The Slow Dismantling of Obamacare

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MachineGhost
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The Slow Dismantling of Obamacare

Post by MachineGhost » Mon Jan 07, 2013 5:30 pm

Even Democrats in Congress aren’t huge fans any more. It seems after passing the law and finding out what’s in it, the allure has faded—so much so that Congress actually repealed part of Obamacare in the fiscal cliff deal last week.

http://blog.heritage.org/2013/01/07/mor ... 6ba778150c
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Re: The Slow Dismantling of Obamacare

Post by Pointedstick » Mon Jan 07, 2013 7:10 pm

I wonder if many congressmen even knew that provision was in the bill. From what I've heard, few got the chance to even read it before they voted on it. Perhaps other surprises might be hidden inside.
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Re: The Slow Dismantling of Obamacare

Post by doodle » Mon Jan 07, 2013 9:07 pm

Im not sure whats in it other than some of the basic provisions, but I really think it is fundamentally important that we start making people take more responsibility for their health in this country. The majority of the illness in this country is self inflicted through lifestyle choices ( albeit culture and advertising makes this unhealthy lifestyle almost inescapable). At the end of the day, people have to have some skin in the game. Ultimately I think the simplest solution might work best.

1. Get rid of insurance companies. They are parasites.

2. force doctors and hospitals to display prices and compete in the marketplace. In todays internet age it should be easy to get every doctor in a database where pricing and quality of their service is easily accessible to consumer.

3. Government gives people a certain amount to spend on basic health procedures every year up to say 500 dollars. After this money is spent, consumer must pay 100 percent out of pocket until a certain deductible is reached....say 2000 dollars. Exceptions can be made for people of desperate means who were born or acquired certain conditions through no fault of their own.

A simple system like this would give people the incentive they need to take care of their health and the information to shop around for doctors and procedures. On the other hand, it would protect against people with legitimate illnesses from going bankrupt.

Anyone see any pitfalls with such a system?
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Re: The Slow Dismantling of Obamacare

Post by RuralEngineer » Mon Jan 07, 2013 9:49 pm

Yeah, I see a pitfall.  You're only superficially forcing people to be responsible for their health issues.  Somebody smokes and develops cancer, or is morbidly obese and poof, they're over the $2000 deductible and I'm on the hook for their poor choices. 

Obviously not everyone with chronic or expensive health issues are as a result of personal lifestyle choices, but your system doesn't differentiate between the two groups.
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Re: The Slow Dismantling of Obamacare

Post by doodle » Mon Jan 07, 2013 9:55 pm

Perfect doesnt exist in an imperfect world. But its a step in the right direction and establishes a balance between compassion and personal responsibilty. Im sure the basic design could be slightly tweaked, but its a lot better than the absolute disaster of a system we have now. Ill admit, congressmen being paid off by lobbyists has is a large part of the problem.
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Re: The Slow Dismantling of Obamacare

Post by murphy_p_t » Tue Jan 08, 2013 12:54 am

doodle...what is it about using government force and coercion that so appeals to you?

In case you're not aware, this is the same tactic used by all totalitarian regimes.
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Re: The Slow Dismantling of Obamacare

Post by doodle » Tue Jan 08, 2013 3:21 am

Murphy,


Umm.....what I am advocating is essentially a rehash of what John Stossel proposed. Forcing doctors to display their prices is not what most people would consider government coercion, but rather the underpinnings of an open and free market. What makes doctors and insurance companies so special that they get to hide basic information from public? Seems like straightforward consumer protection to me.
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Re: The Slow Dismantling of Obamacare

Post by hoost » Tue Jan 08, 2013 3:32 am

doodle wrote: ... Forcing doctors to display their prices is not what most people would consider government coercion ...
Huh?  Who will be forcing doctors to display their prices?
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Re: The Slow Dismantling of Obamacare

Post by doodle » Tue Jan 08, 2013 3:46 am

So doctors and insurance companies have the right to hide and obfuscate their prices from consumers? I guess youre one of those libertarians who opposes any form of consumer protection as well. You just think the market will work things out....have you read "the Jungle" lately?
Last edited by doodle on Tue Jan 08, 2013 3:48 am, edited 1 time in total.
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Re: The Slow Dismantling of Obamacare

Post by hoost » Tue Jan 08, 2013 3:50 am

doodle wrote: So doctors and insurance companies have the right to hide and obfuscate their prices from consumers? I guess your one of those libertarians who opposes any form of consumer protection as well. You just think the market will work things out....have you read "the Jungle" lately?
What does that have to do with whether or not some unmentioned person/entity, presumably the government, forcing doctors to display their prices is considered government coercion?

