314 people who filed for bankruptcy in early 2007, looked at their court records, and then interviewed more than 1,000 of them. They concluded that 62.1 percent of the bankruptcies were medically related because the individuals either had more than $5,000 (or 10 percent of their pretax income) in medical bills, mortgaged their home to pay for medical bills, or lost significant income due to an illness. On average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point.

So it's not as you stated - that they "just' had medical bills.  Rather - from interviews with the affected families and a review of their financial situations - it appears that medical costs were a major, if not defining element of bankruptcy.

You are referring to a later study that also was designed to be misleading. 


Umm, no.  That quote was taken directly from the article I originally linked to.  Did you even venture to read the link or article?

Your argument seems to come down to name-calling the study BS over and over.  You're getting your shorts pretty twisted over this.
« Last Edit: August 25, 2016, 10:17:38 AM by Northwestie »

shenlong55

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Re: ObamaCare Implosion
« Reply #236 on: August 25, 2016, 10:22:38 AM »
tend to agree with Walt on this one. If you don't like what your taxes are spent on, you can either vote for change, put yourself up as a candidate, or move somewhere else.

I understand that those are the practical options. Those + going to jail for refusal to pay taxes.

Doesn't mean that it isn't crappy that someone is limiting your options like that though.

It seems to me like you have a problem with the concept of a society here.  No person or persons are limiting your options like that, the idea of a society is.  You just can't live within a society without intrinsically reaping the benefits of that society.  Therefore, the only fair option, so long as you are insistent upon staying within said society, is for you to share in the costs of those benefits whether you want them or not.  Because you're going to receive them, whether you want them or not and whether you recognize them or not.

I think you have to decide a fundamental question here.  Is the idea of a "society" evil or not?  Because what your talking about is an unavoidable reality of that idea.

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Re: ObamaCare Implosion
« Reply #237 on: August 25, 2016, 10:27:47 AM »
http://billmoyers.com/story/single-payer-healthcare-system-inevitable/

Interesting, thanks.   Gotta love Bill - that guy is just very straight talking.

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Re: ObamaCare Implosion
« Reply #238 on: August 25, 2016, 10:50:40 AM »
tend to agree with Walt on this one. If you don't like what your taxes are spent on, you can either vote for change, put yourself up as a candidate, or move somewhere else.

I understand that those are the practical options. Those + going to jail for refusal to pay taxes.

Doesn't mean that it isn't crappy that someone is limiting your options like that though.

It seems to me like you have a problem with the concept of a society here.  No person or persons are limiting your options like that, the idea of a society is.  You just can't live within a society without intrinsically reaping the benefits of that society.  Therefore, the only fair option, so long as you are insistent upon staying within said society, is for you to share in the costs of those benefits whether you want them or not.  Because you're going to receive them, whether you want them or not and whether you recognize them or not.

I think you have to decide a fundamental question here.  Is the idea of a "society" evil or not?  Because what your talking about is an unavoidable reality of that idea.

Healthcare above a certain level is not a benefit to society. Society does not benefit, say, from having a huge number of elderly persons survive multiple decades after they stop contributing to the tax base.  Just like roads are great - to a point. No one says we should pave every scrap of land because roads benefit society. A military is great - that doesn't mean that every available dollar should be put into training and housing more troops or aircraft carriers.  At some point there is diminishing returns on societal healthcare, and it becomes a drag on societal progress instead of a net positive.

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Re: ObamaCare Implosion
« Reply #239 on: August 25, 2016, 11:23:42 AM »
You're pretending that all costs went up for everybody polled. There is no way that's true. And my point wasn't even talking about cost. It's talking about how people like what the law does. They don't like the word Obamacare because of a smear campaign.
  Believe it or not, most people don't evaluate policy on personal self interest.  They actually care about values and ideas like fairness.  There are certainly self-interested voters out there and I can understand people thinking it's basically everybody based on rhetoric coming from both sides, but most people look beyond "what's best for me personally" and think about how things impact other people, fairness, long term impacts, etc.  There's been some research into it that I think is covered in a book called "The Myth of the Rational Voter." 

