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Karlis

Vote to Repeal Obamacare Passes 245-189

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Br Cornelius

For all your miscasting of the American debate re HC, it is ironic that you mention cancer. The survival rates for all the major types of cancer- breast, lung, and prostate among them-- are higher in the US than in any socialized medicine country. Everyone wants "universal" HC. But not everyone think the way to get it is thru the govt ham-handed involvement. And they are right. We do have the socialized med countries to look at as examples-- and we don't find them to be ones we want to immitate. As it is now our lines are too long and HC is too expensive. Obicare is going to make both those problems worse.

I think your've been taking a bit to much Right Wing think tank cool aid there;

The United States has the highest rates of survival for breast and prostate cancers, while Japan has the highest survival rates for colon and rectal cancers among men. France has the highest survival rates for colon and rectal cancer among women, the report found.

In addition, Canada and Australia also have very high survival rates for most cancers. The lowest rate of survival among both men and women was seen in Algeria.

http://health.usnews.com/health-news/family-health/cancer/articles/2008/07/17/cancer-survival-depends-on-where-you-live

It also points out that USA survival rate is very much correlated to race (ie income disparate);

But, there's a big disparity in cancer survival rates between whites and blacks in the United States, and it favors whites. The differences range from 7 percent for prostate cancer to 14 percent for breast cancer. This disparity is most likely due to differences in the stage of cancer when it is diagnosed, the researchers said.

Of course none of this tells us much about access to treatment, as the survey studies survival rates after treatment - not who actually can access that treatment.

There's Stat and theres damn lies.

The solution seems to be National Health Insurance administered on a not for profit basis, but the political climate within America was never going to make that a runner - hence you got the b****** child of compromise.

Br Cornelius

Edited by Br Cornelius

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Bags123

It staggers me that you Americans would be so against a health care reform which would allow the large minority of American citizens access to some form of health provision. At the moment if you can afford health care insurance you have one of the best health services in the world. If you are locked out of health insurance (as an increasing number are) you die or receive substandard emergency provision.

In Britain and almost all of Europe you are equally entitled to the same health care regardless of your status. I ask you, should you expect to die because you cannot afford health insurance - its hardly very civilised.

Br Cornelius

I will attempt to explain why I am personally against "Obamacare" as I can only speak for myself. For starters, I can't fathom why it's referred to as "reform." Simply by making it the "law of the land," thereby forcing Americans to purchase health care insurance most can ill-afford smacks of socialism, not reformation. True "reform" would have been to make insurance affordable for everyone. Why not have the premiums based on income levels? True "reform" would have been requiring employers to offer access to health insurance for all of their employees, INCLUDING the "part timers." (many large corporations skirt the issue of "benefits" by keeping the bulk of their employees well under the 40 hour mark). These options were not included because (from what I've been able to determine in speaking with supporters) "the corporations and businesses would go bankrupt". I see. It's still all about what's best for the company I work for and not what's best for me. One young man, a supporter of Obamacare, offered this analogy in explanation for his support: "Legally, what are you required to purchase before driving a car? That's right, Insurance. Same with Health Care." My response: Wrong analogy. Every American family is not being forced to buy a car, nor should they be. Proper analogy? President Obama (God bless him, I truly believe he is a good man) and Nancy Pelosi decide to end hunger in America. The solution? Every American family will henceforth be required by law to purchase an additional $100.00 in food staples on a weekly basis or pay a $3000.00 fine when the tax man cometh. There. Now pat them on the back for eliminating hunger in America.

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preacherman76

Thank you Preacherman, for so beautifully proving my point.....

You think Medicare was invented in 1905?

Bravo, Bravo, well done sir! :tu:

So X-rays are only expensive because the government started flipping the bill? Why don't you enlighten us all Preacherman, on the production of X-ray machines, their power usage, the computer-interfaces needed to work them, amount of training radiology technologists need, the amount of years and training a radiologist needs (you know to read the X-ray) and when you're done with that, maybe you can enlighten us heathens and socialists on MRIs and CTs as well?

Yes. And there is no other way about it. Before medicare, made in the 60's, people paid a average of 10 dollars a month to buy health insurance. They only used it for major medical needs. You could afford OUT OF POCKET, minor medical expenses. Very much including a simple x-ray. My family has long been in the health insurance biz, I know this for a FACT. Maybe you should look into what you are talking about before you flip the switch on your God complex.

