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[timetokill]

I don't mean to pry on your situation - but if you and your wife are married, and around the age of the people in the article - wouldn't it seem likely that you might have a kid in the next 10 years?

The numbers are pretty stark - the medical cost of giving birth in the US without complications or surgery is around $20,000 on average. Medical costs for other pregnancies are often $30,000 or more. Even the out-of-pocket costs for insured American couples is around $3500. In fact almost 45% of childbirths in the US today have to be covered by Medicaid for pregnant women.

The fact that the ACA plans cover maternity costs - while most pre-ACA "catastrophic" plans didn't - almost guarantees that coverage makes financial sense for you over the next decade. The $3000/yr you pay in premiums you will be paid back if you have kids and don't qualify for Medicaid. If you have kids twice, it is free money.

Frankly it is a game changer. Most of the people in the OP are in denial about their expected medical costs, because they are in denial about their odds of being involved in a pregnancy in the next 10 years, which will dwarf all their medical expenditures in their life up until that point.

We've discussed having kids but have postponed it indefinitely because we can't afford it at the moment. As you noted the costs are extreme. We definitely wouldn't do it without having insurance, and right now it just doesn't make sense.

With Obamacare in place we will certainly reassess the situation, and certainly get insurance if/when we intend on having a child.

 

[gohepcat]

Probably. I fall squarely into the libertarian realm politically. That doesn't mean that I can't point out warning signs.

Ok. So the whole libertarian thing absolutely does not work with healthcare. Full stop. It's not a product. It's not a commodity. It's exactly the type of thing that a democratic society weaves into it's laws and codes. It's exactly the type of thing that people fight and die for. It's inherently part of what you are as a nation.... what we are as humans.

From a purely financial aspect it's nonsensical... because we don't allow people to suffer and die. We treat everyone. So all the rules about supply and demand, about market forces, about all that go out the window.

Single payer.

 

[Wiktor]

With prices like those it makes most sense to just deliver the pregnancy in home with a help of midewife instead of hospital.

 

[Jonm1010]

You're actually taking assets from the pretty well-off youth, not everyone else.

a lot of the youth get a roughly good deal. Let's review.

A. young people can stay on their parents' insurance til 26.

B. young people will qualify for a lot of subsidies

C. young people will often qualify for the medicaid expansion

D. Most young people who don't qualify for subsidies generally have employer insurance anyway, so they don't even come into the equation.

What's really happening is Obamacare is asking healthy people w/o employer insurance who make over 4 times the poverty level in addition to the youth getting cheap coverage in order to pay more to subsidize people who can't afford insurance now or can't get it at a reasonable rate because of a pre-existing condition

I'm 28 years old. A contract worker trying to pay my way back through a second degree. I make a little under 34,000 a year before taxes. I pay 900 a month in rent, 550 a month in tuition, 100-200 in utilities. A car note, car insurance, food, necessities, gas and still have to buy things like textbooks and school supplies.

Read my post history about my support of obamacare and UHC. You'll find I was at one time one of this forums most vocal advocates.

Now how the fuck you continue to try and spin this current iteration of the law as anything but a complete fuck you to many of the youth today is beyond me. It's literally asking me to pay money I can't afford for the privledge of paying another 5000-6000 dollars if anything were to actually be seriously wrong with me. It's horseshit. It's subsidizing the poor and the old on the backs of the youth(which honestly would be fine if done in a responsible manner, because its how insurance works, but that isn't happening now) who can barely(if at all) afford it. And don't give me this crap that its better to pay 6000-8000 instead of 100,000. Me and most in my situation will still end up in a dire situation if it occurs. And for the majority that nothing will occur, they live with an even worse financial situation and less disposable income in a fragile economy that is in desperate need of increased consumer spending and demand.

And dont just think im some odd exception. i worked in the service industry for many years. imagine the difficulty of a moderately successful server/bartender making 30,000 a year but sporadically and inconsistantly. maybe one year they qualify for subsidies but not the next. or the trouble that will come in the summer slow season when utilities are high and income is low but the healthcare bills still roll in. The fact you and others are jumping through hoops having to explain away these criticisms should set off the self-reflective bells.


