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Kirk W

Where will healthcare go in the near future?

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When someone can show me a plan that will not take away any of the benefits we have, and that will help others without running up more and more debt, I will support it. Any plan must also be paid for by someone.

 

Who should pay?

 

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Who should pay? If it were only so simple. As mentioned earlier some believe health care is a right and others believe it is a privilege. If the two can come together somehow that might be a start.

 

I have worked in the public and private sector and found dramatic differences in the approach to budgeting and handling the finances.

 

In the private sector the emphasis was staying in the black and planning ahead to save enough to pay for a project.

 

In the public sector since it was not their money but tax dollars it was use it or lose each year little long term planning. Some pretty dumb things were purchased so they wouldn't "lose" their money.

 

This will never happen but IF the states were responsible for healthcare instead of the federal government the programs and budgets would be much smaller, easier to handle (less "fumbles" would slip through") and tailored to the residents of that state instead of everyone paying for other states differing priorities.

 

I think most people want a say in where their money goes with the understanding that it is a privilege to live and pay taxes in the US and we will have to pay for some things we don't personally use. But somethings I think most people would agree are just plain crazy to "waste" tax dollars on. The Federal Fumbles Report for 2016 has come out here is a link to the Federal Fumbles for 2015 both are pretty lengthy but if you just look at the table of contents you will get the idea of the unfortunate things your tax payer dollars go to and slip by the tax paying public in the too big for the average person to read federal budget.

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While some of us believe health care is a right, many also believe food, water and shelter are also part of this right. Who should pay for this is indeed an interesting topic but I wonder if this is the best forum for it. I respectfully submit that the moderators should review this topic to see if it is inline with the objectives of THIS forum.

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Just so you know Randy there is a moderator actually participating in this forum discussion. I do think we do a pretty good job of self policing. People are going to walk up to the line and periodically step over it but those kerfluffles quickly blow over and this issue impacts some of our lives directly. The decision is ultimately up to the moderators but I think we all know pure political talk when we see it. I find your objection interesting and wonder if you have read through the entire thread because in this age of disinformation and disrespect, I actually found this discussion helpful in understanding others perspectives. One of the best I have read. I found it reaffirming that people with different worldviews can still communicate, share and exchange information in a respectful manner. I want to hear opinions different than mine. I think all of us are against the simple repeating of political talking points and/or conclusory statements. However, if you read carefully the vast majority of posts are simply updating regarding news on the procedure of repeal and replacement or discussing the nature of healthcare in the US from a factual and philosophical standpoint. Remember that some of us under 65 are trying to, and really need to, understand everything that may occur to determine whether we can even continue with a fulltiming lifestyle.

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A Single Payer Pro, where it is a government program (Simple to say Medicare expanded to all, with possibly rolling in VA to help reduce administration overhead.), would be the billions going into profits of the 'For Profit' insurance companies. For example Unitedhealth Group had $11B in earnings, off of $157.1B in revenues for 2015.

No question that not all of the costs related to revenues would go away, if insurance companies were not in the mix. But, suspect by the time you add up Unitedhealth Drop, Anthem, and the others - many hundred of billions per year of both savings in administration, and for sure several more billions not providing profits - would come out of the overall costs of health.
Shifting that kind of money to actual 'Value Added Health Services'.
To me, that would be a 'Pro'.
And yes, one obvious 'Con', would be hundreds of thousands of jobs related to Health Insurance would evaporate - if we did adopt a single payer/governmental health care system.
Chances of it happening? Probably less the .005% - as Congress has just too many ties to the Health Insurance industry.
But, going back say to early 1900's - maybe we could have done it then:)!
=========
And I too appreciate this thread, and the various views. Many posters are much more knowledgable about this topic then I am. And good to get various viewpoints. And yeah, we remain Pre 65 with very high options for Health Insurance. So high to us in 2017, we no longer have Health Insurance...
My best to all, and thanks to all for keeping this thread viable,
Smitty

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And yes, one obvious 'Con', would be hundreds of thousands of jobs related to Health Insurance would evaporate - if we did adopt a single payer/governmental health care system.