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preacherman76

People can afford health care. What they can't afford is out of pocket medical costs when insurance companies won't cover them their entire lives because of a preexisting condition.

No they cant BM. Thats the whole problem to begin with. Costs.

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preacherman76

Maybe you'd like to answer for Preacherman, as I doubt he will answer;

Right, and you think that "medical facilities" knocking off the cost of your bill just magically absorb the cost of said bill? No really, lets here where you think this bill goes....

Wow you are one smug a**h***.

Why dont you tell us all why it cost 1000 dollars for a simple x-ray? Especialy when that same machine takes 10 to 15 x rays a day. That machine needs to make 10 to 15 grand per DAY?

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questionmark

Wow you are one smug a**h***.

Why dont you tell us all why it cost 1000 dollars for a simple x-ray? Especialy when that same machine takes 10 to 15 x rays a day. That machine needs to make 10 to 15 grand per DAY?

At the cost of over $2.000.000, a live expectancy before major overhaul of 2 years and a maintenance bill of $15000 a month it sure does.

But we can go to the primitive cheap machines again, you won't die from the aneurisma but from cancer caused by the the excess radiation of the non-controlled Braun tube. That was way cheaper.

Edited by questionmark

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preacherman76

More of the same old way, I suspect.

I ask the simple question - do you ordinary jo's feel rich enough to pay for a a course of cancer treatment if you lose your job and medical insurance. For many the answer seems to be no, so death waits with open and welcoming arms. Hurts like crazy untreated cancer

The freedom to die in a Corperatocracy, good result there :clap: .

Br Cornelius

If you dont have a job, or insurance, then you get medicaid. We dont just let people with no means die of cancer. In fact those folks get better treatment them most.

Edited by preacherman76

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preacherman76

At the cost of over $2.000.000, a live expectancy before major overhaul of 2 years and a maintenance bill of $15000 a month it sure does.

But we can go to the primitive cheap machines again, you won't die from the aneurisma but from cancer caused by the the excess radiation of the non-controlled Braun tube. That was way cheaper.

We arent talking about MRI machines, and more complicated machines. They cost FAR more then 1000 dollars for treatment. We are talking a simple x ray machine. And dont tell me they dont exist, cause I had shots taken on one in one of NY's more updated hospitals just a month ago.

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Leonardo

Why dont you tell us all why it cost 1000 dollars for a simple x-ray?

When you ask this, are you suggesting your insurance was billed $1000 for a single x-ray, or are you suggesting that all patients pay $1000 per x-ray?

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preacherman76

When you ask this, are you suggesting your insurance was billed $1000 for a single x-ray, or are you suggesting that all patients pay $1000 per x-ray?

I got a bill for 1000 bucks last x-ray I had taken. I past it on to my insurance company, who paid for it.

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Br Cornelius

Some interesting stats on what the most expensive per capita health care system actually gets you;

The U.S. Census Bureau reported that a record 50.7 million Americans—16.7% of the population—were uninsured in 2009.[1] More money per person is spent on health care in the USA than in any other nation in the world,[2][3] and a greater percentage of total income in the nation is spent on health care in the USA than in any United Nations member state except for East Timor.[3] Despite the fact that not all people in America are insured, the USA has the third highest public healthcare expenditure per capita, because of the high cost of medical care and utilization today.[4][5] A 2001 study in five states found that medical debt contributed to 46.2% of all personal bankruptcies and in 2007, 62.1% of filers for bankruptcies claimed high medical expenses.[6] Since then, health costs and the numbers of uninsured and underinsured have increased.[7]

Active debate about health care reform in the United States concerns questions of a right to health care, access, fairness, efficiency, cost, choice, value, and quality. Some have argued that the system does not deliver equivalent value for the money spent. The USA pays twice as much yet lags behind other wealthy nations in such measures as infant mortality and life expectancy, though the relation between these statistics to the system itself is debated. Currently, the USA has a higher infant mortality rate than most of the world's industrialized nations.[nb 1][8] The United States life expectancy lags 42nd in the world, after some other industrialized nations, lagging last of the G5 (Japan, France, Germany, UK, USA) and just after Chile (35th) and Cuba (37th).[9][10][11]

