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Lawmakers/Aides try to get out of Obamacare


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#61    Merc14

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Posted 06 May 2013 - 01:29 AM

View PostStartraveler, on 06 May 2013 - 01:23 AM, said:

By which you mean the office of Jeff Sessions.



The primary coverage expansions begin next year, but many pieces of the ACA--including those that aim at reforming the way health care is delivered, not just how health insurance markets work--have already begun.



The good news has been health sector-wide, with health care cost and price growth slowing across the board. The fact that Medicare is turning out to be cheaper than expected is part of that slowdown; this is on top of the slowing growth in Medicare costs required by the ACA. In fact, every time the CBO comes out with a new budget picture (twice a year), they have to keep revising downwards their estimates of how much Medicare will cost over the next few years.

If you compare different budget outlooks they've released at different times, you'll see how that's changed. For instance, if you compare the January 2010 numbers (pre-Obamacare) to the August 2010 numbers you can see them incorporate the ACA's Medicare changes. Medicare got just over $500 billion cheaper over the 2010-2020 interval in the period between those estimates being released. But if you compare those January 2010 estimates to this year's February 2013 estimates (which now obviously include the actual Medicare spending numbers for 2010-2012), you'll see that Medicare is now $999 billion cheaper over the interval.

That is to say, Medicare got about a trillion dollars cheaper this decade over the past three years and only about half of that is directly attributable to legislative directives made by the ACA. Now, the component that's indirectly attributable to the ACA due to its health care delivery reforms is open to debate; I'm optimistic.



Says the guy who had to go to a GOP senator's press release to find imaginary 75-year numbers? Please.

The NYTimes articles aren't from their editorial page, it's from their reporting on what the National Health Expenditures Accounts data are showing. Actual numbers tracking what our health sector has been spending.

You know what, I apologize, you aren't a BS artist.  You really believe this stuff don't you?  You honestly believe this won't be a complete and utter disaster.   So, you're not a BS artist you are something either far worse or far sadder.

You asked for Obamamerica, now you are going to get it.  Stand by for suck or as Pelosi says, "Embrace the suck".

#62    ninjadude

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Posted 07 May 2013 - 03:45 AM

View PostMerc14, on 06 May 2013 - 12:55 AM, said:

I am not going to debate all the numbers you put out because, frankly, they are irrelevant

There go, waving the white flag of defeat. If you can't debate on the numbers, you got nothin.

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#63    Merc14

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Posted 07 May 2013 - 03:46 AM

View Postninjadude, on 07 May 2013 - 03:45 AM, said:

There go, waving the white flag of defeat. If you can't debate on the numbers, you got nothin.

Answer my question.

You asked for Obamamerica, now you are going to get it.  Stand by for suck or as Pelosi says, "Embrace the suck".

#64    ninjadude

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Posted 08 May 2013 - 02:29 AM

View PostMerc14, on 07 May 2013 - 03:46 AM, said:

Answer my question.

If you get your head out of someplace, and read post #30, you would have seen it.http://www.unexplain...15#entry4755631

Edited by ninjadude, 08 May 2013 - 02:30 AM.

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#65    Merc14

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Posted 08 May 2013 - 02:40 AM

View Postninjadude, on 08 May 2013 - 02:29 AM, said:

If you get your head out of someplace, and read post #30, you would have seen it.http://www.unexplain...15#entry4755631

So you are just a minion by default?  Not educated, I would guess and certainly not a deep thinker. Reports are you are over 61 years old is that true? I am 53 BTW

Edited by Merc14, 08 May 2013 - 02:40 AM.

You asked for Obamamerica, now you are going to get it.  Stand by for suck or as Pelosi says, "Embrace the suck".

#66    DieChecker

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Posted 08 May 2013 - 03:15 AM

View Postninjadude, on 02 May 2013 - 02:32 AM, said:

the ER is NOT healthcare. That is patently false. It's very EXPENSIVE emergency healthcare.
True enough. But it is used as healthcare by many many people. Many of whom have no insurance.

Question: Can a person go to an ER and get medical attention or not?

