Health Insurance 44

[tbonebanjo]

I was just wondering how many companies still have good insurance and how many have gone the way of Obamacare. I am in a small MEP firm in Maryland. Our health insurance just changed, our premiums went up and our coverage went way down. I have maximum out of pocket expenses of $12,500 per year, $4000 deductable per person, tnen start the copay schedules. Should I start looking for other employment or are all companies being affected this way?

 

[IRstuff]

Try Section 8:
The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof.

General Welfare would seem to fit the bill, and is the basis for most of the arguments in favor of taxation for general welfare items.

Note that the Constitution doesn't explicitly acknowledge the right to privacy, so, kind of hard to argue narrowing the Constitution in one aspect, but expanding it elsewhere. SCOTUS has made the Constitution quite flexible and expandable.

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[zdas04]

JohnRBaker,
History judges past presidents. The further back, the more objectively it seems to me, and it is mostly looking more kindly on GW every year. Your opinion is clearly on record pretty much anytime anyone mentions a court case, or any President, or pretty much any topic. I hope you've noticed that people don't rise to drag the conversation into those particular weeds. Enough already, you didn't like Bush/Cheney, got it, don't know what it has to do with health care, but got it.

David Simpson, PE
MuleShoe Engineering

In questions of science, the authority of a thousand is not worth the humble reasoning of a single individual. —Galileo Galilei, Italian Physicist

 

[cranky108]

So with the words "uniform throughout the United States", why does the Presedent get better health care the the rest of us? Is that uniform? Did Obomacare fix that?

Section 8 seems to say the Presedent should not recieve better care than the remander of the US.

I don't think that is what this section means at all. I don't even think it was intended to apply to healthcare.

I still think it would have been better if we were allowed to purchase insurance over state lines, and not required to purchase insurance we don't need, or want.
After all if contraseptives are part of this health thing, don't allow them to be over the counter. Make people go to the doctor for a note to allow them to buy them.
This has no business in health care.

Another way to reduce the health care costs, is to reduce the regulations on bill collectors. Allow them to call people in the middle of the night, and during dinner. Allow them to staple signs on people frount door.

Regulate hospitals, not doctors, the way they do utilities, by state. Eliminate secondary billing by doctors you have not agreed to hire.

 

[zdas04]

rconnor,
In the threads that I've decided to stop commenting on, I developed the habit of simply not reading your posts. I was doing that just now and noticed my handle.

Yes, honestly. Can you describe a single service (which doesn't include the military) that federal government does better than states? Education? Give me a break, I want education to be at the community level, but getting the Feds out of it is a step in the right direction. Regulation of hospitals? No question, the states do it worlds better (compare your local hospital to a VA facility). Aid to the poor? Again, communities do it better than states, and states do it better than the Feds. Federal social programs are simply too big to: (1) be effective; or (2) avoid fraud and waste.

Access to healthcare is a "right"? Take that to its logical conclusion and providing that "right" becomes an "obligation". Not for the government, but for providers. If a nose-job is a right and doctors are obligated to provide them then who would become a doctor? One person's "right" that requires a disinterested party to "contribute" is simply slavery. Pretty it up with a pretty diploma and assigned parking space and it is still whips and chains. How to you supply that "right" if all of the providers decide to find other ways to make a living? Oh yeah, it is only a "right" if you can coerce qualified people into supplying it. The only "right" I can see in this field is the right to live until you stop. We all stop living sooner or later. If the people of the world had a "right" to medical care, then it would be immoral to have a doctor/patient ratio disparity between the developed world and the developing world. It is not a right, it is a service that we should be willing to pay for. We should be willing to pay the portion of our income that it is worth to us. A Christian Scientist would tell you in the strongest possible terms that it is immoral for you to forcibly take his money to pay for someone else's trip to a doctor that the Christian Scientist does not believe is able to add value. Someone who is anti-vaccine resents paying for vaccinations. Someone who anti-birth-control resents having to pay for others to have access to that technology. "Right" to medical care is a really slippery slope.

