Goodbye Obamacare

[tommyguns2]

I see the writing on the wall. While Obamacare was a complete and utter disaster, what it did do was move the needle with respect to what the US voters think they are entitled to. That is, most voters think that they are entitled to health insurance that covers pre-existing conditions, despite the fact that requiring that makes the product being sold no longer health insurance.

Consequently, premiums will continue to rise uncontrollably and the people will demand a gov't solution, which will be single payer health care. Everyone's taxes will go up (I'm guessing a payroll tax that is matched by the employer like FICA), except of course all those who aren't employed. It's will be crappy health care for all, except for the rich, who will have that option, as well as the ability to purchase a private option.

What I anticipate will happen is that private concierge practices will open up that are small groups of 300-500 patients that will pay a club entry fee like a country club, and then pay monthly dues. In return, you'll get basic health services covered, with it being easy to make an appointment at any time, even home visits by docs and nurses. Then special services will be covered on a "pay as you go" basis.

In short order, everyone on the Medicare/VA system will be in long wait lines with docs and nurses who really don't give a crap, because they really don't need to. Further, medical care will be rationed by limiting the availability of various machines/services. So, you can still get an MRI for free, but it's not available to your for another 3 months. So we'll have two medical systems. A good one for those able to pay, and a crappy one for everyone else. Crappy, but free! LOL

 

[DaSarge]

Tommy, that's exactly what my PCP did (open up a private concierge practice). I don't recall there being an entry fee per se, but there were monthly dues for basic access to him. The PCP in my area that was accepting new patients at the time, turned out to be a giant clusterf*ck of an operation with approximately 50 chairs in the waiting room and only six (6) rooms where him and his NP saw patients. My old PCP had 8 chairs in his waiting room and three (3) patient rooms. I got the f*ck out of there as soon as another PCP started accepting patients.

 

[tommyguns2]

It'll be interesting to see how long it takes for us to get to single payer. Some people I talk to say it won't happen, or if it does, it will be a long time until then. I'm not so sure. I could see it happening in the next 10 years.

What will be interesting to see is how the medical industry changes in response to single payer. What single payer is is gov't insurance, while hospitals and docs/nurses are still provide employees, not gov't employees. They will just have to follow a gov't mandated fee sheet for services. I suppose if a hospital or doc/nurse can't make sufficient money on that service they'll just not offer it. Just not sure what happens when you can't find a doc?

I suppose you can try to force a doc/nurse to provide all scheduled services, but that would just encourage docs/nurses to leave the gov't system more quickly. We are definitely in interesting times. I still think a true healthy market is the best solution, but the present market for health care good/services is so dislocated, I have a difficult time envisioning us going back to a healthy, functioning market. Too many entrenched interests in the present awful configuration.

 

[DaSarge]

The reality is no matter how much you give the socialists it will never be enough. They'll keep moving the goalposts. They'll keep saying it's not good enough or it's not fair enough. It's just like the telephone "issue". The socialists said they couldn't live without having a free telephone. At first it was a free landline, and then that quickly morphed into a free cellphone. Now they're saying they can't live without free internet. The next thing they'll say is they want free internet on their cellphone. It will never end so you might as well just nip it in the bud now and say, "NO"...

 

[Lizard King]

Looks like Aetna is pulling out of all ACA plans. Announced today.

 

[DaSarge]

It's Trump's fault.
Aetna would still be involved in the ACA if Obama were president.

 

[rawdeal]

Goddamn Socialists are gonna ruin it for all of us. Anytime we put People or Planet ahead of Profit, we all lose.

 

[FlyingDragon]

Looks like Aetna is pulling out of all ACA plans. Announced today.

Would LK pull out of Giada De Laurentiis?

 

[Gms585]

Goddamn Socialists are gonna ruin it for all of us. Anytime we put People or Planet ahead of Profit, we all lose.

Socialism = Communism = Scary = Evil = Cant Work = Un-American = ISIS

 

[tommyguns2]

Socialism = Communism = Scary = Evil = Cant Work = Un-American = ISIS

I'm guessing what you're saying here is that tagging something as "socialist" is simply marginalizing the person making the argument. Not exactly sure.

I will go on the record to say that socialized medicine absolutely CAN work, it just can't work the way that most people think it would, or think it should. If you look at the cost curve of medical costs and age, you can see that a substantial amount of medical costs are incurred in the first 6 months, and last 6-12 months of life. We could simply refuse to cover any (or cover only limited aspects) of those type of beginning of life and end of life situations. Voila! Costs reduced. However, do you really think that the American voters would be OK with that? I doubt it. We won't even accept preventing those with pre-existing conditions. Try denying care to little babies or to grandma! I doubt that will happen.

What is scary to me in single payer health care is that we're socializing the costs of health care. That means that a fellow taxpayer is having to pay taxes based on the health of his fellow taxpayers. Rationally, this taxpayer now has an interest in whether you're living a "healthy" lifestyle, right? That only makes sense. For example, I don't care if you go on an expensive vacation, but once I'm paying for part of it, I'm suddenly very interested in how much your lifestyle choices cost. So socializing the costs of health care fundamentally changes the relationship between the individual citizen and the state. If my taxes are going up because you're overweight, or not sleeping enough, or smoking, or taking steroids, or eating too much birthday cake, or sky diving, or whatever, now I have an interest in your life, and am more tempted to want to regulate your behavior.

Conceivably, every aspect of your life touches on your health. We're basically giving the government permission to regulate anything they want to in the name of "public health', because they're paying for it. I can't really blame the gov't for wanting to do that, but I don't want the gov't infringing upon my personal life choices. That's a big problem to me.

 

[DaSarge]

Well, yeah Tommy, but providing healthcare to everyone is the morally right thing to do. Just like ending the death penalty is the morally right thing to do. Then again, killing unborn babies is ok. There's nothing morally wrong with that...

 

[Gms585]

I've been trying to avoid this thread mostly. I don't want to garner a reputation here as a contrarian or overly politically combative. I made that post to mess with Rawdeal thats all.

TommyG; Do you place any correlation to our average life expectancy being below :
Denmark, Greece, Germany, Portugal, Finland, Belgium, UK, Ireland, Austria, New Zealand, Norway, Netherlands, Luxembourg, Canada, South Korea, France, Sweden, Israel, Italy, Iceland, Spain, Australia, Switzerland, Japan
And their stance on healthcare (available to all) nutrition (well educated and regulated) general well being (placed over corporate profits) ?