The democrats lack of balls, like with most of their major legislative initiatives for the last thirty years, is so compromised because of a pussyfied backbone that they compromise what is initially good legislation in favor of shitty legislation that leaves their opponents still angry at them and alienates many of the people they initially tried to help because they are so concerned with the appearance of bipartisanship and appearing centrist that they constantly start at an already compromised position and just move further and further to the right on everything. Scared to admit that government isn't some evil boogeyman like Reagan framed it and that in instances, like healthcare, government administrated care is the ONLY fair and logical course of reform. Maybe if they started at the lefts equivelent of the republicans ideas we might have at least ended up with something that doesn't completely fuck many of today's youth. Which just may risk burning some bridges with a demographic that they have overwhelmingly dominated in terms of support.


So now we have a law that is still vehemently hated by the people they wanted to persuade. And in the process they fucked over many of the people they wanted to support and then there are those not in either camp who are only seeing marginal benefits which isn't going to be enough to build a coalition to push further reform and in turn might just have created enough apathy and/or dissent that a growing opposition will be able to neuter if not completely repeal the law in coming years.

And sadly enough I am struggling right now with who I actually want to support coming up because democrats don't have the balls to fix this clusterfuck but republicans do. But their answer means a worse situation for everyone and a regression of the national conversation that probably won't spark back up for at least another decade.

Once again democrats screwed themselves by screwing the very people they aimed to help.

 

[Septimius]

Is it not worth considering changing from insurance to tax for the US? I'm thinking about how it works in Norway in contrast. I dropped a knife on my foot, rushed to the emergency room and got two stitches and a tetanus vaccine. The whole ordeal came out to 30$. It was almost the same as taking a cab to the emergency room. (probably 20$)

I don't fear the costs of medical help. I don't have to keep track of deductibles, premiums and plans. I pay as much as my income can in tax - where those who make little pay less percentage. My dad got a knee prosthetic, barely cost him anything, with four days of post-op care and months of physiotherapy. In America, I could imagine this would be a hassle of 'preexisting condition', elective operation and otherwise an insurance company that probably doesn't wish to pay what I could assume would be a 200,000$ thing in the end. I might be way off, I might not. I just know things are expensive in the US. The freedom we, in this country, experience when it comes to going to the doctors and paying 20$ for a consultation, automatically receiving subsidiaries when you've bought medicine for more than 100$ that year, and prescription medicine costing 5% of the original cost (like 10 allergy pills costs 15$, but on a prescription 100 pills cost 7$) makes me not be afraid to be sick.

Many people go through life without any serious illness and complications in what they do. A few people are born with diseases that means they're ensured a life full of returns to the hospital. Some 25 year old will fall on the ice and break his wrist, despite being fit and healthy, and in Norway that means he can be rushed to the ER, be fully taken care of, get sick-leave with pay and be checked up on at basically no cost. In the US, the same fit, healthy guy has opted out of insurance, because he's superman. He might be rejected by the ambulance for not having insurance, and his medical bills might leave him in debt for a long time. Insurance pans out to be a middle-man that wants his share of the cake. It may or may not drive prices up, when in an insurance heavy country compared to a subsidized, welfare country. Being able to opt out will mean young people will say it's a luxury and maybe even something they won't need. It puts kids every day in very tough economical situations.

Isn't it worth considering that the consensus, the plural, the wisdom of the state you live in be the ones that put up a safety net for when you go walking on the tight-rope of life? Because we all know that when young people are happy, they're unstoppable. That's a fantastic trait, but an unlucky few will fall from the tight-rope, and when they've said they don't need a safety net, statistically, they were right. But statistics doesn't help the individual.. Isn't it worth considering that if everyone pays a bit more tax, the unlucky few can get full help?

(I know that you can't just flick a switch on a change like this. Higher taxation would put the fickle US economy at risk. It will also create a scarcity of the dollar, which might strengthen the value compared to other currencies, which would boost import. It's easy to see that it's complex. You couldn't just say you're done with one, let's do the other, this post is merely asking for a reflection on what seems to be an inherent evil to the US, almost a taboo. Taxes)

 

[Dennis]

I've always trusted the WSJ before to be fair and balanced when it comes to--

The unhappy children - no doubt worried about mommy and daddy's meagre income - always slay me.

 

[Mr.Pig]

As a European with no knowledge of insurance terms, what is a deductible?

 

[Black Mamba]

I'm 28 years old. A contract worker trying to pay my way back through a second degree. I make a little under 34,000 a year before taxes. I pay 900 a month in rent, 550 a month in tuition, 100-200 in utilities. A car note, car insurance, food, necessities, gas and still have to buy things like textbooks and school supplies.

Read my post history about my support of obamacare and UHC. You'll find I was at one time one of this forums most vocal advocates.

