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Health insurance

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  • 16-11-2016 7:27pm
    #1
    Registered Users Posts: 12,493 ✭✭✭✭


    I know this is hopelessly naive but after reading about Obama care: Why isn't health insurance compulsory for all adults in the U.S even a very basic policy surely that would go a long way to solving the issue.


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  • Technology & Internet Moderators Posts: 28,801 Mod ✭✭✭✭oscarBravo


    mariaalice wrote: »
    I know this is hopelessly naive but after reading about Obama care: Why isn't health insurance compulsory for all adults in the U.S even a very basic policy surely that would go a long way to solving the issue.

    Because Americans don't like government compulsion to spend money on things.

    The ACA makes it kinda-sorta compulsory by imposing fines on people who choose not to be insured. Turns out the fines are cheaper in many cases than the insurance.


  • Closed Accounts Posts: 2,379 ✭✭✭newacc2015


    A lot of Americans believe that Government ie the Federal Government should have minimal intervention in the daily running of the economy. Health insurance should be seen as an unnecessary intervention in the markets for most people.

    The fact is many Americans get free healthcare or low cost from the Government when they are ultralow income and old such as Medicaid and Medicare. Many states also provide their own form of low insurance for low income workers. A lot of companies provide free health insurance for their workers, but a lot companies give their workers low hours to minimise having to pay for it like Walmart

    The probably with US healthcare is the high cost not lack of insurance. Medicine prices are insane in the US and having them closer to European levels would help millions of Americans


  • Moderators, Category Moderators, Science, Health & Environment Moderators, Social & Fun Moderators, Society & Culture Moderators Posts: 38,709 CMod ✭✭✭✭ancapailldorcha


    The idea was that younger, healthier Americans would offset the risk to insurers posed by older and sicker people. Instead, many have eschewed insurance and opted for the often cheaper fines instead leaving those who do take out insurance with more expensive premiums.

    The foreigner residing among you must be treated as your native-born. Love them as yourself, for you were foreigners in Egypt. I am the LORD your God.

    Leviticus 19:34



  • Registered Users Posts: 9,900 ✭✭✭InTheTrees


    newacc2015 wrote: »
    The fact is many Americans get free healthcare or low cost from the Government when they are ultralow income

    No. That isnt a fact. That isn't true at all.

    If you can't afford health care you go to the emergency room where they legally have to treat you. But they'll send you a bill. You can skip out on the bill of course, then your credit will be shot.

    If you have some long term condition like diabetes then you can expect a lot of emergency room visits and growing debt.


  • Registered Users Posts: 9,900 ✭✭✭InTheTrees


    newacc2015 wrote: »
    Many states also provide their own form of low insurance for low income workers.

    If you mean under the Affordable Care Act then that will be going away as soon as trump can repeal it.


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  • Registered Users Posts: 9,900 ✭✭✭InTheTrees


    newacc2015 wrote: »
    A lot of companies provide free health insurance for their workers.

    Its not really "free". It can cost around $10,000/year to provide can employee with health insurance, if you get your insurance under your spouses policy you can often opt out and get a raise in salary for instance.


  • Registered Users Posts: 82,795 ✭✭✭✭Overheal


    InTheTrees wrote: »
    If you mean under the Affordable Care Act then that will be going away as soon as trump can repeal it.

    Said he won't repeal it though.

    Anyway, if the government is going to force people to purchase insurance it may as well be taxed and apply to everyone: aka universal healthcare.

    As for skipping on bills I don't necessarily reccomend it. I do however have an outstanding balance in a hospital for $2500 and a separate trumped up charge from a clinic that I already paid their flat rate visit fee for of $250; which did not stop them from claiming the payment doesn't exist and I somehow owe $755 for labwork done at the time, despite being a service covered in their visit flat rate.

    American healthcare is a shambles. It's better than it was in some respects, worse in others. Profit motives gone wild: I'm surprised insurance companies are this terrible at negotiating down the costs of care. It doesn't work this way in other industries: in the auto industry, insurers and regulators strong-arm auto makers into adopting higher safety standards. I'm confused as to why health insurers aren't pushed to drive healt care costs down in a similar manner.


  • Moderators, Category Moderators, Science, Health & Environment Moderators, Social & Fun Moderators, Society & Culture Moderators Posts: 38,709 CMod ✭✭✭✭ancapailldorcha


    Overheal wrote: »
    American healthcare is a shambles. It's better than it was in some respects, worse in others. Profit motives gone wild: I'm surprised insurance companies are this terrible at negotiating down the costs of care. It doesn't work this way in other industries: in the auto industry, insurers and regulators strong-arm auto makers into adopting higher safety standards. I'm confused as to why health insurers aren't pushed to drive healthcare costs down in a similar manner.