Quote

I guess you missed the last two presidential elections. And the last 5 years of Repulicans NOT working with Democrats.
And Democrats not working with Democrats too.

So, it that going to be the Excuse?? "The Republicans won't let us.... :cry: " Why are the Minority Republicans still making the Rich Richer, but the Majority Democrats can't seem to help the Poor, or educate minorities?

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You're problem here is implying that "minority" equals poor, jobless, government dependent. When in fact the "majority" is all of these things in the majority.
It is not a problem if it is true. A higher percent of minoritys are poor then the percentage of poor Caucasians.

Question: What is the homeless rate of poor black men? What is the unemployment rate of poor black men? What is the imprisonment rate of poor black men? Is all those bad statistics due to Racism, or is it due to a Cultural Problem? IMHO it is cultural.

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#67    DieChecker

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Posted 08 May 2013 - 03:22 AM

View PostStartraveler, on 05 May 2013 - 02:55 PM, said:

The people you're talking about have to rely on the individual market if they want to shop for insurance. They go in without the strength-in-numbers that people in group plans enjoy, they lack many of the consumer protections those people have (e.g. a pre-existing condition is much less of a problem if you're in the group market than if you're shopping on your own), the plans are skimpier, the premiums are more volatile, the marketplace and its products are opaque. It doesn't act much like a market and the field is tilted in the insurance companies' favor.
Yet even the biggest Group Plans continue to go up and up each year. I work at Intel, which employs hundreds of thousands of people and yet, my insurance is reduced each year and the rate percentage that I pay continues to rise.

Will my rate go down, or is the "Win" situation to only slow the rate of expansion?

Quote

The ACA is about to change that. Those people are about to gain access to a transparent marketplace, where they enjoy consumer protections and financial assistance to shop for the plan they like.
Are there protections to prevent Insurance Companies from doing just as the Oil Companies do and regardless of competition, they just keep raising prices. If another gas station appeared in  my neighborhood, then competition should drive prices down, yet it seems that does not occur. The gas station places its prices the same as other nearby gas stations.

How will prices actually be MADE to go down? Or, is comptetition the only motivator for savings in these new markets?

View PostStartraveler, on 06 May 2013 - 01:23 AM, said:

If you compare different budget outlooks they've released at different times, you'll see how that's changed. For instance, if you compare the January 2010 numbers (pre-Obamacare) to the August 2010 numbers you can see them incorporate the ACA's Medicare changes. Medicare got just over $500 billion cheaper over the 2010-2020 interval in the period between those estimates being released. But if you compare those January 2010 estimates to this year's February 2013 estimates (which now obviously include the actual Medicare spending numbers for 2010-2012), you'll see that Medicare is now $999 billion cheaper over the interval.

That is to say, Medicare got about a trillion dollars cheaper this decade over the past three years and only about half of that is directly attributable to legislative directives made by the ACA. Now, the component that's indirectly attributable to the ACA due to its health care delivery reforms is open to debate; I'm optimistic.

Can you link to that? I'd like to read up on that.

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#68    Startraveler

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Posted 11 May 2013 - 05:38 AM

View PostMerc14, on 06 May 2013 - 01:29 AM, said:

You know what, I apologize, you aren't a BS artist.  You really believe this stuff don't you?  You honestly believe this won't be a complete and utter disaster.   So, you're not a BS artist you are something either far worse or far sadder.

When you claimed you had some knowledge of this subject and could support your opinions in a real back-and-forth I was willing to give you the benefit of the doubt. At this point just give up.

View PostDieChecker, on 08 May 2013 - 03:22 AM, said:

Yet even the biggest Group Plans continue to go up and up each year. I work at Intel, which employs hundreds of thousands of people and yet, my insurance is reduced each year and the rate percentage that I pay continues to rise.

Will my rate go down, or is the "Win" situation to only slow the rate of expansion?

Slowing the rate of health care spending growth to match the growth in the economy would be a major victory--health spending would stop gobbling up an ever larger portion of GDP. Slowing it down so much that its growth rate is smaller than that of the economy would slowly shrink the health sector's share of the economy, even as spending continued to grow in real terms.

