patrick.net

Actually Britain and Japan have two very different systems. In Britain, most doctors work directly for the National Health Service, which provides service directly to everyone, no insurance. In Japan, the government sets rules for insurance including guaranteed issue, community rating, and the prices insurers will pay for basic services; providers that take insurance are required to accept the official price as the full price instead of "balance billing", same as Medicare in the US but Japan has thousands of insurers operating on these terms. BTW, around 10% of Japanese don't buy insurance at all, and there is no penalty for individual persons who choose not to buy. Obamacare's individual mandate penalty is unique, the nearest parallel being Switzerland, but even there the insurance companies are not allowed to make a profit on basic health insurance.

Exactly. We get the best government money can buy. It isn't just campaign contributions either, there are also patronage jobs and the revolving door, e.g. Billy Tauzin's $2 million/year job working for PhRMA. The waste, fraud, and abuse are essential to grease the legislative machinery that ratchets up the mandatory costs and penalties. The legislation is not about health, it's about how to maximize the revenue and power that can be derived from public demand to do something about the rising costs of healthcare (rising costs that resulted largely from prior policies that were produced by the same machinery for the same reasons). In practice, that means maximizing waste, fraud, and abuse in order to maximize spending and thus power.

But, it's tough to do anything about that when self-styled "conservatives" don't even know what conservative means, and claim to hate "liberals" without knowing what that means either. Divide and misrule.

Reading more about Johnson & Nixon and the war in Viet Nam, I wonder how America even lasted this long. Then W and the Iraq War showed that Americans hadn't learned anything, and the TBTF bailouts gave the lie to "free market" rhetoric. But I think America may finally have jumped the shark with Obamacare, because the incentives are mostly in the direction of maximizing waste, fraud, and abuse until the whole thing collapses, and it's mandatory.

curious2 says

But, it's tough to do anything about that when self-styled "conservatives" don't even know what conservative means, and claim to hate "liberals" without knowing what that means either. Divide and misrule.

Liberals are those that want to give exemptions and/or delays to their favorite groups (i.e., public worker unions, etc.) for the ACA while eventually calling for increases in the income tax marginal rates to cover "short falls" with the 'Affordable' Care Act.

adarmiento says

Liberals are....

LOL - misusing words doesn't automatically give them new definitions. "Trees are giraffes standing still." If you can misuse words that way and nobody calls you on it, you're living in an echo chamber and need to get out more. It reminds me of George Orwell's warnings about language, in 1984 and elsewhere; when people lose the ability to say what they mean, they become unable to communicate and eventually unable even to think prohibited thoughts. Meanwhile, calling Republicans "conservative" is even further from reality than claiming Obamacare is about patient protection and affordable care.

curious2 says

LOL - misusing words doesn't automatically give them new definitions. "Trees are giraffes standing still." If you can misuse words that way and nobody calls you on it, you're living in an echo chamber and need to get out more. It reminds me of George Orwell's warnings about language, in 1984 and elsewhere; when people lose the ability to say what they mean, they become unable to communicate and eventually unable even to think prohibited thoughts.

That is ironic because the Democrats are using political correctness in a very Orwellian fashion.

Example, preferably one relevant to the OP?

adarmiento says

Liberals are those that want to give exemptions and/or delays to their favorite groups (i.e., public worker unions, etc.) for the ACA while eventually calling for increases in the income tax marginal rates to cover "short falls" with the 'Affordable' Care Act.

So that would make conservatives those that want to give exemptions and/or delays to their favevorite groups (businesses of all types, etc.) while eventually calling for increases in the federal borrowing to cover "short falls" with the "Affordable" Care Act.

curious2 says

Example, preferably one relevant to the OP?

Calling it the 'Affordable Care Act' when it costs many folks more money for more limited coverage.

Calling it tolerance, when an opposing view is shouted down or brings about calls for censorship (see calls for no longer carrying Krauthammer's editorial because he doesn't sip the Kool-Aid for Global Warming).

jojo says

We need a universal plan like England or Japan.

jojo says

Its always funny to see people mindlessly repeat the propaganda (maybe that's
a picture of your thought process).

And in the next sentence ....

The fact is, Universal health insurance was part of the Republican platform in the 70s (Nixon advocated it).

I see this time and again. Someone makes the assertion that the other side only repeats propaganda and talking points, and then instantly repeats the talking point of the other side (e.g., the irrelevant premise that ACA is the Republican's plan).

Here's the most relevant statement from the Republican Platform that you refer to:

We oppose nationalized compulsory health insurance. This approach would at least triple in taxes the amount the average citizen now pays for health and would deny families the right to choose the kind of care they prefer. Ultimately it would lower the overall quality of health care for all Americans.