So no, I'm not pretending that the costs went up for everybody polled and there is nothing in my post that would even logically suggest that. 

Also, the poll in question asks about things that were already part of the law before Obamacare. 

Now you're just making stuff up. We did not have insurance subsidies before ACA. Now we do. We didn't require companies with more than 50 employees to provide insurance. Now we do. Insurance companies weren't required to keep children up to age 26 on a parent's plan. Now they are. Insurance companies used to be able to deny based on preexisting conditions. Now they can't.

It's clear you don't even know what the ACA/Obamacare is so it's pointless continuing this conversation.

You just listed things that the ACA did, which is not responsive to my statement.  My statement was about including things that were already part of the law, like insurance companies not being able to simply drop people after they became sick.  There may be stronger protections regarding this issue in Obamacare, just like there may be stronger protections against fraudulent rescissions by insurance companies, but that doesn't change the fact that the poll asked about things that were already part of the law before Obamacare.  I think you are right that's it's probably pointless for us to converse, but you never know when somebody that seems blinkered might learn something.   

And a lot of people will reflexively be against pretty much any program you propose if you tell them it will cost an additional two trillion dollars over ten years, which is obviously lacking in the analysis department but is not a terrible heuristic

Still making stuff up. Repealing the ACA would increase the deficit. Therefore, it doesn't add 2 trillion over 10 years. Stop repeating GOP talking points that have been proven false hundreds of times.

You're confusing the deficit with costs.  The deficit reflects how much spending exceeds revenue.  The $2 trillion number I used is the number the CBO pegged as Obamacare spending (I think they originally projected something like $1.7 trillion over ten years and then later revised it up to 2.004 trillion).  Obviously CBO numbers are not infallible (often because they are directed to use ridiculous assumptions by the official asking them to score legislation), so maybe there is a more accurate number out there that somebody could find, but even the laws proponents I think projected it's net spending before enactment at close to $900billion, so the 2 trillion gross spending after enactment doesn't seem like an obviously wrong number. 

« Last Edit: August 25, 2016, 11:42:58 AM by Jrr85 »

stoaX

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Re: ObamaCare Implosion
« Reply #240 on: August 25, 2016, 11:25:10 AM »
Also, the poll in question asks about things that were already part of the law before Obamacare. 

Insurance companies weren't required to keep children up to age 26 on a parent's plan. Now they are.

That's correct on a national level but many states had age requirements for group plans ever since I started working in the group medical business in the 1980s.  Utah for example had the age 26 requirement for quite a while, and Ohio had it at 28!  Defining dependents as those up to Age 23 (if a student) has also been an industry norm for decades. 

StarBright

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Re: ObamaCare Implosion
« Reply #241 on: August 25, 2016, 11:32:14 AM »
tend to agree with Walt on this one. If you don't like what your taxes are spent on, you can either vote for change, put yourself up as a candidate, or move somewhere else.

I understand that those are the practical options. Those + going to jail for refusal to pay taxes.

Doesn't mean that it isn't crappy that someone is limiting your options like that though.

It seems to me like you have a problem with the concept of a society here.  No person or persons are limiting your options like that, the idea of a society is.  You just can't live within a society without intrinsically reaping the benefits of that society.  Therefore, the only fair option, so long as you are insistent upon staying within said society, is for you to share in the costs of those benefits whether you want them or not.  Because you're going to receive them, whether you want them or not and whether you recognize them or not.

I think you have to decide a fundamental question here.  Is the idea of a "society" evil or not?  Because what your talking about is an unavoidable reality of that idea.

Healthcare above a certain level is not a benefit to society. Society does not benefit, say, from having a huge number of elderly persons survive multiple decades after they stop contributing to the tax base.  Just like roads are great - to a point. No one says we should pave every scrap of land because roads benefit society. A military is great - that doesn't mean that every available dollar should be put into training and housing more troops or aircraft carriers.  At some point there is diminishing returns on societal healthcare, and it becomes a drag on societal progress instead of a net positive.

I would agree with your point to an extent - but do you really think we are even close to that yet?  Regarding the elderly, FWIW when some very sensible plans for "end of life care conversations" were included in the ACA people started hollering about death panels.

