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Interested to read Sup. Ct. healthcare decision

Discussion in 'Parents Off Topic' started by virgo39, Jun 28, 2012.

  1. hawkeyegirl

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    Well, and in most countries with universal healthcare, the government provides a basic plan, and then those who can afford it buy supplemental policies. It's pretty similar to the way that Medicare works right now. So people get the basics covered, and then they look at supplemental plans to choose the one that best fits their needs and budget. You want a CGM? Choose a plan that covers CGMs.

    As it stands in the U.S., most people don't have any choice at all with respect to their health insurance. They get a job, and that is their health insurance. Period. Sure, you can leave that job and get a different job with better benefits, but (1) good luck comparing the two plans before you have the job; and (2) in this economy, good luck getting that other job in the first place. And, of course, if you lose that job (or if you get divorced, or if your spouse dies), bye-bye health insurance. Yeah, we have COBRA, but most folks can't afford to pay 105% of their premiums, even on a short-term basis, especially if they've just lost their job.

    I'm a lawyer, and often times the most difficult part to deal with in the divorces that I do is what to do about the (usually) wife's health insurance needs. Unless she is disabled and qualifies for SSDI, she is frankly often SOL when it comes to health insurance until she reaches age 65. Tying health insurance to employment is just a bad system, resulting in a whole lot of uncovered people, and I don't think we as a country should tolerate that.
     
  2. MommaKat

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    Except for the uninsured (at least the ones who actually do try to make payments or end up in collections.) They are charged those inflated beginning level costs you mention that the insurance companies than negotiate down from. Hospitals and doctors offices do not routinely offer to reduce costs for cash pay patients, and only if paid in full up front, which most uninsured simply cannot do. So, being charged the ridiculously inflated charge for basic, emergent, or acute care, many end up in collections and face a lifetime of medical debt that colors every facet of life. I watched it as a nurse, have experienced it as a single mom, and it is an untenable situation. It also drives the majority of care being sought on an emergent / acute basis rather than through prevention and well care.

    Swellman, thanks for posting that, I wanted to link to the site, but you covered it way better.

    Sorry, but that's just not going to happen. The Patient Protection and Affordable Health Care Act is and does many things, but it is not socialized medicine, and it does not remove the insurance or pharmaceutical industries from the free market.

    The Forbes article Christopher linked to makes the claim based on this section of the ACA.

    However, the CBO and industry analysts do not see the contention made in Forbes as holding true.
     
  3. MommaKat

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    As for the concern about this being socialized or government run health care - it's not. The insurance exchange is open to for profit and non profit insurance providers that want to apply to become part of the exchange, and also allows for continuation of the individual market. It's still a free market system, but there are some regulatory components to prevent gross misuse of funds and mistreatment of insured who become ill. See the following:

    The above comes from the Kaiser Family Foundations summary of the PP & ACA legislation. There are also three pages on the measures taken / instituted for cost containment, and nearly seven pages summarizing steps and programs implemented to strengthen preventative services and well care because that is where we're going to see savings in health care costs primarily.
     
  4. MommaKat

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    Sorry, the link to the summary was cut off:
    http://www.kff.org/healthreform/upload/8061.pdf

    While I've never championed this as the best possible approach to the dual crises of access to and affordability of health care, it is the best possible solution that's been offered thus far, and likely the only solution that will work given conservative opposition to truly universal healthcare. The idea that this is national health care, government run health care, or an extreme tax hike is unequivocally incorrect. Getting the majority to believe such misstatements is nothing more than politically expedient for conservative politicians, and they recognize the emotional pull of those assertions. (Just as some liberal politicians have found it politically expedient to let citizens believe this is equivalent to or a step toward universal coverage.) More importantly, both political parties rely on the majority accepting what they're told about this legislation rather than researching and learning what they can on their own through independent analysis of the law. It isn't perfect, but it's both the best we're gonna get and very, very necessary.
     
  5. swellman

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    Two things in response.

