Timex
6262
I didn’t even encounter a paywall. But you can just Google the subject and there are a ton of other stories on it.
Timex
6263
It also doesn’t make any sense from a financial perspective.
You can’t cover persisting conditions, while ALSO not requiring people to get health insurance.
Those two ideas are mutually exclusive… Because it’s actually worse than the system before the aca. It removes all incentive to actually get health insurance, since you can just get it after you get sick if you need it.
If you want to cover everyone, then everyone needs to actually get insurance, not just sick people.
Like all of Trump’s plans, it’s just fantasy bullshit.
Oghier
6264
None of the republicans have ever addressed the pre-existing conditions issue. There’s no way you can allow people with them access to affordable insurance without requiring everyone to have it in the first place.
The old model of getting insurance from your employer is broken and getting more so. The economy has been moving toward subcontractors and temps for decades. And a “health savings account” doesn’t help much when treating major conditions can easily top 100 or 200k.
I don’t see how any of the GOP ‘plans’ do not result in massive numbers of people losing coverage, suffering and, in many cases, dying.
The goal isn’t saving lives. People are a business expense that needs to be cut.
The way I’m interpreting his point about HSAs (since they’re a thing that already exists) is that he wants to uncap them and make them tax-free forever which creates a yuge loophole for the rich. Which shouldn’t surprise me.
iirc, they have a 10 article limit per month. It’s the 3rd … wow, Strollen!! Well done, keeping them as popular as they are.
I think Carson’s plan has a lot of merit.
(I’m reading between the lines to some extent)
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Require everyone to buy catastrophic insurance.
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The states use Medicaid money buy catastrophic insurance for poor people
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Employers and individuals are encouraged to contribute to modified health saving account. (He talks about tax deduction but this can easily be a tax credit (even a refundable one)
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The HSA are used to pay for insurance premiums and deductible expenses, but accumulate year to year
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HSA can be shared within an extended family.
Throwing some numbers out.
The employer contributed $2,000 per year (this is enough to buy catastrophic for most people)
I contributed $2,000 getting me a $500-$1,000 tax credit to my HSA.
My annual doctor visit and test run about $300, drugs and misc are another $200 (I’m fat but otherwise healthy) leaving me an excess of $1,500/year in my HSA which accumulate
My niece gets some serious medical condition, the catastrophic insurance pays everything over $13,500 (current ACA limits), but I can transfer money from my HSA to help pay the big deductible, hopefully in the future she’ll return the favor if I get a chronic illness.
It does have a mandate but the difference between paying for ACA plan and catastrophic is significant.
If you delete the Washington Post cookies you will be able to read the article (since that resets the count for the month).
Nesrie
6270
HSA’s are great options for people who are younger and the healthy, people who have existing conditions… not so good. Most of the Republican based plans are a middle-finger to people who have medical conditions today.
I don’t disagree. But many of the most expensive medical conditions are least partially and in many cases almost entirely caused by lifestyle choices. We have to some incentives for people to make better lifestyle choices. I may willing contribute to helping my grand nephew medical expense due to food allergies, but not be so generous to my sisters added expenses due to type 2 diabetes.
Right now ACA provides zero incentive for people to make good lifestyle choices.
The consensus on the medical community is that punitive measures (making people pay more) do nothing to push people towards healthier lifestyles (this is a common topic of discussion in single payer systems).
The idea is that information and nudging does help long term, but punitive measures do not change behavior, so they are actually a horrible incentive and can even increase the final cost because people are then less likely to go to the doctor until later (because on less insurance) and their overall health instead worsens (instead of bettering as is the objective of the measure, unless the objective is to just let them suffer for their mistakes, but I don’t think anybody is really suggesting that).
If an unhealthy lifestyle guy is insured under this framework (high deductible, no help on his HSA) you could get him to not go to the doctor often (because of the huge deductible), but then use the insurance when his health is really poor and undergoing a $200k treatment (costing the insurance much more long term than if the same patient had a lower deductible and had gone to the doctor more often).
What you really want is for people to go more to the doctor so the doctor can push lifestyle choices and keep stuff in check to avoid many expensive treatments further down the line. Sadly, that’s also hard to accomplish (insured people do use the insurance more, but not necessarily for routine checkups).
Timex
6273
The reality is that there is only one legitimate argument for why the government shouldn’t do something (in this case, manage the Healthcare system), and that is because the government is generally less efficient at virtually everything than the market.
