How do we clean up the American health care mess?

Politics US Politics
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Kaiser Family Foundation says it is grossly exaggerated.

washingtonpost.com/blogs/won … rial-doom/

[quote]The worry tends to go something like this: If young adults don’t sign up for insurance coverage through the exchange, then the market loses a wide swath of very healthy enrollees – and wouldn’t have enough people to help pay the claims of the sicker, older subscribers. Without enough young people to subsidize the costs of older enrollees, insurers would instead raise premiums to cover the higher costs. And that would make coverage less desirable to young shoppers in 2015.

Or, if you prefer a bit more hand-wringing: If enough young people don’t sign up for Obamacare, premiums spike, the market goes into a “death spiral” and the health law is doomed.

Levitt has already warned that fears of this alleged death spiral are likely overblown. Now, he, Claxton and Damico put a few numbers to the argument. First, they start with an analysis of who is actually in the market of people eligible to buy coverage on the exchange. These include those currently in the individual market and the uninsured who earn too much to qualify for the Medicaid program.

That’s where you get the breakdown of the market shown below, where 40 percent of potential subscribers are under age 35. “Your ideal, as an insurer, is to get a proportional mix of enrollees,” says Levitt.

That’s what the White House has aimed for: Officials there have estimated that, if 7 million people enroll in 2014 (as the Congressional Budget Office has projected), 2.7 million of them, or 40 percent, need to be under age 35.

Levitt and his colleagues then modeled what would happen if these people didn’t show up. There’s already some evidence that insurance plans are getting enrollees that skew older; in California, for example, only about a quarter of their sign-ups are under 35. Most health policy experts expected the first wave of enrollees to skew older, with the younger population to follow.

But to see what would happen if this trend continued, the trio used data on typical health care costs for older and younger people to figure out how bad that would be for the exchange.

If young adults (those under 35) were 25 percent less likely than the rest of the population to sign up for Obamacare, they would represent 33 percent of exchange enrollees – rather than 40 percent. This means there would be fewer young people to subsidize older insurance subscribers. To make up that difference, the experts estimated, insurers would need to increase premiums by a terrifying … 1 percent. Yes, exactly 1 percent.

Levitt, Claxton and Damico also tested a scenario where young adults are half as likely as older shoppers to enroll. In that case, the younger enrollees would make up only a quarter of the exchange market. Premiums would fall 2.5 percent short of covering subscribers

“I had a general sense it wouldn’t be giant, but this was even smaller than we expected,” Levitt says. “It’s not a terrifying number.”
[/quote]

62

Who are these old school types you imagine? None exist on Fcom as the same people opposed to the ACA were perfectly fine with torture during the Bush years. I would say that is generally true in the right wing media as well. There are a few conservatives, such as Bruce Bartlett, who were opposed to torture and support medical reform (as well as higher taxes) but these are vanishingly rare and have been largely ostracized by the right.[/quote]

They call themselves"neocons" because they’ve turned their backs on time honored democratic principles and replaced them with a set of principles dredged from the dark recesses of western civilization. And, yes, their numbers are legion but it wasn’t always so.

63

There is no inconsistency between being a conservative and believing in universal medical care.

64

It seems conservatives are fine with a state backed army and navy and the associated medical care and pensions but not with national medical care systems or pensions. Don’t really get that either.

65

Come on, that’s too easy. Conservatives generally believe in a “nightwatchman state”. They think government has a legitimate role in providing security of persons and property, both internal and external. Health care and pensions for veterans is just payment to induce them to do what is (or can be) a dangerous and unpleasant job.

Of course “social conservatives” add religious proscriptions to this.

66

Governments have long proved themselves adept at taking lives and destroying things for some reason. Creating things? Building things? Improving quality of life? Not so much. That seems to be why the private sector exists. As soon as you hand government something to do that involves building something it seems to take twice as long, cost three times as much and work about as well as the Obamacare website does.

67

Sure, except health care in every single country that has implemented a universal system gets better or as good results at lower costs. Lots of countries also have perfectly adequate to excellent public education. Taiwan had a great mail system. So did Canada when I was living there. Good roads too. Nice sewers and steady delivery of electricity 24-7.

