02-16-2014 07:38 AM
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  1. SteveISU's Avatar
    Then there's people that make $7.30 an hour and $7.40 an hour. Then l believe there's about 15% of all workers that fall below the poverty line. Maybe make it an adjustable cap determined by your 1040 up to the poverty line? or something like that. I am just throwing an idea out. Like I said, you're thinking it through and tossing out good ideas.

    I agree that Bronze plan sucks unless you have a lot money sitting around. ...and if someone can't pay the $12K in 30 days what happens? Collections? Wages garnished?

    There would be subsidies for those below the poverty line. Those subsidies would come from the dissolved medicaid programs that I would argue should occur. Put those people on plans like the rest of us but get them out of high risk pools and medicaid that very few doctors and/or facilities accept. They will still be responsible for co-pays, they will get subsidies for their premiums and deductible provided they prove they are working and/or going to school.

    The real issue is we have to have a clear definition of poverty and who need subsides. Someone making 92K a year does not need them IMHO, yet under the ACA they would qualify. I don't consider a family of 4 pulling in 92K/year impoverished.
    02-04-2014 02:37 PM
  2. SteveISU's Avatar
    I can agree to some of that, but there needs to be flexibility in the system for people to get plans that best suit them without a lot of extras they don't need. You say consumer driven, but did you read my short explanation of the catastrophic plans with savings option I posted above? That's about the most consumer driven insurance you could have. And once you meet your deductible, everything is covered 100%. No co-pays or anything like that. Yes, it's not for everybody, but why take that option off the table?

    Btw, careful how you use the car insurance analogy. That's a state by state regulation, not federal. It's also meant to cover others for your accidents more than anything. I.E. paying medical bills of the other party and their repair costs if you're at fault, and to protect a lien holder for the loss of collateral. You can get insurance to cover your costs too (some state do require it), but that's not the main purpose of car insurance requirements.
    The point is there is a minimum set of standards/coverage that everyone must possess. Beyond that then the individual can chose what additional coverage they would like. If your healthy and you want a higher deductible, lower premium plan, have at it. If you want a plan that rewards you for losing 50lbs over 3yrs, go for it. Catastrophic is a relative term, you'd have to define what you consider catastrophic (ie....stroke, heart attack, cancer, ect, but what?)

    If you don't think you are paying exorbitant money to try to make up losses when someone doesn't have insurance, you are dead wrong. You having insurance helps you but it also help me from having to fork over more $$$ because you didn't have it.
    02-04-2014 02:44 PM
  3. palandri's Avatar
    ....The real issue is we have to have a clear definition of poverty and who need subsides. Someone making 92K a year does not need them IMHO, yet under the ACA they would qualify. I don't consider a family of 4 pulling in 92K/year impoverished.
    I agree, that sounds really high.
    02-04-2014 02:47 PM
  4. SteveISU's Avatar
    I agree, that sounds really high.
    Obviously that can be relative based on geographic location.

    My point is the government isn't the answer because they can't be trusted to price anything accurately (look at Medicare) and leaving it up to the employers is stifling competition. Most people when they get hired at a business they get offered one plan many times, sometimes 2. Your local supermarket has over 42,000 sku's. We have all the choice in the world for something as trivial as cereal, but when it comes to health insurance we are handcuffed by an employer who know next to nothing about health insurance and if you ask any company they'd gladly get out of the insurance purchasing business all together. Especially when they have to compete globally and wrap those costs up into their products and expect to be competitive.
    02-04-2014 03:15 PM
  5. Mooncatt's Avatar
    Catastrophic is a relative term, you'd have to define what you consider catastrophic (ie....stroke, heart attack, cancer, ect, but what?)

