Health Care

[GH2001]

I guess it goes without saying that I disagree with every word of this.

Healthcare delivery doesn't lend itself to free-market concepts.  And it shouldn't.

At some point the fiction that any market is "free" or unadulteratedly capitalist has to be sloughed off.  We are, as a society, beyond that fable.

One thing I'll say - it's nice to see the adults on here talking it out for an entire page without interruption.

And what I'm mainly driving at here Wes is should we just keep throwing money at something blindly? Or should we address root causes and think outside the box as compared to the last 3-4 decades' way of doing it? Because it's pretty obvious that hasn't worked well. And it's still not.

It would be nice to be able to walk into a dr office for a routine checkup, something preventative or a cold and not have to even have insurance. Just give them anywhere from 15-100 bucks for the services. Then let catastrophic insurance cover major things like an auto accident or cardio event or cancer. Which is much more affordable since it's more rare for that event to happen than a cold. I read where a guy out in witchita is using a similar type model and it's working great. Forget his name. I'm just afraid your single payer idea is throwing more money at the same problem - just in a different way. Same end different means.

[wesfau2]

One thing I'll say - it's nice to see the adults on here talking it out for an entire page without interruption.

And what I'm mainly driving at here Wes is should we just keep throwing money at something blindly? Or should we address root causes and think outside the box as compared to the last 3-4 decades' way of doing it? Because it's pretty obvious that hasn't worked well. And it's still not.

I don't think it's reasonable to think that you can just pull the plug and change directions.  That's why I think the ACA was a good first step.  It will be a process (not only administratively, but culturally as well): Examine what works in the ACA and what doesn't.  Keep the good, tweak the bad.  Rinse, repeat.

Unfortunately, the two camps are currently working towards two opposite goals.

[GH2001]

I don't think it's reasonable to think that you can just pull the plug and change directions.  That's why I think the ACA was a good first step.  It will be a process (not only administratively, but culturally as well): Examine what works in the ACA and what doesn't.  Keep the good, tweak the bad.  Rinse, repeat.

Unfortunately, the two camps are currently working towards two opposite goals.

So is Ryan's plan a good first step at ridding of the bad (mandate, subsidies) and keeping the good (pre existing, age, etc) ?

[wesfau2]

So is Ryan's plan a good first step at ridding of the bad (mandate, subsidies) and keeping the good (pre existing, age, etc) ?

No.  It's the exact opposite of a good plan.  It's a step backwards.

The Ryan-plan is an all-in push far too early.  They tipped their hand and exposed their true end goal: tax cuts for their wealthiest donors.  Nearly every singly other aspect of that plan increases the burden on the people that ACA was designed to help.

[Kaos]

I guess it goes without saying that I disagree with every word of this.

Healthcare delivery doesn't lend itself to free-market concepts.  And it shouldn't.

At some point the fiction that any market is "free" or unadulteratedly capitalist has to be sloughed off.  We are, as a society, beyond that fable.

I guess it goes without saying that I fundamentally disagree with every facet and nuance of your stance. 

Health care lent itself to the free market quite well prior to government intervention.  There was no crisis, there was no need for federal intrusion. 

If "we as a society are beyond that fable" it's only because of the lies espoused by unabashed socialists such as, well ..... you. 

You worked in society's underbelly and wrongly saw an oppressed class of poor folks just trying to make it.  I worked in the same pool of cess and saw it for what it was -- a segment of society determined to do as little as possible and live off the work of others.  You wrongly saw denied opportunity.  I saw opportunity ignored and/or squandered.  You wrongly saw a need to redistribute wealth.  I saw a need to take advantage of the opportunities provided to make your own way. 

Everybody can't be rich.  It doesn't work that way.  But you can't tell me with a straight face that the opportunity to rise above does not currently exist for everyone legally in this country.  I choose not to be responsible for the abysmal life choices made by those who don't. 