    First is that no one is giving up ANY individual choice that I know of ... what choice are they giving up other than NOT to pay for insurance? The insurance companies decide now and will decide later. The government decides now for some on government programs. What's different?

    Secondly, I think it's pretty insulting to assume that people are supporting the act without reading it and, before you say you didn't say that:

    Perhaps most people who are so opposed to it haven't read it.
     
  6. sooz

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    Had the companies kept themselves in check there would have been no need for this bill. They chose not to do so.

    Here is an editorial that may help shed light on the fact that the right decision was made regarding this bill.

    http://www.latimes.com/health/la-ed-health-20120629,0,6646434.story

    Further, I wish people would stop picking apart posts by over-scrutiny of words such as "fear" vrs. "concern."
     
    Last edited: Jul 2, 2012
  7. lynn

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    I would like to step into this conversation only to give an example that has come up in my family. My son has a rare brain disease which requires surgery to correct or as the disease progresses it causes stroke after stroke and ends finally in death. There are two experts in this disease in this country--one on each coast.

    We are very low income so we have both an HMO through my husband's employer and Medicaid for the kids. When we were going through the diagnosis and arranging for surgery for my son Medicaid refused to pay for us to go to an out-of-state expert. Why? There was somebody local who said he could do the surgery. Had he ever done the surgery before? No. Did he know the myriad things that are must be controlled to keep stroke risk to a minimum during surgery? No. Did he want to learn? His response to me was, "It isn't a hard surgery. It isn't even REALLY brain surgery." A very high percentage of patients who have surgery by somebody other than the two experts have at least one stroke during or shortly after surgery.

    What is my point? Private insurance allowed us to go to the surgeon who would give my son the best chance at a whole and healthy future. Government insurance said that anybody would do, California would be too expensive.

    We will likely be paying for that month for the rest of our lives.
     
  8. hawkeyegirl

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    It is silly to state that it is impossible to have an informed opinion about this bill without reading all 2800+ pages or whatever it is. People have posted very good summaries of the bill's provisions (and a quick Google search will reveal about a thousand other summaries as well). Of course, you have to trust your source in that instance, but hopefully people are thinking about that when they choose the source(s) that they do. I have not read this bill, and yes, I do have "a clue" when it comes to what I am supporting.

    As for choice, all I can say to that is seriously?! The vast, vast majority of Americans have ZERO choice when it comes to health insurance. They're stuck with the insurance that their company provides. The insurance industry is NOT a free market. It's a market where all the power lies with the insurer. And who knows how companies choose their insurance, but I'd guess that it often relates more to their bottom line than it does the quality of the coverage. This whole choice thing is a total red herring. My mom (on Medicare + private supplemental insurance that she chooses) has WAY more choice when it comes to insurance than people who are privately insured, and guess what? As I mentioned above, her situation (again, Medicare + private supplemental insurance) most closely resembles Canada's universal health care, and not what most Americans are stuck with.

    I am sorry about your son's situation. However, I believe that it could have been just as likely that private insurance would have denied you the chance to go out of state as to have covered it. I can tell you that our very, very expensive private policy has the proverbial COW if we even think of venturing out of network, much less out of state. Meanwhile, my mom (again, on Medicare) can go to any doctor she chooses to see. Individual anectdotes, while important to the individuals involved, are just that. Anecdotes.
     
  9. caspi

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    Really?! My husband has no say over what insurance his company offers. We either take it or we don't. If we didn't and had to go purchase it for ourselves, considering we have a child with a pre-existing condition, we'd be paying MUCH more than what we pay through his company policy. So while it is true that we have the "opportunity" to change insurance companies, we couldn't afford it.
     
  10. hawkeyegirl

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    And corporations are people too, right? ;)

    Seriously, right now most people have ZERO choice when it comes to health insurance.
     
