The federal outlay, according to the Democratic congress' budget office, would be somewhere on the order of $1.5 trillion. Independent analysis is more pessimistic, but let's be generous and assume that the president's own $800 billion is accurate. (:thumbsup: That's funny stuff right there.) So $80 billion a year. This is in addition to that which we already spend on the private system (somewhere on the order of $2.5 trillion annually). So we'll soon be getting up there around $3 trillion per annum. Military spending at $650 billion. Which is the drop and which is the bucket? The $3 trillion (that would have to be replaced for actual "universal healthcare") is the issue here. The military argument is a diversionary tactic, borne of personal philosophy but applying in no way to the actual debate.

Allowing for your unsubstantiated claim that we have doctor shortages "pretty much everywhere," your answer is that they need to be paid less? I suppose that lower pay could be one way to address a shortage. Good luck with that one.

Your representation of the tax treatment of ex-pats is severely lacking, to say the least. The ten year thing is a monitoring of assets to make sure that rich people don't leave the country without paying the tax on appreciated assets that they would have owed if they had stayed. And it's also another diversion from the actual conversation. Immigration and emigration were not the topic. Healthcare, and specifically the seeking of healthcare across international borders, was the topic. The point is that a healthcare utopia would have no need for citizens to come to the States for treatment and then be able to sue their own government for reimbursement. The option exists and it isn't my wild-eyed idea. It's a part of Canadian law.

And your solution would be what? To say by government decree that the surgeon is getting whatever you say he's getting and he'll have to like it? And I suppose that we'll still get the same talented individuals to spend half their lives in school and line up to take these formerly lucrative careers, now simply out of the goodness of their hearts. Good luck with that one.

A fun talking point, mainly because it contains a grain of truth. The costs of the uninsured are presently passed on to the rest of us to some extent. Only one side of the coin though, as most talking points tend to be. You would save some of these costs by bringing people into the system. You would also add costs to the system by encouraging people to get treatment that they presently forgo. You would also add costs by keeping people alive longer overall, since they would be getting medical treatment that they otherwise would be lacking. Old people spend a boatload of money on chronic conditions that 45-year-olds who drop dead of a heart attack never incur. Make the moral case for people living longer lives if you wish. I have no disagreement with you there. The monetary savings, however, are imaginary.


The exclusion can last a maximum of one year, can look back a maximum of six months, and the one-year maximum is reduced by the number of months that the person was covered during the previous year. Breaks in coverage of more than 63 days are problematic, but COBRA and other options can help prevent such breaks. Even with no offset though, the six-month and twelve-month rules apply. The facts are often less exciting than the dramatic stories at town hall meetings, but they are the facts nonetheless.

I agree that it should be on me if I don't want to pay. My health should be my concern, not yours. This is the exact opposite of your big government solution though. Let's not get confused here. You're the one on the collectivist side of the issue. And the hefty fine is not at all hefty, as I already mentioned. (Section 59B if you care to do a little reading.) It's 2.5% of my adjusted gross for the year, compared to the 2.5% of my actual gross that I currently pay. If my employer chose to pass on more of the premium to me, as many employers have had to do, the fine would then become even less punitive by comparison.

Further to this, they limit the penalty so that people who are not subsidized by an employer (as I am) can't get hit any worse than they would get hit by an average premium...
"‘(i) IN GENERAL- For purposes of subparagraph (A), the ‘applicable national average premium’ means, with respect to any taxable year, the average premium (as determined by the Secretary, in coordination with the Health Choices Commissioner) for self-only coverage under a basic plan which is offered in a Health Insurance Exchange for the calendar year in which such taxable year begins."
For low-income people, the fine is clearly the best option (absent the subsidy, more on that later). For higher-income people, it's a wash.

Long story short - You're being lied to. They're essentially begging people (who take a few minutes to crunch the numbers) to bankrupt the system. If they really wanted us all to stay in insurance plans, then the penalties for non-compliance would be much higher. They would allow plans to sign up new members. They wouldn't ban people who can afford it from self-insuring for small costs and maintaining catastrophic coverage (a practice that actually does reduce costs). They wouldn't force a premium model that bears no semblance to actual premium risk. The subsidies for families well above the poverty line would not exist. (Subsidies, in every form, are mere political leverage to be used at a later date. "Sorry, we're going to have to cut that subsidy next year. Reducing the deficit and such, you understand. No worries though. You might as well go ahead and sign up for the public plan. We have a moral obligation to keep that one nice and cheap, you know, for the people...")