Expecting the dollar amount we spend on health care to ever start shrinking in real terms is unrealistic. Slower growth is the goal.

DieChecker said:

Are there protections to prevent Insurance Companies from doing just as the Oil Companies do and regardless of competition, they just keep raising prices. If another gas station appeared in  my neighborhood, then competition should drive prices down, yet it seems that does not occur. The gas station places its prices the same as other nearby gas stations.

I'd caution against reading too much into analogies. What I will say is that the law limits the percentage of insurance premium revenues that insurers can contribute to non-medical things (including profits), so there are limits to what indiscriminately raising rates can get you. More importantly, a competitive insurance marketplace can drive rates down; see this story out of Oregon just this week.

Two Oregon insurers rethink 2014 premiums as state posts first-ever rate comparison

Quote

This is what competition looks like: One health insurer wants to charge $169 a month next year to cover a 40-year-old Portland-area non-smoker. Another wants $422 a month for the same standard plan.

The new health insurance marketplace envisioned by federal health reforms doesn't formally kick in until fall. But it already is taking shape – and consumers for the first time can compare, premium by premium, identical plans by different insurers.

Soon they'll be able to compare benefit-by-benefit as well.

On Thursday, a comparison of proposed 2014 health premiums became public online, causing two insurers to request do-overs to lower their rates even before the state determines whether they're justified.

The unusual development was sparked by a comparison that used to be impossible because plan benefits varied so widely. But under the federal reforms that take effect Jan. 1, health insurance is mandated and every insurer must offer certain standard plans.



DieChecker said:

How will prices actually be MADE to go down? Or, is comptetition the only motivator for savings in these new markets?

This is a very short overview of the start the ACA makes on costs: The Affordable Care Act Addresses Health Care Cost Containment.

DieChecker said:

Can you link to that? I'd like to read up on that.

If you want to see the actual numbers, you'll need to actually just look up the particular CBO budget outlooks you want. So for instance, you can actually look at each iteration of their spending projections table and watch their spending estimates for every single year over the next decade tick down each time.
January 2012: The Budget and Economic Outlook: Fiscal Years 2012 to 2022 (Table 3-1, page 49)
August 2012: An Update to the Budget and Economic Outlook: Fiscal Years 2012 to 2022 (Table 1-2, page 6)
February 2013: The Budget and Economic Outlook: Fiscal Years  2013 to 2023 (Table 1-3, page 16)

If you go back further and compare to the numbers shortly after Obama took office, in CBO's March 2009 Medicare baseline, the differences are even more stark. Take a particular year and look at their projections across the years. How much is Medicare going to cost in 2019? Ask CBO in 2009 and they'll say $943 billion; ask earlier this year and they'll say $811 billion.

If you just mean you want to see the media coverage of Medicare getting cheaper, it's surprisingly scant. But occasionally there's a storyl

CBO: Medicare spending slowing faster than expected (2/5/13)

Quote

The Congressional Budget Office (CBO) lowered spending projections for Medicare on Tuesday, noting that the program's bills have been "significantly lower" than predicted for three years straight.

Medicare spending forecast reduced in new CBO analysis (8/22/12)

Quote

(Reuters) - Medicare, the popular healthcare program for the elderly that both political parties vow to rescue from financial ruin, will spend less money over the coming decade than previously expected, U.S. analysts said on Wednesday.

In a report on the U.S. economy and budget, the non-partisan Congressional Budget Office reduced its spending forecasts for Medicare by $19 billion for 2012 and by $169 billion over the coming decade from earlier this year. Total Medicare spending is projected at $7.7 trillion for the 10 years ending in 2022.

Others have picked up on this:

Quote

Remember that the Affordable Care Act was signed by President Obama in March 2010. That law deliberately triggered about $449 billion in Medicare saving and reductions between 2010 and 2019. In August, 2010 the Congressional Budget Office (CBO) put out Medicare spending projections for that 10-year period documenting the near half trillion in savings triggered by the ACA. Between August 2010 and February 2013, the CBO redid its estimates.  The Center for Budget and Policy Priorities now finds, based on the newer CBO analysis, that Medicare spending will, in fact, drop by an additional $511 billion more than estimated in the 2010 calculation.