Now how the fuck you continue to try and spin this current iteration of the law as anything but a complete fuck you to many of the youth today is beyond me. It's literally asking me to pay money I can't afford for the privledge of paying another 5000-6000 dollars if anything were to actually be seriously wrong with me. It's horseshit. It's subsidizing the poor and the old on the backs of the youth(which honestly would be fine if done in a responsible manner, because its how insurance works, but that isn't happening now) who can barely(if at all) afford it. And don't give me this crap that its better to pay 6000-8000 instead of 100,000. Me and most in my situation will still end up in bankruptcy or unable to pursue our ambitions if a serious injury or illness occurs because our money is spread so thin.

In the other posts in this thread I indicated there will be some people caught in a tough spot, a spot you seem to describe. It's unfortunate, and as I said, I am not happy about that regarding this bill. I think the subsidies should be higher for those in the $25-40k range, especially if you're under 35.

But I'm not spinning anything, Look at the chart I posted above. The poor and the youth are pretty intertwined right now. Of the 25 million 18-35 year olds without employer insurance, 20 million of them earn under 200% of the poverty line. Of those 20 million, nearly, 15 million will qualify for medicaid and that number would be higher if none of the states opted out. The other $5 million will be heavily subsidized and in some cases paying nothing or nearly nothing.

Again, most of the uninsured youth will qualify for medicaid or free insurance on the exchanges. The "youth" isn't subsidizing. It's mostly the "well-off" youth plus the currently affluent along with the previously uninsured who would like to pay a reasonable price who will be subsidizing the sick and poor. Unfortunately, there is a bloc of people that will be screwed and for that there is no excuse.

I agree with your criticisms of the Dems lacking balls. There should be a public option at the very least.

There are numerous things to criticize the bill for, inlcuding what you just did. I think the employer mandate is poor policy. I think it doesn't do nearly enough to stem health care costs. Etc. I'm not trying to jump through hoops to explain away criticisms, I'm trying to do my best to put out what is actually going on. I think it's unfair to say the youth are being screwed because among those that don't have employer insurance, most will get free state insurance. yes, some will be screwed and it's fair to point it out, but it's also fair to point out it's not the norm in that group (even if it shouldn't happen).

It's not a perfect law, it might not even be a very good law, but it's still better than what we have now. And I'm truly sorry if you're one of the

 

[Septimius]

As a European with no knowledge of insurance terms, what is a deductible?

It's how much you need to pay, yourself, not matter how big the bill.

Let's say your deductible is 1000$. If you get a bill for 500$, you pay it all. If you get a bill for 1000$, you pay it all. if you get a bill for 1500$, you pay 1000, but the insurance covers 500.

It's normal practice with most insurances. I know European car insurances has it.

EDIT: So close, yet so far

 

[Black Mamba]

As a European with no knowledge of insurance terms, what is a deductible?

A deductible is the amount you have to pay before the insurance kicks in.

Depending on your policy, a doctor visit may not be part of your deductible (may be free or you may pay a flat fee, say $30). Emergency room visit might also not be part of it (but the services are).

Very often, after you meet your deductible, you still have to pay something; usually it's a split like 70% insurance, 30% you until you hit your "out of pocket maximum" where the insurance now covers 100%. Prescription medication is usually separate, too.

it resets each year.

Example is a $5k deductible with a $10k out of pocket max and a 70/30 split. Something happens, you need MRIs and what not, then maybe surgery. You pay all of it til you hit $5k, then you pay 30% until you hit another $5k (or another $16.66k total which you pay 30% of), then you're done.


High deductible policies are cheaper. But if something catastrophic happens, you pay a lot more. Employer insurance usually has much lower deductibles than individual.

 

[Funky Papa]

The unhappy children - no doubt worried about mommy and daddy's meagre income - always slay me.

The single mom with a 260k income does it for me. That poor lass.

 

[Jonm1010]

In the other posts in this thread I indicated there will be some people caught in a tough spot, a spot you seem to describe. It's unfortunate, and as I said, I am not happy about that regarding this bill. I think the subsidies should be higher for those in the $25-40k range, especially if you're under 35.

But I'm not spinning anything, Look at the chart I posted above. The poor and the youth are pretty intertwined right now. Of the 25 million 18-35 year olds without employer insurance, 20 million of them earn under 200% of the poverty line. Of those 20 million, nearly, 15 million will qualify for medicaid and that number would be higher if none of the states opted out. The other $5 million will be heavily subsidized and in some cases paying nothing or nearly nothing.

