Budget Fight: Why Don't The Gop De-Fund Medicare / Social Security?

[Bliz]

I never said repeal.

 

And you will pay the costs, just through premiums :-)

 

Preventative  care means one free doctors appointment a year.

Emergency room costs aren't from people running in there with a boil on their azz.  And the people that can't pay for their emergency room costs now are the same people that can't pay for their insurance plus emergency room and or doctor visit costs later.  We are just massaging the poop, we aren't cleaning it up.

 

Preventative care also means a prescription for heart medication.  Which means the difference between being able to afford that medication or not (or, if you prefer, incentive to take medication that only costs $25 per month vs incentive to take medication that costs $250 per month (I have no idea what the real number is).  Which in turn means that you should see fewer people going to the hospital with heart attacks in the first place.  And, the percentage of those that do end up in the hospital who are insured should go up.  Saving society lots of money in the long run.

[twa]

strange that heart medicine is not free then

 

gonna be interesting

[Larry]

strange that heart medicine is not free then

Perhaps the Republicans should propose an amendment.

[twa]

Perhaps the Republicans should propose an amendment.

Perhaps a swap

[@DCGoldPants]

Preventative Care is what this whole thing should have been built around in the 1st place. Then again, that argument against would be that "making" people get checkups which could potential save their lives is really a secret plan to track everybody thanks the gov't now having blood samples and updated health records on the regular.

 

Nevermind it would be cheaper over the long haul.

[twa]

Preventative Care is what this whole thing should have been built around in the 1st place. Then again, that argument against would be that "making" people get checkups which could potential save their lives is really a secret plan to track everybody thanks the gov't now having blood samples and updated health records on the regular.

 

Nevermind it would be cheaper over the long haul.

 

There is some question that it is cheaper in the long run, but quality of life does have value

 

http://dmarron.com/2009/08/10/does-prevention-reduce-costs/

 

Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.

...

For completeness, I should note that CBO also considers another budget impact from prevention: successful preventative health may increase lifespans — a good result, to be sure, but one that may increase spending in other programs such as Social Security and Medicare.

[Larry]

For completeness, I should note that CBO also considers another budget impact from prevention: successful preventative health may increase lifespans — a good result, to be sure, but one that may increase spending in other programs such as Social Security and Medicare.

Recall somebody once making the claim that supposedly, smokers actually save the government money. Yes, they have a lot of health problems that cost a whole lot of money. But they also die sooner, thus saving a decade or more of SS and other spending.

No clue if it's true, but it seems like it would make a good urban legend, at least.

[twa]

Recall somebody once making the claim that supposedly, smokers actually save the government money. Yes, they have a lot of health problems that cost a whole lot of money. But they also die sooner, thus saving a decade or more of SS and other spending.

No clue if it's true, but it seems like it would make a good urban legend, at least.

yeah and they get to charge smokers up to 50% higher premiums....****s

 

but maybe I will die early and save myself some money 

 

add

study on it

 

The actual numbers for lifetime from 20 years old medical costs were: 

 

The lifetime costs were in Euros:

Healthy: 281,000

Obese: 250,000

Smokers: 220,000

http://daveatherton.wordpress.com/2012/03/17/the-true-costs-of-treating-smokers-the-obese-and-the-healthy/

 

 

[Predicto]

yeah and they get to charge smokers up to 50% higher premiums....****s

 

but maybe I will die early and save myself some money 

 

add

study on it

 

The actual numbers for lifetime from 20 years old medical costs were: 

 

The lifetime costs were in Euros:

Healthy: 281,000

Obese: 250,000

Smokers: 220,000

http://daveatherton.wordpress.com/2012/03/17/the-true-costs-of-treating-smokers-the-obese-and-the-healthy/

 

Of course, comparing "lifetime costs" can also be misleading.  Someone who lives 15 years longer also pays insurance premiums for 15 years longer, don't they?  

[twa]

Of course, comparing "lifetime costs" can also be misleading.  Someone who lives 15 years longer also pays insurance premiums for 15 years longer, don't they?  

with Medicare? (I wouldn't think supplemental policy premiums would come anywhere near the costs)....of course that was a Brit study.

 

any number is misleading if I don't agree with it. 

[AsburySkinsFan]

Frankly, what Congressional Republicans are scared to death of is that Obamacare will work despite their nonstop efforts to sabotage it and that the people will like it. That's why they need to defund it, need to stop it, and will ignore everyone from the Supreme Court to their own leadership to try to upend it.