Life expectancy in the USA is ranked 50th in the world after the European Union (40th).[12][13] The World Health Organization (WHO), in 2000, ranked the U.S. health care system as the highest in cost, first in responsiveness, 37th in overall performance, and 72nd by overall level of health (among 191 member nations included in the study).[14][15] The Commonwealth Fund ranked the United States last in the quality of health care among similar countries,[16] and notes U.S. care costs the most.[17]

According to the Institute of Medicine of the United States National Academies, the USA is the "only wealthy, industrialized nation that does not ensure that all citizens have coverage" (i.e., some kind of private or public health insurance).[18][19] The same Institute of Medicine report notes that "Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States."[18] while a 2009 Harvard study published in the American Journal of Public Health found a much higher figure of more than 44,800 excess deaths annually in the United States due to Americans lacking health insurance.[20][21]

http://en.wikipedia.org/wiki/Health_care_in_the_United_States

What I found most interesting is that uninsured cost contributed to a substantial proportion of personal bankruptcies in America, its not bad enough to lose your health - without an overwhelming fear of losing all your wealth. Also the figure of at least 18,000 excess deaths due to lack of health coverage (ie no health insurance or public provision).

Not very good really. It blatantly is more expensive and less effective dollar for dollar then many other publically financed health care systems.

The current bill may not be an effective solution for the fundamental problems of American healthcare provision - but the real solutions could never fly in Corporate dominated American politics.

Br Cornelius

Edited by Br Cornelius

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preacherman76

Some interesting stats on what the most expensive per capita health care system actually gets you;

http://en.wikipedia.org/wiki/Health_care_in_the_United_States

What I found most interesting is that uninsured cost contibuted to a substantial proportion of personal bankruptcies in America, its not bad enough to lose your health - without an overwhelming fear of losing all your wealth.

Not very good really. It blatantly is more expensive and less effective dollar for dollar then many other publically financed health care systems.

The current bill may not be an effective solution for the fundamental problems of American healthcare provision - but the real solutions could never fly in Corperate dominated American politics.

Br Cornelius

Exactly BR. That statment wraps up 100% of ALL our political problems. Thats why its attractive to many people when people run for office preaching small government latly.

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Leonardo

I got a bill for 1000 bucks last x-ray I had taken. I past it on to my insurance company, who paid for it.

Might I assume you had to provide your insurance details before getting the x-ray taken (or the hospital already had those details from a previous visit)?

In which case, the hospital would have known what the insurance would pay out for an x-ray, and billed accordingly. This is why your health system is so expensive.

Edited for you latest post, preacherman...

Exactly BR. That statment wraps up 100% of ALL our political problems. Thats why its attractive to many people when people run for office preaching small government latly.

Small government will not resolve the issues America has with corporate influence. Small government cannot effectively regulate big business, and voting in a small (Federal) government will only achieve having to have much larger State Governments to accommodate.

The size of your government is immaterial to how corrupt your system is. What is required to fix that is better regulation of the government you have - which means more government, not less.

Edited by Leonardo

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Br Cornelius

Exactly BR. That statment wraps up 100% of ALL our political problems. Thats why its attractive to many people when people run for office preaching small government latly.

Small government means a greater roll for Corporations and less security for the individual. Unfortunately the interests of the corporate sector do not correspond to the interests of the citizens.

This is why the Corporate sector is bankrolling the "Tea Party" movement, because it serves their interests to minimise government regulation and control- this is the opposite of the public interest.

Br Cornelius

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Br Cornelius

Might I assume you had to provide your insurance details before getting the x-ray taken (or the hospital already had those details from a previous visit)?

In which case, the hospital would have known what the insurance would pay out for an x-ray, and billed accordingly. This is why your health system is so expensive.

We have all been in the situation when hiring a tradesman where he asks you whether the job is insured or not, and if not, suddenly the bill drops by 50%.

Insurance based anything leads to hire costs. National Insurance based health care has lower costs.

Br Cornelius

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preacherman76

Might I assume you had to provide your insurance details before getting the x-ray taken (or the hospital already had those details from a previous visit)?

In which case, the hospital would have known what the insurance would pay out for an x-ray, and billed accordingly. This is why your health system is so expensive.

Edited for you latest post, preacherman...