As you say... Maybe this is a picture of your thought process, but you need to stop following a party line mindlelessly, and evaluate ideas (and do your research) individually.

jojo says

Its always funny to see people mindlessly repeat the propaganda (maybe that's
a picture of your thought process).

Rather than insult you, as you tried to do to me. The bottom line of Obamacare was what a group-grope it was, is and continues to be. It is a horrible mismash of just about everything wrong that could be shoved together. Look, there were some good ideas, like people with pre-existing conditions should have been able to get insurance at a reasonable price (to name one). But rather than stop there, no we gotta do everything for everybody, but instead we are merely DOING everybody, and in one of the worst ways. I do NOT look forward to standing line (literally or figuratively) when I need/want to see a doctor; and that is what is already starting to happen and it the 'norm' in Britain and Canada. Obamacare, for most of us, is NOT a good deal.

mmmarvel says

Calling it the 'Affordable Care Act'....

Well done, and I have to agree with you there, but I had intended the question for a different User who seemed lost in the usual misuse of words that had discrete meanings but have been reduced to tribal labels.

mmmarvel says

people with pre-existing conditions should have been able to get insurance at a reasonable price....

The main reason people with pre-existing conditions had trouble getting insurance at a reasonable price is the series of unfunded mandates that turned insurance into "health maintenance" and turned chronic conditions into revenue models. If insurers could write true insurance policies, i.e. coverage against the unexpected but foreseeable risks of life, and if people could take care of their own chronic conditions instead of running for an Rx every month to a prescriber whom PhRMA has "incented" to prescribe the most expensive thing, then true insurance could be cheap even for those with pre-existing conditions. OTOH, I think there is also a good case to be made for covering true emergencies and vaccines via a single payer or NHS model. Those account for less than 10% of total spending; the big $$$ is in exploiting chronic conditions and selling elective procedures that are often of dubious merit.

mmmarvel says

Calling it the 'Affordable Care Act' when it costs many folks more money for more limited coverage.

So for how many people does it cost more for more limited coverage? Care to give us a number?

People are somewhat clueless about how insurance works. I like how any insurance premium increase in the past 5 years has basically been blamed on the Affordable Care Act, even before its implementation.

In reality, insurance premiums are somewhat correlated to the economy, the stock market, and the bond market. If the insurance companies reserves are doing well in whatever they are invested, premiums don't rise very much. If the investments aren't doing well, premiums have to rise to fill in the gap.

jojo says

Universal health insurance was part of the Republican platform in the 70s (Nixon advocated it).

That depends on what you mean by "universal". Nixon emphasized that his plan would be strictly voluntary. Somewhere around 1993/94, the definition of "universal" shifted to mandatory. That is what sank ClintonCare with the public. The Clintons had campaigned on "universal healthcare" in the sense that Nixon meant, i.e. everybody would be eligible, then they switched to a mandatory plan that later became RomneyCare, Hillary's Plan, and Obamacare. Some blame the shift on a 1990 report from the Heritage Foundation and say it was therefore a Republican idea, but the Republicans didn't impose anything like it when they held the White House and majorities in both houses of Congress. In 1994, CBO wrote that it would be an unprecedented expansion of federal power, with the nearest precedent being conscription. Nobody imposed anything like it until 2010.

curious2 says

Some blame the shift on a 1990 report from the Heritage Foundation and say it was therefore a Republican idea

Umm, yeah, that's pretty obvious. Mandated health insurance was put forth in a paper published by the Heritage Foundation, and it was supported by Republicans in Congress as an alternative to HillaryCare, as the Republicans lampooned Clinton's health plan.

http://www.heritage.org/research/lecture/assuring-affordable-health-care-for-all-americans

http://americablog.com/2013/10/original-1989-document-heritage-foundation-created-obamacares-individual-mandate.html

Now you have some of these people backtracking that they ever said that. The truth is out there, but many people ignore it.

mmmarvel says

I do NOT look forward to standing line (literally or figuratively) when I need/want to see a doctor; and that is what is already starting to happen and it the 'norm' in Britain and Canada. Obamacare, for most of us, is NOT a good deal.

How was that not the case before the Affordable Care Act? Both pre- and post- an insurance company is determining whether or not to cover your doctor visit, and the amount of available doctor visits is determined by the supply of doctors. How has this changed? Please be very specific, and don't make bogus comparisons to Britain and Canada. For example, certain specialists have always had a several week wait to get an appointment here in the US.

turtledove says

When they first started talking about the Cadillac tax, I was curious as to what defined a gold plan, for example. I choked on my own spit when I saw that a gold plan is an 80/20 plan. Traditionally, that's what insurance covered. 80%. Now that's considered a luxury?