Remember that the total net federal cost of the ACA between 2010 and 2019 was about $950 billion. The rest of the $500B price tag was paid primarily with tax increases on wealthier Americans and on drug, device and insurance companies. Turns out, surprisingly, that the Medicare deceleration alone would have been sufficient to finance the total ten-year cost of the ACA.



#69    DieChecker

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Posted 11 May 2013 - 07:00 AM

View PostStartraveler, on 11 May 2013 - 05:38 AM, said:

Quote

But under the federal reforms that take effect Jan. 1, health insurance is mandated and every insurer must offer certain standard plans.

That is what I'm looking for... Basically with Apples and Apples, customers can actually look for the better deal, rather then always looking at a Apple versus a Mango and a Orange, and a Kiwi, and a Pear. Rather then trying to figure out with all the differences between plans, which is the better one for the money, this will make it more straightforward and thus, should actually spur competition???

Is that right?

Standardization will be what brings down prices?

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#70    lightly

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Posted 11 May 2013 - 12:03 PM

Nothing works in a health care system whose costs have spiraled out of control....   My (uninsured)  sister in law went to the hospital for a dizzy spell... i thought it was most likely an inner ear infection and antibiotics should clear it up ....   Dr. recommended ONE NIGHT  in the hospital for observation and  TESTS  which came to $8000.00 !*!*!*!*!*!*!*!* ...  diagnosis and successful  treatment???  antibiotics for an inner ear infection!•

   The entire health care system/industry, including drug companies,  needs to be REGULATED back to reality•

ER  will treat many things  , expensively....   walk in with a huge cancerous growth on your body, or severe emphysema, or a long term heart condition...  and see how effective ER treatment is.    * i'll never forget W. , on Television!,  suggesting ER treatment for the uninsured.   brilliant.

Edited by lightly, 11 May 2013 - 12:10 PM.

Important:  The above may contain errors, inaccuracies, omissions, and other limitations.

#71    F3SS

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Posted 11 May 2013 - 01:39 PM

View PostDieChecker, on 11 May 2013 - 07:00 AM, said:



That is what I'm looking for... Basically with Apples and Apples, customers can actually look for the better deal, rather then always looking at a Apple versus a Mango and a Orange, and a Kiwi, and a Pear. Rather then trying to figure out with all the differences between plans, which is the better one for the money, this will make it more straightforward and thus, should actually spur competition???

Is that right?

Standardization will be what brings down prices?
You're really hopeful aren't you?

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#72    Kowalski

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Posted 11 May 2013 - 01:50 PM

View Postlightly, on 11 May 2013 - 12:03 PM, said:

Nothing works in a health care system whose costs have spiraled out of control....   My (uninsured)  sister in law went to the hospital for a dizzy spell... i thought it was most likely an inner ear infection and antibiotics should clear it up ....   Dr. recommended ONE NIGHT  in the hospital for observation and  TESTS  which came to $8000.00 !*!*!*!*!*!*!*!* ...  diagnosis and successful  treatment???  antibiotics for an inner ear infection!•

   The entire health care system/industry, including drug companies,  needs to be REGULATED back to reality•

ER  will treat many things  , expensively....   walk in with a huge cancerous growth on your body, or severe emphysema, or a long term heart condition...  and see how effective ER treatment is. * i'll never forget W. , on Television!,  suggesting ER treatment for the uninsured.   brilliant.

It really is ridiculous how much it costs to go to the doctor or dentist. The problem with healthcare is COST. It's all about the money.

I remember a friend of mine, went to the ER, for stomach pains. Well, it turned out she was pregnant. Well, she gets a bill from the ER, and you wanna know how much they charged her for a pregnancy test? $1,000.

Edited by Kowalski, 11 May 2013 - 01:51 PM.


