OBAMACARE ( because you can't afford it )

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Calvin
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OBAMACARE ( because you can't afford it )

https://www.msn.com/en-us/money/insurance/what-obamacare-health-insuranc...

The link will explain itself. Obamacare costs more than medicare by over three times.
Why do they believe this is good for Maine?
Why can't we buy insurance across state lines ? Maine is #44 on the expensive end.
Keep on buying into that "Gov'mint" koolaid and we will be priced right off the page.

Thomas Carter
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Remember that time the

Remember that time the Republicans controlled the White House, Senate, and House of Representatives and still couldn't "repeal and replace" Obamacare?

Pepperidge Farm remembers.

Matt
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They couldn’t even repeal it.

They couldn’t even repeal it.

Speak very, very loudly and carry a teeny, tiny stick. Just ask Stormy.

knucklehead
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Game's changing. We need to

Game's changing. We need to produce more health care professionals - not even doctors, but RNs, PAs, Radiologists, etc,. etc.. More doctors would be good as well. That will lower prices. Then we open insurance to competition. The government doesn't DO anything - they just get out of the way and let markets work.

anonymous_coward
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@knucklehead: "Game's

@knucklehead: "Game's changing. We need to produce more health care professionals - not even doctors, but RNs, PAs, Radiologists, etc,. etc.. More doctors would be good as well. That will lower prices. Then we open insurance to competition. The government doesn't DO anything - they just get out of the way and let markets work."

Unfortunately, you're wrong.

The reason you're wrong, is that medical care is not chosen based on price, it's based on patient happiness and convenience.

Remember HMOs? It was a scheme to reduce health care costs by getting patients to use a smaller group of providers (and thus increase usage rates of facilities).

Less convenient, because if you were a member of an HMO, you had a more limited set of doctors to choose from, but cheaper.

What did people pick? Not cheaper, they chose *the doctor I want*.

HMOs chose to compete based on price, and they lost. The free market spoke, and the free market said, I would like to have more expensive health care, because the cost is being shared with everyone else that's on the plan. If I have a really serious disease, I don't give a flying fig how much it costs, b/c everyone else is paying for it.

Now, to be fair, the movie Jerry McGuire had a huge influence on that, and that *is* completely stupid. But I suspect that Jerry McGuire was a catalyst for a reaction that was going to happen anyway (could be wrong - that's just my opinion).

knucklehead
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OK - To your point, that's

OK - To your point, that's still allowing markets to decide. I also want smaller, decentralized hospitals, which more healthcare workers will make a reality. Winthrop has multiple-practice health center in the old woolen mill that is associated with Maine General in Augusta and they do bloodwork and Xrays. Very convenient and there's enough room in the facility to expand services and maybe add some beds.

johnw
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The reality is that large for

The reality is that large for profit medical conglomerates are buying up all of the available small health care clinics and small hospitals.... eliminating competition. Insurance companies are invested in for profit hospitals and pharmaceutical companies , talk about a nice little incestuous monopoly.
My daughter who is a doctor gave me quite a dissertation on the number of foreign trained doctors that are being hired , not to hold down costs to the patient but rather to reduce labor cost and fatten the bottom line for ,for profit health care. The other interesting point she made was that many of these doctors don't share the same kind of medical compassion and end of life ethics for patients that is instilled in American trained doctors....I have to admit that she has truly disabused me of many of my ideas about how medicine is practiced.....Doctors may become wealthy but at what a price .

anonymous_coward
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@knucklehead: "OK - To your

@knucklehead: "OK - To your point, that's still allowing markets to decide. "

Agreed. But there is a prevailing notion that "just letting the free market run wild and free" will reduce health care costs - and I'm saying that it absolutely won't.

(Not to say that a policy like Obamacare will - it also won't. One of my biggest criticisms of Obamacare is it does very little to reduce costs on the long term. It's almost entirely focused on increasing coverage.)

Economike
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To say that HMOs were somehow

To say that HMOs were somehow a test of market forces is a stretch.

There's been no way to determine real costs in health care for at least fifty years.

When prices have no relationship to costs there's no information for decision-making.

anonymous_coward
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@Economike: "When prices have

@Economike: "When prices have no relationship to costs there's no information for decision-making."

There's a very real price of premiums & deductibles. It's extremely transparent, and most people are very aware of when their premiums go up. Or what the difference in premium price is between a high and low deductible plan.

The problem is there's an agency conflict between the choosers of treatment (patients) and the payers of treatment (the insurance companies). A patient who has met their deductible has no incentive to keep costs down, since their price is the same regardless of which treatment they choose.

Economike
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anon-

anon-

Yes, one can see premiums and deductibles. Out-of-pocket is easiest to track.