Again, most of the uninsured youth will qualify for medicaid or free insurance on the exchanges. The "youth" isn't subsidizing. It's mostly the "well-off" youth plus the currently affluent along with the previously uninsured who would like to pay a reasonable price who will be subsidizing the sick and poor. Unfortunately, there is a bloc of people that will be screwed and for that there is no excuse.

I agree with your criticisms of the Dems lacking balls. There should be a public option at the very least.

There are numerous things to criticize the bill for, inlcuding what you just did. I think the employer mandate is poor policy. I think it doesn't do nearly enough to stem health care costs. Etc. I'm not trying to jump through hoops to explain away criticisms, I'm trying to do my best to put out what is actually going on. I think it's unfair to say the youth are being screwed because among those that don't have employer insurance, most will get free state insurance. yes, some will be screwed and it's fair to point it out, but it's also fair to point out it's not the norm in that group (even if it shouldn't happen).

It's not a perfect law, it might not even be a very good law, but it's still better than what we have now. And I'm truly sorry if you're one of the

That's still 5-10 million people with a new expense each month. In one of the most unstable and weak demographics when it comes to income potential and job stability.

Even many who fall under the category of subsidized will still be paying expenses they likely can't afford. Just because you were able to get under the umbrella doesn't mean you're not gonna get wet. At least with this bill.

Those making near the subsidy threshold aren't going to be seeing much in savings. Putting many of them in a similar situation as I'm in.

No, not all the youth are like me but there are going to be a not insignificant number(as you point out) of young people - many who have remained obtuse to this whole policy change - who are going to find themselves suddenly having to pay an additional expense every month and wondering why the hell it makes any sense since the major benefits will be behind another paywall. It's like being told you know have to pay for Xbox live gold only to find out you'll also have to pay for xbox live platinum just to access multiplayer.

Many of these people will suddenly find themselves either over the edge - even with subsidies - or getting even closer to it. And for those still having to pay even a micro payment to get insurance - whom will probably be pretty poor by most standards - it will be a scary new expense.

Is it gonna help many? Yes. Is it going to end up possibly hurting the financial flexibility of millions of young people and possibly limit their opportunities and potential? Yes. Which is sad to say from a professed liberal like me and sad to say about a party that claims to pride themselves on building ladders for the lesser amongst us, not knocking them down for some in the process.

 

[LordCanti]

I don't think most of my peers will pay for coverage. Their parents might, however, in a bid to not be hit with an astronomical bill if worse came to worst. Those that aren't as fortunate will just hope for the best and probably declare bankruptcy if things go sideways, due to an inability to pay.

 

[RJT]

And this summarizes perfectly is why Universal Healthcare should be public. No insurance bullshit.

BTW: I say this as a person that actually has private insurance. The thing is: I still also use the public system, and my insurance costs 200€ per year.

 

[Foffy]

And this summarizes perfectly is why Universal Healthcare should be public. No insurance bullshit.

This is too logical for America. Please think this over..

 

[TomServo]

A few years ago my employer moved us from a "Cadillac" health plan to something very much like the gold/silver/bronze exchange setup.

Based on my experiences with that, there needs to be a lot more awareness / education around HSA's. As a relatively young (34), healthy, and single guy, the equivalent of a bronze plan is bearable when coupled with an HSA.

Still... I do think it's a valid concern that someone that's young and healthy is not going to pay $150 / month for a plan that doesn't offer them any real benefit until they've spent $5000 in a given year. If you don't get those folks into the risk pool the whole plan falls apart.


EDIT: I'll also say this; my single largest frustration with being on a high deductible plan is that so many doctors and hospitals base their charges on the assumption that you're on Medicare, Medicaid, or a traditional copay model and thus don't give a shit about how much things actually cost. I had very minor outpatient surgery (mucocele removal) and the oral surgeon's office couldn't tell me what I was going to pay until midway through the procedure... and it was $1200 for a ten minute procedure. From now on I won't let anyone touch me until I have the costs in writing.

 

[Majima Everywhere System]

For those crowing about not purchasing health insurance because it's simply not worth it (not because of financial hardship):

Wait till you get something that is entirely out of your control. My dad developed pancreatic cancer, and he did not drink or smoke. He ate homecooked meals three times a day, almost every day of the month (we ate out once a month). He worked out every day, to the point that he was doing heavy construction work on his own at home at the age of 70 and it barely phased him. He cycled every weekend that he could. He juiced vegetables and fruits 3 times a day. He put on sunscreen and made sure to go to the doctor regularly.