There are also scores of examples of the private market misallocating resources, building useless companies, failing, and generally delivering shitty service for an inflated price.

Being a conservative these days means never having to challenge your assumptions when the facts say differently.

And no it isn’t the same on the other side. Most liberals today have largely come to accept that capitalist markets do a better job as raising people out of poverty than socialist policies, have accepted that a certain amount of deregulation can spur business and entrepreneurialism, that private enterprise is superior at delivering quality for many things, that excessively high taxes dampen investment (though where the balance lies is debatable), that many matters should be left to individuals to decide even when the state has an interest in regulating it, and so on. General conservative ideas, especially the general respect conservatives have for free enterprise have become mainstream. Because they have been proven to work. Hardcore socialist of the old school simply have no credibility anymore.

This is not the same with your side which continues to believe in things that are demonstrably untrue (government can’t provide services) or to believe something (universal affordable healthcare) proven to work over and over again simply cannot work because…Obama, libtards, Reid, Marx, Hitler, slopes, slopes, so slippery…

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I always think of it in terms of competitive advantage and survival of the fittest.

A private company is a streamlined operation that can be very good at certain tasks, as long as it doesn’t become a monopoly situation. At the same time, many private companies cannot see beyond the next quarter let alone next year. They have their own focus on shareholders and must make a profit. They do not have a remit nor the necessity or vision to see ‘the bigger picture’. That’s not necessary when there’s a guiding hand to control and guide them, but if they get too big for their boots or corrupt the regulator you get things like the credit crisis, where their own short term profit motive and greed can bring down the whole system.

Governments can look past the short-term and invest in infrastructure and education now to give the big return later, and help to lift the whole country up by removing weak points that a private operator cannot handle (for instance you might have a good investment opportunity but it’s too dangerous to invest and work in a given place (MEXICAN BORDER), or cheap and educated workers but no infrastructure to do business (INDIA).

On the other hand if you concentrate too much power in government hands you often don’t get enough responsibility and focus on getting the job done on budget and on time. There’s often not enough experimentation in terms of different models of doing business, and there’s not much competition to spur them forward. Corruption can seep into the system as too much power is concentrated in politicians and civil servants hands.

So it’s obvious that a mix of public and private resources can give the best result, to balance each other out and cover the weaknesses of both.

It’s also very important to understand that all governments are not the same and all corporations are not the same.

It’s also very important to understand that a given policy or strategy will give a different result with the same government and the same corporation, and vice-versa.

Getting the mix right is using some good judgment, keeping an open mind, remaining flexible and enjoying a good dose of luck because that’s the real world right there!

69

What can one say about a country that spends far more than any other on the offence, but spends so little on the defence, of its own people?
Something basically wrong with that.

70

Honestly I don’t think Republicans even know what they stand for anymore. Here we are in the midst of a pretty solid recovery, and the only point of contention seems to be with unemployment. Yet if you look at the numbers, the private job market is doing fine, it’s the public sector that has taken a beating. Obama is the only President ever that hasn’t flooded the public sector with stimulus following a recession, which would seem to satisfy Republicans no? Low government spending and not pumping up the numbers by bloating the public sector. Isn’t that right up Republicans alley?

Yet if Obama did roll out massive stimulus like all other Presidents before him (and like I personally think he should have) and if he did bloat the public sector like all other Presidents before him, Republicans would be complaining that he’s spending too much and just increasing the size of the public sector. I guess the only thing we know for sure is Republicans love to complain, regardless of whether it aligns with their views or not…

So no high fives from the right for Obama? Republicans don’t stand for anything consistent these days, except the anti of everything left regardless…

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If you believe that Clinton was responsible for the budget surplus and welfare reform then I suppose you will also have no problem praising Obama for lowered government payroll jobs… nice simplistic graphs that are well-suited to the intended audience.

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[quote=“BrentGolf”]
Honestly I don’t think Republicans even know what they stand for anymore. Here we are in the midst of a pretty solid recovery, and the only point of contention seems to be with unemployment. …[/quote]

I’d like to see a graph which shows what kind of jobs are back, not just a catchall jobs graph. i spend a good deal of time in the U.S. and the common message I hear from those there who are actually living the graph is that, yes, jobs are back, but by and large they’re not the same jobs that left. They’re $10 an hour jobs with limited benefits The good jobs that you can support a family on are still as scarce as chicken lips.

