Health Insurance

bdgan

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Oct 12, 2021
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Gone down? No, you're right. Increased at a smaller rate than what we're getting now? Yeah, most likely.
Why do you say that?

The subsidies they're talking about are only for people who purchase their insurance on the exchange.

Insurance through employer isn't impacted.
Medicare isn't impacted.
Medicaid isn't impacted.

We're essentially talking about people who are self employed (who can already deduct their premiums), who work for a small company who doesn't offer insurance, or who are unemployed. In each of those cases it mostly impacts those making 6 figures. For everybody else what you see is what you get.
 

bdgan

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Oct 12, 2021
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All the reason why just extending subsidies is not the right answer to our healthcare, and neither is Medicare for all. Smart people need to throw away their democrat or republican biases and work together on a health care plan that works and that people can afford.
Having the government pay for somebody's premium doesn't reduce the cost of insurance. It just means that somebody else is paying for it.
 
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bdgan

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Oct 12, 2021
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the rates aren't going down even if the subsidies are extended. In fact it's estimated rates could go up by 20%
That's for plans purchased on the marketplace. Employer provided plans, Medigap plans, and Medicare Advantage plans are going up but not by nearly that much.
 

PalmettoTiger1

Heisman
Jan 24, 2009
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I’ve always suggested we pay for it by phasing out social security and reallocating some of the military budget. Will that cover all of it? Probably not, but any tax increase would likely be less than the premiums people pay today plus the elimination of most out of pocket costs.

This would be a net positive, even if taxes increased.
Phase out Social Security

You will never win an election
 

PawPride

Heisman
Nov 28, 2004
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Why do you say that?

The subsidies they're talking about are only for people who purchase their insurance on the exchange.

Insurance through employer isn't impacted.
Medicare isn't impacted.
Medicaid isn't impacted.

We're essentially talking about people who are self employed (who can already deduct their premiums), who work for a small company who doesn't offer insurance, or who are unemployed. In each of those cases it mostly impacts those making 6 figures. For everybody else what you see is what you get.
I'm basing that assumption based on analyses conducted by people much more knowledgeable in this field than me that said the ACA slowed the rate of increase in Medicare spending which kept premiums lower than they would've been without the ACA.* I have no idea if that's completely accurate, but I tend to take the word of people whose job it is to study these things.


*https://www.kff.org/affordable-care-act/what-are-the-implications-of-repealing-the-affordable-care-act-for-medicare-spending-and-beneficiaries/#:~:text=Prior to the ACA, federal,Payment Advisory Commission (MedPAC).&text=The ACA reduced payments to,based bonus payments to plans).

edit: to add, my comment to ned was wrt insurance premiums in general affected by the ACA, not directly related to the subsidies. also, it looks like i misinterpreted his original comment that i responded to so i'm probably talking about peanuts in a discussion about catalytic converters.
 

baltimorened

All-Conference
May 29, 2001
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And as for the points around wait times, stifled innovation, physician talent, etc?
you're assuming that corporate taxes wouldn't offset what they spent for healthcare. The money for your national healthcare plan has to come from somewhere, unless doctors and medical personnel are willing to work for free.

sorry this post should have been to FLAW 47 post
 

FLaw47

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Dec 23, 2010
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you're assuming that corporate taxes wouldn't offset what they spent for healthcare. The money for your national healthcare plan has to come from somewhere, unless doctors and medical personnel are willing to work for free.

sorry this post should have been to FLAW 47 post

Wait, what's the question?
 

FLaw47

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Dec 23, 2010
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just make the assumption my post is the most brilliant in the last six months
The Wire Roland Brice GIF
 

TigerGrowls

Heisman
Dec 21, 2001
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Remember when the insurance industry wrote the Affordable Care Act.
Remember when Nancy Pelosi said they did not need to read the health care bill before passing it.
Remember when they pushed Obamacare through the reconciliation process to avoid the filibuster.
Remember when they spent billions on a government website that never worked.
Remember when Obama said that if you liked your doctor you could keep your doctor.
Remember when they promised healthcare premiums would go down.
Remember when John McCain walked onto the Senate floor and gave his famous thumbs down to ending Obamacare.
Remember when Chief Justice Roberts called the mandate a tax instead of a fine just to save Obamacare.

Well now it is 2025 and Obamacare is a failure.
And the only people who became rich off that scam were the health insurance companies and the politicians who sponsored the bill.

And America is sicker than ever.
 

baltimorened

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May 29, 2001
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What makes you think single payer will bring costs down?
it won't. The hope is that with single payer someone else will pay the majority of their health care. the overall costs don't go down - doctors, hospitals, drugs - only who pays for them
 

baltimorened

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May 29, 2001
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I’ve always suggested we pay for it by phasing out social security and reallocating some of the military budget. Will that cover all of it? Probably not, but any tax increase would likely be less than the premiums people pay today plus the elimination of most out of pocket costs.