Don't get me wrong, wes. I have no problem with short-term assistance.  I have no qualms about helping people who find themselves in difficult situations.  But only on a short-term basis, to give them a chance -- education, re-training, job preparation, etc. -- to find a way out of it. 

I unilaterally oppose, however, the life-time entitlements that have become accepted by that particular class.  They get "disability" checks.  They get WIC. They get food stamps. They get ADC. The kids get "crazy checks."  They get subsidized rent. 

The government has used Section 8 to turn quality apartments and housing into squalid slums.  Then when the formerly nice apartments fall into disrepair and decay, the residents (who are paying little to nothing) agitate and insist on something better because "their house isn't as nice as their neighbors."  So the government forces Section 8 on another nice complex. The tenants move, the ones who just destroyed the old complex move in and the pattern repeats itself.   I've lived that too.  The first apartments I lived in started to accept Section 8 tenants.  Six months later, after the second time my apartment and car was broken into, I moved. When that complex accepted its first Section 8 tenant two years later? I moved again.  Every time I moved I had to pay substantially higher rent because the Section 8 hordes were artificially inflating the market. 

We've got an entire subclass of people now who are in the second, third and fourth generation of living on the dole.  Ethel Lee is a prime example.  She filed for disability because she was "down in her back" when she was 18 years old.  She had "bad knees."  She pumped out seven kids by multiple different men.  All of them lived in public housing and drew government checks.  None of them worked.  I personally heard her tell her 16 year old daughter -- who already had one child -- that she needed to have another one because they needed the additional check for it.  None of her kids ever even thought about working.  Well, one worked at Wendy's for a short time and was ridiculed by the rest of the family.  Then she got pregnant, quit the job and moved into Rosedale Courts on her own and one the dole. 

I paid for that.  You paid for that. 

And now you want me to pay more? You think I should give Ethel Lee and her ilk a fucking "baseline?" 
You honestly believe that the addition of another lifetime entitlement is the answer? 

 That's only palatable to me if there are consequences for her actions.  She made the choices.  Her kids made their choices.  Her children went to the same schools mine would have, would have had the same teachers, would have had the same classes. They would have better chances to get financial aid for college than my kids, a lowered standard to be accepted, more help.  I can easily make the case that Ethel Lee's children actually have BETTER opportunity than my kids do.  So I should pay for their failures when they elect NOT to or are not motivated or encouraged to take advantage of them? 

You are more wrong about this than you could ever imagine. 

[GH2001]

No.  It's the exact opposite of a good plan.  It's a step backwards.

The Ryan-plan is an all-in push far too early.  They tipped their hand and exposed their true end goal: tax cuts for their wealthiest donors.  Nearly every singly other aspect of that plan increases the burden on the people that ACA was designed to help.

ACA put a burden on more than rich people like snags though. It doesn't set too well with me when I get the max I can taken out of my paycheck every month on taxes, pay more for my premiums the last 2 years (mostly because of this legislation let's be honest) - and still owe the IRS an amount with a comma in it every April. While someone else pays very little tax and very little healthcare premium at the expense of someone else. That just doesn't sit right. And I know it's more than just rich people. And more than just me. The middle class gets the shaft every single time on these things.

[Kaos]

I don't think it's reasonable to think that you can just pull the plug and change directions.  That's why I think the ACA was a good first step.  It will be a process (not only administratively, but culturally as well): Examine what works in the ACA and what doesn't.  Keep the good, tweak the bad.  Rinse, repeat.

Unfortunately, the two camps are currently working towards two opposite goals.

W.R.O.N.G.

It's a step that: a) wasn't necessary, b) should never have been taken and c) should be abandoned in its entirety. 

it was a horrible idea, an absolute disaster.

[wesfau2]

I guess it goes without saying that I fundamentally disagree with every facet and nuance of your stance. 

Health care lent itself to the free market quite well prior to government intervention.  There was no crisis, there was no need for federal intrusion. 

If "we as a society are beyond that fable" it's only because of the lies espoused by unabashed socialists such as, well ..... you. 

