The US Healthcare Mass Debate

[Scot Dutchy]

What is that Joe?

[Joe]

It's a law that requires hospitals that participate in Medicare, pretty much all of them, to provide emergency service to anybody who shows up regardless of their ability to pay. However, the law provides no funds to reimburse the providers for their expenses.

Prior to the ACA Medicaid expansion, the uninsured used the emergency rooms when they needed care. The hospitals would recoup their costs by charging more to insured patients.

ER expenses were one of the largest drivers of health care cost, and the ACA helped slow this down by giving more people the ability to go to a doctor's office, which is generally much less expensive than the ER.

[Scot Dutchy]

Thanks Joe. Paying for some one else is not in the American psyche.

[Forty Two]

Yeah, because EMTALA was working just fine.

The current state of affairs is unsustainable.

Let's not forget that the "uninsured" in 2010 when Obamacare was passed were not primarily people who could not afford insurance. All children were covered under Chip, etc. Medicaid covered the really poor. If it was about covering people who could not afford it, we could have just picked an income level at which Medicaid kicks in and raise that threshold - we could have made it graduated so higher incomes get progressively less subsidy to their Medicaid, down to zero.

But, since that wasn't the main problem, that wasn't the solution. The main problem was that 30,000,000 million people who didn't have health insurance were nevertheless making incomes above the median income level in the country, but opting not to buy insurance with their money (using it for something else). Half of the reamining 10,000,000 were illegal aliens. And, a large percentage of the last bit were already eligible for some form of assistance, whether it be Medicaid or Chip, but failed to sign up.

This was a small problem, that wasn't in need of a solution, that was presented as a big problem, in order to pass a law requiring everyone to get health insurance.

[Forty Two]

Thanks Joe. Paying for some one else is not in the American psyche.

That's an ignorant absurdity, as we have a generous social safety net, and Americans are among the most generous charitable givers in the world. https://www.washingtonexaminer.com/amer ... -donations "Americans out-donate Britain and Canada two-to-one and nations like Italy and Germany 20-to-one. What's more, more than half of every single income class except those earning less than $25,000 donate to charity."

According to the World Giving Index, Americans are the second most charitable people in the world, second only to Myanmar. https://www.cafonline.org/docs/default- ... f?sfvrsn=4

So, it most certainly is part of the American psyche to pay for someone else.

[Tero]

Generous safety net!

[Joe]

Yeah, because EMTALA was working just fine.

The current state of affairs is unsustainable.

Let's not forget that the "uninsured" in 2010 when Obamacare was passed were not primarily people who could not afford insurance. All children were covered under Chip, etc. Medicaid covered the really poor. If it was about covering people who could not afford it, we could have just picked an income level at which Medicaid kicks in and raise that threshold - we could have made it graduated so higher incomes get progressively less subsidy to their Medicaid, down to zero.

But, since that wasn't the main problem, that wasn't the solution. The main problem was that 30,000,000 million people who didn't have health insurance were nevertheless making incomes above the median income level in the country, but opting not to buy insurance with their money (using it for something else). Half of the reamining 10,000,000 were illegal aliens. And, a large percentage of the last bit were already eligible for some form of assistance, whether it be Medicaid or Chip, but failed to sign up.

This was a small problem, that wasn't in need of a solution, that was presented as a big problem, in order to pass a law requiring everyone to get health insurance.

Well, your argument is certainly unsustainable Forty Two. How about linking to the source of the numbers you're throwing around?

For now, I'll just assume you got it wrong.

[Joe]

Generous safety net!

A guy bitching about his $2000 health insurance premiums thinks we have a generous safety net.

It's true it's pretty good if you compare it to poor countries. It's also true that we have many wonderful and generous people, with a fine reputation for giving, but Seth alone puts a stain on that.

[Forty Two]

Yeah, because EMTALA was working just fine.

The current state of affairs is unsustainable.

Let's not forget that the "uninsured" in 2010 when Obamacare was passed were not primarily people who could not afford insurance. All children were covered under Chip, etc. Medicaid covered the really poor. If it was about covering people who could not afford it, we could have just picked an income level at which Medicaid kicks in and raise that threshold - we could have made it graduated so higher incomes get progressively less subsidy to their Medicaid, down to zero.

But, since that wasn't the main problem, that wasn't the solution. The main problem was that 30,000,000 million people who didn't have health insurance were nevertheless making incomes above the median income level in the country, but opting not to buy insurance with their money (using it for something else). Half of the reamining 10,000,000 were illegal aliens. And, a large percentage of the last bit were already eligible for some form of assistance, whether it be Medicaid or Chip, but failed to sign up.

This was a small problem, that wasn't in need of a solution, that was presented as a big problem, in order to pass a law requiring everyone to get health insurance.

Well, your argument is certainly unsustainable Forty Two. How about linking to the source of the numbers you're throwing around?

For now, I'll just assume you got it wrong.

Because we've been over it many times before.

From 2009 -- "The Census states that 46.3 million Americans were uninsured at some point in 2008. Yet, 17.8 million of the uninsured earn more than $50,000 annually. It's likely that many of them -- particularly the 9.7 million that make more than $75,000 a year -- have chosen to forego coverage." https://www.washingtonexaminer.com/sall ... -uninsured Nearly half of the uninsured made roughly average incomes in 2008.

The stats back then said about 7.3 million of the unininsured were children - ""The Georgetown University Health Policy Institute estimates that seven in 10 uninsured children already qualify for the State Children's Health Insurance Program, Medicaid, or both. And the federal government already approved an additional $32 billion to help expand SCHIP earlier this year." Of the total number of uninsured at the time, "roughly one in four Americans without coverage is already eligible for government-provided care."