Also, what do you do that has you up at this hour/what part of the [edit: world] are you in?
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Re: The Slow Dismantling of Obamacare

Post by Benko » Tue Jan 08, 2013 7:18 am

doodle wrote: I really think it is fundamentally important that we start making people take more responsibility for their health in this country.
While it would be nice, do you realize you sound like a dictator (not that that is a shock)?
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Re: The Slow Dismantling of Obamacare

Post by doodle » Tue Jan 08, 2013 7:45 am

Benko wrote:
doodle wrote: I really think it is fundamentally important that we start making people take more responsibility for their health in this country.
While it would be nice, do you realize you sound like a dictator (not that that is a shock)?
So people shouldnt take responsibilty for their health? Either the health care system is designed in a way that makes/ incentivizes people to take care of their health, or not. When I use the word "make" Im not talking about a govt official shoving broccoli spears down your throat for crying out loud. Every system influences and shapes human behavior...in other words it "makes" people tend to behave in a certain way. A free market system "makes" me behave in a certain way. There is no true freedom, only the illusion of such. Inevitably we are all bound together. Coming from a buddhist perspective this would be called "the illusion of independent existense".
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Re: The Slow Dismantling of Obamacare

Post by doodle » Tue Jan 08, 2013 7:52 am

hoost wrote:
doodle wrote: So doctors and insurance companies have the right to hide and obfuscate their prices from consumers? I guess your one of those libertarians who opposes any form of consumer protection as well. You just think the market will work things out....have you read "the Jungle" lately?
What does that have to do with whether or not some unmentioned person/entity, presumably the government, forcing doctors to display their prices is considered government coercion?

Also, what do you do that has you up at this hour/what part of the [edit: world] are you in?
So what Im gathering is that there shouldnt be any laws or regulations in the health care industry at all. Every law and regulation is ultimately a form of government or societal coercion.
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Re: The Slow Dismantling of Obamacare

Post by jimbojones » Tue Jan 08, 2013 8:18 am

hoost wrote:
doodle wrote: ... Forcing doctors to display their prices is not what most people would consider government coercion ...
Huh?  Who will be forcing doctors to display their prices?
I think we all glazed over the effect that Step 1 would have.  Getting rid of insurance companies results in consumers purchasing their medical care themselves.  Once that happens, consumers will ask for the price before committing to medical services.  So doctors will eventually have to compete on price (or quality of service).  No government coercion required.
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Re: The Slow Dismantling of Obamacare

Post by doodle » Tue Jan 08, 2013 8:34 am

jimbojones wrote:
hoost wrote:
doodle wrote: ... Forcing doctors to display their prices is not what most people would consider government coercion ...
Huh?  Who will be forcing doctors to display their prices?
I think we all glazed over the effect that Step 1 would have.  Getting rid of insurance companies results in consumers purchasing their medical care themselves.  Once that happens, consumers will ask for the price before committing to medical services.  So doctors will eventually have to compete on price (or quality of service).  No government coercion required.
This is true, but there is a need for medical insurance. I just think that this could be something that is taken on by a single payer government system combined with appropriate incentives through structuring deductibles in such a way as to get consumers to seek out the best price possible. Let hospitals and doctors compete amongst each other.

If we're going to operate under a free market system, at least we can make it work to society's benefit. Presently, the health industry in this country doesn't do that.
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Re: The Slow Dismantling of Obamacare

Post by murphy_p_t » Tue Jan 08, 2013 11:49 am

doodle wrote:
If we're going to operate under a free market system, at least we can make it work to society's benefit. Presently, the health industry in this country doesn't do that.
agreed. this is largely courtesy of gov't manipulation.