 

Many of those jobs would NOT go away because the single payer system would need many of those people to process the claims the same way they do today for the private companies. Most likely the government would hire many of the health insurance companies to be the contractors who actually implement the system. Most people don't realize it, but, for example, there are many thousands of contractor employees who work continuously for the Social Security Administration in the processing of claims and your monthly checks. I don't have first hand experience with Medicare, but I suspect there are many contractors working for it also.

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I am really not sure what to make of this but it is well worth reading. This article contains the latest from the President-Elect on healthcare and he is talking about something quite expansive. What Mr Trump says here is totally inconsistent with the views of Paul Ryan and Congressman Price who Mr Trump just appointed to head the HHS. So this is a bit of a head scratcher.

 

https://www.washingtonpost.com/politics/trump-vows-insurance-for-everybody-in-obamacare-replacement-plan/2017/01/15/5f2b1e18-db5d-11e6-ad42-f3375f271c9c_story.html?postshare=1231484529419268&tid=ss_tw&utm_term=.cc0979db5af5

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There are many articles with sensational headlines and depressing facts but few suggestions on how to turn things around. If all the suggestions could be thrown on the board then see what goes together and what does not and maybe the combination of some will be a workable solution.

 

For example: I can't remember the city but a recent news show profiled a small town mayor that worked with the local community college to taylor the curriculum to local business needs. Teacher tenure can be an obstacle when a teachers skills are no longer relevant and/or they choose not to evolve but the mayor solicited new business with customized incentives from the community and a college curriculum to meet those businesses needs. This retooling can be expensive and requires continual forward movement but the partnership has brought new business to the area and keeps the flow of graduates in tune with the new jobs to come from the businesses coming to their town. The students don't have to leave town for jobs. I don't believe college is the be all end all, not everyone is college material and there is nothing wrong with that. For students that want to get working right away high school used to have vocational classes to teach skills students could use as soon as they graduated and not be saddled with college debt.

 

One example relating to health care: with the aging population a vocational class for certified nursing assistants... once in the field opportunities for continuing education could be a career path acknowledging experience on the job. Another outside of our topic is air conditioning classes for high schools in the south west or furnace classes in the north east etc. IMHO we will always need a/c's and furnaces so could be job security as I always see lots of a/c or heater repair trucks with the first heat spell or snow storm of the season.

 

This won't solve everything but one step at a time now could make a big difference later getting people jobs and preventing the increase in college debt leaving money aside for health care.

 

It is human nature to resist change but the world will keep turning and if we don't keep up we will be left behind. There are many changes that should have been slowly assimilated into our system years ago in anticipation of an aging society. Those changes weren't made so we have to catch up and it will hurt but better now than to have nothing down the road.

Edited by JM

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If there is to ever be a truly workable solution that doesn't bury us all in debt, we must begin to listen to each other and work together. As long as we allow such issues to be dominated by political positions and principles we will never get a system that actually works.

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Here is a Washington Post article that discusses an Obamacare replacement plan just put forward by Republican Senators Cassidy and Collins. In essence each state would get the federal funding they currently get and decide for themselves whether they wanted to keep the obamacare model, adopt a different model or refuse all funding. I actually think (as many of you know I tend toward progressive solutions to problems) this is a good faith proposal by the Republicans and worthy of discussion. For those of us under 65, it would put a premium on domicile shopping but that is a luxury we have as full time roamers. Schumer rejected it out of hand which I find disappointing but perhaps to be expected at this stage of negotiations. It seems to me that the Senate Republicans would have a harder time selling this to the House Republicans than Democrats. https://www.washingtonpost.com/news/powerpost/wp/2017/01/23/gop-senators-pitch-plan-that-would-let-some-states-keep-obamacare/?tid=sm_tw&utm_term=.e76e5824c166

Edited by Daveh

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Right Zulu. Even assuming the author's numbers are correct the author uses the set up costs of the exchanges and counts them as annual maintenance costs. No appropriate accounting. How much will it costs to tear down the entire exchange system and set up something new?

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OP...I don't know where it is going...I do know where it needs to go.