#73    Startraveler

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Posted 11 May 2013 - 02:18 PM

View PostDieChecker, on 11 May 2013 - 07:00 AM, said:

That is what I'm looking for... Basically with Apples and Apples, customers can actually look for the better deal, rather then always looking at a Apple versus a Mango and a Orange, and a Kiwi, and a Pear. Rather then trying to figure out with all the differences between plans, which is the better one for the money, this will make it more straightforward and thus, should actually spur competition???

Is that right?

Standardization will be what brings down prices?

The assumption is that a transparent, competitive marketplace is going to do better than the opaque broken "markets" we have now. The cost problem isn't entirely on the insurer side and the ACA devotes a lot of attention to starting to reform the care delivery side and way services are paid for, but obviously fixing insurance markets is a major goal.

That Oregon example does demonstrate something important: a degree of standardization allows prices to actually become meaningful to the consumer. That, in turn, allows the choices consumers make to send meaningful signals back to the sellers. So the new actuarial tiers of coverage--bronze, silver, gold, and platinum--will allow people to make apples-to-apples comparisons between plan options and, as we're seeing in Oregon, they won't allow insurers to hide behind an opaque and incomprehensible market structure.

There's a good, succinct introduction to what the ACA is trying to fix about insurance markets and how it's going to do that in this article: Health Insurance Exchanges.

Quote

One of the great challenges in buying health insurance has been a highly fragmented market. Individuals and group purchasers lack a reliable means for seeing their choices in one place and in a manner that allows them to compare what the plans cover, which providers are in various plans’ practice networks, how cost-sharing might differ, and how numerous competing plans might compare on key measures of quality performance. Nor has there been an active, consumer-oriented system for assuring that insurance plans that are offered in the individual and small group markets provide comparable coverage, cover the benefits that are considered essential to any health insurance plan, have accessible provider networks, and are accountable for specific measures of health care quality. State insurance departments play a different role in most states, overseeing health insurers’ solvency and marketing and business practices. But typically insurance departments do not, as part of their work, organize the health insurance market to make it accountable and user-friendly to individual and group consumers.



#74    Jeremiah65

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Posted 11 May 2013 - 02:18 PM

Well here is where I am going to throw a curve and those that know my general mind on the topics of politics and philosophy are going to be scratching their heads.

Obamacare....erm....the affordable healthcare act...is a sham.  It is a prop for the securities markets and nothing else.  You do understand that insurance companies take your monthly premiums and turn around and invest them in Wall Street don't you?  Basically what Obamacare does is "insure" the profitability of insurance companies while simultaneously providing liquid capital to the stock market.

If Obama was really and truly concerned about the healthcare of a nation...he should have went with a single source provider...aka...socialized medicine.  Believe it or not...I am not opposed to socialized medicine.  I have done my homework and most industrialized countries know they need their workers to be healthy so they provide healthcare.  Only here do we set a profit margin on the health of human beings...how ****g corrupt is that?

People are not supposed to live forever...folks get sick...folks die...it is the natural order of things.  Healthcare is a racket...a racket based on fear and pain.  If you look at the countries that have actual, functioning state controlled healthcare...it might be a little inconvenient...but it works.  Norway, Sweden, Finland, Denmark, Canada... It can be done and it can be done somewhat efficiently.

We have a problem though that goes much deeper.  Our higher education system.  In a world where healthcare is controlled and costs are absorbed by the Gov...being a Doctor might not be the most high paid job you can have.  In our education system...the cost of a medical degree is astounding.  To justify the cost, you need a very lucrative practice to pay off your education...it is a mind blowing when you realize that our healthcare system is so expensive because the cost of the education to become a healthcare provider is so expensive...never mind the ridiculous cost of malpractice insurance.

"IF" we want a decent and affordable healthcare system...we have to stop allowing it to be a "for profit" industry...it should not be...life should not have a profit margin.  However...it does.  There are many doctors, pharmacy companies and hospitals that will throw you in the street to die for a dollar...FACT.

I hope I get hit by a train...I do not want to grow old in this system and have to pay my last dollar to a puke that drives a 100,000 dollar car that he bought deciding who can live and who can die based on their bank account.