This would be a net positive, even if taxes increased.
that's the best way for anything? government run healthcare! We may be able to get somalis to manage it, they seem to do better managing our money than the government officials do
 
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fatpiggy

Heisman
Aug 18, 2002
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it won't. The hope is that with single payer someone else will pay the majority of their health care. the overall costs don't go down - doctors, hospitals, drugs - only who pays for them
As someone who is paying $4,200 a month in health insurance insurance premiums I’m willing to try almost anything.

I have serious doubts something called single payer will work. How is competition encouraged under single payer? If there is no competition, there is no doubt in my mind we will end up with inferior health care with inferior service.
 

FLaw47

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Dec 23, 2010
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it won't. The hope is that with single payer someone else will pay the majority of their health care. the overall costs don't go down - doctors, hospitals, drugs - only who pays for them

Well the idea is that insurance administration costs go down and that it applies downwards pressure on billing rates because of stronger leverage. I feel like it's disengeous to ignore that (but us having single payer, on its own, won't bring us in line with everyone else's costs).
 

FLaw47

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Dec 23, 2010
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As someone who is paying $4,200 a month in health insurance insurance premiums I’m willing to try almost anything.

I have serious doubts something called single payer will work. How is competition encouraged under single payer? If there is no competition, there is no doubt in my mind we will end up with inferior health care with inferior service.

There's not really a whole lot of value in competition on the payer side. What great innovations have our insurance companies provided us, honestly?
 

fatpiggy

Heisman
Aug 18, 2002
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There's not really a whole lot of value in competition on the payer side. What great innovations have our insurance companies provided us, honestly?
The alternative will be worse, if there is no competition. Think it’s bad now? Just wait until there is no incentive to keep prices lower.

While very skeptical, I don’t deny it may be better than our current system. At this point I’d be willing to try. The current system is broken.
 
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baltimorened

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Well the idea is that insurance administration costs go down and that it applies downwards pressure on billing rates because of stronger leverage. I feel like it's disengeous to ignore that (but us having single payer, on its own, won't bring us in line with everyone else's costs).
my wife has a genetic disorder that requires her to have frequent phlobotomies. She is on a Facebook page with people with similar issues all over the world - Europe, Australia, UK, Ireland - places with single payer, government provided healthcare. The comments are something every American should read.....first of all, the care is far from free. Everybody is taxed to pay for it. But, our foreign friends complain that they can't get appointments, or have to wait a year for an appointment. They envy the fact which we consider somewhat basic, that we can get appointments with the proper doctors in a timely fashion.

Our healthcare system is expensive and smart people who might have become doctors are now going into finance, computers, AI...because there's more money, less education cost, better working conditions/hours. Can you imagine the adjustment for doctors when they become government employees.

If our leaders thought single payer was the answer, Bernie Sanders would be in his third term as President
 

fatpiggy

Heisman
Aug 18, 2002
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I think robots are our best chance to bend the curve on health care costs. I think it will have a major effect. Probably still 3-5 years out on basic care and 5-10 years out on major surgeries.

Would love to be wrong on the timelines.
 
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FLaw47

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Dec 23, 2010
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The alternative will be worse, if there is no competition. Think it’s bad now? Just wait until there is no incentive to keep prices lower.

While very skeptical, I don’t deny it may be better than our current system. At this point I’d be willing to try. The current system is broken.

To be clear, single payer is only talking about insurance. Service providers would not be government owned. We already see that Medicare administrative costs are lower than Private Insurance so I'm not sure why we think they would suddenly get worse.

I don't think that single payer is the right fit for our country, though.
 
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FLaw47

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my wife has a genetic disorder that requires her to have frequent phlobotomies. She is on a Facebook page with people with similar issues all over the world - Europe, Australia, UK, Ireland - places with single payer, government provided healthcare. The comments are something every American should read.....first of all, the care is far from free. Everybody is taxed to pay for it. But, our foreign friends complain that they can't get appointments, or have to wait a year for an appointment. They envy the fact which we consider somewhat basic, that we can get appointments with the proper doctors in a timely fashion.

I don't think very many people think "single payer" is truly "free". I also don't agree that healthcare should be "free" at the point of service. I think token copays are actually a good way to ensure that we're at least being thoughtful about our utilization of the system and there's a lot of data that backs this up.

I know that wait times for some things go up but I think this "can never get an appointment" thing is somewhat undermined by the fact that the United States has fewer doctor's visits than the rest of the world.