You worked in society's underbelly and wrongly saw an oppressed class of poor folks just trying to make it.  I worked in the same pool of cess and saw it for what it was -- a segment of society determined to do as little as possible and live off the work of others.  You wrongly saw denied opportunity.  I saw opportunity ignored and/or squandered.  You wrongly saw a need to redistribute wealth.  I saw a need to take advantage of the opportunities provided to make your own way. 

Everybody can't be rich.  It doesn't work that way.  But you can't tell me with a straight face that the opportunity to rise above does not currently exist for everyone legally in this country.  I choose not to be responsible for the abysmal life choices made by those who don't. 

Don't get me wrong, wes. I have no problem with short-term assistance.  I have no qualms about helping people who find themselves in difficult situations.  But only on a short-term basis, to give them a chance -- education, re-training, job preparation, etc. -- to find a way out of it. 

I unilaterally oppose, however, the life-time entitlements that have become accepted by that particular class.  They get "disability" checks.  They get WIC. They get food stamps. They get ADC. The kids get "crazy checks."  They get subsidized rent. 

The government has used Section 8 to turn quality apartments and housing into squalid slums.  Then when the formerly nice apartments fall into disrepair and decay, the residents (who are paying little to nothing) agitate and insist on something better because "their house isn't as nice as their neighbors."  So the government forces Section 8 on another nice complex. The tenants move, the ones who just destroyed the old complex move in and the pattern repeats itself.   I've lived that too.  The first apartments I lived in started to accept Section 8 tenants.  Six months later, after the second time my apartment and car was broken into, I moved. When that complex accepted its first Section 8 tenant two years later? I moved again.  Every time I moved I had to pay substantially higher rent because the Section 8 hordes were artificially inflating the market. 

We've got an entire subclass of people now who are in the second, third and fourth generation of living on the dole.  Ethel Lee is a prime example.  She filed for disability because she was "down in her back" when she was 18 years old.  She had "bad knees."  She pumped out seven kids by multiple different men.  All of them lived in public housing and drew government checks.  None of them worked.  I personally heard her tell her 16 year old daughter -- who already had one child -- that she needed to have another one because they needed the additional check for it.  None of her kids ever even thought about working.  Well, one worked at Wendy's for a short time and was ridiculed by the rest of the family.  Then she got pregnant, quit the job and moved into Rosedale Courts on her own and one the dole. 

I paid for that.  You paid for that. 

And now you want me to pay more? You think I should give Ethel Lee and her ilk a fucking "baseline?"   That's only palatable to me if there are consequences for her actions.  She made the choices.  Her kids made their choices.  Her children went to the same schools mine would have, would have had the same teachers, would have had the same classes. They would have better chances to get financial aid for college than my kids, a lowered standard to be accepted, more help.  I can easily make the case that Ethel Lee's children actually have BETTER opportunity than my kids do.  So I should pay for their failures when they elect NOT to or are not motivated or encouraged to take advantage of them? 

You are more wrong about this than you could ever imagine.

So, let's continue to punish the children born into the life crafted by "poor choices?"  We have to invest in a healthier, better educated population.  That means ALL of our population, not those with generations of advantage.

We have to give the kids an opportunity to get out by leveling the field.  It is undisputed that socioeconomic status determines in large part the arc of a child's life.  The kid didn't choose that circumstance, so why are we continuing to force them back into it?

The short term cost (this is also responsive to your post GH) is going to be "unfair" for those at the top of the earnings brackets, but this investment will yield a deeper workforce from which to draw that will ultimately make us a better and stronger America. 

[wesfau2]

W.R.O.N.G.

It's a step that: a) wasn't necessary, b) should never have been taken and c) should be abandoned in its entirety. 

it was a horrible idea, an absolute disaster.

Obviously you disagree with my stated ultimate goal. 

[AUChizad]

Ultimately, this is the root of the issue.  Fundamentally, you either agree that the playing field is equal for all participants at birth or you do not.

I do not.

