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04/01/2014 06:33:47 PM · #201
Hi everyone! I know its been a long time since I have posted (doesn't mean I haven't been lurking), but this subject always seems to suck me in. Cory, and everyone else who has similar feelings, I understand your frustrations about having to help cover others healthcare costs, but there is so much of the affordable care act that is so important.

I know that I view it in a different light because of how it has affected me, but my story is a prime example of some of the good that it has done. I am 30. I have worked since I was 15. I worked 3 jobs to help put myself through college. I've never used any social services ever- no welfare, no unemployment, nothing. I was diagnosed with cancer at 27. I went through weeks of radiation, spent weeks in an oncology intensive care unit, and now suffer from some pretty bad chronic pain, amongst dozens of other pretty bad side effects. I was insured at the time, thankfully, as my medical bills were in the low million dollar range. I was told, by my doctors, that I should go on disability before I started treatment. I refused, and worked most of the time that I was on treatment (worked remotely, from another state, often laying in a hospital bed). As soon as I was medically cleared, I was back in the office working as much as my body allowed. It didn't allow much, and unfortunately, finding an employer that understands my conditions is not an easy feat. My prognosis is constantly changing, including, at one point, being told I have a year left to live (this has since changed, and my outlook is good right now). Because of the affordable care act, I have been able to maintain insurance coverage, though I am currently purchasing it myself right now- AND NOT THROUGH ANY SUBSIDIES. YOU ARE NOT PAYING A DAMN CENT FOR MY INSURANCE. But, since the end of my treatment, I have racked up a hefty mid six figures worth of bills being sent to my insurance. Without the affordable care act, I would be sunk. I am a prime example of the success of this bill. I've done everything right. I have worked hard, fought the good fight, and my only fault is a fluke in my freaking body that I cannot control.

I'm beginning to believe that the majority of people who are so against this bill have never had the misfortune to struggle so personally. I'm glad you're life appears to be so blessed.

/rant
04/01/2014 06:55:15 PM · #202
Originally posted by DrAchoo:

Originally posted by Kelli:

My aunt, who's in her early 60's and who has also been without insurance for the past 8 years got an awesome plan for $58/month. $10 copays at the doctor, $7 prescriptions, $750 total out of pocket maximum. My medicare plan can't touch this and I'm paying $140/month.


Looking at specific stories is generally not a great way to decide what is the best course of action for society. I am happy for her. You are aware that her premium is so low because other people are paying part of the premium for her, right? We haven't magically made health care cost $58/month, it's just that your aunt only pays $58 of the price.

Thanks for those bullet points in your other post. They were helpful. I didn't think about people who signed up outside the exchanges. They would be added to the number of newly insured.

EDIT: Argh. I went to your link and was immediately turned off by the byline "real liberal politics". That doesn't make the statements untrue, but one does now worry about selective reporting and/or bias. Even then, the headline seems to bump the number up from only 7 million to "nearly 10 million". Not a large increase and, I assume, that's the best case scenario.


Would an article from Forbes make you less skeptical? //www.forbes.com/sites/rickungar/2014/03/10/the-real-numbers-on-the-obamacare-effect-are-in-now-let-the-crow-eating-begin/
04/01/2014 07:04:18 PM · #203
Originally posted by Cory:

Originally posted by Kelli:


Why? Her husband had a stroke. He's now disabled and on medicare. She worked when she was young, before she had kids then was a stay at home mother after that. They've lost everything. Their savings, their home. Why would you begrudge her coverage?


Look, I feel for her, but in the end life's kinda like that - you can't always win... But when you try to make sure everyone wins the only realistic outcome is that everyone loses.

The fact is that we're lessening the impact of bad choices, while devaluing the benefit of making good choices.. Frankly I have an ex who has three kids with three different men, all of whom are in jail or unemployed, and she's doing at least as well as I am while earning minimum wage and working 30 hours a week.... Is that supposed to be perceived as fair? It certainly doesn't strike me as being so, and this is just another small tentacle of the same issue.

So don't think it's something personal towards your aunt, it's simply the observation that our system is actively rewarding irresponsible decision making while punishing responsible decision making.