So, 17.8 million earned over $50,000 per year, and about 12 million already were eligible for government provided care. That's 27 or 28 million people of the uninsured that plainly could afford insurance or already were elible for free health care at the time.

SEPTEMBER 26, 2011 SALLY C. PIPES THE WALL STREET JOURNAL
The Wall Street Journal

The U.S. Census Bureau has released its latest estimates on poverty, income and health-insurance coverage. Strikingly, the official poverty rate is the highest it’s been in 50 years.

As one might expect, the number of Americans without health insurance also rose—to 49.9 million, an increase of 919,000 since 2009.

But that large number hides more than it reveals. And diving into it shows that the uninsured rate won’t fall unless the economy starts humming again. Unfortunately, ObamaCare’s billions of dollars in new taxes and regulations won’t allow that to happen.

Let’s take a closer look at the 49.9 million uninsured. The Census reports that 9.5 million of them, about 19%, have household incomes over $75,000. In other words, a fifth of the uninsured make at least 50% more than the median American. They can afford to purchase a plan but have chosen not to.

Another 8.8 million uninsured make between $50,000 and $75,000. Paying for coverage might be more of a stretch for these folks, but they still have incomes higher than the majority of Americans.

For these two subsets of the uninsured population, an insurance plan might not be worth the money, particularly if they’re young and healthy. And with ObamaCare set to drive up the cost of a basic individual insurance plan by 10% to 13%, according to the Congressional Budget Office, the number of voluntarily uninsured is certain to grow.

Another 9.7 million of the uninsured are noncitizens, both legal and illegal immigrants. Illegal immigrants will not be able to participate in ObamaCare’s exchanges, so they’ll continue to seek care in expensive emergency rooms and community hospitals, thereby adding to the cost of care for everyone else. Add these three groups up, and more than half of the people the Census Bureau counts as uninsured could be considered questionably so.

The uninsured truly in need of help are those with household incomes below $25,000. They represent roughly a third of the uninsured, or 16.1 million.

Now, 16 million uninsured is nothing to sneeze at. But they represent only 5% of the American population. Finding coverage for them doesn’t require remaking one-sixth of the U.S. economy, as ObamaCare does. Many of these 16 million people are already eligible for public insurance, chiefly Medicaid and the State Children’s Health Insurance Program. They just haven’t signed up.

The Census figures also show that the number of people with private insurance dropped by 300,000 last year. About 1.5 million people lost their employer-sponsored insurance, most likely because of the economic downturn. But that loss in coverage was partially offset by the fact that over a million people bought coverage for themselves or their families on the private market.

https://www.wsj.com/articles/SB10001424 ... TopOpinion

Thus, while the problem was not nonexistent, the problem was not what the Democrats sold it as - a crisis of 50 million poor people unable "afford" insurance. And their solution was to compel people to buy insurance, and then subsidize them, but as the subsidies were added, the cost of health insurance doubled, tripled and quadrupled.

They promised LOWER insurance premiums. Anyone who lived through it should remember that the Affordable Care Act was supposed to reduce premiums across the board, like $2500 per family, and then there were cost savings - we were going to save $50 billion annually in fraud prevention. We were going to save money because everyone would be getting preventative care, and all the policies were going to offer broad coverage (they didn't tell us that deductibles were going to go up to $3,000 and then $6,000+ annual deductibles).

The solution to the problem was to mandate the purchase of health insurance and then require us to disclose on our tax returns to the IRS whether we had health insurance. If we did not, the law was going to require a penalty, and if the penalty wasn't paid then there would be criminal repurcussions. And, when you want a subsidy, you went to the exchange and put all your income information in there, and guess what your annual income would be for the upcoming year. Then you get a subsidy based on that. But if you earned more money that year, then when you filed your return they would recalculate your subsidy and you'd get pinged by the IRS for the difference in premium and a penalty for not accurately stating your estimated income and if you didn't have the money to pay the IRS, then you would face interest and penalties on that.

It was a non-solution to a different problem, and it became a shit-sandwich.

[Forty Two]

Generous safety net!

A guy bitching about his $2000 health insurance premiums thinks we have a generous safety net.

Nets are for when you fall, not when you're still up and walking.

It's true it's pretty good if you compare it to poor countries. It's also true that we have many wonderful and generous people, with a fine reputation for giving, but Seth alone puts a stain on that.

You're still talking about Seth, whose been banned from the site for what? A year? His name comes up so much around here, I think some of you actually miss the guy. Ironic.

[pErvinalia]

Well look at his quote in my signature. It's hard to forget someone as whacko as that..

[Forty Two]

Well look at his quote in my signature. It's hard to forget someone as whacko as that..

LOL - you still think your link proves what I said was wrong. That's cute.

[pErvinalia]

[Tero]

Generous safety net!

A guy bitching about his $2000 health insurance premiums thinks we have a generous safety net.

Nets are for when you fall, not when you're still up and walking.

It's true it's pretty good if you compare it to poor countries. It's also true that we have many wonderful and generous people, with a fine reputation for giving, but Seth alone puts a stain on that.

You're still talking about Seth, whose been banned from the site for what? A year? His name comes up so much around here, I think some of you actually miss the guy. Ironic.

That would be the US system. Nets are there for every single parent in Scandinavia until the kid goes to school. Somewhat less but useful support for two parent family. One parent will work and the other stays hone for a while if that is their best solution. Child care preschool is cheap for two parents working.

[JimC]

Forty Two wrote:

You're still talking about Seth, whose been banned from the site for what? A year? His name comes up so much around here, I think some of you actually miss the guy. Ironic.

He was suspended (not banned) for 6 months, after an escalating series of posts. Since then, he has shaken the dust of Rationalia from his feet, and moved on. Ironically, it is Joe (not here in Seth's heyday, I think) who mentions him the most...