What is "traditionally"? Every plan I've been offered in the last several years has covered either 70% or 90% -- usually the employer offered a choice between these two. These would be called "silver" and "platinum" on an exchange.

Call it Crazy says

I believe like 47% of people DON'T pay taxes

I've noticed that the people most likely to complain about this are people who regularly get paid or once got regularly paid by the federal government, whether as a job or in government benefits. The correlation is pretty good.

I've always suspected that half the people who complain about this probably don't pay federal income tax themselves and are too stupid to know it.

For reference, here are the groups that don't pay federal income tax:

http://www.taxpolicycenter.org/taxtopics/federal-taxes-households.cfm

There's additional detail here on why those households don't pay federal income tax:

http://thinkprogress.org/economy/2012/09/18/864291/romney-the-47-percent/#

So which ones to you propose to tax more? Please be specific.

Given this following comment, I suspect you might have trouble doing so:

Call it Crazy says

If they're not paying income taxes, they aren't paying many of the other taxes you listed either...

Call it Crazy says

Here's a little history on how cost effective government run health care is:

Actually, Medicare is well known as one of the most efficient healthcare programs. None of it goes to profit, and very little goes to administration, compared to, say, the typical insurance company.

jojo says

medicare is EXTREMELY efficient and cost effective. It's too bad more people do not understand this. In my opinion this fact is intentionally muddled by private interests who benefit from people not understanding this fact.

There are two sides to that argument. Medicare's administrative overhead is 1/10th as much as insurance companies' overhead and profits, and besides that the myriad insurance companies with complicated policies and payment structures add a vast amount of cost on the provider side also, and thus a strong argument can be made that Medicare is much more efficient than the private insurance system. Canada has a system similar to Medicare for all, and the Canadian system costs 1/3 less than the American system, while delivering often better results. OTOH, Medicare's population tends to be older and sicker, so the administrative overhead % reflects a higher payment base and thus some of the difference is a function of that. Also, Medicare is vulnerable to waste, fraud, and abuse, and some would argue that Medicare's greater vulnerability in that area narrows or eliminates the gap with private insurance. Also, Medicare payment rates are often lower than private insurance, so it can be difficult for patients on Medicare to find doctors who accept it - primary care providers complain they aren't paid enough, and they have difficulty finding specialists who are willing to accept new patients on Medicare. The whole fee for service model is profoundly flawed, and one of the few good things in Obamacare is the possibility of moving from fee-for-service to fees based on diagnosis.

Call it Crazy says

corntrollio says

Actually, Medicare is well known as one of the most efficient healthcare programs.

And you know this, how???

Through the numerous studies that have been done on this. There is a ton of suspect research that doesn't compare apples to apples coming from certain organizations with an agenda, but every proper analysis I've seen has shown that Medicare has lower administration costs than the private sector. A good example is CBO's analysis of Medicare vs. private plans under Medicare Advantage.

Call it Crazy says

Think for a minute.... why is Medicare a fraction of the cost????

I'll give you a second......

OK, Times up..

Because it covers only people over 65 years old and the disabled, which make up a small subset of the population....

This just shows again that you don't know what you're talking about. People over 65 and the disabled consume a huge proportion of medical care, far disproportionate to any subset of the population that they are. I don't know the percentage of disabled, but the over 65 population in the US is probably around 14%, which isn't pocket change. When you consider how much health care the elderly consume, it's really not pocket change.

jojo says

Its just common sense, the more layers involved the higher the costs will be. Everyone has to take a cut. Remove the layers and remove the cost.

Sounds good. $20.00 per month at GNC will outperform all the layers above. The only problem is you'll live to 150.

jojo says

We need a universal plan like England or Japan. It will eventually happen but for now we are stuck with the ACA.

Quit either being retarded or pretending to be.

Obama thought Obamacare through the same way that he thought his mission to Mars in 2030, with no budget even discussed for it.
His hubris is so huge, he's like that Elizabeth Taylor character that Mike Myers used to play on Saturday night live.

"OK I'll pick an issue for the 2030 presidency, "Mars!" talk amongst your selves..."

Talk is Cheap, and if language was currency Obama's words would be Zimbabwean currency.

jojo says

As i stated previously, i agree with you. ACA is not the answer. ACA is also not the same as medicare (it's not even close).

Man pick a stance and stick with it.

You were just singing Obamcare's praises in another thread.

CaptainShuddup says

Quit either being retarded or pretending to be.

Hmmm. Is this what they mean when they talk about the pot calling the kettle black ?