Sauce:
Americans generally utilize fewer core healthcare services—such as doctor visits and hospital stays—compared to many other high-income countries, despite spending significantly more on care. Higher costs are driven by higher prices for services, administrative waste, and, in some cases, greater use of specialized technology (e.g., MRIs) rather than a higher volume of primary care. [1, 2, 3]


Key Findings on U.S. Healthcare Utilization vs. Other Countries:
  • Fewer Visits: Americans have fewer physician visits per year (approx. 4) than residents in many peer nations, such as Germany or Japan.
  • Lower Hospital Utilization: The U.S. has fewer, albeit shorter, hospital stays compared to many OECD countries.
  • Higher Intensity/Specialized Care: Americans have higher rates of certain specialized, high-cost procedures, such as hip replacements.
  • More Diagnostic Imaging: The U.S. leads in the use of diagnostic imaging, such as MRI and CT scans.
  • Prescription Drugs: Americans use more prescription drugs, with higher prices for these drugs. [1, 3, 4, 5, 6]
Why the Discrepancy?
  • Prices, Not Volume: The main driver of high U.S. health spending is higher prices for services, not more frequent use of them.
  • Access Barriers: Lower utilization of primary care may be linked to a lower supply of general practitioners and higher out-of-pocket costs, despite higher overall spending. [1, 2, 5, 7]
Essentially, Americans spend more money to receive less, or at least less frequent, healthcare compared to their international peers. [3, 8]

AI responses may include mistakes.
[1] https://www.healthsystemtracker.org...nd-use-in-the-u-s-compare-to-other-countries/
[2] https://www.pgpf.org/article/how-does-the-us-healthcare-system-compare-to-other-countries/
[3] https://www.commonwealthfund.org/pr...high-income-nations-has-lower-life-expectancy
[4] https://www.healthsystemtracker.org...nding-in-the-u-s-compared-to-other-countries/
[5] https://www.commonwealthfund.org/pu...20/jan/us-health-care-global-perspective-2019
[6] https://pmc.ncbi.nlm.nih.gov/articles/PMC8579210/
[7] https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/
[8] https://www.bmj.com/content/383/bmj.p2340

Our healthcare system is expensive and smart people who might have become doctors are now going into finance, computers, AI...because there's more money, less education cost, better working conditions/hours. Can you imagine the adjustment for doctors when they become government employees.

Single payer would not have doctor's become government employees. That'd be single provider.

But I don't disagree, I think doctor's salaries in this country are the primary reason our healthcare is so expensive and untying that knot is quite difficult. All I can really think to do is have medical school be heavily government subsidized (in exchange for working in positions of needs, at least temporarily) and not requiring such high salaries to pay back the enormous medschool debt they get.
 

PawPride

Heisman
Nov 28, 2004
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I’m on month two of a waiting list to get an MRI at Roper for a mass on my liver, so it’s not like Wait times are great here in the states
 
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fatpiggy

Heisman
Aug 18, 2002
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I’m on month two of a waiting list to get an MRI at Roper for a mass on my liver, so it’s not like Wait times are great here in the states
There are people on the board / used to be on the board of Roper on Tigerillustrated. You should make a post.
Or if you are willing to to take the help dm me, my best friend is a radiologist at roper or contracts through roper.
 

baltimorened

All-Conference
May 29, 2001
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To be clear, single payer is only talking about insurance. Service providers would not be government owned. We already see that Medicare administrative costs are lower than Private Insurance so I'm not sure why we think they would suddenly get worse.

I don't think that single payer is the right fit for our country, though.
each of the providers be they GP, neurosurgeons, cardiologists have negotiated rates with insurers. Medicaid/Medicare rates are extremely lower that rates for private insurers. For example, I'm on Medicare. My wife had foot surgery, the billed costs was in the $15,000 range, Medicare paid just over $1,000 (that's 80% pay, you need a supplement to pick up the rest or some portion of it). The private insurers pay at significantly higher rates, and I would assume Obamacare does also. So consider single premium/Medicare for all. So, while I don't have all the numbers, if every provider was paid at Medicaid/medicare rates, I'm not sure our system survives financially.

I believe that there are already some hospitals in the Midwest who have closed because they have a predominance of Medicaid/Medicare patients and they weren't generating sufficient money to keep the lights on.
 

PawPride

Heisman
Nov 28, 2004
53,126
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There are people on the board / used to be on the board of Roper on Tigerillustrated. You should make a post.
Or if you are willing to to take the help dm me, my best friend is a radiologist at roper or contracts through roper.
I appreciate that - if it was an emergency I'd probably hit you up, but based on word from my docs it's nothing too serious - probably just a fatty deposit. The MRI is just standard procedure. One of my best friends is an anesthesiologist at Roper, and he said he'd be able to get me a quicker date if it was necessary, but it doesn't seem that pressing.
 
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firegiver

Heisman
Sep 10, 2007
73,258
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I’m on month two of a waiting list to get an MRI at Roper for a mass on my liver, so it’s not like Wait times are great here in the states
You should try Charlotte NC. My kid had a broken foot not showing up on x ray so i demanded an MRI and we got in that week. Damn doctors kept dismissing me and he kept reinjuring it. MRI revealed the fracture.
 

fatpiggy

Heisman
Aug 18, 2002
23,599
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I currently pay $4200 a month for family health insurance.

When the affordable Care act was passed I was paying about $1600 a month.


 
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TigerGrowls

Heisman
Dec 21, 2001
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I think robots are our best chance to bend the curve on health care costs. I think it will have a major effect. Probably still 3-5 years out on basic care and 5-10 years out on major surgeries.

Would love to be wrong on the timelines.
I agree with this. AI and robotics will be doing a lot more in the near future.
 
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