Exactly, they brought nothing to the table that they walked away from repeatedly, they have no new ideas other the be obstructionists and oppose EVERYTHING that the President puts forward. They want to scream like impetulent children about oppression as if they even have a frickin' clue what oppression really is, they want to scream about the debt even while most of the voted to fund trillion dollar wars and farm subsidies all while cutting food stamps because you can't have the government giving hand out to poor people because we all know that it's the rich people that need the hand outs. Personay, I hope the GOP splinters into a hundred bickering factions and a third party takes over and brings back statesmanship and intellectual debate rather than cheering the Palin and Bachmann practice of appealling to prejudice and lies.

[PeterMP]

Recall somebody once making the claim that supposedly, smokers actually save the government money. Yes, they have a lot of health problems that cost a whole lot of money. But they also die sooner, thus saving a decade or more of SS and other spending.

No clue if it's true, but it seems like it would make a good urban legend, at least.

 

Forget SS.

 

People that live a long time and die slowly are expensize.

 

From an economic stand point having somebody die of lung cancer at 60 is better than them dying of Alzheimers at 85 in terms of the care they need and associated costs.

 

(And I understand your personal situation and this isn't meant as a personal dig or a criticism or even comment on your personal situation, and I think you'd actually understand the situation given your personal situation.  And that doesn't even take into account the extra taxes smokers pay over their life times.)

[twa]

maybe Obamacare will help them die quicker

[chipwhich]

Obamacare will help the poor get poorer and the rich get richer.

 

If I were uninsured, I would just pay the $750 penalty for not signing up and go to the emergency room for free.  A much cheaper option.  How many uninsured people you know that can afford $300 a month plus copays and deductibles.

[HOF44]

Obamacare will help the poor get poorer and the rich get richer.

 

That's general policy for either party I believe.

[Wrong Direction]

This right here is why gov't must step in to improve health maintenance and health care. Because there is NO financial incentive to provide better care. More expensive care, sure. Better care? Not so much.

 

So insurance companies don't adjust payment to incent cheaper products and services that are within clinical guidelines? I think you aren't familiar with payment schemes that have been in place for years.

 

 

Politicians don't set any prices for healthcare.  Not now, not with Obamacare.  Not in the foreseeable future.  

...

Medicare doesn't pay above market rates.  They pay below market rates.  Hospitals hate it, but they agree to take it because the won't get anything from huge portions of their "consumers" who will be deemed uninsurable by private insurance companies whose sole and unapologetic goal is to make money for the company.

 

Politicians absolutely set the rules behind pricing. They just direct the bureaucrats to do the math. Once the math was done once, every CPI price update made by Congress was a pricing update. Congress has power over pricing and reimbursement for ever part of Medicare.

 

You can only say Medicare pays below Market rates if you don't think the $600+ billion Medicare pays every year is somehow not part of the marketplace. Medicare sets the market. 

 

Oh, I think there are some hints of valid points in there.

I've said for some time that one fear I have, should we go to single payer, is that it will result in everybody pressuring the government to cover everything. (And I don't think there's any way the government could turn down all those special interests all pulling in the same direction).

 

This is already the case. Medicare is already the most heavily lobbied government program. 

[Elessar78]

It's sad when people make the argument that innovation will practically stop once America gets universal health care. Yet, other countries with universal healthcare, Australia, Canada, United Kingdom, Germany, France, Japan—never fall short of their own medical discoveries.

 

It's another of those bull****ifed perversions of American Exceptionalism. Take away our financial incentive and we stop to innovate. Tell that to Jonas Salk. 

[Wrong Direction]

It's sad when people make the argument that innovation will practically stop once America gets universal health care. Yet, other countries with universal healthcare, Australia, Canada, United Kingdom, Germany, France, Japan—never fall short of their own medical discoveries.

 

It's another of those bull****ifed perversions of American Exceptionalism. Take away our financial incentive and we stop to innovate. Tell that to Jonas Salk. 

 

I don't talk in absolutes. There are degrees on just about all issues. If you want to think that financial incentives don't drive innovation, I don't know what to tell you. 

[Elessar78]

But the point that incentives, financial or otherwise, would not exist in an environment of universal healthcare is moot. 

 

Right now, every level of the healthcare industry seeks to pad their invoices and health care for businesses is such an uncontrolled cost. If the business employs more than 49 people, then it can't participate in the exchanges anyway. BUT BUT the cost of healthcare goes up? Well, the cost of healthcare goes up and up each year. 

 

FWIW, if you do have 50 or more employees you have to pay this:

 

Amount of the Employer Shared Responsibility Payment

The amount of the annual Employer Shared Responsibility Payment is based partly on whether you offer insurance.