    Because if your car gets too expensive, you trade it in for a bus pass or carpool and split the cost. That option doesn't exist for your body so there's no incentive to keep costs down.

    The foreigner residing among you must be treated as your native-born. Love them as yourself, for you were foreigners in Egypt. I am the LORD your God.

    Leviticus 19:34



  • Registered Users Posts: 9,900 ✭✭✭InTheTrees


    Overheal wrote: »
    As for skipping on bills I don't necessarily reccomend it.

    No. Exactly. In a lot of cases poor people dont have any choice though, for them healthcare IS the emergency room. The cost, through corporate debt write off, inevitably ends up with the US taxpayer.


  • Closed Accounts Posts: 39,022 ✭✭✭✭Permabear


    This post has been deleted.


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  • Registered Users Posts: 82,795 ✭✭✭✭Overheal


    Permabear wrote: »
    This post had been deleted.

    There are conditions for waiving it. I've had it waived 2 years


  • Closed Accounts Posts: 39,022 ✭✭✭✭Permabear


    This post has been deleted.


  • Registered Users Posts: 26,511 ✭✭✭✭Peregrinus


    Overheal wrote: »
    American healthcare is a shambles. It's better than it was in some respects, worse in others. Profit motives gone wild: I'm surprised insurance companies are this terrible at negotiating down the costs of care. It doesn't work this way in other industries: in the auto industry, insurers and regulators strong-arm auto makers into adopting higher safety standards. I'm confused as to why health insurers aren't pushed to drive healt care costs down in a similar manner.
    Because it's not in their interests to do so. Basically, their business model works on a "cost-plus" basis - they make a margin of (let's say) 10% on all the money that goes to doctors and hospitals and drug suppliers and so forth. So, the more money that gets spent on medicine, the more money the insurer makes.

    There's a bit of a tension here. At the level of the individual claim, the insurer has an interest in getting the payout down. But, looking at claims as a whole, the bigger the turnover the bigger the profit.

    The result is that when insurers are negotiating about individual claims they'll argue over whether this particular treatment was necessary, was aprpopriate, was beneficial. But they generally won't argue about what it cost. The result is that hospitals, etc, price treatments very highly, accepting that in a large proportion of cases the insurer will refuse to pay for the treatment, and those cases have to be covered by the cases where payment is made. And the result of that is that, if you're not insured, you end up being charged the extremely high unit price and you're not in a position to argue that the treatment was unnecessary or inappropriate.


  • Registered Users Posts: 12,493 ✭✭✭✭mariaalice


    Permabear wrote: »
    This post had been deleted.

    That is only effective if you could buy a policy for 695, the fine needs to be greater than the cheapest policy available.


  • Closed Accounts Posts: 39,022 ✭✭✭✭Permabear


    This post has been deleted.


  • Registered Users Posts: 19,309 ✭✭✭✭alastair


    Permabear wrote: »
    This post had been deleted.

    The premium cost of coverage over the fine isn't that great for most though:
    HHS, in an analysis released Monday, found that 72 percent of HealthCare.gov customers would be able to find a plan that would cost them less than $75 per month after financial assistance.

    And 77 percent of customers will be able to find plans that cost them less than $100 per month, after assistance.

    The assistance is available to low- and moderate-income people — ones who earn between 100 percent and 400 percent of the federal poverty level. Officials said Monday that the typical HealthCare.gov consumer earns 165 percent of the poverty level, or about $40,000 for a family of four, or $19,000 for a single person.

    About 85 percent of current HealthCare.gov customers qualify for financial aid, in the form of federal tax credits.

    An annual $500 above and beyond the fine, for coverage, for 77% (or an extra $200 for 72%) is not what I'd consider unaffordable.


  • Registered Users Posts: 2,256 ✭✭✭MayoSalmon


    mariaalice wrote: »
    I know this is hopelessly naive but after reading about Obama care: Why isn't health insurance compulsory for all adults in the U.S even a very basic policy surely that would go a long way to solving the issue.

    No economic issues especially health and poverty will be solved by socialist systems of government intervention. NONE


  • Registered Users Posts: 82,795 ✭✭✭✭Overheal


    MayoSalmon wrote: »
    No economic issues especially health and poverty will be solved by socialist systems of government intervention. NONE

    Yet there are successful models for this, though some would point to the failures to make you forget that. Similarly there are failed capitalist economies


  • Registered Users Posts: 2,256 ✭✭✭MayoSalmon


    Overheal wrote: »
    Yet there are successful models for this, though some would point to the failures to make you forget that. Similarly there are failed capitalist economies

    Wheres your evidence?


  • Registered Users Posts: 12,493 ✭✭✭✭mariaalice


    MayoSalmon wrote: »
    No economic issues especially health and poverty will be solved by socialist systems of government intervention. NONE

    So what has solved them?