The article you linked to has specific criteria (not disclosed) to place a country in a position in the ranking. This is common, and last year I tried to find raw scores and weighting algorithms for one of the studies. When I finally dug out the basis for a score, I found that they were heavily weighted towards "providing health care to all without stigma". "Quality of care" (measured by the number of fatalities compared to number of doctor visits) was weighted 10th in that study. It also gave zero credit to someone being able to walk into an ER and be seen, because there is a stigma attached. It gave no weight at all to ratio of patients to doctors, to number of citizens served by a hospital, or to geographic area served by a hospital. When a study considers these minor points the rankings change a bit.

David Simpson, PE
MuleShoe Engineering

In questions of science, the authority of a thousand is not worth the humble reasoning of a single individual. —Galileo Galilei, Italian Physicist

 

[JohnRBaker]

"After all if contraseptives are part of this health thing, don't allow them to be over the counter. Make people go to the doctor for a note to allow them to buy them."

To be totally fair, you'd have to include condoms in this as well . . . or are you going to suggest that that's different? If so, how so (be careful how you respond as we're now getting down to the real crux of the issue aren't we)...

John R. Baker, P.E.
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[beej67]

beej67, firstly, let’s clarify our terms...

...Capitalism sets up the “market” and the “free” part comes from removing restrictions and regulations such that consumers and producers can operate independently. In reality, you can’t have a producer (of any substantially large size…to say produce drugs safely) that operates independently of a capitalist market. Therefore, the free markets operates within a capitalistic frame work and advocating for a more free market healthcare system is to advocate for a more capitalist healthcare system...

No.

Capitalists corner markets for profit. Free markets are not cornered markets. See above. I'm not going to type the same things again, I want you to read it the first time and take the time to understand it. Our current healthcare system is very capitalist, but in no way free. There are ten reasons I can't go buy penicillin, even if I need it, and someone else wanted to sell it to me. That is not a free market. Not a free market. It is a cornered market. If you think our system, before or after Obamacare, was a free market, then you are part of the problem.

However, you’d have to not just blow up the entire US healthcare system but fundamentally change the entire US economic system (in which capitalism is just a little, teeny, tiny bit rooted). The only practical way to limit the effect of profit-driven capitalism on healthcare is to limit participation in the market and move to a universal healthcare system.

No you would not. You would merely have to remove the obstructions to the free exchange of goods and services that I wrote about above. Further limiting people from participating in the marketplace only drives costs up, and entrenches the big money makers. That's why the big companies love regulation. Regulation squeezes out the little guy and carves their market position in stone. You Blues are the worst, because you think you're sticking it to the man, when in fact you're giving the man a free ride for the next century.

If we can’t use universal healthcare as an option to compare against than what are you advocating for?

Read the post at (23 Sep 14 9:52).

I'm totally with you on car wrecks and heart attacks.

I'm virulently against you on prescription drugs and routine health care.

You can't compare us to Sweden because we're not made of Swedes. For that system to work here, we would need to replace our population with a bunch of Swedes, with the Swedish mindset, Swedish pride in their work, Swedish sense of cultural responsibility, and Swedish government that's not completely beholden to money. If you want to know how single-provider health care plays out in the United States, we already know how that plays out. We already have that. It's called the VA.

So in this free market utopia every citizen has the access to proper medical education such that they can self-diagnose without error, won’t abuse an uncontrolled drug market and every citizen has the money to afford the drugs that they need (through accurate self-diagnoses). This system perfectly encapsulates the two fundamental and fundamentally incorrect assumptions of free market ideology:
1) Opportunity applies equally to everyone. There’s no such thing is social, cultural, economic impediments.
2) Once a fully free market is obtain, people will magically live altruistically, co-operatively, and efficiently. While under restrictions/regulations, people are selfish, greedy and lazy (“lack of an individual’s motivation to keep their own costs down and the systems motivation to do everything to drive costs up”).