  11. caspi

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    But HE doesn't have a choice. And aren't we already "taxing people for not purchasing goods" with the Medicare tax we all have withheld from our paychecks? I am assuming you have a problem with that as well? :rolleyes:

    Bottom line is that while this may not be the perfect solution, it is a start. We have to start somewhere and if it costs us more, then so be it. We're already footing the bill for all the uninsured that end up in the emergency rooms because they can't be seen by a doctor.
     
  12. Sarah Maddie's Mom

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    Arrogant much?:rolleyes:
     
  13. sooz

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    Had you read the link I posted you would know why I think the government will help. I don't believe I said any thing about waste in military spending. Military spending has nothing to do with this topic except for the fact if we spent far less on it, we would have plenty of money to care for our citizens. Since you were so kind to respond to my wish as you did, I won't ask you to explain. I'm sure you would feel it would be a waste of time. For the record though, it had nothing to do with YOUR word choice, rather, your disapproval of the previous poster's word choice. Your signature goes a long way in explaining your position re govt regulations and health care.
     
  14. hawkeyegirl

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    How can it get worse than ZERO choice??

    I give you kudos for your absolute confidence in how all of this will turn out. I think you're wrong, but at least I acknowledge that it's impossible to predict all of the ramifications of this legislation.
     
  15. swellman

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    As a learning critical thinker there is one thing I KNOW for sure and that is when someone says they KNOW something, not because of polls or statistics or studies but because it's intuitively obvious to them, it's almost certainly "confirmation bias". To set the record straight, contrary to your attributing omniscience to me, I can honestly say (and my wife can confirm this) I have no such power and I have no idea what people do or don't do behind their little glowing screens. While we're at it might I suggest a quick refresher on "straw man" arguments and "red herrings".

    So, go back to the summary I posted earlier and tell us which parts, precisely, you don't like and, if you don't mind, expand on your reasons.
     
    Last edited: Jul 2, 2012
  16. caspi

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    "Thousands upon thousands of tax collectors to enforce this tax"? And you know this how???

    Once again I agree with you. :eek::p;)
     
  17. swellman

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    Not to mention the unforgivable bastardization of a brilliant scientist's words.
     
  18. lynn

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    I would say that life is a string of anecdotes, oftentimes called experience.

    I will share a few more with you. When I called to inquire about a cgm for Nathan I was laughed at by the woman from Medicaid. When my daughter with arthritis needed to move to Enbrel it took weeks to get the agreement that Medicaid was willing to pay the 10% that insurance doesn't cover because it is too expensive and they weren't convinced that she needs it. My son has been suffering from debilitating headaches since his surgeries and he is finally being referred to a headache clinic. We went for the initial consultation yesterday and we were told that they will work to get us coverage from Medicaid but it is unlikely that they will cover.

    I have a lot of anecdotal experience with government insurance.
     
  19. hawkeyegirl

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    Yes, it makes sense that Medicaid covers the basics and that your private insurance covers the rest. That's how it works in most places with universal healthcare. Regardless, this plan does not just thrust everyone onto governmental coverage. I wish we were eligible for overlapping coverage, frankly. It would be nice to have Medicaid pick up some of those co-pays.

    This bill will make a whole lot of people eligible for insurance who weren't before. I suspect they'll be grateful for the terrible coverage that you detest.
     
    Last edited: Jul 3, 2012
  20. swellman

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    Firstly, I'm honestly confused ... are you seriously against nutritional info requirements? Are you against cancer beds ... I mean tanning beds? You must be joking so I won't even continue down that path.

    Everything else you stated is wild speculation based on little or no evidence ... at least none that you are willing to share. You don't think that if more doctors are needed that more will step up to the profession? Your entire basis as, quoted here, is entirely based on that one assumption. Give us something at least that reports anything about the lack of doctors. I would be more willing to speculate that there will be a shortages of nurses. Perhaps our system will need to adjust to the point where the normal duties of general practitioners are distributed to physician's assistance and even nurses - give me a quality nurse just about anytime over a green doctor. In any event if that scenario is your biggest concern over the act then maybe you should spend more time investigating whether your basis is, in fact, based in fact.
     

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