He still got cancer. It still killed him. If he had not been wise and taken out extensive life insurance along with supplementing his Medicare with employer provided health insurance, we would have been in the poor house. It is thanks to him and his foresight that I can attend an excellent university and have prospects for a good job so that I can take care of the family.

If he had not had health insurance along with other protective measures, we'd have lost the house and been out on the streets. One experimental operation that he had cost $120,000 alone.

If you give one SHIT about your family, friends, and loved ones, you get health insurance. I have health insurance through my university, and I go in for regular check ups because I want to avoid a repeat of this situation for my family. I plan on getting some one way or another upon getting a job.

Worth mentioning, why are we doing expensive experimental procedures on 70 year old men? Maybe we should come to terms with dieing, and ease that process. Also playing a role are families that don't want to let go or feel guilt.

Nothing against you and yours, it's a systemic question that is out there.

 

[teruterubozu]

WSJ is so disconnected from reality. It really exemplifies Wall Street in general.

 

[TomServo]

Worth mentioning, why are we doing expensive experimental procedures on 70 year old men? Maybe we should come to terms with dieing, and ease that process. Also playing a role are families that don't want to let go or feel guilt.

Nothing against you and yours, it's a systemic question that is out there.

And questions like that are why we'll never get single payer.

You tell people we're going to give up on them at 70 (which is not end-of-life) and you can pretty much kiss any dreams of single payer goodbye.

 

[ThisWreckage]

This is going to be a massive clusterfuck. Many people are militantly opposed to it and even people that support it have qualms with it.

 

[shakin_haitian]

People tend to forget that having insurance, even before you hit your deductible, saves you money because the insurance company has worked out a discount with providers. My wife's doctor bills, after a nasty bout of strep throat, was 350 bucks. Without insurance, we would have been charged almost 1000 dollars, not including lab tests, which would have been an additional 300 dollars rather than 15 dollars.

 

[Manmademan]

Is the American healthcare system actually set up in the patient's/society's best interest? Looking from the outside it really doesn't look like it. It seems pretty inefficient and unfair. Why not move to a nationalised healthcare?

because republicans oppose anything that's "socialism" or that "democrats want" on principle. That means the current healthcare plan, imperfect though it is, needed every single democrat in congress on board- some more liberal than others.

this was a decent compromise. single payer never would have passed.

 

[Manmademan]

A few years ago my employer moved us from a "Cadillac" health plan to something very much like the gold/silver/bronze exchange setup.

Based on my experiences with that, there needs to be a lot more awareness / education around HSA's. As a relatively young (34), healthy, and single guy, the equivalent of a bronze plan is bearable when coupled with an HSA.

Still... I do think it's a valid concern that someone that's young and healthy is not going to pay $150 / month for a plan that doesn't offer them any real benefit until they've spent $5000 in a given year. If you don't get those folks into the risk pool the whole plan falls apart.


EDIT: I'll also say this; my single largest frustration with being on a high deductible plan is that so many doctors and hospitals base their charges on the assumption that you're on Medicare, Medicaid, or a traditional copay model and thus don't give a shit about how much things actually cost. I had very minor outpatient surgery (mucocele removal) and the oral surgeon's office couldn't tell me what I was going to pay until midway through the procedure... and it was $1200 for a ten minute procedure. From now on I won't let anyone touch me until I have the costs in writing.

Part of your complaint here is that costs for medical procedures are all negotiated with insurance companies. So the oral surgeon probably didn't know what your cost would be until she checked. Switching to a new dentist, I had to wait for the assistant to literally call the insurance company on the phone since she wasn't familiar with the charge for something I wanted, and that's not exactly fast.

Your complaint that people are paying $150 for something with "no benefit" until you hit the deductible underscores the fact you are unaware of how medical pricing works.

Here's the benefit- have an accident and need to go to the ER? With insurance, whether you hit your deductible or not, the charge is a couple hundred dollars because the pricing has been negotiated in advance.

no insurance? Thousands of dollars for something as simple as being given an aspirin, or a couple of band aids.

 

[jimi_dini]

Worth mentioning, why are we doing expensive experimental procedures on 70 year old men?

Was it an accident that you wrote 70 year old MEN?

Or should they still do expensive experimental procedures on 70 year old women?