Maybe semantics, but this is where we disagree for the most part. Equality of opportunity should be, and are constitutionally, guaranteed. Not equality of outcome. And they shouldn't be conflated.

[wesfau2]

Maybe semantics, but this is where we disagree for the most part. Equality of opportunity should be, and are constitutionally, guaranteed. Not equality of outcome. And they shouldn't be conflated.

I agree.

Not level outcomes, just a baseline standard of living that meets the basic needs of the citizenry.  The outcome is always up to the participant.

Is asking Bama to abide by the NCAA rules (level playing field) and compete the same as demanding that AU be awarded as many NCs (mythical and non) as Bama?

[Kaos]

ACA put a burden on more than rich people like snags though. It doesn't set too well with me when I get the max I can taken out of my paycheck every month on taxes, pay more for my premiums the last 2 years (mostly because of this legislation let's be honest) - and still owe the IRS an amount with a comma in it every April. While someone else pays very little tax and very little healthcare premium at the expense of someone else. That just doesn't sit right. And I know it's more than just rich people. And more than just me. The middle class gets the shaft every single time on these things.

You're SO right.  I'm not rich.  I was never going to get there under Obama's socialist plans.

My insurance now costs me something like $1500 a month.  Eight years ago it was under $500.  How is that right? 

My taxes?  Oh, madon....   I'm not going to get into how much I pay specifically but in the last eight years combined there's more than one comma in there.   I pay roughly 4x what I bring home.   

Insurance and taxes are now my biggest expense.  Surpassing what I pay my employees. 

It wasn't like that pre-Obama and pre- this spectacularly shitty entitlement program. 

It has to stop. 

[AUChizad]

I agree.

I posted as soon as I read that and before finishing the thread. But this is relevant.

[wesfau2]

You're SO right.  I'm not rich.  I was never going to get there under Obama's socialist plans.

My insurance now costs me something like $1500 a month.  Eight years ago it was under $500.  How is that right? 

My taxes?  Oh, madon....   I'm not going to get into how much I pay specifically but in the last eight years combined there's more than one comma in there.   I pay roughly 4x what I bring home.   

Insurance and taxes are now my biggest expense.  Surpassing what I pay my employees. 

It wasn't like that pre-Obama and pre- this spectacularly shitty entitlement program. 

It has to stop.

Is there an amount that you would be ok paying?  An amount, that if was levied upon the "makers" and given to the "takers" that would provide them basic healthcare?

[Kaos]

So, let's continue to punish the children born into the life crafted by "poor choices?"  We have to invest in a healthier, better educated population.  That means ALL of our population, not those with generations of advantage.

So now we're getting to the root of the issue.  Wes has white guilt.  Period. 

Your entire point of view is built on that fallacy.

Among my many jobs, wes, I taught in a very poor school for years.  I taught history.  And I was a damn good teacher.  Almost everybody there was good. Everybody in that place was working their ass off for scant wages, working because we felt like we could make a difference. 

So I'm there making $28,000 a year because I loved it.  There were many days I had to bring sandwiches from home because I couldn't afford to buy the school lunch and still get gas for my truck. 

And I'm watching kids wearing $150 shoes, $90 Ralph Lauren jeans, jewelry... they're eating free lunches. 

I can look back at the kids I taught.  There were some, one in particular I remember, who had absolutely nothing. A mom who spent her entire paycheck at the casino and a dad who was in jail for drugs.  That kid? He owns a chain of retail stores now.  He started it himself.  There were others who had everything and did nothing with their lives. 

You can't legislate that.  You can't "even" that playing field. 

We have to give the kids an opportunity to get out by leveling the field.  It is undisputed that socioeconomic status determines in large part the arc of a child's life.  The kid didn't choose that circumstance, so why are we continuing to force them back into it?

The short term cost (this is also responsive to your post GH) is going to be "unfair" for those at the top of the earnings brackets, but this investment will yield a deeper workforce from which to draw that will ultimately make us a better and stronger America.

No offense, but you're a raving lunatic if you think that giving even more is going to achieve that level playing field.