    If you don't think you are paying exorbitant money to try to make up losses when someone doesn't have insurance, you are dead wrong. You having insurance helps you but it also help me from having to fork over more $$$ because you didn't have it.
    Catastrophic plans have already been around and thus defined. As far as the individual is concerned, what "catastrophic" is is defined by their choice of deductable. Lets say you have the $3000 deductable. What you're saying as an individual is that "I can safely cover all of my medical expenses up to that amount, and I'll need help with anything more." Even with several kids, you'd be hard pressed to come close to that deductable with basic colds and such. Now if you had a bad accident that required a week in the hospital, yes you're still on the hook for up to $3000 depending on how much you've spent so far this year, but insurance covers anything over that. You'd pull that from your savings account if you have it or set up a payment plan with the hospital, but that's a small amount compared to the over all stay. Not to mention for the rest of the year, your insurance picks up the tab on every other medical expense, even if it's seeing the doctor for the common cold. Lets say worst case scenario and you can't pay your deductable. Maybe you had just filed bankrupcy before the accident. $3000 is chump change to them when they are still getting a couple hundred thousand from the insurance company. It's not like the uninsured that would leave the entire amount unpaid.

    As I also pointed out earlier, it makes people think twice about their medical choices. Even with money set aside to cover it, you'll ask yourself if you're really sick enough to warrant a doctors visit. One of the problems today is people that go in for every little cough and sniffle, expecting (and often getting) some prescription from their doctor when they don't really need it. These types of plans help cut down on that and free up the doctors for treating the truely sick. And since those services you do get are purchased at a cheaper price, it's more money left in your pocket over all and more for the economoy in general.

    In short, it's like saying I'll take a plan that's way better than your insurance suggestions, but I'll pay my own way first and only use the insurance when I really need it. How is that a bad thing?
    02-04-2014 03:29 PM
  6. palandri's Avatar
    Obviously that can be relative based on geographic location.

    My point is the government isn't the answer because they can't be trusted to price anything accurately (look at Medicare) and leaving it up to the employers is stifling competition. Most people when they get hired at a business they get offered one plan many times, sometimes 2. Your local supermarket has over 42,000 sku's. We have all the choice in the world for something as trivial as cereal, but when it comes to health insurance we are handcuffed by an employer who know next to nothing about health insurance and if you ask any company they'd gladly get out of the insurance purchasing business all together. Especially when they have to compete globally and wrap those costs up into their products and expect to be competitive.
    To get pricing right, just do a comparison study of prices in Canada, UK, France, Germany...etc...
    02-04-2014 03:30 PM
  7. SteveISU's Avatar
    To get pricing right, just do a comparison study of prices in Canada, UK, France, Germany...etc...
    You can't, those countries have socialized medicine where the government controls costs on just about everything. That and they also rely on a broad tax base to pay for everything.
    02-04-2014 03:32 PM
  8. palandri's Avatar
    You can't, those countries have socialized medicine where the government controls costs on just about everything. That and they also rely on a broad tax base to pay for everything.
    You have a major distrust of government, I don't.

    How are you going to control cost? The invisible hand of the free market? Doctors advertising, buy one hip replacement, get the second one for free?

    Once we have everyone paying for healthcare, we'll have a broad tax base for healthcare.
    02-04-2014 03:47 PM
  9. cdmjlt369's Avatar
    You have a major distrust of government, I don't.

    How are you going to control cost? The invisible hand of the free market? Doctors advertising, buy one hip replacement, get the second one for free?

    Once we have everyone paying for healthcare, we'll have a broad tax base for healthcare.
    Some people don't want it. And what do you do about the illegals and other workers working off the books? And I definitely don't trust the government. Why should I trust them? They think they know what's best for me, my kids, and everyone else.

    Sent from my XT1060 using AC Forums mobile app
    02-04-2014 04:01 PM
  10. SteveISU's Avatar
    You have a major distrust of government, I don't.

    How are you going to control cost? The invisible hand of the free market? Doctors advertising, buy one hip replacement, get the second one for free?

    Once we have everyone paying for healthcare, we'll have a broad tax base for healthcare.
    Go look at what accounting gimmicks our government uses for SS and Medicare and then look at their unfunded liabilities and then come back and talk about the trust you should have in those two systems. Clearly it has been proven that politicians cannot be upfront or honest about how much anything costs because they would never get elected. When you have the government involved, you will ultimately have lobbyists involved and that is part of the problem.