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  • Registered Users Posts: 19,309 ✭✭✭✭alastair


    MayoSalmon wrote: »
    Wheres your evidence?

    The socialised health provision models in pretty much every other advanced nation in the world?


  • Registered Users Posts: 2,256 ✭✭✭MayoSalmon


    mariaalice wrote: »
    So what has solved them?

    The free market has solved them and continues to do so.

    Singapore Health system is the model worldwide healthcare should be striving towards and is a beacon of personal responsibility.


  • Registered Users Posts: 2,256 ✭✭✭MayoSalmon


    alastair wrote: »
    The socialised health provision models in pretty much every other advanced nation in the world?

    Which are all complete failures.

    I hardly need to point out of the substantial cost per captia in delivering the system here, spiraling costs, the long wait lists etc


  • Registered Users Posts: 19,309 ✭✭✭✭alastair


    MayoSalmon wrote: »
    The free market has solved them and continues to do so.

    Singapore Health system is the model worldwide healthcare should be striving towards and is a beacon of personal responsibility.

    Singapore is a city-state, and therefore has less of a challenge with healthcare provision - similar small-scale nations do just as well in healthcare system rankings on socialised models: San Marino, Andorra, Malta, Monaco, Iceland, Luxembourg.

    http://thepatientfactor.com/canadian-health-care-information/world-health-organizations-ranking-of-the-worlds-health-systems/


  • Registered Users Posts: 19,309 ✭✭✭✭alastair


    MayoSalmon wrote: »
    Which are all complete failures.

    Really? Because that's a notion at odds with all the evidence.


  • Registered Users Posts: 12,493 ✭✭✭✭mariaalice


    MayoSalmon wrote: »
    The free market has solved them and continues to do so.

    Singapore Health system is the model worldwide healthcare should be striving towards and is a beacon of personal responsibility.

    Singapore has a non-modified universal healthcare system where the government ensures affordability of healthcare within the public health system, largely through a system of compulsory savings, subsidies, and price controls.

    Singapore's system uses a combination of compulsory savings from payroll deductions to provide subsidies within a nationalised health insurance plan known as Medisave

    Medishield is a low cost insurance scheme intended for those whose savings are insufficient to meet their medical expense.

    Hmmm


  • Registered Users Posts: 2,256 ✭✭✭MayoSalmon


    alastair wrote: »
    Singapore is a city-state, and therefore has less of a challenge with healthcare provision - similar small-scale nations do just as well in healthcare system rankings on socialised models: San Marino, Andorra, Malta, Monaco, Iceland, Luxembourg.

    http://thepatientfactor.com/canadian-health-care-information/world-health-organizations-ranking-of-the-worlds-health-systems/

    I have a simple question, do you not think that healthcare should be provided by the free market much like the rest of the services we have in society?

    And do you think the costs would rise or fall if the private sector took over the industry?


  • Registered Users Posts: 2,256 ✭✭✭MayoSalmon


    mariaalice wrote: »
    Singapore has a non-modified universal healthcare system where the government ensures affordability of healthcare within the public health system, largely through a system of compulsory savings, subsidies, and price controls.

    Singapore's system uses a combination of compulsory savings from payroll deductions to provide subsidies within a nationalised health insurance plan known as Medisave

    Medishield is a low cost insurance scheme intended for those whose savings are insufficient to meet their medical expense.

    Hmmm

    I am well aware and thats hardly ideal however its system stands above all others in the world.

    The chief concept that allows it to prosper and succeed is the fact that the public sector hospitals are operated as private limited companies in order to compete with on service and quality.

    Stop socializing the cost of healthcare return every dollar to the tax payer


  • Registered Users Posts: 12,493 ✭✭✭✭mariaalice


    MayoSalmon wrote: »
    I am well aware and thats hardly ideal however its system stands above all others in the world.

    The chief concept that allows it to prosper and succeed is the fact that the public sector hospitals are operated as private limited companies in order to compete with on service and quality.

    Stop socializing the cost of healthcare return every dollar to the tax payer

    Did you see the bit about subsidies, price control, universal health care in Singapore.


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  • Registered Users Posts: 9,900 ✭✭✭InTheTrees


    MayoSalmon wrote: »
    No economic issues especially health and poverty will be solved by socialist systems of government intervention. NONE
    MayoSalmon wrote: »
    The free market has solved them and continues to do so.
    Singapore Health system is the model worldwide healthcare should be striving towards and is a beacon of personal responsibility.
    mariaalice wrote: »
    Singapore's system uses a combination of compulsory savings from payroll deductions to provide subsidies within a nationalised health insurance plan known as Medisave
    MayoSalmon wrote: »
    I am well aware and thats hardly ideal however its system stands above all others in the world.

    So subsidies, compulsory payroll deductions and government control are good then.


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