And what about say 15 or 25 or 35 year old disabled and/or chronically ill humans? Should we stop treating them too at some point, especially in case doctors say that their life expectancy is low? Who are you to decide who gets treatment and who doesn't?

btw. hint: experimental procedures may become regular procedures and may help younger humans as well.

 

[TomServo]

Your complaint that people are paying $150 for something with "no benefit" until you hit the deductible underscores the fact you are unaware of how medical pricing works...

Here's the benefit- have an accident and need to go to the ER? With insurance, whether you hit your deductible or not, the charge is a couple hundred dollars because the pricing has been negotiated in advance.

no insurance? Thousands of dollars for something as simple as being given an aspirin, or a couple of band aids.

Easy there, killer. I'm painfully aware of how medical pricing works. You're making the assumption that my insurer has negotiated extremely favorable pricing with healthcare providers. Emergency care will cost me far more than "a couple hundred dollars", and I'd be stunned if someone on a bronze exchange plan isn't in the same situation.

That $1200, 10 minute procedure? That was the negotiated rate with my insurer. Was it cheaper than the $1500 chargemaster price? Yup. Was it in any way related to the actual costs to provide the care (as Medicare is)? Not at all. The best thing of all? By offering to pay cash, I got quoted a better price than my insurer negotiated. I took the $1200 hit though because a cash payment wouldn't have gone towards my deductible. It's been that way for literally every medical need I've had since we went to the high deductible plan.

It's only going to get worse. The insurance industry is losing its leverage over the healthcare providers as those providers consolidate into huge healthcare businesses. Time highlighted this in their issue on health care in America as one of the drivers of increased medical costs.

EDIT: To be clear, I do agree that there is some benefit to the lower negotiated rates. I don't think it's nearly as much as you think it is, and I still think a $5000 deductible on a bronze plan that some twentysomething is paying $150 / month for is a huge hurdle to get over in terms of acceptance of healthcare exchanges.

 

[Chojin]

Between me and my wife I pay 200 bucks a paycheck which comes out around 400 bucks a month for our insurance. Deductible is 1000 thousand dollars and its a 80% them 20% split for us. Thankfully preventive stuff is 100 percent free as well as my high blood pressure meds.

It's the most I've ever paid insurance for. Prior to working where I do I never paid more than 34 dollars a paycheck for coverage.

It's worth it though, 8 years back I had my gall bladder removed and that would have cost me 40,000 dollars if I was uninsured. I only paid 400 bucks out of pocket for that with my old company.

Still, 400 bucks a month is a large chunk of our budget until my wife finds work (just got here in the country and only recently got a work permit)

 

[Krauser Kat]

im 27 and make 46k a year. I already budget 150ish a month for health insurance. I wish they would expand the preventive stuff to include more. My deductible has always been crazy high but i dont really go to the doctor, its their to keep me from bankrupting. Though my divorce is doing a hell of job at that already.

 

[afternoon delight]

I make less than 15k a year and insurance will double what I currently pay in utilities each month. Hmmmm.

Edit: Thanks to this thread I'm looking into medicaid!

 

[Lv99 Slacker]

Fuckin' racket.

 

[shakin_haitian]

This is going to be a massive clusterfuck. Many people are militantly opposed to it and even people that support it have qualms with it.

Because those people believe since it's a soschalist gubbment program, it's going to hurt their medicare and social security.

 

[Azih]

I don't like the idea of the government paying for me

Government pays for your roads, sewers, police coverage, defense, fire coverage etc. Do you not like those ideas either?

 

[Jack Remington]

It's great that exchanges are forcing insurers to compete more and lower the cost of coverage, but a lot more needs to be done to address the cost of medical services.

I'm really disappointed that the ACA didn't include a price transparency mandate.

We're way past the point where we can afford to allow a system where insurers and providers haggle over prices with completely fictitious uninsured rates as the providers' leverage. All providers need to be forced to post their prices for every procedure on an easily accessible website. Given that procedures can have complications and become more expensive, these could include a low-end and a high-end range, with a median price also listed.

 

[shakin_haitian]

Government pays for your roads, sewers, police coverage, defense, fire coverage etc. Do you not like those ideas either?

I'm really fucking pissed that I don't have to expect my car to blow up or my house to randomly collapse on my head. It's an atrocity that I don't have to pay a hundred dollars a day for a weather forecast.

 

[gregoden]

I will not be forced by the government to buy health insurance.