Every kid I taught had the same opportunity to learn, to improve their status, to make it out. 

Nobody is "forcing" them into anything. 

The opportunity is there.  The playing field is more level than you understand.  You're utterly and completely wrong about this. 

It's a matter of personal choice.  Oh, the path may be easier for somebody born in Newport Rhode Island whose dad has a yacht than it is for somebody born in Newbern Mississippi whose mom gets her monthly checks and watches The Chew everyday on TV.  But the path is there for both should they choose to travel it. 

You take that kid from Newbern?  The system will break itself in half today trying to make sure he succeeds.  That kid -- if he's willing to try -- will have just as much opportunity if not more than the Newport kid. 

You're just wrong, wes.  Fundamentally wrong.  The answer is accountability, not more entitlement.

[Kaos]

Is there an amount that you would be ok paying?  An amount, that if was levied upon the "makers" and given to the "takers" that would provide them basic healthcare?

No. 

Because I disagree with that concept on a fundamental level. 

I have no desire to fund "takers."   

I'd be more inclined to support anything that actually promotes personal accountability and ties the ability to receive with the desire to improve.  But the current state of entitlement, where people think they are owed something just by virtue that they breathe?  Nope. 

[AUChizad]

I guess it goes without saying that I disagree with every word of this.

Healthcare delivery doesn't lend itself to free-market concepts.  And it shouldn't.

At some point the fiction that any market is "free" or unadulteratedly capitalist has to be sloughed off.  We are, as a society, beyond that fable.

So, I'll try again. I disagree with this as well. I'm not beyond it. In fact, it's really the only thing (as central to the debate as it is) that I disagree with you on in regards to the ACA.

I think "build a better mousetrap" is undeniable economic 101 truth and fact. As is "you pay for what you get".

I understand that you ideally want an opt out option for private insurance for people who can afford it, but I think that ignores bigger problems. First, the status quo is that 99% of people (that's Chizad math, didn't look up an actual stat) of people get quality health care plans from their employers. You offer a subpar government plan to everyone who doesn't want to buy their own "Cadillac" plan, and that goes away. Your choice is truly to take VA quality healthcare plan or spend a fortune to have your own plan, not subsidized by your employers. Secondly, I think common sense absolutely bares out that when doctors start getting paid average-Joe wages, you are no longer going to get the best and the brightest entering the field of medicine. Can't imagine how you would expect that to be the case.

[CCTAU]

I guess it goes without saying that I fundamentally disagree with every facet and nuance of your stance. 

Health care lent itself to the free market quite well prior to government intervention.  There was no crisis, there was no need for federal intrusion. 

If "we as a society are beyond that fable" it's only because of the lies espoused by unabashed socialists such as, well ..... you. 

You worked in society's underbelly and wrongly saw an oppressed class of poor folks just trying to make it.  I worked in the same pool of cess and saw it for what it was -- a segment of society determined to do as little as possible and live off the work of others.  You wrongly saw denied opportunity.  I saw opportunity ignored and/or squandered.  You wrongly saw a need to redistribute wealth.  I saw a need to take advantage of the opportunities provided to make your own way. 

Everybody can't be rich.  It doesn't work that way.  But you can't tell me with a straight face that the opportunity to rise above does not currently exist for everyone legally in this country.  I choose not to be responsible for the abysmal life choices made by those who don't. 

Don't get me wrong, wes. I have no problem with short-term assistance.  I have no qualms about helping people who find themselves in difficult situations.  But only on a short-term basis, to give them a chance -- education, re-training, job preparation, etc. -- to find a way out of it. 

I unilaterally oppose, however, the life-time entitlements that have become accepted by that particular class.  They get "disability" checks.  They get WIC. They get food stamps. They get ADC. The kids get "crazy checks."  They get subsidized rent. 