I'm sure you're not directing the "bad choices" comments at my aunt, but I just can't seem to get past it. How in the world could a stroke be a part of making bad choices? This is a man who worked for the same company for 30+ years until they moved their operation to Mexico. He lost a good paying job and immediately began working 2 & 3 jobs to make less then half what he made at the one he lost. They went through their savings trying to keep their home, feed their family and keep their daughter in college. He became diabetic, lost so much weight we thought he had cancer then had a terrible stroke. While waiting for disability, and under the weight of crushing medical bills they lost their house with only about 3 years left on their mortgage. Where exactly is the bad choice?
04/01/2014 07:10:48 PM · #204
Originally posted by Kelli:

Would an article from Forbes make you less skeptical? //www.forbes.com/sites/rickungar/2014/03/10/the-real-numbers-on-the-obamacare-effect-are-in-now-let-the-crow-eating-begin/


I do have a little less automatic concern about Forbes (although, frankly, one does well to have concern with EVERY article they read.) The numbers reported are lower. You saw that, right?

"The Gallup-Healthways Well-Being Index is out this morning and reveals that 15.9 percent of American adults are now uninsured, down from 17.1 percent for the last three months of 2013 and has shown improvements in every major demographic group with the exception of Hispanics who did not advance.

That translates roughly to 3 million to 4 million people getting coverage who did not have it before."

Message edited by author 2014-04-01 19:11:31.
04/01/2014 07:13:56 PM · #205
amathiasphoto, it's a false conclusion to assume that if someone is "against the ACA" they "don't care" or "haven't been there". Arguments can be much more nuanced then that.
04/01/2014 07:18:27 PM · #206
Originally posted by DrAchoo:

Originally posted by Kelli:

Would an article from Forbes make you less skeptical? //www.forbes.com/sites/rickungar/2014/03/10/the-real-numbers-on-the-obamacare-effect-are-in-now-let-the-crow-eating-begin/


I do have a little less automatic concern about Forbes (although, frankly, one does well to have concern with EVERY article they read.) The numbers reported are lower. You saw that, right?

"The Gallup-Healthways Well-Being Index is out this morning and reveals that 15.9 percent of American adults are now uninsured, down from 17.1 percent for the last three months of 2013 and has shown improvements in every major demographic group with the exception of Hispanics who did not advance.

That translates roughly to 3 million to 4 million people getting coverage who did not have it before."


That 3 to 4 million is only for the past 3 months. Unless I'm reading it wrong.

"The Gallup-Healthways Well-Being Index is out this morning and reveals that 15.9 percent of American adults are now uninsured, down from 17.1 percent for the last three months of 2013 and has shown improvements in every major demographic group with the exception of Hispanics who did not advance.

That translates roughly to 3 million to 4 million people getting coverage who did not have it before.

According to Gallup, the number of Americans who still do not have health insurance coverage is on track to reach the lowest quarterly number since 2008."
04/01/2014 07:19:13 PM · #207
Dr, you're absolutely right. That comment, honestly, was directed squarely at Cory for his "The fact is that we're lessening the impact of bad choices, while devaluing the benefit of making good choices" comment. I know that my comment was by no means accurate, and I apologize if I offended.
04/01/2014 07:34:36 PM · #208
Originally posted by amathiasphoto:

Dr, you're absolutely right. That comment, honestly, was directed squarely at Cory for his "The fact is that we're lessening the impact of bad choices, while devaluing the benefit of making good choices" comment. I know that my comment was by no means accurate, and I apologize if I offended.


No. I'm not offended. I don't even really qualify for the typical "against ACA" group. I want it to succeed, but I just don't think it's working as planned yet (not a surprise).
04/01/2014 07:38:48 PM · #209
Originally posted by Kelli:

That 3 to 4 million is only for the past 3 months. Unless I'm reading it wrong.


Good spot. So they don't list a total number. But 3-4 months gets us back to January. The ACA exchange only rolled out in, what, October? We can't really have a substantial number to add for the previous time. But still, good to point out the reported number was "apples and oranges" in exactly what it was reporting compared to your other site.

Frankly what I wish is we lived in a society where people can admit things aren't going as well as hoped. I think the feeling is if we admit that we somehow either betray "our side" or, worse, admit the "other side" is completely correct. Neither is true. I think most people are disappointed with how things have gone so far (outside of the "winners" in stories like your aunt or amathiasphoto who are obviously very pleased) and the ones cheering unabashedly are the typical kool-aid drinkers who would cheer regardless because that's what they are expected to do.

Message edited by author 2014-04-01 19:39:00.
04/01/2014 08:11:31 PM · #210
Originally posted by DrAchoo:

Originally posted by Kelli:

That 3 to 4 million is only for the past 3 months. Unless I'm reading it wrong.