Still, it's difficult to know the price of one's heath insurance, and that's not close to tracking cost.

Maybe my experience is typical. Part of my coverage is paid by the government, part by my former employer, and part by me. I know what I pay. I could probably determine a price of what my former employer pays. But there's no way I can determine real costs. Given the direct subsidies and cross-subsidies built into system, some part of expenditure charged to my account is paying for someone else. Or maybe someone else is subsidizing me.

As you write, once I've paid my deductibles, I have no incentive to limit consumption.

Ugenetoo
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Insurance is just another

Insurance is just another socialist tool.

Economike
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"Insurance is just another

"Insurance is just another socialist tool."

Insurance is pure capitalism. It's a market for allocating risk, and it predates socialism by a century.

It would be erroneous to confound insurance with government subsidies.

Ugenetoo
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Insurance operates in the

Insurance operates in the same fashion as socialism.
Share the wealth.
Share the risk.
They both allow the participants to spend other people's money with no regard to cost.
The whole process is rife with opportunities for fraud, which the cost of is just folded into the premiums and passed on.
You want affordable healthcare?
Eliminate the insurance industry first.
Then work on the other cost increase drivers such as lack of competition and government interference.

johnw
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Had an employee turn down a

Had an employee turn down a move to a salaried position and a bigger pay check because they would lose their Obamacare subsidy ,stayed at a lower hourly rate and works 29 hours a week. Ah the upward mobility of socialism at work.

Economike
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Ugenetoo -

Ugenetoo -

Perhaps I'm misunderstanding your ideas about insurance.

Do you insure your house against fire and theft?

If so, is that a contract at mutually agreed terms between the insurer and you? (I. e. A business transaction.)

Or is it a government-run program that allows the insurer or you to collect rent from taxpayers? (I. e. Socialism.)

It's correct to say that insurance is a means of sharing risk. Unlike socialism, it's voluntary, with all costs paid by the volunteers by contractual agreement, including a regard for costs.

Can we agree that "health insurance" isn't true insurance?

Melvin Udall
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Emike: "There's been no way

Emike: "There's been no way to determine real costs in health care for at least fifty years. When prices have no relationship to costs there's no information for decision-making."

I agree completely. I worked in defense electronics where we designed and produced very complex systems.

Pricing such efforts was a long and arduous task of collecting costs, documenting them, and then dealing with numerous audits and government "fact finding." Along the way, contracting methods and terms like "allocables" were part of the mix.

I've felt for a very long time that there is no longer a core, isolatable cost structure in the vast majority of the health care service industry.

With multiple payers, and billed prices that vary with user/patient, how could there be any true understanding any longer?

Have been on Medicare (Advantage) for a long time. Looking at EOB's can make your head spin as to trying to ferret out underlying reality. In truth, there is no underlying cost reality.......especially now that most doctors are becoming hospital employees. Instead, there are large "cost pools" that must be allocated or whatever you want to call it. Throw in multiple prices for the same thing, and you have a mess that cannot be easily brought under common sensical control.

Sort of like government.

Economike
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Agreed, Mel.

Agreed, Mel.

In effect, Medicare sets prices for all medical services. (Every provider must charge all patients Medicare's prices.) And those prices are unrelated to costs.

The effect of this is widespread cross-subsidization. Government (Medicare, Medicaid) underpays providers, with private insurers overpaying to keep providers solvent.

Melvin Udall
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Exactly. Which is why

Exactly. Which is why "medicare for all" is a wet dream, which is probably why mattzine supports it.

Economike
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Exactly. On another thread

Exactly. On another thread we're talking about a debt crisis driven by Medicare's unfunded liabilities. Meanwhile, leftists from Fantasyland dream about doubling down.

Ugenetoo
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You don't think people are

You don't think people are forced to buy insurance?
Go apply for a home mortgage loan, automobile loan, heavy equipment loan, etc, and get back to me.
Insurance allows the inept among us to continue making stupid mistakes and be covered by insurance, while people like me continue to act responsibly and help pay for those idiots (or fraudsters).
Why do insurance companies pay out for the destruction of McMansions built on the shores of disaster prone areas and then continue to cover them when they are rebuilt?
The smart money would see to it that they were built in a better place, but it seems with the insurance industry, it's business as usual: "Cost Plus".
Share the risk.
Share the wealth.
Same thing.

Economike
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Ugenetoo -

Ugenetoo -

No one forces me to buy house insurance. I'd be crazy not to buy it.

Would you support legislation banning insurance? Seriously?

Ugenetoo
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Possibly.

Possibly.

What I would support whole heartedly is legislation that would continually lower individual premiums based on not using that insurance to be offset by raising premiums on those that do.

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