I don't know if you've noticed or not, but for 99% of ailments all the doctor is doing is spouting off the same BS you can get off WebMD. I've been misdiagnosed more than I've been properly diagnosed. Your position, and the position of the whole industry to date, suffers from the two fundamental flaws of nanny state progressivism:

1) People can't be trusted to do what's right for themselves
2) The government can't be bought

Your progressive government is bought. The people you voted for are bought. The head of the FDA is a Montsanto lobbyist. The head of the FCC is a Comcast lobbyist. Obamacare was written by lobbyists. The fundamental underpinnings of progressive nannystateism don't work if the government is bought. It works in Sweden because the Swedes don't put their government up for auction. That's why it won't work here.

I'm not saying it doesn't work there. I'm saying we are not them.

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[JohnRBaker]

David (AKA zdas04), I will give Geoge Bush credit for one thing; he promised that when he left office he would walk away from the political arena and that further, he would not publicly second-guess his predecessor, and he's pretty much kept his word and I applaud him for that. Too bad the same can't be said of Dick Cheney...

John R. Baker, P.E.
Product 'Evangelist'
Product Engineering Software
Siemens PLM Software Inc.
Industry Sector
Cypress, CA
Siemens PLM:
UG/NX Museum:

To an Engineer, the glass is twice as big as it needs to be.

 

[CELinOttawa]

Applicability of the fourteen amendment to your constitution was near unanimous. If memory serves it was seven or eight judges who agreed.

s to the form of the objection, it was a speculative play at best. The recount which DID occur later as forced through court actions by Gore supported and the media (gee, I wonder what cause they had to see continued controversy) showed that, while smaller, Bush still had more than a marginal victory in Florida.

Look to the form of your elections if you want a constructive place to lay blame, not technicalities on vote counting. Your country was founded with an inherent paranoia regarding delay in declaring the uncontested winner. Together with that ungodly Electoral College system it has produced several permanently controversial results.

 

[JohnRBaker]

I agree that the Electoral College system has long outlived any sort of applicability in our modern society (eliminating it would have of course made the entire Florida insanity in 2000 moot since Gore took the popular vote by better than a HALF MILLION votes). With that in mind, in 1992, I voted for Ross Perot with the hope that enough other concerned Americans would do the same so that he would get enough votes so as to scare the Congress and the rest of the country into demanding that we do away with the Electoral College system before we had a situation where the House of Representatives would end-up being the ones who choose the new President. If we thought the 2000 election was something with the guy who got the most votes losing, what if the guy who came in 3rd, but who was of the same party as was controlling the House, was picked for President? That would be too much to stand and would probably lead to something a lot worse than what did happened in 2000.

But back to the idea that IF the Florida recount had been allowed to continue. Well that would have been a lot better situation than having 5 activists judges make that decision for us when there was still a chance that a recount could have shown that Bush had NOT gotten the most votes in Florida. In some ways, we were damned lucky that the recount was finally done (which BTW was paid for by several Florida media outlets) and that it did show that Bush got the most votes and that he did deserve Florida's Electoral votes after all. But what would it have been like in this country if that exercise had shown the opposite? Just think about it...

John R. Baker, P.E.
Product 'Evangelist'
Product Engineering Software
Siemens PLM Software Inc.
Industry Sector
Cypress, CA
Siemens PLM:
UG/NX Museum:

To an Engineer, the glass is twice as big as it needs to be.

 

[CELinOttawa]

My bet as a reasonably impartial third party: Controversy for a few weeks followed by the same pernament "he didn't deserve it" style of grumbling that I see all over the internet as it is...

 

[JohnRBaker]

NO, it would have been a lot worse than that. For sure it could very well have changed the course of history in terms of both the aftermath of 9/11 and the presidential election of 2004.