 

America needs a 2 tier healthcare system. One healthcare system for the rich as a fee for service and one for the average person that is gov supplied - aka socialized healthcare. That is the only way you can do it. The rich can have whatever they want and the poor / average person can still get some healthcare. Socialized med wont be as good as rich med, but it can be doable. If you don't like socialized medicine, get 4 jobs and pay for the rich healthcare.

 

Obamacare can't be replaced. Obamacare was never workable from the start. The system we have for healthcare is broken in the US, it will only keep spiraling out of control. Once healthcare turned into big biz it was put on a trajectory for destroying the ability of the average person paying for healthcare out of pocket. The healthcare provider know they can rape the insurance companies with exaggerated costs, so the whole system is rotten and greed filled.

 

It is the same as the VW diesel cheating fiasco. If VW could of...they would of. Same with Obamacare. This issue has to be looked at from a radical new way to make something usable when it comes to healthcare in the USA.

 

Don't like my plan...then keep what you got and let it keep spiraling and spiraling as the greedy capitalist philosophy dictates.

 

Socialized education is has served us for ages, although the reps seem to want to dismantle that system. The public education cost is in the RE taxes and even if you have no kids you end up chipping in. If you don't want to use the socialized education system then you can pay for private school. This is how the healthcare should be. Everyone pays 3% of their income and gets some medical care. Or charge a sales and usage tax to cover basic healthcare for all. The usage tax may be good, the foreign tourists will even chip in.

 

What is basic socialized healthcare? You got a bursting appendix, you can get it out...you need a heart transplant...go get the rich healthcare.

 

Socialized med is hard to promote in the US. We are a capitalist country. The greedy special interests and rich will tear it down as communism. The only way healthcare in the US can work any longer is to have a 2 tier system. The rich can pay for the best if they don't want socialized med. The average person can use the socialized plan. But you can never have success if you force the average person to pretend they are rich and force a high cost, unaffordable health plan on them.

 

It is no different than having a high earner and a low earner in a marriage. You either live to the budget that is double of the lower earner or the high earner has to pay for the bulk of it if they want to live on a higher level. You can't force a low earner to be a high earner if it is not in them.

 

Here is Obamacare in action...

 

I used to be able to cover doctor office visits out of pocket, but can't afford it any more. In Jan '16 I called a dermatologist to ask about a wart removal and it is $490 for 5 minutes of work. The doctor does not even do it...his assistant does it. In 2015 it was $175 for the same wart removal, but they raised the rates if your uninsured. They said under Obamacare it is illegal for me to not have med insurance and it is insurance fraud for them to charge a different rate than what they get under Obamacare when they bill insurance companies...$490.

 

Medicine prices started to skyrocket once the greedy learned they can hike up medicine costs by astounding percentages. They can hold the chronically ill by ransom...it is pay up or die. There is nothing wrong with that is there? This is textbook material on how a good capitalist should work. Get the highest price the market will bear for the product. If a pill cost .35 cents to make, why not mark it up to $1000 a pill? If an insurance company will pay for it why not $5,000 a pill? There is no law against making profits...this is not the 1960's Mayberry.

 

It is not even a question of being able to afford Obamacare med plans. They are useless, at least for me. Thousands of $ in deductibles and copay. I think the goal of insurance companies is to sell you insurance you can not use unless you are very sick and rich.

 

If the US ever does get a socialized healthcare system then the job is to keep it from spiraling out of control with costs. Humans have a tendency to F' up whatever they get their hands on. This is why we don't make good communists. If we were bees or ants we would make good communists. But self-centered greedy humans can't do it. Bees or ants will give their life for the good of the colony...humans generally wont (military notwithstanding), it is every man and every woman for themselves.

 

Now that Cuba is opening up some may want to look at that option for healthcare. People have been going to Mexico for healthcare for years. I heard Cuba provides good healthcare and it is affordable. Sad the US is so screwed up with healthcare, but that is our world. You people that want to go back to 1960's Mayberry have to face the music. We will never get back to it.