 

[ivysaur12]

I'm not sure I understand your point. Yes, increasing the age at which children can no longer be covered under their parents' insurance gives 18-26 year olds more options when it comes to acquiring health insurance. And yes, that fact has decreased and will certainly continue to decrease the number of uninsured aged 18-26. However, it won't zero that number out, and ultimately does little to solve the fundamental problem surrounding the ACA the article highlights: convincing largely healthy, low-income young people to buy insurance.

I didn't understand why you chose 25 as an age when 25 year olds can stay on their parents' insurance if that option exists. Not to mention most young people will get large subsidies if they choose to buy them through their state's exchanges, or they could qualify for Medicaid now if their state expands it. That's the reason the mandate exists. It's not a campaign to convince... it's a mandate.

 

[shakin_haitian]

I will not be forced by the government to buy health insurance.

Would you prefer we leave you to die if you're in an accident? That's the choice here, because there's infinite demand for healthcare. We either let people who don't have insurance die, or we socialize the system.

 

[Opiate]

Buy that insurance to pay for old people's care. Seemingly similar to social security.

Or to any type of insurance ever.

Safe drivers buy car insurance to pay for bad driver's care. People who live in safe areas buy home insurance to pay for people who live in high crime areas or disaster areas. The list is long, and the concept is not new.

 

[Opiate]

Looking through this thread more thoroughly, it really does seem as if many people are only recently becoming aware of the conceptual framework of insurance generally. Yes, in any insurance system, the healthy effectively pay for the sick, the safe pay for the reckless, and the stable pay for the instable.

I don't mean you have to agree with this system, mind you. But some people seem to be saying it out loud as if it's a new idea, and if by bringing it to light I will respond, "oh my goodness, I never knew about this! How have I been played for a fool for so long?" Yes, I know I'm paying for old sick people. In various ways, I'm also paying for bad drivers and the financially irresponsible. I'm paying for obese people. I'm paying for roads I will never drive on and street signs I will never see in distant parts of my state. I am paying for the education of people I will never meet and for the upbringing of children I will never know.

Yes, I knew about this, and I am fine with it, because that is the purpose of a society.

 

[Wubby]

The healthcare in US is one of the things that makes me hesitant to ever move back there. I really like the national health care plan I have here in Japan.

When I was in the US I went a number of years in my twenties without health care. I wasn't making a whole lot at that time so I'm glad I wasn't forced into buying any. Even when I had good health insurance later on through my company the costs I had to pay out of pocket were much more than I have to pay now. Especially when you factor in Medicaid tax which we don't have here. I was working for a big company so we supposedly had good coverage.

Here's an example. One of my wisdom teeth started hurting in the US and I went to the dentist to get it yanked out. I had the separate dental insurance and still had to pay something like $300 out of pocket iirc. Another wisdom tooth started hurting here so went to the dentist. No separate dental, basic stuff like cavities, cleaning and wisdom teeth are covered under the same national plan. Out of pocket for this one + meds was around $25.

 

[Delusibeta]

Tax financial transactions

London thanks you for your patronage in their efforts to be financial capital of the world.

The healthcare in US is one of the things that makes me hesitant to ever move back there. I really like the national health care plan I have here in Japan.

When I was in the US I went a number of years in my twenties without health care. I wasn't making a whole lot at that time so I'm glad I wasn't forced into buying any. Even when I had good health insurance later on through my company the costs I had to pay out of pocket were much more than I have to pay now. Especially when you factor in Medicaid tax which we don't have here. I was working for a big company so we supposedly had good coverage.

Here's an example. One of my wisdom teeth started hurting in the US and I went to the dentist to get it yanked out. I had the separate dental insurance and still had to pay something like $300 out of pocket iirc. Another wisdom tooth started hurting here so went to the dentist. No separate dental, basic stuff like cavities, cleaning and wisdom teeth are covered under the same national plan. Out of pocket for this one + meds was around $25.

Yeah, it wouldn't surprise me if it was cheaper for pregnant women to fly to Britain, give birth in an NHS hospital, then fly back to America.

That said, dentistry is a poor example, it's one of the few things in the NHS where you have to pay an fee to use (specifically, £18 for check ups, £49 for minor surgical work such as removing teeth, and £214 for the more heavy duty procedures, and for dentures). That said, there's a bunch of exceptions, including everyone who is under 18 years of age, pregnant women (or women who gave birth in the last 12 months), people on Income Support, Jobseeker's Allowance or the Universal Credit, or Pension Credit.