From your comments, I gather that you really don't mind this and you would prefer that we went full-on socialist. Your fellow Americans, however, disagree by a large majority.

A debate is always fun. A dishonest one is obnoxious. Our president is on record, multiple times, as wanting to get to a single-payer system through a gradual approach. I just spelled out this (rather transparent) gradual approach for you. But now we're told that he doesn't want such a system anymore? Why did his views change then? Did the circumstances that formed his views change? Have costs stopped rising, or have insurance companies suddenly become benevolent benefactors? Are there fewer uninsured Americans, or have doctors started working for free? Of course not. Nothing has changed. If the proponents of this plan had any gonads, they would try to make the case that we're better off with a public system down the road. Instead of being honest though, they prefer to be 'technically accurate.' Yeah, you can keep your private coverage... for now. Once your plan goes belly up though, since the bureaucrats are dictating unsound business practices, well good old Uncle Sam will step in and run things like a champ, dontcha know.

See above. No better deal. The fine is cheaper and I can get covered after the fact.

And then see further above. No tangible reduction in costs. Medical costs will go down based on what, exactly? The president's say-so? Good luck with that one.

 

This discussion contains no emotional component for me, since I'm an unemotional ***** for the most part. I prefer to stick to facts and leave the emotions to others. I do have something of an emotional attachment to certain concepts like freedom, mind you, but such things are often difficult to define and are always impossible to quantify. Therefore I don't bring them up if I can avoid doing so. You've managed to find the one part of this chat that does piss me right off though. Argue the merits of one approach vs. another if you wish, but this canard that it's either some whacked-out Big Brother model or the status quo is completely bogus. You base your entire argument on the notion that nobody else knows how much we spend on healthcare. (Hint: We're not the rubes that you wish we were.) This as you try to defend a plan that will increase, not decrease, the amount that we spend on healthcare.

Person A: I could stand to lose around five pounds.

Person B: Let's get a chainsaw and lop off your feet.

Person A: What the hell are you talking about? How would I walk?

Person B: Well, if you don't want to lose the five pounds...

Person A: Dude, that doesn't even make sense.

Person B: The average human foot is 2.3 pounds. Your feet are a little big, so...

Person A: This is craziness.

Person B: You can act like it's okay to be five pounds overweight if you want to, but you'll see.

Person A: I could, like, exercise a little more or something.

Person B: Yeah, that's what the health club industry wants you to think. I knew a guy in Guam who had no feet and he loved it.

The fact of the matter is that the rising costs are the issue. The 46 million people is another canard, but we could have a safety net for the ~10 million who really can't afford coverage if we kept costs down. Or we could certainly go single-payer and control costs. The Democratic leaders (other than Barney Frank) are presently insisting that they don't want this, to make sure we're clear here, but it's one way to go. The way that governments control costs is actually quite simple. Well, to be more accurate, they don't control costs. They simply refuse to pay them. Pretty cool perk from being the only buyer in town, eh? For some people it's all good and for others it's tragic. The tradeoff comes down to either this group getting screwed or that one getting screwed.

Even for those who can't afford the absolute best, it's not in our nature as Americans to accept less for ourselves because it might be better for three other people that we've never met. Maybe you can convince the population to see things that way eventually, but you're not anywhere close to being there right now, according to every polling firm under the sun.

Or... there are, you know, other ways of controlling costs. Less insurance red tape for simple office visits. Tax deductible savings accounts combined with high-deductible plans. Interstate competition. Ten or twenty year level term rates for individuals, preventing them from getting dropped after an illness and having to shop around in the high risk pool. Limiting non-monetary malpractice damages and reforming lawsuits in general, so doctors don't have to test for things that they don't suspect, just in case. Other approaches are out there as well. The Democrat party is unwilling to listen to them at the present time and they control the levers of power.

To imply that there is only one choice, when that choice isn't even reasonably understood by its own supporters, is a copout. The one question before the country, right now, is whether or not to pass a bill that more than half the population now finds very troubling. That question has to be answered before any others are even relevant.