 

The powerful healthcare and pill industry will fight a socialized add on plan. It will no doubt take $ from them. They can't rape the sytem if there is a socialized option and competition. But someday we should consider what is best for society instead of what is best just a few rich ones. This goes under the auspices of putting America, specially Americans first.

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Slackercruster - I read your posts, and understand man of your points. The one that did not pass my filer is why with Socialized option any person should pay more then another? Would be about as fair as a person living on the West side of a town paying more then the person living on the East side of town. Or maybe redheads should pay more then blond people.

 

If a person works and earns more income, or took the risk in investing, or just by luck inherited a hunk of funds - why should they pay more then say a person that lived off credit cards, milked the system for EBT's and subsidized housing or preferred to sit on the couch doing bongs and playing video games - and thus earn lower income?

 

I'm in favor of helping those that truly can't help themselves. For example, my mid 40's BIL is very low functioning down syndrome. He can't communicate, let alone work. I'm also in favor of helping those that need a 'hand up', but do not want a 'hand out'. Providing assistance to help a person get back on their feet after whatever the crisis/event was that forced them into a situation. I've always set time limits on this kind of help. Where once x or xx months goes by, if the still require assistance - they also start paying it back via different forms of community service.

 

My earlier post was not specifically about socialized medicine, but very similar as far as a single system for all. But one where with minor exceptions, the costs are equally shared by all.

 

And sure not trying to pick on your posts, and respect your opinion. It was the comment about rich paying more that peeked my interest. Oh, and by the way, I'm in favor of a simple and equal percentage tax program too. Do not feel that special interest should get tax incentives/breaks and or that Earned Income Credit is fair either. (Only the government could call giving out more money to potentially someone that is a deadbeat should be called 'Earned'.),

 

On this thread in general, just read it all again, really appreciate the different perspectives and thought sharing. I've shared before that IMO that ACA had many good parts to it, and equally that they had some areas I felt were not fair. Looking for change, and sure hope the next evolution is an improvement...

 

Best to all,

Smitty

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If a person works and earns more income, or took the risk in investing, or just by luck inherited a hunk of funds - why should they pay more then say a person that lived off credit cards, milked the system for EBT's and subsidized housing or preferred to sit on the couch doing bongs and playing video games - and thus earn lower income?

 

I really think there are more than these 2 options -- the lucky rich vs the slackers.

 

The gap between rich and poor in the US and the world is nothing short of astounding (or appalling). That Top 1% you've probably heard about control most of the world's wealth . . . and this data comes from a variety of sources, right-wing InfoWars and ultra-conservative Credit Suisse. So I think most of us can agree that this vast wealth gap actually exists.

 

So?

 

To me, I would find ways (taxes, fees, etc) to get some of that money into basic health care access coverage for everyone . . . even the slackers. Even if each and one of these uber-weathly acquired their wealth from working their fingers to the bone in sweat shops -- too much wealth is concentrated in too few hands.

 

Finally, the great con of recent years is that the poor (especially minorities or immigrants) are responsible for our country's ills. It's time to shift our gaze from the bottom to the top earners.

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I lived in Germany for 7 years. They, like Canada, have socialized medicine, as does every first world country except the US. Do the research on their systems and you'll find that, unlike here, the rich are not subsidized with tax exemptions that reduce their tax actually paid to zero. I would suggest those for social safety nets for all equally, and those that think they are better than all the categories folks use to feel superior, will both benefit by investigating for yourselves why those other 1st world countries are not hobbled with homeless, nor are going bankrupt.

 

We need a socialized medical system to start using our talented as a start.

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I lived in Germany for 7 years. They, like Canada, have socialized medicine, as does every first world country except the US. Do the research on their systems and you'll find that, unlike here, the rich are not subsidized with tax exemptions that reduce their tax actually paid to zero.

 

We need a socialized medical system to start using our talented as a start.

Thus my support of a flat tax variant. It does not solve everything, but it gets rid of some of the ridiculous lobbying, etc that creates "special" classes of taxes (or exemptions). Most studies show it would go a long way towards curing some of the ills in our system. I'm not generally in favor of government doing much of anything other than protecting us and infrastructure projects that require nationwide participation. But in healthcare, I think it is appropriate that the government at least lay the groundwork for a nationwide system. It may be administered by the states, but it is going to take the federal government to establish the groundwork for it. Oh, and it is NOT what we have now...since I think EVERYONE would indicate that it is not working and will die a hard death if left alone.