Jrr85

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Re: ObamaCare Implosion
« Reply #242 on: August 25, 2016, 11:41:33 AM »
Well - it's always good to cast a critical eye on studies - but I don't see why you call this a BS study- especially since you provide no proof of this retort.

From the study methods:

Woolhandler and her colleagues surveyed a random sample of 2,314 people who filed for bankruptcy in early 2007, looked at their court records, and then interviewed more than 1,000 of them. They concluded that 62.1 percent of the bankruptcies were medically related because the individuals either had more than $5,000 (or 10 percent of their pretax income) in medical bills, mortgaged their home to pay for medical bills, or lost significant income due to an illness. On average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point.

So it's not as you stated - that they "just' had medical bills.  Rather - from interviews with the affected families and a review of their financial situations - it appears that medical costs were a major, if not defining element of bankruptcy.

You are referring to a later study that also was designed to be misleading. 


Umm, no.  That quote was taken directly from the article I originally linked to.  Did you even venture to read the link or article?

Your argument seems to come down to name-calling the study BS over and over.  You're getting your shorts pretty twisted over this.

Sorry, you did reference the 2007 study both times; I did not notice your link in the original post.  But as I noted in my previous post, it still has basically the same problems as the 2001 study, although they modified it some, and the problems are so egregious that there is no way they weren't intentional.  They wanted to create a sound bite that could be used in insurance policy debates, so they purposefully picked ridiculously low hurdles to qualify as a "medical bankruptcy", even if it required that they be misleading.

I get my shorts pretty twisted over this because I would like for their to be some standards that encourage honesty in what purports to be academic research.  I know you can't completely eliminate bias, but it would be nice if academics self-regulated the most egregious abuses of trust like this.  Most people don't have time to do even glance at the underlying study when a headline grabbing claim is made.  It would be nice if a study came out from a Harvard professor, it would be reasonable to assume "they probably at least tried to be intellectually honest, because putting out pure garbage would get them ostracized by their peers."  Obviously that's not a reasonable assumption, which makes public policy and debate that much harder.  There are increasingly no trustworthy institutions left and that's a problem because if you are going to have a government as large as ours, you need some trustworthy institutions.  It's also nice to have a reasonably informed voting populace, which is hard to do without some institutions that can be relied upon to provide reasonably unbiased information.

Telecaster

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Re: ObamaCare Implosion
« Reply #243 on: August 25, 2016, 11:42:02 AM »

Healthcare above a certain level is not a benefit to society. Society does not benefit, say, from having a huge number of elderly persons survive multiple decades after they stop contributing to the tax base.

WTF?   Is that really what this comes down to?   Human value is only measured in terms of contributing to the tax base?   

Elderly people contribute plenty to society.   Maybe not in dollars, but in lots of other ways that are plenty valuable to society. 

There is some disturbing shit in this thread. 


Mississippi Mudstache

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Re: ObamaCare Implosion
« Reply #244 on: August 25, 2016, 11:46:29 AM »
There is some disturbing shit in this thread.

Yep

stoaX

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Re: ObamaCare Implosion
« Reply #245 on: August 25, 2016, 12:02:50 PM »

Healthcare above a certain level is not a benefit to society. Society does not benefit, say, from having a huge number of elderly persons survive multiple decades after they stop contributing to the tax base.

WTF?   Is that really what this comes down to?   Human value is only measured in terms of contributing to the tax base?   

Elderly people contribute plenty to society.   Maybe not in dollars, but in lots of other ways that are plenty valuable to society. 

There is some disturbing shit in this thread.

And if you retire early and stop being a serious contributor to the tax base, does your value as a human diminish?  I better give up my early retirement ideas and plan on working into my 90's lest I be thought of as expendable. 

However, I doubt Metric Mouse was advocating the "obligation to die" point of view regarding the infirm elderly.  I prefer to think it was an attempt to make a point about the sometimes ineffective over-expenditures on medical care at the end of life.  Atul Gawande's book "Being Mortal" is an excellent book about these issues.