 

[Balphon]

I didn't understand why you chose 25 as an age when 25 year olds can stay on their parents' insurance if that option exists. Not to mention most young people will get large subsidies if they choose to buy them through their state's exchanges, or they could qualify for Medicaid now if their state expands it. That's the reason the mandate exists. It's not a campaign to convince... it's a mandate.

I chose 25 because the guy the segment of the article quoted in the OP spends most of its time talking about is 25. And you're right, the expanded availability of parental health insurance means that 18-26 year olds are now less likely to be uninsured than 27-35 year olds, but that's only a half step towards ensuring enough young people are buying in (or being bought in) to the risk pool to make this system work.

Likewise, you're right, the subsidies and expansion of Medicaid should also help further the aforementioned goal. Still, going off some of the statements in the article and this thread, there are still a quantity of people who are going to weigh the cost of paying for insurance against the cost of the penalty or their ability to buy concert tickets. And to the extent these people are a large enough bloc to gum up the system for everyone, this is a campaign to convince, "mandate" or not.

 

[CyclopsRock]

What's the intended purpose of the fine? How does it help people without insurance? Or is it purely there as an incentive to get some? If so, I don't understand why they don't just make it the law to get it (I understand a lot of people can't afford it, but presumably they aren't the ones intended to be targeted by the fine, either?)

 

[shakin_haitian]

London thanks you for your patronage in their efforts to be financial capital of the world.

Unless the UK becomes about ten times as large, I really doubt that's going to happen.

 

[Opiate]

What's the intended purpose of the fine?

To encourage people to get insurance.

How does it help people without insurance?

It doesn't. It's intended to help people with insurance.

Or is it purely there as an incentive to get some?

Correct.

If so, I don't understand why they don't just make it the law to get it (I understand a lot of people can't afford it, but presumably they aren't the ones intended to be targeted by the fine, either?)

Because American conservatives resent government oversight of virtually every kind. Obviously liberals would love to take it even farther and produce a single payer mandated system. Conservatives resent the system even as it is here, let alone with even broader government power to actually arrest people who don't get insurance.

 

[Delusibeta]

Unless the UK becomes about ten times as large, I really doubt that's going to happen.

Tax financial transactions will mean that all the financial institutions will probably flee overseas. Considering most of them will have a EU HQ in London (because, y'know, English), it'll probably mean they'll make that their main HQ. Hence, London becomes financial capital of the world.

 

[CyclopsRock]

Because American conservatives resent government oversight of virtually every kind. Obviously liberals would love to take it even farther and produce a single payer mandated system. Conservatives resent the system even as it is here, let alone with even broader government power to actually arrest people who don't get insurance.

Is there not even a means-test for the fine? If the OP is accurate, then even someone on the much-argued-about DC Walmart $12.50 would hardly get much in the way of a subsidy, so it's entirely likely they couldn't afford it. Would they still be fined?

 

[Opiate]

Is there not even a means-test for the fine? If the OP is accurate, then even someone on the much-argued-about DC Walmart $12.50 would hardly get much in the way of a subsidy, so it's entirely likely they couldn't afford it. Would they still be fined?

Yes, there are exclusions for the very poor who cannot reasonably be expected to pay for health insurance. You also do not have to have health insurance if you are unemployed, are Indian, are in jail, or several other exceptions.

There are, of course, arguments about how poor "too poor to pay for health insurance" is.

 

[Balphon]

Is there not even a means-test for the fine? If the OP is accurate, then even someone on the much-argued-about DC Walmart $12.50 would hardly get much in the way of a subsidy, so it's entirely likely they couldn't afford it. Would they still be fined?

It's pegged to one's income with a set floor ($695 in 2016), and is ostensibly designed to be more expensive than simply buying insurance at that point. But yes, they could still be fined.

 

[Opiate]

It's pegged to one's income with a set floor ($695 in 2016), and is ostensibly designed to be more expensive than simply buying insurance at that point. But yes, they could still be fined.

Not necessarily. In 2012, the minimum household income to be exempt from the fine was a total income of ~23,000 or below. From there, you are correct that the fine is scaled to a percentage of income.

 

[NYCmetsfan]

Yes, there are exclusions for the very poor who cannot reasonably be expected to pay for health insurance. You also do not have to have health insurance if you are unemployed, are Indian, are in jail, or several other exceptions.

There are, of course, arguments about how poor "too poor to pay for health insurance" is.

I read this and was confused until I realized you mean Native American.