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Old 05-11-2013, 08:24   #196
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by Mambo View Post
We already all pay.

Until we reach the day where we let people die in the streets then we all pay for the care of the uninsured. The real kicker is that under the current system we not only pay for the healthcare -- we pay for it in both the most expensive and least effective manner. We treat poor people in emergency rooms and don't provide them with preventative care. It is the worst of all worlds. That is why the US has some of the highest healthcare costs and some of the worst healthcare outcomes.
Really? Is that really why our health care is so expensive -- around double what other countries pay?

Because it seems to me that emergency room visits aren't why our care costs double that of other developed countries who have similar outcomes.

I don't believe for a minute it's because of the misuse of emergency rooms. I think it's more because there is absolutely no incentive, or method, to shop for health care services by quality of care or by cost.

The current system goes to great lengths to hide that kind of information. Health care today is run by an interconnected set of monopolies who don't really want to tell you where the money goes. Even experts find it difficult to track costs.

So we really don't seem to know what services cost, what they should cost, or where our money goes. The consumer has no input.

Without the Affordable Care Act, about 85% of Americans had insurance. Of the remaining 15%, about half couldn't afford care. So this is a solution that forces the 7.5% of people who didn't want care (mostly young, healthy people who don't use much) to buy in, and then subsidizes care for that other 7.5%.

My issue with all of this is that we didn't solve the BIG problem, which is that we're paying double what other countries pay for care. Why not try and cut the cost in half, put it on parity with what other countries pay, and the other 15% could have been covered with the savings while the rest of us got a 35% reduction in costs.

The problem is that those who have vested interests in health care profits (insurance companies, hospitals, doctors, big pharma, and tort lawyers) like their profits and higher pay, so they really don't want this thing to be analyzed too much. And people are mostly looking at health care from a position of fear that they'll lose something with any change to the system.
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Old 05-11-2013, 08:28   #197
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Re: Affordable Care Act - catastrophic plans cancelled

It is amazing to me that people accept the idea that someone else ought to "pay your way". If I went into a restaurant and ordered dinner and then explained that the other diners would pay extra so I could eat for free I would be thrown out.

As cruisers, we are wrong to impose responsibility for our well being on the communities we pass through. The subsidies the ACA provides are not paid by government, they are taken by force from our neighbors..... It is so strange that anyone feels this is ok.

The detriment to cruisers, as Rich has pointed out, is that many will have coverage cancelled and then be offered plans they can not afford.

The private market has been modified in a way that it can not operate... Business can not operate at a loss and continue to do so. Sure, it sounds great to require 25yo children to be treated as children, and to reward folks who do not buy insurance until they need it.... But the reality of the free market will drive these prices up. The government is broke, and spending more will not be sustainable.

I believe the best option for a cruiser is to stay healthy and to pay cash for care where ever possible. I suspect that will be the only way it will be available in the US soon anyway.
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Old 05-11-2013, 08:40   #198
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Re: Affordable Care Act - catastrophic plans cancelled

The alternative, of course, is for people to be paid enough to afford healthcare.....but I suppose that would raise the cost of your Big Mac and be "ripping" money out of your hands that way?
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Old 05-11-2013, 08:50   #199
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Re: Affordable Care Act - catastrophic plans cancelled

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While not free technically, the majority of the people going to the ER for their routine medical care have no money, no assets and no home to pledge so in reality what happens is these bills are never paid. So, in the case of a private hospital (which is required by law to see any patient that comes into the ER insured or not, able to pay or not) these costs are passed on to the other patients. In the case of a publically owned facility those costs are passed on to the taxpayer.
....
The hospital is required to treat the patient in the ER, but only as far as stabilizing them. Not any followup care or treatment.
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Old 05-11-2013, 08:53   #200
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Re: Affordable Care Act - catastrophic plans cancelled

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The alternative, of course, is for people to be paid enough to afford healthcare.....but I suppose that would raise the cost of your Big Mac and be "ripping" money out of your hands that way?
That is the beautiful thing about the free market. If the Big Mac became too expensive I could opt to cook food at home.... Unless government forced me to buy it.... No one would be "ripping money out of my hands". Why is flipping burgers now a job one needs to be paid "enough" at anyway? I recall working part time jobs my entire childhood (starting at 10).... I never expected "benefits" to raise a family from them.... Remember when flipping burgers was a summer job for a high school student?

When I turned 18 and wanted to start a family I had to do something that would allow me to AFFORD to have that luxury. I believe this idea is foreign today.

I believe that likewise when we decide to cruise we have to make decisions that allow us this luxury. Many here (like Rich) had done that and are now finding that the ACA is hindering their ability to do so.

I appreciate this thread, and hearing about how some are approaching the problem.... I hope these approaches are successful, and that this government experiment does not cost folks the fruit of their life choices.
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Old 05-11-2013, 09:01   #201
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by s/v 'Faith' View Post
It is amazing to me that people accept the idea that someone else ought to "pay your way". If I went into a restaurant and ordered dinner and then explained that the other diners would pay extra so I could eat for free I would be thrown out.