John R. Baker, P.E.
Product 'Evangelist'
Product Engineering Software
Siemens PLM Software Inc.
Industry Sector
Cypress, CA
Siemens PLM:
UG/NX Museum:

To an Engineer, the glass is twice as big as it needs to be.

 

[CELinOttawa]

Your country, I'm likely wrong. It isn't like everyone in the states represents polar extremes that never seem to be able to find any functional middle ground... /sarcasm

A sincere bit of praise, from a citizen of a country founded by the Loyalists who fled the American Revolution: You were founded by some of the greatest free thinkers of their time, men who demanded equal say in their futures. Many of them are inspirational even to this day... They also happen to be a well off group working for their own self-interest, a number of whom were terrified of the democracy they were creating. In many ways the fears Thomas Jefferson expressed when wishing for a revolution every twenty years have been realized.

If you think TJ's wishes unrealistic, just look to the French... That is if you can get over the whole "Freedom Fries" bit and see that they were once your greatest and most important ally. That and the fact that just because someone doesn't agree with you shouldn't mean they should be derided and mocked. Google "French Military Victories" and hit -I'm feeling lucky-. Classy.

Now how did we get here from health care? *sigh*

 

[JohnRBaker]

That whole "Freedom Fries" thing was an unmitigated load of crap, period. Besides, "French Fries" are NOT even French. They originated in Belgium, but Americans have a 'soft spot' for alliterations.

John R. Baker, P.E.
Product 'Evangelist'
Product Engineering Software
Siemens PLM Software Inc.
Industry Sector
Cypress, CA
Siemens PLM:
UG/NX Museum:

To an Engineer, the glass is twice as big as it needs to be.

 

[moltenmetal]

A reasonable healthcare system in the US is impossible, period. There are too many people making too much money- 7% of the US GDP is a VERY large amount of money, and that large amount of money has incredible power. The only power which can rival it is the power of the people- but you will not use it.

You're all getting hosed, big time, and there's virtually nothing truly effective you can do about it which is a political POSSIBILITY in the United States. There are too many people in your country that fear their own government to the point where any kind of trust is impossible. See where it's getting you on this one? Enormously greater cost than any other jurisdiction where this idealization of the so-called "free market" doesn't border on religion...And yes, despite its failings it does provide excellent health care- for the very richest among you, who will always be able to hire their own doctors.

 

[ornerynorsk]

"the democracy they were creating"

Nope. That's definitely not what they were after. That's partly why we're in this mess now. Mob rule.

It is better to have enough ideas for some of them to be wrong, than to be always right by having no ideas at all.

 

[rb1957]

"a country founded by the Loyalists who fled the American Revolution" ... really CEL ? really ?

i thought the French had a hand in it, and the Brits, some 100 years before.

ok, they gave us the Loyalists, we gave them Cajans (Arcadians).

another day in paradise, or is paradise one day closer ?

 

[CELinOttawa]

In fact I am French Canadian, of a sort... I'm a Jackatar. For our southern friends I thought I'd keep it simple and highlight the pertinent part of the story...

You're quite right however, a gross oversimplification. Apologies to the other Canucks. *smiles*

 

[cranky108]

The electoral college was set up so that it was fair for both small and big states. Each state has at least three votes, where larger states have more. And the intent was to force the perspective office holders to visit as many states as possible, and not just the more populus states. The rural states would be neglected and oppressed by city dwellers if this reminit from the past were to go away. So it does help even out the concerns of rural America in the elections.

Besides, the recount was something like in only 9 counties, and not the whole state of Florida. After all Al was not interested in what rural Florida had to say.

 

[moltenmetal]

For comparison, the 7% of GDP the US is spending on health care in excess of what countries like Canada, the UK, Germany etc. are spending, is greater than the total US expenditure on national defense, which was around 4.7% in 2010. That is the amount of extra money we're talking about, and I take that as an approximate measure of just how much power that much money has over government policy...It's for that reason primarily that I would conclude that no real solution for health care is politically possible in the US. And let's be clear- part of that additional expenditure arises because there IS a partial parallel public system in the US- medicare, Medicaid and the VA system etc.