Good spot. So they don't list a total number. But 3-4 months gets us back to January. The ACA exchange only rolled out in, what, October? We can't really have a substantial number to add for the previous time. But still, good to point out the reported number was "apples and oranges" in exactly what it was reporting compared to your other site.

Frankly what I wish is we lived in a society where people can admit things aren't going as well as hoped. I think the feeling is if we admit that we somehow either betray "our side" or, worse, admit the "other side" is completely correct. Neither is true. I think most people are disappointed with how things have gone so far (outside of the "winners" in stories like your aunt or amathiasphoto who are obviously very pleased) and the ones cheering unabashedly are the typical kool-aid drinkers who would cheer regardless because that's what they are expected to do.


Exactly. I don't actually even have a horse in this race right now, as I'm on medicare. But I still struggle with healthcare costs on a regular basis and hope that things can only get better.
04/01/2014 09:07:23 PM · #211
Originally posted by Kelli:

Originally posted by cgino:

Originally posted by Cory:

Originally posted by Kelli:

My aunt, who's in her early 60's and who has also been without insurance for the past 8 years got an awesome plan for $58/month. $10 copays at the doctor, $7 prescriptions, $750 total out of pocket maximum. My medicare plan can't touch this and I'm paying $140/month.


Yeah... Awesome isn't it. She should probably send a thank you letter to all the hard working folks who are paying 8x that per month so that she doesn't have to.

I don't mean to be offensive here, but stories like that are only serving to further upset me.


You nailed it with the 8x, Cory. I'm 59, work my ass off at 2 to 3 jobs (which definitely do NOT leave me rich), have been without coverage for the past eight years, and the best deal I could find was about $475/ month with a $6000 deductible. Seriously? That sucks.

Kelli, I'm sorry for your aunt's situation and I don't begrudge her coverage, but I sure as shit don't think that paying a $5700 premium then $6000 out of pocket each year before coverage kicks is in any stretch of the imagination "affordable".


When I was working I paid $800/month for my coverage through my employer. According to them, that was half. When my job got offshored, they offered me cobra @$2k a month (which was more than my unemployment). Seriously, this was 7 years ago. So, I really don't think your premiums are unaffordable if you're working 2 or 3 jobs.


12K a year for normal care isn't, by any stretch, affordable. Maybe we should have called this the "Communist Health Care Act"
04/01/2014 09:28:24 PM · #212
Originally posted by Cory:

Originally posted by Kelli:

Originally posted by cgino:

Originally posted by Cory:

Originally posted by Kelli:

My aunt, who's in her early 60's and who has also been without insurance for the past 8 years got an awesome plan for $58/month. $10 copays at the doctor, $7 prescriptions, $750 total out of pocket maximum. My medicare plan can't touch this and I'm paying $140/month.


Yeah... Awesome isn't it. She should probably send a thank you letter to all the hard working folks who are paying 8x that per month so that she doesn't have to.

I don't mean to be offensive here, but stories like that are only serving to further upset me.


You nailed it with the 8x, Cory. I'm 59, work my ass off at 2 to 3 jobs (which definitely do NOT leave me rich), have been without coverage for the past eight years, and the best deal I could find was about $475/ month with a $6000 deductible. Seriously? That sucks.

Kelli, I'm sorry for your aunt's situation and I don't begrudge her coverage, but I sure as shit don't think that paying a $5700 premium then $6000 out of pocket each year before coverage kicks is in any stretch of the imagination "affordable".


When I was working I paid $800/month for my coverage through my employer. According to them, that was half. When my job got offshored, they offered me cobra @$2k a month (which was more than my unemployment). Seriously, this was 7 years ago. So, I really don't think your premiums are unaffordable if you're working 2 or 3 jobs.


12K a year for normal care isn't, by any stretch, affordable. Maybe we should have called this the "Communist Health Care Act"


I think you are missing my point. 7 years ago I was paying almost 10k a year in premiums. While it was an HMO, so I didn't have a deductible, I did still have co-pays. You act like this is something new. Insurance rates have been out of control for years. It seemed when I was working, my rates soared each and every year. So a 2k difference from what I was paying 7 years ago seems about right (or maybe even less than I thought it would be). It's a relative number number because what you are making determines what you are paying. 12k is a drop in the bucket for some. For others, it's a years salary.