And what exactly about the current proposal can you point to that will change this? The magical $80 billion in savings for the donut hole that the president promises? That's nice and all, but then why are the leftists now throwing a hissy fit about him promising the drug companies that they won't get beaten down on drug costs? Maybe they're in on the game together? Naw, couldn't be. Remember the bit about open meetings on C-SPAN and whatnot? Come on now. Don't try to imply that I'm somehow the one with my head in the sand. I never believed that a 'new kind of politics' was coming to Washington. Quite a few of you did.

And when those European countries are no longer getting subsidized by our markets, where will their drug costs go? The answer, I would conclude, is inevitably up. Since the European drug companies all fled here so they could try to make a profit, it only seems logical that there would be a consequence once we cap that profit. And when we've all made it to the public plan and Medicare no longer has anywhere to dump its unreimbursed costs, where will drug availability go? The answer, I would conclude, is down. Since doctors and hospitals who are routinely underpaid by Medicare are presently defraying costs via privately insured individuals, it only seems logical that they would provide less service once there is no place else to turn. Your mileage may vary.

I won't quite call myself an insurance expert, but I do have a leg up on most people regarding the topic. I wasn't always a truck driver, you see. Several of my small business clients provided health insurance to their employees and each of them was working with a unique set of circumstances. Nothing is perfect, but we were able to find workable solutions for them and their workers. I can assure you that there is more than one way to skin a cat. And egads! I actually always recommended the plan that was best for the client, even if it didn't pay the highest commission. Why? Because a happy client was good for me. I was competing with others for their business, unlike Uncle Sam.

One more part of the reliance on the employer-based system that our president now claims to be protecting. See the hypocrisy here? If it all sucks, then make that case honestly and stop trying to reassure people that they can keep what they like.

My preferred approach would be vastly different, but apparently my only choice (according to your talking points) is to be an ignorant rube who wants everyone to go bankrupt or to accept the current proposal.

Where do I begin with this part? Now it's almost $2 trillion on the military? What happened? And nobody complains about it? You can't be serious. Further to that, what exactly would you suggest? Disband the military and make them all free-clinic doctors? Defense is one issue and medicine is another. You may well get your demilitarized wish anyway though. Entitlements will eat the whole budget before long and we don't have the guts to support a politician who will tell the truth about it. We'll keep voting for the guys who say they'll "find savings." That sounds so nice.

Again with the strawmen now? Nobody called you socialist. Nobody called you any names. Nobody suggested that socialism came about when Obama stepped into office. Strawmen don't fly with me. I've simply addressed specific points of the discussion at hand, so I'll humbly request that you save this kind of crap for someone who can't spot it from a mile away. I take no personal offense, but attributing bogus claims to the other party does nothing for the discussion.

You don't really want to go down the 'angry mob' route while you defend a far-left policy, do you? If so, I hope that we never have an unpopular war dragging on for years in a foreign country during your lifetime. You might have to see an angry mob demonstration or something. Wait a minute... err... nevermind. Even on the healthcare town halls themselves, the only violence that I've seen consisted of some union goofball beating up a guy selling buttons and another union goofball shoving an old man up against a wall so the old man couldn't try to listen to the discussion. For the record, neither of those union goofballs are a reason for me to oppose the legislation. They are outliers, just like anyone who actually broke a window would be. I have heard no such reports, but I'll take your word for it.

"Fine the way it is...?" Who has said that? Anywhere? Please. I'm sure you can do better than this. Thanks for the good luck wishes though. I can always use some of that.

 

I spoke with a girl at the Petro in El Paso a few year ago. We got to talking about the high cost of prescriptions in this country. She told me that her grandmother would go across the border and buy her $70 medication for about $8. Doctors prescribe tests that may not be needed just to protect themselves from litigation. Hospitals do the same thing. Insurance companies and the government require such a high level of paperwork that healthcare providers must add staff just to take care of all the paperwork. These costs must be passed along to the patients and those paying the bills. We elect lawyers to pass legislation which benefits their industry but add additional costs to healthcare. This country does subsidize other countries prescription costs. Another reason our medications are so high are the cost of litigation. Having the government to get involved will likely result in more paperwork and rationed care. Those who are receiving medicaid or other form of government subsidized healthcare have their care rationed already. They can only receive a certain number of prescriptions per month. It is likely that any national healthcare program that is run by the government will result in a similar model.