    Consumers are going to control costs. 270million people with insurance are going to control costs. Remember, the mandatory insurance must be not for profit and everyone pays the same regardless of age or health status. Competition across state lines will lower cost when companies can openly fight for your $$ (a small country like Switzerland has 90 insurance companies, competition is fierce) Prices for everything should be published and consumers are going to have to start taking responsibility for becoming educated. Hospitals charging 45k for a hip replacement will have to come down when the hospital down the street can do the same for 25k (yes, such a scenario already occurs).
    02-04-2014 04:13 PM
  11. GadgetGator's Avatar
    LOL Consumers are going to have to take responsibility for being educated? Yeah right. Most people don't take the time to even educate themselves on who to vote for or the details of an issue. And you want them to be educated on something complicated like health insurance? Yeah, that's not going to happen.

    Posted via Android Central App
    02-04-2014 05:37 PM
  12. cdmjlt369's Avatar
    LOL Consumers are going to have to take responsibility for being educated? Yeah right. Most people don't take the time to even educate themselves on who to vote for or the details of an issue. And you want them to be educated on something complicated like health insurance? Yeah, that's not going to happen.

    Posted via Android Central App
    So the ones of us that pay attention to details and educate our selves are responsible for the ones who aren't responsible? That's a sad concept.

    Sent from my XT1060 using AC Forums mobile app
    02-04-2014 05:51 PM
  13. GadgetGator's Avatar
    So the ones of us that pay attention to details and educate our selves are responsible for the ones who aren't responsible? That's a sad concept.

    Sent from my XT1060 using AC Forums mobile app
    It is sad, but it is reality. That being said, healthcare isn't the same kind of product as say a new car. Often decisions have to be made very quickly and in crisis. Comparison shopping isn't an option. It's hard to be an empowered consumer when you are unconscious and other people are making healthcare decisions for you be they loved ones, a paramedic you've never met, or a doctor in some unfamiliar hospital you've been brought to.

    Posted via Android Central App
    02-04-2014 06:06 PM
  14. cdmjlt369's Avatar
    It is sad, but it is reality. That being said, healthcare isn't the same kind of product as say a new car. Often decisions have to be made very quickly and in crisis. Comparison shopping isn't an option. It's hard to be an empowered consumer when you are unconscious and other people are making healthcare decisions for you be they loved ones, a paramedic you've never met, or a doctor in some unfamiliar hospital you've been brought to.

    Posted via Android Central App
    That's why you make the decision about your healthcare before you need it.

    Sent from my XT1060 using AC Forums mobile app
    02-04-2014 06:15 PM
  15. Scott7217's Avatar
    So the ones of us that pay attention to details and educate our selves are responsible for the ones who aren't responsible? That's a sad concept.
    This concept is best illustrated by the question, "Am I my brother's keeper?" A lot of people would say yes, they do have some responsibility to their fellow citizens.
    02-04-2014 08:38 PM
  16. NoYankees44's Avatar
    This concept is best illustrated by the question, "Am I my brother's keeper?" A lot of people would say yes, they do have some responsibility to their fellow citizens.
    If people actually took responsibility for fellow citizens, the government would not be in all the places it should not be now. There would be no need for any entitlement programs. No attempts at universal health care. Taxes would be cut in half. The government would only protect the population and police human interactions. What government is supposed to do in other words. All the "help" the government provides can be easily and more effectively done by citizens providing caring and intelligent aid for each other.
    cdmjlt369 likes this.
    02-04-2014 09:30 PM
  17. Mooncatt's Avatar
    Government could also be reduced if people would be more responsible for themselves and not relying on government or other people to take care of and provide for them.
    cdmjlt369 likes this.
    02-04-2014 09:59 PM
  18. yotavota's Avatar
    The sole purpose of government is income redistribution. It could be to the poor, the rich, individuals or corporations. It could be the homeland or abroad. What truly dictates the flow of redistribution is who/how government is influenced. Had lunch/dinner with a politician lately?