The real action needed is either insurance reform or better yet, take the insurance companies out of the picture and go to a single payer system like the rest of the civilized world.
04/01/2014 09:43:04 PM · #213
Originally posted by Kelli:

Originally posted by Cory:

Originally posted by Kelli:

When I was working I paid $800/month for my coverage through my employer. According to them, that was half. When my job got offshored, they offered me cobra @$2k a month (which was more than my unemployment). Seriously, this was 7 years ago. So, I really don't think your premiums are unaffordable if you're working 2 or 3 jobs.


12K a year for normal care isn't, by any stretch, affordable. Maybe we should have called this the "Communist Health Care Act"


I think you are missing my point. 7 years ago I was paying almost 10k a year in premiums. While it was an HMO, so I didn't have a deductible, I did still have co-pays. You act like this is something new. Insurance rates have been out of control for years. It seemed when I was working, my rates soared each and every year. So a 2k difference from what I was paying 7 years ago seems about right (or maybe even less than I thought it would be). It's a relative number number because what you are making determines what you are paying. 12k is a drop in the bucket for some. For others, it's a years salary.

The real action needed is either insurance reform or better yet, take the insurance companies out of the picture and go to a single payer system like the rest of the civilized world.


Ok, so, first, no deductible, that's the first major difference. No doubt about it, another $6-7k a year is significant. What about the co-pay? Was that also fairly low? (I just had a 60% copay on surgery I had a couple of weeks ago)

Secondly, are you telling me that YOU payed that for YOUR insurance, or was this a family plan that covered more than just yourself? Because that's also a fairly significant difference. Also, did you have any pre-existing conditions?

Yes, insurance rates HAVE been out of control for years, as have profits.. The problem with our current laws, and what makes them different from the rest of the world (as Ray asked about), is that our laws require us to do business with a private, for profit, company that is not structured anything at all like other countries universal health care systems are.

Finally, you're ABSOLUTELY right about the fact that our system actively punishes those who are working, like you said, when you were working your rates soared... Clearly you've figured it out, you're WAY better off now not trying to earn a living, but instead just taking what you're given... I absolutely understand that, and don't at all fault you or your aunt for that. My entire point is that I fault THE SYSTEM for that, if you make it the best choice for someone, of course they're going to take advantage of it, it's normal human behavior. Give me a nice steak dinner for $5 or a crappy hamburger for $50 and I'll choose the steak every damned time.

So in the end, we absolutely agree on the large points here, even if we might disagree on some of the finer points - what we actually need is real reform, not this mess.
04/01/2014 09:48:44 PM · #214
Here... This is a video explanation of why I have issues with what we're doing...

Granted, this is a bit of an extreme example, but it should make the whole thing reasonably clear for everyone, no matter how liberal they are.
04/01/2014 10:04:15 PM · #215
Originally posted by DrAchoo:

You are aware that her premium is so low because other people are paying part of the premium for her, right?

You are aware that this is how insurance works, and as long as our health care is paid for by profit-making insurance go-betweens it will.

Doesn't anybody remember how "broken" our health care system was before? Double-digit rate increases every year, dropped coverage when you got sick (if you could get coverage, after having had acne as a kid), limitations on practitioners, caps on benefits, denials of benefits ...
04/01/2014 10:04:39 PM · #216
Originally posted by Cory:

Originally posted by Kelli:

Originally posted by Cory:

Originally posted by Kelli:

When I was working I paid $800/month for my coverage through my employer. According to them, that was half. When my job got offshored, they offered me cobra @$2k a month (which was more than my unemployment). Seriously, this was 7 years ago. So, I really don't think your premiums are unaffordable if you're working 2 or 3 jobs.


12K a year for normal care isn't, by any stretch, affordable. Maybe we should have called this the "Communist Health Care Act"


I think you are missing my point. 7 years ago I was paying almost 10k a year in premiums. While it was an HMO, so I didn't have a deductible, I did still have co-pays. You act like this is something new. Insurance rates have been out of control for years. It seemed when I was working, my rates soared each and every year. So a 2k difference from what I was paying 7 years ago seems about right (or maybe even less than I thought it would be). It's a relative number number because what you are making determines what you are paying. 12k is a drop in the bucket for some. For others, it's a years salary.

The real action needed is either insurance reform or better yet, take the insurance companies out of the picture and go to a single payer system like the rest of the civilized world.