Honestly, they had no idea if I had insurance. The x-ray department is run completly seperate from the hospital. The hospital knew my insurance info, thats why I didnt get a bill from them. I just got a statment from them of the costs, and that my insurance paid it. Which was a aditional 500 bucks. And all they did was have a doctor send me to the x-ray department. He was then told what the x-ray showed, wrote a prescription for some pain pills, and sent me home. 500 bucks.

In fact they told me on the bill that IF I had insurance, to forward the bill to them.

Small government will not resolve the issues America has with corporate influence. Small government cannot effectively regulate big business, and voting in a small (Federal) government will only achieve having to have much larger State Governments to accommodate.

The size of your government is immaterial to how corrupt your system is. What is required to fix that is better regulation of the government you have - which means more government, not less.

If you listen to folks like Ron Paul, it most certainly will. Number 1 on the radar is controling corprete influance. Though I admit, he and a couple others, have a very different Idea of what small government means then most who preach it.

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preacherman76

Small government means a greater roll for Corporations and less security for the individual. Unfortunately the interests of the corporate sector do not correspond to the interests of the citizens.

This is why the Corporate sector is bankrolling the "Tea Party" movement, because it serves their interests to minimise government regulation and control- this is the opposite of the public interest.

Br Cornelius

They bankrolled the tea party movement cause they were affraid of it, and knew they better get control of it fast. Im not saying that everyone who preached small government this last election actualy meant it. There is a small handfull, that are gaining popularity though, that would control corperate influance. If people would just get behind those guys, we might get something done. Though I admit, they have a big hill to climb.

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Br Cornelius

They bankrolled the tea party movement cause they were affraid of it, and knew they better get control of it fast. Im not saying that everyone who preached small government this last election actualy meant it. There is a small handfull, that are gaining popularity though, that would control corperate influance. If people would just get behind those guys, we might get something done. Though I admit, they have a big hill to climb.

If you reduce government provision of public services, those services are either lost or replaced by Corperate provision. Corperations can only be controlled in some small degree by having a strong government defining the terms of their contracts. By allowing Corperations to write their own public provision contracts then inevitably those without purchasing power will not be served as well as those with. The situation will arise where public police forces will be replaced by private security forces, who will secure walled estates of wealthy people who can afford to pay. The rest will be left to get on with it, and contained when they stray into the wealthy public sphere.

Its a truly horrible and scary future that the Corperate lobbyists are building across the world. Control of society to serve the interests of wealthy share holders, and the poor can just go away and die quitely.

Br Cornelius

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preacherman76

If you reduce government provision of public services, those services are either lost or replaced by Corperate provision. Corperations can only be controlled in some small degree by having a strong government defining the terms of their contracts. By allowing Corperations to write their own public provision contracts then inevitably those without purchasing power will not be served as well as those with. The situation will arise where public police forces will be replaced by private security forces, who will secure walled estates of wealthy people who can afford to pay. The rest will be left to get on with it, and contained when they stray into the wealthy public sphere.

Its a truly horrible and scary future that the Corperate lobbyists are building across the world. Control of society to serve the interests of wealthy share holders, and the poor can just go away and die quitely.

Br Cornelius

Police arent paid by the federal government. They are paid by the states. Even less they are paid by each county in any given state. But what you said about replacing them with hired security is probably true, and thats cause the states are broke. Corperations will be the only ones able to afford it, so the rest of us will have to fend for ourselfs.

Americas problem is the same problem every great powerful nation faced in the past. Thier quest for empire. The first thing RP would do is dimantle every millitary base we have all over the world. And cut millitary spending to a fraction of what we spend. (which is nearly as much as the entire civilized world combined) Saving us trillions. He'd end the war on drugs, saving us trillions. This and several other situations just like them. It isnt that we cant afford public service. Its that we cant afford public service AND waste trillions on fruitless costly and corupted expences.

Throw all this on top of the fact that our government has sold us out to countries like China, and has allowed them to steal most of our production jobs through insainly unfair treaties, and you have the situation we are in today.

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Startraveler
Simply by making it the "law of the land," thereby forcing Americans to purchase health care insurance most can ill-afford smacks of socialism, not reformation. True "reform" would have been to make insurance affordable for everyone. Why not have the premiums based on income levels?