My guess is that the insurance companies could benefit from a government run program. Someone would need to pay the bills and process the paperwork. If everyone is required to purchase insurance then the private insurance companies are likely going to benefit.

 

You hit the nail right on the head. This is what health care reform should be about. One reason health insurance is so high is because of ALL of the above. The really funny thing is: All of the above things that have increased costs ( except for a standard insurance form ) was created by GOVERNMENT, and we want to give them MORE control???

Why can I not buy my insurance from a company that is out of state?

Why do I have to pay for insurance to cover my wife having a baby when we KNOW there will be no more little "ridge runners" ???

Why can I not buy a policy with a $10,000.00 deductible if I have $10,000.00 in the bank with a "pick and choose" plan where I choose what I want to cover?

Why??? I'll tell you why...... The Government made it illegal for the insurance company to sell me what I want to buy.

One other thing I am against is the "Multi-Tier paying system. There should be ONE cost and it should apply to all. That $1,000.00 dollar bill for the guy paying cash is $1,000.00. If you are on an insurance PPO plan it is $600.00. If it is a government plan it is $350.00.

Is this not backwards??? In any other business you would get a discount for paying cash. No paperwork no waiting to get paid and you get the shaft.

 

My wife had Rectal Cancer back in '01, and the treatment went through the first quarter of '02. Under Blue Cross, we had an annual cap of $3,000, but at midnight on New-Years-Eve, the group insurance was switched to Humana, with a straight 80% coverage. You find that the 80% coverage really does not mean a lot when you start looking at the things that were not covered. This follow-up visit to the doctor (under doctor's orders) not covered, that test (ordered by the doctor) not covered, and by the time we were done, it looked more like they only covered about 25% of the cost. Add to that the problems getting them to pay for covered expenses because they insisted it was Blue-Cross's expense, not theirs. Nearly had to hold a gun to their heads to get them to pay. We pay their premiums for that kind of treatment?

Then, when we had to switch companies (other company doesn't exist anymore), COBRA was a wonderful thing, but the new company screwed up our pay, and it was an honest mistake, we were not able to maintain the COBRA. Ever since, my wife has not been able to get insurance because of the cancer that has not showed any sign of return over the last 8 years. On our group insurance, she's covered for everything else, but if cancer were to come back anywhere in her body, she has no coverage for it. To see a doctor today, for any kind of follow-up visit pertaining to cancer, no coverage. Surgery to remove a tumor, or any other kind of treatment, NO COVERAGE! So, the moral of the story is, "if cancer comes back, PUT A ROPE AROUND YOUR NECK."

And, legislators are very reluctant to pass laws to put that to a stop because insurance execs are among the largest $ figure contributors to their campaigns.

Now, of the entities that received bail-outs this year, how many of them are also associated with an insurance company.

The first thing we need to do is, vote out of office, anyone that voted for the bailouts. Second, do not vote for a candidate that receives contributions to his campaign from an insurance exec. About the only way they'll get the message.

 

It is next to impossible for anyone who has a preexisting medical condition to get insurance coverage.

 

Anyone with a pre existing medical condition should be shot, as well as everyone over the age of 65 who is a burden on our society..

That way you solve all of our problems....

 

Good debate!!! Both V and D brought up some very good points and did so in a respectful manner. I do want to bring up one point tho. When we talk of people having to file for bankruptcy due to medical care; is it all due to medical bills??? If the "breadwinner" is the one laid up and unable to work then this could happen very quickly. There are a lot of "other" costs that go along with a medical problem, travel, lodging, ect...


Just some food for thought,


Ridge

 

Where i see the debate kind of spliting in half is when it comes to this public options that democrats want to create. I simply suggest that we should create a non profit HMO, which is tottaly independent of the government in which we can pay into ourselves and be covered. You have to create more competition in the market and the problem that we have right not is that no organisations can stand up to the trillion dollar machine i mentioned above, except the government. I dont want them involved but then again, i dont want them involved in alot of things in which they are involved in anyway..

Great Britain has a National Health Service which is praised around the world for its effectiveness in providing quality health care to its citizens. It aint perfect but what is in todays world, but comparing it to what we have here, its like apples and oranges more so if you think about that our system is nowhere else to be found on the planet, no country follows it as their own...Its broke and we still dont know it.