The stupidity of the democrats

[Cali Coug]

Originally Posted by MikeWaters

A tax/fine of $200 is not requiring people to have insurance. It was originally proposed to be $4000. What happened?

Let's say insurance costs my family $1200 a month out of pocket on the open market. In one year, that is $14,400.

How many of you had $14,400 in medical costs last year? May will have had less. Some will have had close to no cost. Now weight $14,400 against a $200 fine and ability to enroll in insurance at any point and start paying the $1200.

Ok- so, again, are you favoring stricter penalties? It IS a requirement, but it sounds like you don't think the penalty is sufficient.

[Levin]

Originally Posted by Cali Coug

Ok- so, again, are you favoring stricter penalties? It IS a requirement, but it sounds like you don't think the penalty is sufficient.

You're obtuse. End of story.

[MikeWaters]

The fundamental issue here is this: Who should pay for sick people?

1. Employers?
2. Healthy people with jobs?
3. The sick people themselves?
4. Everyone pay equally?

No one wants to insure cars before a demolition derby. It's often easy to predict that some sick people will have huge costs. It's not really insurance. It's cost-spreading.

Insurance is normally viewed as a way of spreading unforseen financial risk.

There is nothing unforseen about patients that are train wrecks.

If the solution were easy, we would already have a solution.

Doctors don't want to foot the bill. Hospitals don't either.

The government doesn't want to pay for it (because they want to be able to say they won't have to raise taxes to cover everyone).

Relatively healthy people with insurance don't want to pay for it--many can barely afford insurance as it is.

And of course all of this avoids a very important question: where are the financial incentives to have a healthy lifestyle?

Obama and the democrats are hoping to pull a fast one. They are desperately hoping that everyone is stupid and that they can fool the public, without being honest about how the costs will be spread.

[Cali Coug]

Originally Posted by Levin

You're obtuse. End of story.

So you know the answer? Go hug a wolf.

[Cali Coug]

Originally Posted by MikeWaters

The fundamental issue here is this: Who should pay for sick people?

1. Employers?
2. Healthy people with jobs?
3. The sick people themselves?
4. Everyone pay equally?

No one wants to insure cars before a demolition derby. It's often easy to predict that some sick people will have huge costs. It's not really insurance. It's cost-spreading.

Insurance is normally viewed as a way of spreading unforseen financial risk.

There is nothing unforseen about patients that are train wrecks.

If the solution were easy, we would already have a solution.

Doctors don't want to foot the bill. Hospitals don't either.

The government doesn't want to pay for it (because they want to be able to say they won't have to raise taxes to cover everyone).

Relatively healthy people with insurance don't want to pay for it--many can barely afford insurance as it is.

And of course all of this avoids a very important question: where are the financial incentives to have a healthy lifestyle?

Obama and the democrats are hoping to pull a fast one. They are desperately hoping that everyone is stupid and that they can fool the public, without being honest about how the costs will be spread.

Then once again, how about you give the answer instead of just talking about how dumb everyone else is?

[MikeWaters]

In our current system, if you are a sickly person, here are your options:

1. Keep your job w/ insurance. (Employer and fellow employees pay the cost). Failing to keep your job, pay for the COBRA.

2. Buy your own insurance on the market (very, very expensive).

3. Get medical disability coverage--Medicare. (Govt. pays). Takes time--many months, sometimes years.

4. Get medicaid coverage (state) , or local county coverage, based on income (Govt. pays). May or may not qualify.

5. Pure charity care. As in friends, family, church, doctors working gratis, hospitals providing free care, free charitable clinics (donor funded).

6. Pay cash. Probably almost never happens, because someone with cash can buy insurance.

Problems with these sources:
1. Employers/employees--increasingly burdensome to afford insurance.
2. Buy individual policy on open market--no risk-spreading, very expensive.
3. Govt.--slow, poor benefits, long waits.
4. Charity--unreliable, cannot absorb large unpredictable costs.

So what to do? Again the problem is the lack of connection between health choices and costs. No incentive to live more healthily.

We ought to think of health choices in two categories: the things that are controllable and the things that are uncontrollable. We ought to do cost/risk stratification based on the controllable choices a person makes, thus incentivizing better choices.

Create Health Tiers based on lifestyle health choices. Let's say 5 tiers. Based on things like your level of obesity, your use of tobacco.....go through a list here. You live better, you are in a better tier, and your tier changes, and thus the better your choices, the cheaper your insurance. You can change your profile by getting healthier--that's the whole point.

How that translates to a private/public funding plan and cost-sharing--not sure. I got real work to do, so better leave this as is for now.

[Archaea]

Originally Posted by MikeWaters

In our current system, if you are a sickly person, here are your options:

1. Keep your job w/ insurance. (Employer and fellow employees pay the cost). Failing to keep your job, pay for the COBRA.

2. Buy your own insurance on the market (very, very expensive).

3. Get medical disability coverage--Medicare. (Govt. pays). Takes time--many months, sometimes years.

4. Get medicaid coverage (state) , or local county coverage, based on income (Govt. pays). May or may not qualify.

5. Pure charity care. As in friends, family, church, doctors working gratis, hospitals providing free care, free charitable clinics (donor funded).

6. Pay cash. Probably almost never happens, because someone with cash can buy insurance.

Problems with these sources:
1. Employers/employees--increasingly burdensome to afford insurance.
2. Buy individual policy on open market--no risk-spreading, very expensive.
3. Govt.--slow, poor benefits, long waits.
4. Charity--unreliable, cannot absorb large unpredictable costs.

So what to do? Again the problem is the lack of connection between health choices and costs. No incentive to live more healthily.