The law provides subsidies (i.e. refundable, advanceable tax credits) to assist low-to-moderate income people in exchanges to buy coverage. The way the subsidies are structured, premiums are based on income levels. To steal a table from the wiki page on the ACA, it looks like this:

Picture%2B1.png

There is a cap on the percent of income an individual/family will pay for insurance premiums and that cap varies between income tiers. If your health plan costs a higher percentage of your income than listed in that table, you're granted a tax credit that will pay the rest (up to a certain reference plan; you can't, for example, buy the priciest, gold-plated plan you can find and have the federal government pay for all of it above your required personal contribution).

For most people this doesn't matter, as they will be getting insurance through an employer (just as most people with private insurance do right now). Regardless, short of switching to an entirely public system, this is the way to do what you're suggesting.

True "reform" would have been requiring employers to offer access to health insurance for all of their employees, INCLUDING the "part timers." (many large corporations skirt the issue of "benefits" by keeping the bulk of their employees well under the 40 hour mark).

Perhaps, though part-timers can get insurance through an exchange and take advantage of the system I just described.

Proper analogy? President Obama (God bless him, I truly believe he is a good man) and Nancy Pelosi decide to end hunger in America. The solution? Every American family will henceforth be required by law to purchase an additional $100.00 in food staples on a weekly basis or pay a $3000.00 fine when the tax man cometh. There. Now pat them on the back for eliminating hunger in America.

In the Democratic primaries in 2008 when Obama and Hillary Clinton were sparring, he argued that an individual mandate wasn't necessary for this sort of system (subsidies to make private insurance more affordable for people). His argument, as I recall, was that people generally want insurance and if you make it more affordable for them they will buy it. People who want it will buy it if we make it more affordable. Hillary Clinton argued that an individual mandate is necessary.

She was right and he was wrong. Part of the goal of this reform law is to eliminate pre-existing condition exclusions and severely limit the ability of insurers to vary rates based on factors like gender, age, or medical history. A healthy person who has little use for health insurance now may buy it because people aren't invincible and he may become sick or injured. With medical underwriting in place, that means if he opts to hold off on buying insurance but then becomes sick, he won't be able to buy coverage (or, if he does, it will be much more expensive that it would formerly have been for him). Underwriting punishes irresponsibility and prevents free-riding. Unfortunately, it also tends to discriminate against people for things they have little or no control over. It's the latter reality that makes underwriting unpopular and has led to its elimination.

But that still leaves us with the problem of free riders. Taking away underwriting takes away the primary deterrent to it and threatens the stability of insurance pools. The healthy no longer have a compelling reason to buy insurance--if they get sick, they can just buy it then without fear of consequence. This is why the mandate is introduced. Its role is to preserve the incentive structure that makes insurance pools work by punishing irresponsibility.

If you dont have a job, or insurance, then you get medicaid. We dont just let people with no means die of cancer. In fact those folks get better treatment them most.

I've often seen this assumption that having a low-income is all it takes to be eligible for Medicaid. That will be true (in 2014) for the first time under the ACA but it certainly wasn't the case before. it.

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preacherman76

I've often seen this assumption that having a low-income is all it takes to be eligible for Medicaid. That will be true (in 2014) for the first time under the ACA but it certainly wasn't the case before. it.

Really? Not saying you are wrong, but I live 10 mins from a town where nearly everyone is on mediaid. Those folks didnt have a problem getting it. What reason could they have to denie you?

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Startraveler

Really? Not saying you are wrong, but I live 10 mins from a town where nearly everyone is on mediaid. Those folks didnt have a problem getting it. What reason could they have to denie you?

Eligibility varies from state to state; I don't what state you're in so I can't tell you what the criteria are in your area.

But let's say you live in Texas. As always (due to federal guidelines), Medicaid eligibility is most generous when it comes to children and pregnant women. So pregnant women or infants in families up to 185% of the federal poverty level are eligible, as are children ages 1-5 in families with incomes up to 133% FPL and children ages 6-19 in families up to 100% of the poverty level. If you don't happen to be a child or currently pregnant, you'd better be a parent. If you're a non-working parent, you can be eligible for Medicaid if your income is below 13% of the poverty line. Anything above and you're ineligible. If you're a working parent you get a little more leeway: eligible extends up to 27% of the poverty line. I believe on top of the income test, Texas also has a $2,000 asset test (having assets above that threshold renders you ineligible).

If you're not a parent and you're not a child, you're not eligible no matter what your income is. The exception to that would be someone like a disabled person receiving SSI.