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Well if I thought that people would be interested in a 10 page full employment report I’d throw one together, but from what I’ve seen people are more interested in drive by comments rather then honest in depth analysis (which is fine, it’s not a judgement, more of an observation) So my point wasn’t that the job scene is fantastic, but rather that it’s fairly ironic that Republicans for years have been saying they don’t want a bloated public sector at the expense of increased government spending. Well, isn’t that EXACTLY what Obama is giving them? Yet because Obama did it they hate it and it’s obviously the work of the devil. If Bush did the exact same thing it would have been treated as the second coming… :unamused:

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Higher taxes, higher wages, more top 20% job growth in the U.S. is good for me personally so I don’t have a vested interest in opposing/disputing Obamanomics/Obamacare. I’m just not seeing it happening. Maybe there’s a one page Jobs Growth for Dummies graph available somewhere which shows living wage jobs are actually returning to the U.S. economy in significant numbers, in which case, 'Go ‘Bama!’

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BrentGolf:

Government payroll is decreasing because of the sequester: see Tea Party budget protests. Do you credit Obama for this?
State government payroll is decreasing because of poor state government finances. Do you credit (haha) Obama for this?
The state governments that have cut payrolls the most are probably New Jersey and Wisconsin. Remember the major protests agains the two Republican governors and their efforts? and you would like to credit Obama with this?

It is like Clinton taking credit for the balanced budget after the Republicans shut down the federal government AND for the welfare reform that he vetoed twice and had shoved down his throat. It is akin to Obama now taking credit for increased energy production in the US, despite his endless bureaucracy and environmental “protections” that have hindered not helped. Energy production is up DESPITE Obama. I would argue that the government payroll is a similar case. To argue that Obama has lowered this is laughable.

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So I suppose you also believe that if you piss in the ocean it’ll turn yellow right? :unamused:

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online.wsj.com/news/articles/SB1 … 2490593594

[quote]Health insurance should be individual, portable across jobs, states and providers; lifelong and guaranteed-renewable, meaning you have the right to continue with no unexpected increase in premiums if you get sick. Insurance should protect wealth against large, unforeseen, necessary expenses, rather than be a wildly inefficient payment plan for routine expenses.

People want to buy this insurance, and companies want to sell it. It would be far cheaper, and would solve the pre-existing conditions problem. We do not have such health insurance only because it was regulated out of existence. Businesses cannot establish or contribute to portable individual policies, or employees would have to pay taxes. So businesses only offer group plans. Knowing they will abandon individual insurance when they get a job, and without cross-state portability, there is little reason for young people to invest in lifelong, portable health insurance. Mandated coverage, pressure against full risk rating, and a dysfunctional cash market did the rest.

Rather than a mandate for employer-based groups, we should transition to fully individual-based health insurance. Allow national individual insurance offered and sold to anyone, anywhere, without the tangled mess of state mandates and regulations. Allow employers to contribute to individual insurance at least on an even basis with group plans. Current group plans can convert to individual plans, at once or as people leave. Since all members in a group convert, there is no adverse selection of sicker people.[/quote]

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Well regardless of which side of the Obama care debate people fall on one thing is for sure. It’s certainly sparked a lot of meaningful dialogues on the issue. Whether Obama care survives in it’s current form or is radically changed doesn’t really matter. Obama care was necessary to reach an eventual workable solution. If the Obama administration didn’t so aggressively tackle this issue the Republicans would have been quite content ignoring it for another 20 years.

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That’s it. Keep walking it back. Further.

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One must truly wonder about how some people presume to make money and investment decisions for others when their own judgement is so clearly stuck in a sand trap that any swing would be better than the guesses that they hazard. But no doubt they have very good pitches and keep their eye on the ball… Who knew that Lincoln was already being given such clever and effective advice while he was writing his Gettysburg Address. FOUR! SCORE! and on the seven!