Metric Mouse

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Re: ObamaCare Implosion
« Reply #246 on: August 25, 2016, 12:34:34 PM »
And if you retire early and stop being a serious contributor to the tax base, does your value as a human diminish?  I better give up my early retirement ideas and plan on working into my 90's lest I be thought of as expendable. 

However, I doubt Metric Mouse was advocating the "obligation to die" point of view regarding the infirm elderly.  I prefer to think it was an attempt to make a point about the sometimes ineffective over-expenditures on medical care at the end of life.  Atul Gawande's book "Being Mortal" is an excellent book about these issues.

That's pretty close. I never said anything about intrinsic human value. It was a response to the argument that healthcare is always 'for the greater good' of society. This is untrue, after a certain level of healthcare is achieved.  In response to the question upthread, I would argue America is pretty close to that level, in general. Obviously, there are many other reasons to provide better healthcare to everyone; societal need just isn't a well-reasoned one.

golden1

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Re: ObamaCare Implosion
« Reply #247 on: August 25, 2016, 12:41:23 PM »
The people who are fine in theory about letting old people die because it is too expensive are usually young and in good health themselves and have very little experience with illness or decline.  Would you be willing to sign a legally binding agreement that doctors are not allowed to use any life extending treatments on you past the age of 75-80?  Would you be comfortable convincing your elderly loved ones to sign the same agreement?  Are you comfortable going to a hospital full of sick people, and once you talk to the MDs about which patients will require expensive treatments, could you tell them to their face that it is their time to go? 

shenlong55

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Re: ObamaCare Implosion
« Reply #248 on: August 25, 2016, 12:49:24 PM »
tend to agree with Walt on this one. If you don't like what your taxes are spent on, you can either vote for change, put yourself up as a candidate, or move somewhere else.

I understand that those are the practical options. Those + going to jail for refusal to pay taxes.

Doesn't mean that it isn't crappy that someone is limiting your options like that though.

It seems to me like you have a problem with the concept of a society here.  No person or persons are limiting your options like that, the idea of a society is.  You just can't live within a society without intrinsically reaping the benefits of that society.  Therefore, the only fair option, so long as you are insistent upon staying within said society, is for you to share in the costs of those benefits whether you want them or not.  Because you're going to receive them, whether you want them or not and whether you recognize them or not.

I think you have to decide a fundamental question here.  Is the idea of a "society" evil or not?  Because what your talking about is an unavoidable reality of that idea.

Healthcare above a certain level is not a benefit to society. Society does not benefit, say, from having a huge number of elderly persons survive multiple decades after they stop contributing to the tax base.  Just like roads are great - to a point. No one says we should pave every scrap of land because roads benefit society. A military is great - that doesn't mean that every available dollar should be put into training and housing more troops or aircraft carriers.  At some point there is diminishing returns on societal healthcare, and it becomes a drag on societal progress instead of a net positive.

While a discussion about the societal benefits of various programs would be a great discussion I was not talking about societal benefits here.  I was discussing benefits to individuals.  If an individual lives in a society and that society decides to build roads then that individual is likely to benefit from those roads whether they wanted them or not and whether they use them or not.  The only way for them to avoid benefiting from those roads is for them to physically remove themselves from the society.  That's not something the people in the society decided, that's just a basic fact of societies.  That's why this argument seems so immature to some people, because it makes it seem like people just want to have the benefits of living in a society without any of the cost and then they blame others for this basic fact of reality.

I don't think anyone suggests moving out of the country because it is what they want.  It's just the only way to extricate yourself from the benefits of society and therefore the only way to fairly remove the burden of paying for society.

StarBright

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Re: ObamaCare Implosion
« Reply #249 on: August 25, 2016, 12:54:51 PM »
FWIW - I took Metric Mouse's earlier post to mean that we should seriously question throwing tons of money on life extending medical treatments when someone might benefit more from palliative noncurative care. Maybe that is not what they meant but that is how I took it.

My 93 year old nonni passed two years ago from a metastasized cancer and all of her oncologist's original treatment plans were unlikely efforts to give her another year rather than letting her die with as little pain as possible in a few months. She was actively looking for pain management and comfort rather than life extension and it took a while to convince her doctor of that.

 

Wow, a phone plan for fifteen bucks!