The morals here are:

1) Being poor isn't enough to make you eligible for Medicaid unless you're a child. You could be a working parent at 50% of the poverty line and you wouldn't be eligible for it in states like Texas. There are, of course, states with more generous thresholds but, in general, even for parents simply being below 100% poverty isn't enough.

2) If you're not a parent, you're probably not eligible regardless of how low your income is. A handful of states offer some very limited benefits for certain childless adults but that's rare.

Medicaid has never been a program for the poor (full stop). It's been a program for poor children and, occasionally, their parents (and then usually only if they're very poor). That's one of the very large paradigm shifts in the ACA.

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danielost

I think your've been taking a bit to much Right Wing think tank cool aid there;

http://health.usnews.com/health-news/family-health/cancer/articles/2008/07/17/cancer-survival-depends-on-where-you-live

It also points out that USA survival rate is very much correlated to race (ie income disparate);

Of course none of this tells us much about access to treatment, as the survey studies survival rates after treatment - not who actually can access that treatment.

There's Stat and theres damn lies.

The solution seems to be National Health Insurance administered on a not for profit basis, but the political climate within America was never going to make that a runner - hence you got the b****** child of compromise.

Br Cornelius

ahh no. This disparity is most likely due to differences in the stage of cancer when it is diagnosed, the researchers said.

it also says

Coleman believes the differences among countries -- and within regions of countries -- is directly related to access to health care. "This is not a question of the competence of doctors in any particular country," he said. "This is an issue of the overall effectiveness of health services."

i thought ever country on the planet had universal health care, except the usa. seems universal health care doesnt fix anything.

Edited by danielost

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preacherman76

Ouch.

Im in NY, seems nearly everyone who applies gets it, so long as you are under a certain poverty level. At least thats how it seems from what I have seen. Then again, Ive never had to walk into a welfare office to apply. Not yet anyway. Things in this state are not looking good, especialy in my line of business

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danielost

The law provides subsidies (i.e. refundable, advanceable tax credits) to assist low-to-moderate income people in exchanges to buy coverage. The way the subsidies are structured, premiums are based on income levels. To steal a table from the wiki page on the ACA, it looks like this:

Picture%2B1.png

There is a cap on the percent of income an individual/family will pay for insurance premiums and that cap varies between income tiers. If your health plan costs a higher percentage of your income than listed in that table, you're granted a tax credit that will pay the rest (up to a certain reference plan; you can't, for example, buy the priciest, gold-plated plan you can find and have the federal government pay for all of it above your required personal contribution).

For most people this doesn't matter, as they will be getting insurance through an employer (just as most people with private insurance do right now). Regardless, short of switching to an entirely public system, this is the way to do what you're suggesting.

Perhaps, though part-timers can get insurance through an exchange and take advantage of the system I just described.

In the Democratic primaries in 2008 when Obama and Hillary Clinton were sparring, he argued that an individual mandate wasn't necessary for this sort of system (subsidies to make private insurance more affordable for people). His argument, as I recall, was that people generally want insurance and if you make it more affordable for them they will buy it. People who want it will buy it if we make it more affordable. Hillary Clinton argued that an individual mandate is necessary.

She was right and he was wrong. Part of the goal of this reform law is to eliminate pre-existing condition exclusions and severely limit the ability of insurers to vary rates based on factors like gender, age, or medical history. A healthy person who has little use for health insurance now may buy it because people aren't invincible and he may become sick or injured. With medical underwriting in place, that means if he opts to hold off on buying insurance but then becomes sick, he won't be able to buy coverage (or, if he does, it will be much more expensive that it would formerly have been for him). Underwriting punishes irresponsibility and prevents free-riding. Unfortunately, it also tends to discriminate against people for things they have little or no control over. It's the latter reality that makes underwriting unpopular and has led to its elimination.

But that still leaves us with the problem of free riders. Taking away underwriting takes away the primary deterrent to it and threatens the stability of insurance pools. The healthy no longer have a compelling reason to buy insurance--if they get sick, they can just buy it then without fear of consequence. This is why the mandate is introduced. Its role is to preserve the incentive structure that makes insurance pools work by punishing irresponsibility.

I've often seen this assumption that having a low-income is all it takes to be eligible for Medicaid. That will be true (in 2014) for the first time under the ACA but it certainly wasn't the case before. it.

wrong they dont have a choose, buy it or fine it and then go to jail it.

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