Ok, so, first, no deductible, that's the first major difference. No doubt about it, another $6-7k a year is significant. What about the co-pay? Was that also fairly low? (I just had a 60% copay on surgery I had a couple of weeks ago)

Secondly, are you telling me that YOU payed that for YOUR insurance, or was this a family plan that covered more than just yourself? Because that's also a fairly significant difference. Also, did you have any pre-existing conditions?

Yes, insurance rates HAVE been out of control for years, as have profits.. The problem with our current laws, and what makes them different from the rest of the world (as Ray asked about), is that our laws require us to do business with a private, for profit, company that is not structured anything at all like other countries universal health care systems are.

Finally, you're ABSOLUTELY right about the fact that our system actively punishes those who are working, like you said, when you were working your rates soared... Clearly you've figured it out, you're WAY better off now not trying to earn a living, but instead just taking what you're given... I absolutely understand that, and don't at all fault you or your aunt for that. My entire point is that I fault THE SYSTEM for that, if you make it the best choice for someone, of course they're going to take advantage of it, it's normal human behavior. Give me a nice steak dinner for $5 or a crappy hamburger for $50 and I'll choose the steak every damned time.

So in the end, we absolutely agree on the large points here, even if we might disagree on some of the finer points - what we actually need is real reform, not this mess.


That 12k figure she gave was including her deductible. Her premium was $5700/year. My premium 7 years ago was $10k. I definitely put out at least $2k a year in co-pays. I paid $40 to see a doctor and 50% on prescriptions. And yes, I did have pre-existing conditions, but they weren't relevant to my premiums since it was an HMO. All of my coworkers paid the same rates.

As for your video. You need to realize, not everyone is out to game the system. Yes, they exist. I even know some. But, there really are people in the world incapable of working. My aunts husband can't even go to the wawa in their town (about 10 blocks away) without getting lost. His brain damage is considered severe enough that he isn't even allowed to handle his own money. It isn't a matter of not wanting to work. Trust me, especially for people that have worked most of their lives, it's not a choice to be disabled.
04/01/2014 10:13:43 PM · #217
Originally posted by amathiasphoto:

Hi everyone! I know its been a long time since I have posted (doesn't mean I haven't been lurking), but this subject always seems to suck me in. Cory, and everyone else who has similar feelings, I understand your frustrations about having to help cover others healthcare costs, but there is so much of the affordable care act that is so important.

I know that I view it in a different light because of how it has affected me, but my story is a prime example of some of the good that it has done. I am 30. I have worked since I was 15. I worked 3 jobs to help put myself through college. I've never used any social services ever- no welfare, no unemployment, nothing. I was diagnosed with cancer at 27. I went through weeks of radiation, spent weeks in an oncology intensive care unit, and now suffer from some pretty bad chronic pain, amongst dozens of other pretty bad side effects. I was insured at the time, thankfully, as my medical bills were in the low million dollar range. I was told, by my doctors, that I should go on disability before I started treatment. I refused, and worked most of the time that I was on treatment (worked remotely, from another state, often laying in a hospital bed). As soon as I was medically cleared, I was back in the office working as much as my body allowed. It didn't allow much, and unfortunately, finding an employer that understands my conditions is not an easy feat. My prognosis is constantly changing, including, at one point, being told I have a year left to live (this has since changed, and my outlook is good right now). Because of the affordable care act, I have been able to maintain insurance coverage, though I am currently purchasing it myself right now- AND NOT THROUGH ANY SUBSIDIES. YOU ARE NOT PAYING A DAMN CENT FOR MY INSURANCE. But, since the end of my treatment, I have racked up a hefty mid six figures worth of bills being sent to my insurance. Without the affordable care act, I would be sunk. I am a prime example of the success of this bill. I've done everything right. I have worked hard, fought the good fight, and my only fault is a fluke in my freaking body that I cannot control.

I'm beginning to believe that the majority of people who are so against this bill have never had the misfortune to struggle so personally. I'm glad you're life appears to be so blessed.

/rant


I don't disagree with anything you've said. Other than your confidence that I've never struggled, you've got all of that pretty much right - except for the fact that we're settling for something that costs more than it should for less coverage than we should get. Profits are still being made, and those profits are pretty sweet. That HAS to change before I support this.

Also, your story IMO, qualifies you for top level care, not only for what you HAVE done, but for the fact that you are the type that will continue to earn their way and try to add value to the world. No problem with that here.