What concerns me is that many greedy people in Canada would also love to slice off an additional 7% of our GDP for their own private gain. They would like to subvert our single payor system by providing an "out" for the rich in the form of a parallel private system. While that apparently does exist without the total destruction of the public system in some jurisdictions, I can guarantee you that the minute rich people here were allowed to opt out, they would DEMAND a dramatic reduction to the taxes which fund the public system everyone else depends on. When there's no out for the rich and powerful, there's a motivation on their part to maintain the public system for their own benefit, which coincidentally also benefits everyone else in society. The very wealthiest can of course fly wherever they prefer and obtain whatever gold-plated healthcare they desire, irrespective of where they live normally.

 

[rconnor]

Beej67, firstly I mistakenly forgot to delete my paragraph that starts with “If we can’t use…”. I wrote it prior to seeing your 3rd response, where you did outline your position. My mistake.

Fundamentally, I feel we are pretty close to the same core understanding of the issue but our solutions go in completely different directions. We both see the US as an corporate oligarchy and that this has directly caused the healthcare system to not be in the people’s best interest. Your stance, if I can attempt to paraphrase and correct me if I’m wrong, is because of the corporate corruption of the political system, healthcare shouldn’t be controlled by the government (i.e. universal/socialized). Instead, it should be allowed to operate, as much as possible and as closely as possible, directly between the producer and consumer.

My stance is that the “producers” in this case will, as they always will in a capitalist economy, put profits before creating an equitable healthcare system. That same corrupting influence on our government is now directly, and with less regulation, in charge of the healthcare system. Even though the government is far from perfect, it is much more accountable to the people than a for-profit hospital or big pharma company. I just cannot understand how a producer in an idealized free-market is not the same as a producer in a capitalist economy. It is also easier to be much more equitable to all citizens in a universal, socialized sense than on an individual level. I feel that a free-market solution would “help those that can help themselves” and make it even harder for the disenfranchised in the society.

Now to your two objections to my ideology:
1) I think that people, in mass, will naturally do what’s right for themselves but not what’s right for society. That’s my point. Furthermore, culture and advertising tells people “what’s right for them”, which really may not be what’s right for them (hence why so many people live outside their means, eat terrible food, smoke, etc.). Free-market ideology promotes an individualistic society, centered around consumption and predicated on a “you get what you deserve” attitude. The disenfranchised are seen as people that do not want to work for themselves, which completely ignores any and all social, economic or cultural barriers. That’s just fundamentally not a society I want to live in.
2) I touched on this already but I absolutely agree that government can be bought. However, I still have much more say in how the government works than I do how corporations work. Mass boycotting of companies on ethically grounds (which is the only “voice” you have in an idealized free-market) is difficult for the average person, especially if the companies costs are lower than competitors (i.e. the Walmart example or why 99% of clothes coming from sweat shops, etc.). People respond to the product, not the means of producing the product. Therefore, while, in theory, an idealized free market should promote cheap, quality products, it has no control (nor does it care to control) the ethical and ecological means of production. This is a problem for me.

zdas04,
…I just deleted the rest of my reply to you after I read this gem: “One person's "right" that requires a disinterested party to "contribute" is simply slavery”. This is disgustingly apathetic and so grossly extenuates actual slavery. So you feel that universal healthcare is slavery - where you, the tax payer, are the “slave” and under privileged families, receiving free, publically healthcare, are the “slave masters”. The fact that you are “disinterested” in supporting the disenfranchised in your society does not make you a “slave”, it makes you egocentric.

Leave it to some white, middle-upper class, libertarian male to declare themselves a “slave” because they have to pay into social welfare programs that support the disenfranchised and most marginalized groups in their society. That’s insulting on so many levels.