The government has used Section 8 to turn quality apartments and housing into squalid slums.  Then when the formerly nice apartments fall into disrepair and decay, the residents (who are paying little to nothing) agitate and insist on something better because "their house isn't as nice as their neighbors."  So the government forces Section 8 on another nice complex. The tenants move, the ones who just destroyed the old complex move in and the pattern repeats itself.   I've lived that too.  The first apartments I lived in started to accept Section 8 tenants.  Six months later, after the second time my apartment and car was broken into, I moved. When that complex accepted its first Section 8 tenant two years later? I moved again.  Every time I moved I had to pay substantially higher rent because the Section 8 hordes were artificially inflating the market. 

We've got an entire subclass of people now who are in the second, third and fourth generation of living on the dole.  Ethel Lee is a prime example.  She filed for disability because she was "down in her back" when she was 18 years old.  She had "bad knees."  She pumped out seven kids by multiple different men.  All of them lived in public housing and drew government checks.  None of them worked.  I personally heard her tell her 16 year old daughter -- who already had one child -- that she needed to have another one because they needed the additional check for it.  None of her kids ever even thought about working.  Well, one worked at Wendy's for a short time and was ridiculed by the rest of the family.  Then she got pregnant, quit the job and moved into Rosedale Courts on her own and one the dole. 

I paid for that.  You paid for that. 

And now you want me to pay more? You think I should give Ethel Lee and her ilk a fucking "baseline?" 
You honestly believe that the addition of another lifetime entitlement is the answer? 

 That's only palatable to me if there are consequences for her actions.  She made the choices.  Her kids made their choices.  Her children went to the same schools mine would have, would have had the same teachers, would have had the same classes. They would have better chances to get financial aid for college than my kids, a lowered standard to be accepted, more help.  I can easily make the case that Ethel Lee's children actually have BETTER opportunity than my kids do.  So I should pay for their failures when they elect NOT to or are not motivated or encouraged to take advantage of them? 

You are more wrong about this than you could ever imagine.

Thank you for putting this in a way even socialists can understand.

Now we will get, "but what about the children" argument.

You did leave out the ton of money these "poor children" get to attend college. IF, they could just find it in themselves to actually graduate from high school. But I guess that is not their fault either.

While my children work or join the military to be able to attend college, they get more money than they ever had thrown at them. BUT yet, they are "stuck in poverty"!

[Kaos]

So, I'll try again. I disagree with this as well. I'm not beyond it. In fact, it's really the only thing (as central to the debate as it is) that I disagree with you on in regards to the ACA.

I think "build a better mousetrap" is undeniable economic 101 truth and fact. As is "you pay for what you get".

I understand that you ideally want an opt out option for private insurance for people who can afford it, but I think that ignores bigger problems. First, the status quo is that 99% of people (that's Chizad math, didn't look up an actual stat) of people get quality health care plans from their employers. You offer a subpar government plan to everyone who doesn't want to buy their own "Cadillac" plan, and that goes away. Your choice is truly to take VA quality healthcare plan or spend a fortune to have your own plan, not subsidized by your employers. Secondly, I think common sense absolutely bares out that when doctors start getting paid average-Joe wages, you are no longer going to get the best and the brightest entering the field of medicine. Can't imagine how you would expect that to be the case.

Oh no.  I agree with you.

I would like to add that the 99% USED to get quality healthcare from their employers. What's happened to so many like me since this ridiculous legislation was passed is that we no longer have the ability to provide it.

Prior to this ACA I paid for full coverage for all employees and their families. The plan had reasonable deductibles, low copays and provided inexpensive prescriptions.  Since? I can't pay for it all. They have to shoulder too much of the burden.  The deductible has quadrupled in some cases. The copay more than doubled. Procedures that were once covered now cost.  $400 for an MRI. Many treatments -- even preventative ones -- are no longer included.

It is an abomination.  For whom is it actually affordable? 

[CCTAU]

It is an abomination.  For whom is it actually affordable?

It is now affordable for all of those people getting subsidies. While the people who previously were barely able to afford it, now have no insurance.
So essentially, you stole from the working middle class to give to the poor.