So how is that for twisting your brain?  There are certain things in this world that should not be for profit if we want to ever grow socially and reach for the stars...as long as every aspect of life is purely about profit...we will be trapped on this rock until the sun goes red giant and consumes the inner solar system.

"Liberty means responsibility.  That is why most men dread it."  George Bernard Shaw
"I would rather be exposed to the inconveniences attending too much liberty than to those attending too small a degree of it."  Thomas Jefferson

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#75    F3SS

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Posted 11 May 2013 - 02:36 PM

View PostJeremiah65, on 11 May 2013 - 02:18 PM, said:

Well here is where I am going to throw a curve and those that know my general mind on the topics of politics and philosophy are going to be scratching their heads.

Obamacare....erm....the affordable healthcare act...is a sham.  It is a prop for the securities markets and nothing else.  You do understand that insurance companies take your monthly premiums and turn around and invest them in Wall Street don't you?  Basically what Obamacare does is "insure" the profitability of insurance companies while simultaneously providing liquid capital to the stock market.

If Obama was really and truly concerned about the healthcare of a nation...he should have went with a single source provider...aka...socialized medicine.  Believe it or not...I am not opposed to socialized medicine.  I have done my homework and most industrialized countries know they need their workers to be healthy so they provide healthcare.  Only here do we set a profit margin on the health of human beings...how ****g corrupt is that?

People are not supposed to live forever...folks get sick...folks die...it is the natural order of things.  Healthcare is a racket...a racket based on fear and pain.  If you look at the countries that have actual, functioning state controlled healthcare...it might be a little inconvenient...but it works.  Norway, Sweden, Finland, Denmark, Canada... It can be done and it can be done somewhat efficiently.

We have a problem though that goes much deeper.  Our higher education system.  In a world where healthcare is controlled and costs are absorbed by the Gov...being a Doctor might not be the most high paid job you can have.  In our education system...the cost of a medical degree is astounding.  To justify the cost, you need a very lucrative practice to pay off your education...it is a mind blowing when you realize that our healthcare system is so expensive because the cost of the education to become a healthcare provider is so expensive...never mind the ridiculous cost of malpractice insurance.

"IF" we want a decent and affordable healthcare system...we have to stop allowing it to be a "for profit" industry...it should not be...life should not have a profit margin.  However...it does.  There are many doctors, pharmacy companies and hospitals that will throw you in the street to die for a dollar...FACT.

I hope I get hit by a train...I do not want to grow old in this system and have to pay my last dollar to a puke that drives a 100,000 dollar car that he bought deciding who can live and who can die based on their bank account.

So how is that for twisting your brain?  There are certain things in this world that should not be for profit if we want to ever grow socially and reach for the stars...as long as every aspect of life is purely about profit...we will be trapped on this rock until the sun goes red giant and consumes the inner solar system.

Well then why should anything of societal benefit be for profit? I fix houses and shelter is one of the big things in a good life. Food, shelter, water, clothing. A sound home is beneficial to good health. Roof leaks can cause all kinds of unsanitary problems as well as plumbing issues can especially cause health problems. Should I fix these things only for cost because they are detrimental to good health at home? Grocery stores... Non-profit too? We absolutely need them. We in the cities are far removed from self-sufficiency.
But with healthcare, it should not be non-profit. Sure it's excessive but it doesn't have to exclude making good money. For example, brain surgery. What's a fair price for that? As I see it that is an incredibly complicated and specialized skill worth whatever the guy performing it wants. You say you can't put a price on life but if you need brain surgery I'll bet you can't do it. And like with all things in life the harder and rarer the product or skill the more it costs.
On the side though, I agree that universal healthcare would be great and when the day arrives that Washingtoon shows that they can't be fiscally responsible and allocate money taken in to exactly where it's supposed to go I really don't want to give them anymore to waste until then. If they defund obamacare and truly cut out all unnecessary spending and rain in the out of control social programs and affirmative action programs we probably already do give them enough taxes to pay for universal healthcare.

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