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To me, I would find ways (taxes, fees, etc) to get some of that money into basic health care access coverage for everyone . . . even the slackers. Even if each and one of these uber-weathly acquired their wealth from working their fingers to the bone in sweat shops -- too much wealth is concentrated in too few hands.

 

Finally, the great con of recent years is that the poor (especially minorities or immigrants) are responsible for our country's ills. It's time to shift our gaze from the bottom to the top earners.

Most "experts" agree that if you redistribute wealth but leave the marketplace free, it isn't very long before the wealth has returned to the same group that had it before. Having spent a lot of volunteer time working with programs for the low income family, I have learned that financial well-being is more a factor of money management than of income amount. The majority of the financial burden of any plan must be placed on the working people because there are just not enough wealthy people to carry the burden alone. And if we make the wealthy carry the burden, who then gets to determine at what income lever you are wealthy? To the welfare mother, most everyone in this thread is wealthy.

 

Whatever is created, we must all expect to pay our part of it.

Edited by Kirk

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I pay for my food, I pay for my shelter, I pay for my cloths and my other expenses. As much as I would like someone else to pay for my insurance, I think it is everyone's responsibility to provide for themselves if possible. Why is insurance different?

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If a person makes 25k a year taking 10% of his income hurts but is doable leaving $22,500. Taking 10% with no exemption from a person making 1 million leaves 900,000. We are talking a single family of four (Average) trying to scrape by on $900k a year. That is only paying their share at 10%. The tax rate when Reagan left office was 40%. When Eisenhower was President the rich paid up to 70%,and as Warren Buffet and Bill Gates just said, the top 1% were happy to pay their fair share.

 

Paying your fair share for the infrastructure and the health of the work force the top income use to make their wares or products of the mind like computer programs and security, is no redistribution of wealth. Let's take the CEO of Microsoft. His products take advantage of the infrastructure using roads, public utilities at every location, aircraft whose control in the sky is funded by the FAA, and their businesses, and very lives protected by the US military. Not to mention their local use of fire and police.

 

The distraction of calling the wealthy paying their fair share, as the rest of us 99% must, some form of communism, is really off base because in a communist/totalitarian society the wealthy (theoretically) would not be asked to pay their fair share, but to take no more than the working man regardless of their level or work hours. That is wealth redistribution.

 

Requiring the wealthy as well as the poor to pay their fair share as a flat tax or a raised tax for the very rich over, let's say $250,000, would be fair.

 

But regardless of the tax laws favoring those who can buy a legislator, everyone is right, we cannot afford to continue giving the rich a free ride.

 

Every working class family is paid with the federal income tax already taken out. So they already are paying for government programs.

 

Making millions and paying nothing makes every person who pays nothing with six figure incomes because of legal deductions is gaming the system.

 

That is just my opinion.

 

I pay my fair share of taxes and made far less as a career military professional who made up some of it with a five year stint heading up a construction company. I paid 33% of a six figure income and expect them to pay no less, or to eliminate my taxes, along with theirs, with exemptions as ridiculous as theirs.

 

Sorry but trying to label everything as us and them, or subsidizing the top income families to the tune of them paying nothing in return for the infrastructure they use, the protections of the military, and the local protections of police, fire, and , not even in charitable donations like Jobs was notorious for avoiding even discussing charities.

 

Healthcare in every other first world country is not any reason for concern. The old are cared for as well as the young.

 

In Germany they even pay all families a stipend for each child called Kindergeld. IT is not paid according to income but all taxpaying Germans are entitled to it and get it until the child reaches 18 years old. This is to insure that kids get the nutrition they need during physical and mental development. During the entire 7 years I was there I never saw one homeless person.

http://www.howtogermany.com/pages/kindergeld.html

 

But without first hand experience, it is difficult for Americans to grasp. Any discussion about health care is not politics anywhere in the first world except here.

Edited by RV

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