We ought to think of health choices in two categories: the things that are controllable and the things that are uncontrollable. We ought to do cost/risk stratification based on the controllable choices a person makes, thus incentivizing better choices.

Create Health Tiers based on lifestyle health choices. Let's say 5 tiers. Based on things like your level of obesity, your use of tobacco.....go through a list here. You live better, you are in a better tier, and your tier changes, and thus the better your choices, the cheaper your insurance. You can change your profile by getting healthier--that's the whole point.

How that translates to a private/public funding plan and cost-sharing--not sure. I got real work to do, so better leave this as is for now.

The most difficult problem is how to fund and to create risk pools for persons where lifestyle did not create the truly high expense, high risk health care. That's where I stumble, not knowing a human answer. But perhaps those persons are statistically rare and with a large enough risk pool, where true "insurance" is possible.

You've made my arguments more cogently.

The argument of the Democrats is a lie and a subterfuge. First, they lie stating universal coverage wont' raise taxes, and a lot. They know this to be true yet in order to entice the voters, they are willing to bankrupt the country by saddling it with debt which can't be paid. Second, the subterfuge is to make smokescreens and to appeal to interested, biased voter bases.

I mean who really what's to say to an already obese population, "you're fat and because you're fat, you are in a disfavored health tier"? Too many voters for the Dems to do that. But that's what needs to happen.

Incentives to choose healthy lifestyle is essential if we're ever to deal with the perceptions and realities of our health care.

[Cali Coug]

Originally Posted by MikeWaters

In our current system, if you are a sickly person, here are your options:

1. Keep your job w/ insurance. (Employer and fellow employees pay the cost). Failing to keep your job, pay for the COBRA.

2. Buy your own insurance on the market (very, very expensive).

3. Get medical disability coverage--Medicare. (Govt. pays). Takes time--many months, sometimes years.

4. Get medicaid coverage (state) , or local county coverage, based on income (Govt. pays). May or may not qualify.

5. Pure charity care. As in friends, family, church, doctors working gratis, hospitals providing free care, free charitable clinics (donor funded).

6. Pay cash. Probably almost never happens, because someone with cash can buy insurance.

Problems with these sources:
1. Employers/employees--increasingly burdensome to afford insurance.
2. Buy individual policy on open market--no risk-spreading, very expensive.
3. Govt.--slow, poor benefits, long waits.
4. Charity--unreliable, cannot absorb large unpredictable costs.

So what to do? Again the problem is the lack of connection between health choices and costs. No incentive to live more healthily.

We ought to think of health choices in two categories: the things that are controllable and the things that are uncontrollable. We ought to do cost/risk stratification based on the controllable choices a person makes, thus incentivizing better choices.

Create Health Tiers based on lifestyle health choices. Let's say 5 tiers. Based on things like your level of obesity, your use of tobacco.....go through a list here. You live better, you are in a better tier, and your tier changes, and thus the better your choices, the cheaper your insurance. You can change your profile by getting healthier--that's the whole point.

How that translates to a private/public funding plan and cost-sharing--not sure. I got real work to do, so better leave this as is for now.

Thank you for responding. In some respects, what you have outlined mirrors life insurance premiums. But is that right for health insurance? If someone is obese, is it necessarily because they are lazy and overeat? To what extent does genetics play a role? If you are trying to charge people more to "incentivize" them to be healthier, don't you first need to know if they are physically capable of actually being healthier? Certainly an individual with a highly overactive thyroid and a serious resulting problem with obesity can't be "incentivized" to lose weight, so why charge that person more money under your system? Is each American supposed to go through an analysis to determine whether their high risk areas are the result of personal decisions or uncontrollable factors? For those who are actually high risk because of poor choices, what if they can't afford the health care (which you are charging them more to obtain)? Are they really incentivized to not have health insurance at all? What do you do if they go to the emergency room with no health insurance? Refuse treatment? Require them to purchase health insurance and penalize them if they don't?

I see a lot of people throwing a lot of rocks at the proposals of the Democrats right now, but it is amusing to me how far they get when they are actually asked to build something constructive instead of tearing away at the proposals on the table.

[MikeWaters]

Originally Posted by Cali Coug

Thank you for responding. In some respects, what you have outlined mirrors life insurance premiums. But is that right for health insurance? If someone is obese, is it necessarily because they are lazy and overeat? To what extent does genetics play a role? If you are trying to charge people more to "incentivize" them to be healthier, don't you first need to know if they are physically capable of actually being healthier? Certainly an individual with a highly overactive thyroid and a serious resulting problem with obesity can't be "incentivized" to lose weight, so why charge that person more money under your system? Is each American supposed to go through an analysis to determine whether their high risk areas are the result of personal decisions or uncontrollable factors? For those who are actually high risk because of poor choices, what if they can't afford the health care (which you are charging them more to obtain)? Are they really incentivized to not have health insurance at all? What do you do if they go to the emergency room with no health insurance? Refuse treatment? Require them to purchase health insurance and penalize them if they don't?

I see a lot of people throwing a lot of rocks at the proposals of the Democrats right now, but it is amusing to me how far they get when they are actually asked to build something constructive instead of tearing away at the proposals on the table.

No, most people are not incentivized to live better, because it is a small % of people that buy their insurance on the open market. They get insurance through their employer or get coverage through the govt.

[Cali Coug]

Originally Posted by MikeWaters

No, most people are not incentivized to live better, because it is a small % of people that buy their insurance on the open market. They get insurance through their employer or get coverage through the govt.

I'm confused. I was talking about your proposal. Are you saying your proposal involves maintaining the employer-based system? Because that isn't what I got out of your proposal.