Now, with that being said, are you honestly so naive as to think that your story is, in any way, normal or average? I think you are very much exceptional.
04/01/2014 10:22:52 PM · #218
Originally posted by Kelli:

Originally posted by Cory:

Originally posted by Kelli:

Originally posted by Cory:

Originally posted by Kelli:

When I was working I paid $800/month for my coverage through my employer. According to them, that was half. When my job got offshored, they offered me cobra @$2k a month (which was more than my unemployment). Seriously, this was 7 years ago. So, I really don't think your premiums are unaffordable if you're working 2 or 3 jobs.


12K a year for normal care isn't, by any stretch, affordable. Maybe we should have called this the "Communist Health Care Act"


I think you are missing my point. 7 years ago I was paying almost 10k a year in premiums. While it was an HMO, so I didn't have a deductible, I did still have co-pays. You act like this is something new. Insurance rates have been out of control for years. It seemed when I was working, my rates soared each and every year. So a 2k difference from what I was paying 7 years ago seems about right (or maybe even less than I thought it would be). It's a relative number number because what you are making determines what you are paying. 12k is a drop in the bucket for some. For others, it's a years salary.

The real action needed is either insurance reform or better yet, take the insurance companies out of the picture and go to a single payer system like the rest of the civilized world.


Ok, so, first, no deductible, that's the first major difference. No doubt about it, another $6-7k a year is significant. What about the co-pay? Was that also fairly low? (I just had a 60% copay on surgery I had a couple of weeks ago)

Secondly, are you telling me that YOU payed that for YOUR insurance, or was this a family plan that covered more than just yourself? Because that's also a fairly significant difference. Also, did you have any pre-existing conditions?

Yes, insurance rates HAVE been out of control for years, as have profits.. The problem with our current laws, and what makes them different from the rest of the world (as Ray asked about), is that our laws require us to do business with a private, for profit, company that is not structured anything at all like other countries universal health care systems are.

Finally, you're ABSOLUTELY right about the fact that our system actively punishes those who are working, like you said, when you were working your rates soared... Clearly you've figured it out, you're WAY better off now not trying to earn a living, but instead just taking what you're given... I absolutely understand that, and don't at all fault you or your aunt for that. My entire point is that I fault THE SYSTEM for that, if you make it the best choice for someone, of course they're going to take advantage of it, it's normal human behavior. Give me a nice steak dinner for $5 or a crappy hamburger for $50 and I'll choose the steak every damned time.

So in the end, we absolutely agree on the large points here, even if we might disagree on some of the finer points - what we actually need is real reform, not this mess.


That 12k figure she gave was including her deductible. Her premium was $5700/year. My premium 7 years ago was $10k. I definitely put out at least $2k a year in co-pays. I paid $40 to see a doctor and 50% on prescriptions. And yes, I did have pre-existing conditions, but they weren't relevant to my premiums since it was an HMO. All of my coworkers paid the same rates.

As for your video. You need to realize, not everyone is out to game the system. Yes, they exist. I even know some. But, there really are people in the world incapable of working. My aunts husband can't even go to the wawa in their town (about 10 blocks away) without getting lost. His brain damage is considered severe enough that he isn't even allowed to handle his own money. It isn't a matter of not wanting to work. Trust me, especially for people that have worked most of their lives, it's not a choice to be disabled.


Ok, so, first, I don't know how your HMO worked, but when we had one at our company, our rate was rather high because of our median age, and several pre-existing conditions. It was very noticeable because of the size of our company, but I think it's very likely that your insurance premium was higher because of your conditions. And of course, as you said, your co-workers rates were the same as yours - in other words, they were each covering part of the extra cost.

Next, you didn't mention if that was an individual policy, did it only cover you, or was there family on that policy as well? Clearly that's a big deal.

Of course I realize that not everyone is out to game the system. But I equally realize that there are a significant number who are out to game the system, and furthermore I recognize that what we are doing right now is not sustainable.

As for your disabled uncle, I find it very strange that he's not on SSDI and medicare. Not meaning to pry, but what the heck is up with that? We've long had social programs to help the genuinely disabled (even if I do think they are also gamed too damned often by cheaters).. Those programs are nothing new.

04/01/2014 10:40:53 PM · #219
The plan was a family plan myself and my 2 kids. My husband had his own plan through his work or it would have cost more. But the HMO's here weren't able to discriminate, everyone got the same rate. They never even asked about medical history.