    Sent from my SM-N900W8 using Tapatalk
    02-04-2014 09:59 PM
  19. Mooncatt's Avatar
    The sole purpose of government is income redistribution. It could be to the poor, the rich, individuals or corporations. It could be the homeland or abroad. What truly dictates the flow of redistribution is who/how government is influenced. Had lunch/dinner with a politician lately?

    Sent from my SM-N900W8 using Tapatalk
    Not sure if you're serious or facetious. :what:
    02-04-2014 10:56 PM
  20. palandri's Avatar
    Go look at what accounting gimmicks our government uses for SS and Medicare and then look at their unfunded liabilities and then come back and talk about the trust you should have in those two systems. Clearly it has been proven that politicians cannot be upfront or honest about how much anything costs because they would never get elected. When you have the government involved, you will ultimately have lobbyists involved and that is part of the problem. ....
    So lets say you run for office and get elected as a senator from Illinois, you would suddenly, magically morph into a dishonest person that couldn't be trusted or upfront with people? That's what you're saying.
    02-04-2014 11:57 PM
  21. GadgetGator's Avatar
    That's why you make the decision about your healthcare before you need it.

    Sent from my XT1060 using AC Forums mobile app
    Not every thing can be planned for in advance. For instance, should a young person price out the cost of replacement legs just in case they lose them in a car accident, and see who gives the better deal? That is unlikely to happen.

    Posted via Android Central App
    02-05-2014 12:09 AM
  22. Mooncatt's Avatar
    Not every thing can be planned for in advance. For instance, should a young person price out the cost of replacement legs just in case they lose them in a car accident, and see who gives the better deal? That is unlikely to happen.

    Posted via Android Central App
    Insurance, living wills, advanced directives, having a regular doctor, etc can all be handled well in advance of anything. In an emergency, of course you get the quickest help you can to get you stabilized. If you have insurance, that will generally cover you, at least a bit (I.e. traveling and cared for out of network). With the exception of emergencies, you can pretty much plan for how/where you want your treatment.
    02-05-2014 12:30 AM
  23. SteveISU's Avatar
    LOL Consumers are going to have to take responsibility for being educated? Yeah right. Most people don't take the time to even educate themselves on who to vote for or the details of an issue. And you want them to be educated on something complicated like health insurance? Yeah, that's not going to happen.

    Posted via Android Central App
    Go read up on Pareto's law. Is everyone an auto expert, or a computer expert? No! We all manage because most of us follow what the really smart people do. Does my employer know what will suit me? Does the government? No one in Springfield comes knocking on anyone's door who is poor to help them sign up for public aid, yet they manage and we have plenty of people on it.
    02-05-2014 09:46 AM
  24. SteveISU's Avatar
    So lets say you run for office and get elected as a senator from Illinois, you would suddenly, magically morph into a dishonest person that couldn't be trusted or upfront with people? That's what you're saying.
    Keep me there long enough and it's a great possibility. Suddenly the behavior you would likely find appalling is just how it is in Washington. The one thing I would do to hopefully prevent that is talk to zero lobbyists and never let them in my door. The decisions I would make are my own, not because someone wants to give me a $10k a plate fund raiser to get my coffers filled in exchange for a vote that might not effect anyone in IL, but will in another state. Isn't that what we saw in the ACA crafting, certain states getting massive carve outs in order to secure their vote. That Senator just sold 49 other states down the river so he didn't get any flak when he went home, the president got his political victory and photo op.
    02-05-2014 09:53 AM
  25. SteveISU's Avatar
    Not every thing can be planned for in advance. For instance, should a young person price out the cost of replacement legs just in case they lose them in a car accident, and see who gives the better deal? That is unlikely to happen.

    Posted via Android Central App
    How hard is it if the basic national policy covers all inpatient procedures and outpatient rehab? At least use an example that is more to the point. Person forgoes purchasing dental and they need a root canal (which happens all the time right now). Yeah, that's $500 whoops on their part.
    02-05-2014 09:57 AM
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