As cruisers, we are wrong to impose responsibility for our well being on the communities we pass through. The subsidies the ACA provides are not paid by government, they are taken by force from our neighbors..... It is so strange that anyone feels this is ok.

The detriment to cruisers, as Rich has pointed out, is that many will have coverage cancelled and then be offered plans they can not afford.

The private market has been modified in a way that it can not operate... Business can not operate at a loss and continue to do so. Sure, it sounds great to require 25yo children to be treated as children, and to reward folks who do not buy insurance until they need it.... But the reality of the free market will drive these prices up. The government is broke, and spending more will not be sustainable.

I believe the best option for a cruiser is to stay healthy and to pay cash for care where ever possible. I suspect that will be the only way it will be available in the US soon anyway.
So you're cool with shutting down Medicare then?
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Old 05-11-2013, 09:03   #202
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Re: Affordable Care Act - catastrophic plans cancelled

Again with the judgements. So someone who makes your food doesn't deserve a living wage. What about the people that watch your children? Or educate them?

Why does a man that can hit a baseball make millions and a scientist make five figures?

Why did we decide that some professions were valuable and others not?
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Old 05-11-2013, 09:05   #203
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Re: Affordable Care Act - catastrophic plans cancelled

Can we get back to discussing the op post? This ACA debate has been debated, won, passed, upheld, put in practice.

CF is not the place for political and moral mud fights...that for SA and others, go play in their sandbox.
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Old 05-11-2013, 09:06   #204
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by skipmac View Post
100% correct. Go to an ER with a real problem and see how many people are sitting in the waiting room with minor, routine medical problems. I tried to go to an ER a few weeks ago with a vision problem that could have been serious. I was told 5-6 hours to see a doctor due to the dozens of people waiting for free, non-urgent medical care.

My daughter is doctor in emergency medicine and when she worked in an urban hospital many days she spent the majority of her time treating everything from chickenpox to toothaches.

Of course, Saturday night on a holiday weekend things got a bit more interesting.
This raises another significant issue. I can tell you that I had patients who were on Medicaid. It was often difficult working them into the schedule around all their other appointments. When a resource is freely available, it's utilization goes up. Now ideally that would reflect a higher standard of care.... Sadly in medicene (especially in mental Heath services) availability often is abused as people use services to fill other needs.

Part of ACA is increasing the number of folks on Medicaid. How much easier will transient access for a cruising Sailor likely be?
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Old 05-11-2013, 09:07   #205
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Re: Affordable Care Act - catastrophic plans cancelled

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So you're cool with shutting down Medicare then?
I'm cool with having some government programs, and not others.

Is that what you're asking? Because I'm pretty sure that's been asked before in this thread.
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Old 05-11-2013, 09:09   #206
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Re: Affordable Care Act - catastrophic plans cancelled

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The alternative, of course, is for people to be paid enough to afford healthcare.....but I suppose that would raise the cost of your Big Mac and be "ripping" money out of your hands that way?
Well if you're going to get picky about it, we SHOULD raise the price of Big Macs to cover the health care costs we all incur as a result of people eating them.
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Old 05-11-2013, 09:14   #207
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by letsgetsailing3 View Post
I'm cool with having some government programs, and not others.

Is that what you're asking? Because I'm pretty sure that's been asked before in this thread.
Not to mention that starting these programs creates an implied contract. Folks pay into social security over a lifetime, that creates a contract that ought to be honored. Medicare is a similar program, having been created and in place the contract has been made and ought to be honored.

The nation can not afford any new contracts right now.

The affects of this are already affecting people who have worked and planned and the consequences of this will be with us for a long time. Even if we are still able to afford to cruise, will our children be?
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Old 05-11-2013, 09:15   #208
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Re: Affordable Care Act - catastrophic plans cancelled

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Well if you're going to get picky about it, we SHOULD raise the price of Big Macs to cover the health care costs we all incur as a result of people eating them.
I would say we should lower the pay of CEOs to something closer to the Ben and Jerry model.
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Old 05-11-2013, 09:16   #209
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Re: Affordable Care Act - catastrophic plans cancelled

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Can we get back to discussing the op post? This ACA debate has been debated, won, passed, upheld, put in practice.

CF is not the place for political and moral mud fights...that for SA and others, go play in their sandbox.

I don't think we're done debating the ACA here or anywhere else.

Mostly because both parties turned the issue into a partisan debate instead of trying to fix the biggest problem associated with American health care: the cost. And the reason both parties did that is because they are both supported in a big way by corporations who have a vested interest in health care profits.
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Old 05-11-2013, 09:16   #210
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by letsgetsailing3 View Post
Well if you're going to get picky about it, we SHOULD raise the price of Big Macs to cover the health care costs we all incur as a result of people eating them.
Actually, you don't have to do that. All you have to do is charge more for insurance to the folks to eat too many. That is the beauty of the free market.

Unless, of course, the government gets involved.
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