• If you don't offer insurance, the annual payment is $2000 per full-time employee (excluding the first 30 employees)
• If you do offer insurance, but the insurance doesn't meet the minimum requirements, the annual payment is $3000 per full-time employee who qualifies for premium savings in the Marketplace

If it affects your business, treat it like you would any cost increase, eat it or pass it on. 

[chipwhich]

Elessar,

 

Y'all wanted a single payer system, that is universal health care.  What you got is a tax on Americans and businesses.

 

Not sure what your post about the Employer Shared Responsibility has to do with anything.  That's what I do in my business, eat it or pass it on.

 

When we get true universal health care, then we can talk about innovation.

 

You don't get innovation by setting up a marketplace for Americans to find the cheapest policy available.  Nor do you get universal health care.  You just get a tax to get into the broken health care system or a tax to stay away.

Without a single payer system, all conversations are just mute points.  Nobody wins.

[twa]

a marriage tax in the ACA

http://pjmedia.com/blog/the-wedding-tax/

 

talk about a cliff

[chipwhich]

Exactly, they brought nothing to the table that they walked away from repeatedly, they have no new ideas other the be obstructionists and oppose EVERYTHING that the President puts forward. They want to scream like impetulent children about oppression as if they even have a frickin' clue what oppression really is, they want to scream about the debt even while most of the voted to fund trillion dollar wars and farm subsidies all while cutting food stamps because you can't have the government giving hand out to poor people because we all know that it's the rich people that need the hand outs. Personay, I hope the GOP splinters into a hundred bickering factions and a third party takes over and brings back statesmanship and intellectual debate rather than cheering the Palin and Bachmann practice of appealling to prejudice and lies.

 

Asbury,

 

Go talk to the uninsured in your parish.  Tell them the joy they get on Oct 1 to pay $300 a month for health insurance plus a max out of pocket around $6000 - $13000 a year.  Let them know how great it is.  Let me know their response.  Make sure you tell them they get a free doctors visit each year for preventative health plus free birth control, and whatever else they get "free".  Let me know their reaction to this deal.

 

This isn't a single payer system, it's just a tax on the poor and middle class who have no options for health care.  I would love to know their response.  No political inference is needed.   Thanks.

[Elessar78]

Chip,

With all due respect, no one called this a tax until the Supreme Court came back with its ruling. To say otherwise is revisionist.

Tax or not, it's all a semantic argument. Someone ends up paying, it's either business or the individual. Since we cannot tax everyone at a 50% rate like they do in other countries, businesses take the brunt IF they don't already provide adequate healthcare.

I've only worked at one place that I believe would be affected because their insurance was inadequate. But in every place I've worked at in the last decade, the big jumps in insurance premiums that get taken out of my paycheck act like a tax anyway. I believe, and I'm sure you feel otherwise, that the ACA makes these cost increases more predictable and hopefully caps them.

The Shared Responsibility payment I mentioned was because those are the stipulations for employers with 50+ employees.

[Elessar78]

Go talk to the uninsured in your parish. Tell them the joy they get on Oct 1 to pay $300 a month for health insurance plus a max out of pocket around $6000 - $13000 a year...

Where do you even get these numbers? There's got to be some conservative repository for fear-mongering "facts".

Take a state like Florida, a self employed individual can get a mid-tier plan for about 92 bucks biweekly. A family of four for a mid-tier plan is about $34, biweekly.

The out of pocket costs are grossly exaggerated, especially when taken into account that insurance companies can no longer decide how much they will cover of a procedure. And this is not limited to the aca.

So yeah, now people can go get that preventative screening without hesitating because they're worried about being crushed by the what is not covered.

[Larry]

Where do you even get these numbers? There's got to be some conservative repository for fear-mongering "facts".

Take a state like Florida, a self employed individual can get a mid-tier plan for about 92 bucks biweekly. A family of four for a mid-tier plan is about $34, biweekly.

The out of pocket costs are grossly exaggerated, especially when taken into account that insurance companies can no longer decide how much they will cover of a procedure. And this is not limited to the aca.

So yeah, now people can go get that preventative screening without hesitating because they're worried about being crushed by the what is not covered.

Just pointing out a few things.

chip says $300/month. You respond with $92, biweekly.

I will observe that, on a biweekly plan, then twice a year there will be a "three payday month".

So, this may simply be a case of this being one of those Republican style "well, it's kinda true, sometimes, in the right situation, if you cherry pick just right, and if you put in a few disclaimer words that I intentionally left out, to make it sound like I was saying something else" kind of thing, which passes for truth in the modern Republican meme generator.

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I will also observe that, when I read your numbers, what I see is that a family of four costs a third as much as insuring one person?