He is on SSDI and medicare. But, because my aunt isn't yet 65 it doesn't cover her. With his work history he gets a decent amount. In 2 years when he turns 65 it will switch over to straight SS.

edit to add: After his stroke it took over a year for the disability to get processed. That was a full year with absolutely no income coming into their household.

one more edit: The company that I worked at had well over 1000 employees.

Message edited by author 2014-04-01 22:45:45.
04/01/2014 11:04:45 PM · #220
Originally posted by Kelli:

The plan was a family plan myself and my 2 kids. My husband had his own plan through his work or it would have cost more. But the HMO's here weren't able to discriminate, everyone got the same rate. They never even asked about medical history.

He is on SSDI and medicare. But, because my aunt isn't yet 65 it doesn't cover her. With his work history he gets a decent amount. In 2 years when he turns 65 it will switch over to straight SS.

edit to add: After his stroke it took over a year for the disability to get processed. That was a full year with absolutely no income coming into their household.

one more edit: The company that I worked at had well over 1000 employees.


Ok, so all of that more or less makes sense.

Firstly, I've just gotta point out that your mention of your uncle was a total red herring... (bad Kelli!) :)

More importantly, one big point you made was about that year of purgatory - this is something that is absolutely true and horrible, and it's an issue with unemployment as well (to a lesser degree of course), essentially there is no safety net, once you can take advantage of the programs that are in place you've already fallen so far that your chances of full recovery of previous status is extremely unlikely. It's absolutely mad.

As for your edit - the fact that you had an HMO with 1k+ employees is a HUGE help. Try getting sick on an HMO with 20 employees - everyone feels the pain much more acutely.

--

Again though, we really do agree on the big points here, we still have a rather broken system that needs fixed... It's just the smaller point of the cost/benefit ratio of our current system upon which we don't exactly agree. It's a bit like riding around in a ghetto whip and trying to decide if it's just good that we've got a car at all, or if we should complain about the tread-free tires or the knocking engine that spews smoke like a mosquito fogger. ;)
04/01/2014 11:16:17 PM · #221
Originally posted by Cory:

Originally posted by Kelli:


Why? Her husband had a stroke. He's now disabled and on medicare. She worked when she was young, before she had kids then was a stay at home mother after that. They've lost everything. Their savings, their home. Why would you begrudge her coverage?


Look, I feel for her, but in the end life's kinda like that - you can't always win... But when you try to make sure everyone wins the only realistic outcome is that everyone loses.

The fact is that we're lessening the impact of bad choices, while devaluing the benefit of making good choices.. Frankly I have an ex who has three kids with three different men, all of whom are in jail or unemployed, and she's doing at least as well as I am while earning minimum wage and working 30 hours a week.... Is that supposed to be perceived as fair? It certainly doesn't strike me as being so, and this is just another small tentacle of the same issue.

So don't think it's something personal towards your aunt, it's simply the observation that our system is actively rewarding irresponsible decision making while punishing responsible decision making.


So, you'd rather pay for her healthcare via higher costs and bills when people like her wait until they're sick enough to go to the ER instead of taking preventative measures for less by going earlier to a physician or health clinic?

Or do you view health as a crapshoot where, if the poor get sick, it should just be "Tough luck, try to die quietly and not to make too much ruckus." That seems to be the only alternative to the ACA that I've heard from Republicans you want to endorse out of spite. Then again, the most controversial parts of the ACA itself were lifted from the Heritage Foundation's playbook and I'd hardly paint them with the same political brush as the president.


Message edited by author 2014-04-01 23:19:41.
04/02/2014 12:56:39 AM · #222
Originally posted by Spork99:

Originally posted by Cory:

...

So don't think it's something personal towards your aunt, it's simply the observation that our system is actively rewarding irresponsible decision making while punishing responsible decision making.


So, you'd rather pay for her healthcare via higher costs and bills when people like her wait until they're sick enough to go to the ER instead of taking preventative measures for less by going earlier to a physician or health clinic?

Or do you view health as a crapshoot where, if the poor get sick, it should just be "Tough luck, try to die quietly and not to make too much ruckus." That seems to be the only alternative to the ACA that I've heard from Republicans you want to endorse out of spite. Then again, the most controversial parts of the ACA itself were lifted from the Heritage Foundation's playbook and I'd hardly paint them with the same political brush as the president.


Ok, so one point at a time here.