-can't buy insurance over state lines
-no tort reform
-obamacare is/will drive UP prices by forcing more into system, increasing handouts like contraception
-if you are curious you can find many more examples, i'm sure

to see where free markets drive prices down and move technology forward, for example, refer to the electronics industry.
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Re: The Slow Dismantling of Obamacare

Post by Pointedstick » Tue Jan 08, 2013 12:07 pm

murphy_p_t wrote:
doodle wrote:
If we're going to operate under a free market system, at least we can make it work to society's benefit. Presently, the health industry in this country doesn't do that.
agreed. this is largely courtesy of gov't manipulation.

-can't buy insurance over state lines
-no tort reform
-obamacare is/will drive UP prices by forcing more into system, increasing handouts like contraception
-if you are curious you can find many more examples, i'm sure
Many more.

- Favorable tax treatment of employer-sponsored health insurance and historical remnants from WWII wage controls cause companies to offer health plans, tying people to their employers.

- Mandates that insurance pay for plannable expenses raise the cost of medical services and insurance, and allow service providers to hide prices from consumers, inhibiting people's ability to shop around like they can in other markets.

- EMTLA forces emergency rooms to treat people who can't pay but doesn't compensate them for it, causing them to push costs onto other customers and their insurance, raising the price of medical services and insurance.

- Medicare underpays doctors, causing them to push costs onto other customers and their insurance, raising the price of medical services and insurance.

- The government-enforced prescription system forces consumers to see a doctor at cost to themselves to obtain permission to purchase benign, safe medications they may already know they need, raising the price of services and insurance.

- Medical patents permit companies to obtain monopolies on prescription drugs and set the price incredibly high, raising the price of insurance that covers prescription drugs.

- The FDA approval process that takes years and cost billions puts companies in the red before their product even hits the market, causing them to abuse the above-mentioned patent system in an effort to recoup the costs of the approval process.

I could go on and on.
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Re: The Slow Dismantling of Obamacare

Post by MachineGhost » Tue Jan 08, 2013 5:40 pm

doodle wrote: Im not sure whats in it other than some of the basic provisions, but I really think it is
http://www.gpo.gov/fdsys/pkg/BILLS-111h ... 590enr.pdf
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Re: The Slow Dismantling of Obamacare

Post by MachineGhost » Tue Jan 08, 2013 5:43 pm

doodle wrote: 1. Get rid of insurance companies. They are parasites.
Who will provide coverage for major medical issues then?
doodle wrote: 3. Government gives people a certain amount to spend on basic health procedures every year up to say 500 dollars. After this money is spent, consumer must pay 100 percent out of pocket until a certain deductible is reached....say 2000 dollars. Exceptions can be made for people of desperate means who were born or acquired certain conditions through no fault of their own.
I don't understand this logic.  What does it serve to give a hand out to people then take it away, then provide it again?
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Re: The Slow Dismantling of Obamacare

Post by MachineGhost » Tue Jan 08, 2013 5:46 pm

Pointedstick wrote: - The government-enforced prescription system forces consumers to see a doctor at cost to themselves to obtain permission to purchase benign, safe medications they may already know they need, raising the price of services and insurance.
Informed consumers buy their medicines without prescriptions off the Internet.  Just sayin'....
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Re: The Slow Dismantling of Obamacare

Post by Pointedstick » Tue Jan 08, 2013 5:52 pm

MachineGhost wrote:
Pointedstick wrote: - The government-enforced prescription system forces consumers to see a doctor at cost to themselves to obtain permission to purchase benign, safe medications they may already know they need, raising the price of services and insurance.
Informed consumers buy their medicines without prescriptions off the Internet.  Just sayin'....
Antibiotics? All the sites I found looked like scams.
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Re: The Slow Dismantling of Obamacare

Post by Albert2011 » Tue Jan 08, 2013 6:09 pm

Public Broadcasting had a documentary several years ago which was a survey of the various health care plans around the world.  If I recall Taiwan was deciding on which way to go and investigated options around the world.  Most Americans think that it is either our insurance company base "free enterprise" system or "socialists medicine."  Not so according to this program.  Switzerland for instance narrowly voted in a system where insurance companies provide the bulk of the health insurance policies BUT they must be 100% not for profits to be allowed to compete in the marketplace.  The Swiss had NO problems finding companies willing to provide insurance!  Now why did we not survey what works before getting Obamacare???