However, that distinction disappears when you start taking about healthcare, because Healthcare in the US does not traditionally obey normal market forces.
It’s inelastic, and consumers are generally incapable of acting as radical actors. In most of the most expensive medical procedures, the consumer has very little option. Either you take what’s offered, or you die. This prohibits any normal market interaction. Add in the opacity resulting from the insurance system, and this becomes even more true, where even for mundane things consumers generally have no idea what they are paying. They have no idea how to shop around.
This is why for so long prices have skyrocketed. The market can’t really handle this particular commodity in a manner which we find acceptable as a society.
And once you accept that, then the chief argument against the government being involved in the system falls away.
In not generally in favor of the government trying to manage complex systems like this , because the government sucks balls at it. But in this particular case, there isn’t much alternative that works better.
Irrational Trump Supporter: Our candidate will make this country great again!
Democrat’s reply: Oh! The Audacity of Hope!
Nesrie
6275
Yeah this is bullshit. You think someone on this board who has cancer made a lifestyle choice to have it. You think all the women with breast cancer should have done what exactly? What is a person with type-1 diabetics supposed to do just not be born. You think the people who started smoking when they were 10 in the 60s when no one really warned them should just die and do us all a favor. If I have huntingon’s should I just apply for assisted suicide right… oh wait the GOP doesn’t like that either. If one person weighs 250 pounds and the guy next to them is 400, but the 250 person has type II, should we just throw them into the ocean to save us the trouble and congratulate the 400 pound guy because he has more robust genes than the one next to him?
Not that I agree that consequences are “entirely lifestyle choices”, how much weight would you assign any consequence to lifestyle choices?
Strolled stated his view, but what’s the reasoned stand? It’s cannot be “it’s all pre-determined!” unless you want to argue for pre-determinism, so how much weight does choice play in the equation?
Timex
6277
From a purely factual perspective, strollen’s statement is accurate.
While certainly cancer is not one of the conditions he is talking about, it is also not as expensive as those he is.
America spends the most money on illnesses like type 2 diabetes and heart disease currently, and these are in many cases caused by lifestyle choices.
Who cares? Only evil scum would deny someone healthcare for an existing condition regardless of the cause.
Timex
6279
We’ll… No. That’s not true.
It’s not really fair for me to have to subsidize your bad choices.
For instance , imagine you compete in some kind of extreme sport where you get injured constantly because you suck.
There is nothing evil about saying that is bullshit for me to is have to pay for that.
And what Strollen is saying is that there is a problem if you remove disincentives for certain behavior, because doing so will result in more of that behavior. If it’s expensive behavior, then the result will be increased costs for the whole system because you are severing the decision maker from the payment maker.
There is nothing moral or immoral about this statement. It is simply a logical fact.
Nesrie
6280
Yeah the ignorance about healthcare being shown here is actually pretty surprising consider how educated many of you seem to be.
What I just said is completely, factually true. There are people out there who look healthy and are certainly not, and there are very large people who look unhealthy and are certainly not. There are entire articles out there telling the world to stop trying to use BMI and the consumption of junk food to determine whether or not someone is a healthcare risk.
Someone can absolutely eat anything they want, not exercise and be perfectly fine and the same “lifestyle” choice made by another person leads to a lifetime of chronic diseases. You’re not punishing the lifestyle, you’re targeting the person who happens to have a different genetic make-up than the other person does. There are people who can smoke for decades, never gets lung cancer, and someone who smoke for two years, hasn’t smoked for twenty years, and still get it. It’s not as simple as putting down the donuts… dear lord.
I think what makes this system different is who is doing the paying and who is doing the nudging. Aunt Susie fast food made her a type 2 diabetic. Last year she ended up in the hospital for several days and ran up a 40K bill, the large deductible (13.5K) exhausted her HSA. If I have $5,000 in HSA which can only be used for medical expense, I’m probably ok with contributing $1,000 along with 1/2 dozen family members to help Aunt Susie out. However, next year at family functions I’m certainly urging Susie to try my sisters great salad, and not the 2nd slice of birthday cake and talk about how while I still hate exercise having a class helps. In turn, Susie knowing that family chipped into to help her may feel a sense of obligation to take some positive steps. I think the combination of love and financial incentive may make a difference.
I think the idea of sharing families sharing HSA is an innovative one and consistent with conservative principals.