First, the whole "So, you'd rather pay for....than..." bit is a total false dichotomy.. But, yes... I support them having access to preventive care. However, like the other things you get when you cannot pay for them yourself, I think they should not receive the same services as those who pay for the service they receive. Would you support giving the homeless million dollar condos and yachts? Do soup kitchens serve filet mignon? The simple fact is that yes, I do think those who have earned the means to pay for their services should have a better experience. And I cannot and will not apologise for that, otherwise wtf do I bust my ass for? Why did I go to college and avoid having children? I chose those things because I want a better quality of life, and legislation like this really screws with that balance and it does upset me.

As for how I view healthcare - you've boxed me in again, perhaps unintentionally. I don't support your suggested hypothetical practice, however, I also do not support massively expensive treatments on publicly funded insurance which are at best band-aids, and at worst a sugar pill, a placebo. I would strongly prefer that more reasonable amounts were spent on palliative care and counseling. Now, take all those savings and two things can happen, first, you can provide better care to those who are mildly ill or even provide more preventive care for the relatively healthy; the second benefit would be simple cost savings, drop those massive hail-mary end of life expenditures and even more people can afford insurance.

Sorry, but if you want crazy coverage like that you should need to buy a hail-mary rider, and I don't care to subsidize that, ever. So in short, preventive care yes, palliative care yes, platinum care no. If you want to drive a Ferrari you earn it, if you want top end medical coverage, you should damned well have to earn that too.

Message edited by author 2014-04-02 00:57:32.
04/02/2014 02:54:35 AM · #223
Things seem to work fine here, i pay €40 a month for a complimentry insurance but even if I didn't have it, I would be covered for all major things and I'd have 60% coverage on everything else.

Man becomes great exactly in the degree in which he works for the welfare of his fellow men.
Mohandas K. Gandhi
04/02/2014 03:10:49 AM · #224
Originally posted by jagar:

Things seem to work fine here, i pay €40 a month for a complimentry insurance but even if I didn't have it, I would be covered for all major things and I'd have 60% coverage on everything else.

Man becomes great exactly in the degree in which he works for the welfare of his fellow men.
Mohandas K. Gandhi


Here, people would just complain about the 40% copay, demanding that all preventative care should be totally free like major medical, because it helps to avoid the cost of major medical.

And while I'm sure it works fine there, what you don't have is multiple layers of unneeded complexity, which we have in abundance. What Gandhi failed to mention was that having a group of corrupt middlemen who make a profit off of said welfare changes the game - and I really doubt he could even imagine the entitlement mentality some folks here are afflicted with. Remember that Gandhi was all about education and hard work - he directly spoke against "wealth without work", and frankly I'm pretty certain he would say that you need to earn your way and not expect others to pay for what you should earn. (ETA: Found a good quote that strongly supports this argument, see below)

You and I aren't likely to agree on what is good, given that you're about as conservative as our president, but surely even you recognize that the current state of affairs here has little resemblance to the system there. Furthermore, I'm jealous, it sounds like your system actually does work MUCH better than ours.

A few questions:
Can you choose to see whatever doctor you want? (within reason of course, clearly a referral is appropriate for specialist services)
Are your hospitals allowed to charge for services like ours are? ($5 for a tiny paper cup and $40 for a sharpie, see "Charge Master")
Do you get medications much cheaper than we do in the US? I know Canadians pay FAR less for the same drugs.
How much of your actual taxes go to pay for this? What's the REAL cost to you as a citizen?

--

“All have not the same capacity. I would allow a man of intellect to earn more, I would not cramp his talent.”
- Mahatma Gandhi

“Why should I, who have no need to work for food, spin? ' may be the question
asked. Because I am eating what does not belong to me. I am living on the
spoliation of my countrymen. Trace the source of every coin that finds its way
into your pocket, and you will realise the truth of what I write. Every one
must spin.”
- Mahatma Gandhi

“Disease increases in proportion to the increase in the number of doctors in a place.”
- Mahatma Gandhi

Message edited by author 2014-04-02 03:52:04.
04/02/2014 05:53:31 AM · #225
"You and I aren't likely to agree on what is good, given that you're about as conservative as our president" what's that mean Cory ?

Some people are not as courageous as others, some people are more skillful, some people are more fortunate, some people are less disciplined than others, some people are fragile emotionally while others are as solid as rocks and some are just downright selfish. A vast web different beings and it's our job to love them all. Happiness is not an individual matter.
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