I know several physicians in private practice.  In my opinion too many are businessmen first and medical doctors second.  During the presidential campaign we heard how wonderful the Mayo and Cleveland Clinics are in providing medical care.  Well, unless I am wrong the doctors who work for those facilities are salaried and have no self interest in promoting expensive and un-needed services unlike many businessmen doctors.
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Re: The Slow Dismantling of Obamacare

Post by hoost » Tue Jan 08, 2013 6:19 pm

doodle wrote:
hoost wrote:
doodle wrote: So doctors and insurance companies have the right to hide and obfuscate their prices from consumers? I guess your one of those libertarians who opposes any form of consumer protection as well. You just think the market will work things out....have you read "the Jungle" lately?
What does that have to do with whether or not some unmentioned person/entity, presumably the government, forcing doctors to display their prices is considered government coercion?

Also, what do you do that has you up at this hour/what part of the [edit: world] are you in?
So what Im gathering is that there shouldnt be any laws or regulations in the health care industry at all. Every law and regulation is ultimately a form of government or societal coercion.
Why do you have such a hard time sticking with an argument?

I don't know how you could gather that there shouldn't be laws or regulation.  My comments have certainly not said anything about that.  You're making up false arguments and drawing false conclusions in your head based on false preconceived notions that you've come up with about me without any regard for what I actually stated.

Yes, I agree that every law and regulation is a form of government coercion; I'm glad you also accept that.

Now all you need to do is admit that you were wrong when you said that:
... Forcing doctors to display their prices is not what most people would consider government coercion ...
I suppose you could hedge your argument by saying that you did say "most people"; if that's what you want to do, I guess that's fine, but if you did that you'd be making a different baseless argument with no evidence to back it up.
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Re: The Slow Dismantling of Obamacare

Post by MachineGhost » Tue Jan 08, 2013 6:56 pm

Pointedstick wrote: Antibiotics? All the sites I found looked like scams.
I admit its 100x tougher to find legit sites than it used to be.  So much garbage now.  You've got to use private lists or have grandfathered sites before the deluge.
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Re: The Slow Dismantling of Obamacare

Post by doodle » Tue Jan 08, 2013 8:53 pm

MachineGhost wrote:
doodle wrote: 1. Get rid of insurance companies. They are parasites.
Who will provide coverage for major medical issues then?



Government single payer like medicare or medicaid.
doodle wrote: 3. Government gives people a certain amount to spend on basic health procedures every year up to say 500 dollars. After this money is spent, consumer must pay 100 percent out of pocket until a certain deductible is reached....say 2000 dollars. Exceptions can be made for people of desperate means who were born or acquired certain conditions through no fault of their own.
I don't understand this logic.  What does it serve to give a hand out to people then take it away, then provide it again?
This is actually how my insurance plan works at my job. The first $500 dollars is covered so that I can get basic services if I get sick or what not. This amount is rolled over if I don't use it during the year.  After that the next $1500 dollars comes completely out of my pocket. This incentivizes me to be judicious about going to the doctor for little things. It also keeps me actively engaged in looking after my health because I don't want to spend my own money for sicknesses that I can prevent. After the $1500 dollar limit is reached I think insurance kicks in again with an 80/20 split until $4000 dollars has been spent at which point they cover 100%.

The good thing about this design in my opinion is that it gives people access to basic care...checkups and a few doctors visits a year. After that, you are paying out of your own pocket. So you have a strong incentive to take care of your health as well as search out good prices. Finally if something like cancer were to strike you are covered above and beyond $4000 dollars so that you don't go bankrupt.
Last edited by doodle on Tue Jan 08, 2013 9:11 pm, edited 1 time in total.
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