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And Social Security would work even better and we wouldn't be facing the prospect of it not having enough funds if they removed the cap on SS taxes. My husband and I don't pay SS taxes on all of our wages due to the cap, but we'd be happy to pay on all of it in order to keep the system solvent and ensure enough will be there for those who need it. Just as we would be happy to pay more in taxes, if necessary, to have some form of universal healthcare in this country. And I'm not just talking theory here. We are exactly the type of people who would likely pay more due to the taxes we don't pay now on our employee sponsored plans and our current tax rates.

 

Same. Our SS taxes aren't a hardship.  Make us pay our fair share.

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Yeah, that statement was borderline cruel, especially after everyone has been patient with your lack of empathy on this thread, Arctic Mama.

Ha. Lack of empathy? Really? I'm expressing my own experiences and being told all the reasons I'm wrong about it and I'm the one lacking empathy? There are two sides to this. It isn't just those with pre existing conditions and concerns who matter in the calculation as to what the government needs to do for the entirety of the public.

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And Social Security would work even better and we wouldn't be facing the prospect of it not having enough funds if they removed the cap on SS taxes. My husband and I don't pay SS taxes on all of our wages due to the cap, but we'd be happy to pay on all of it in order to keep the system solvent and ensure enough will be there for those who need it. Just as we would be happy to pay more in taxes, if necessary, to have some form of universal healthcare in this country. And I'm not just talking theory here. We are exactly the type of people who would likely pay more due to the taxes we don't pay now on our employee sponsored plans and our current tax rates.

 

Same here.  I personally would go with the plan Sanders has proposed which would remove the cap from high wage earners over time, and we will likely need to up the age for full benefits some, but overall SS has done wonders for those at retirement age for decades.  As has Medicare.

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Why aren't we pushing for higher reimbursement rates now? Or if someone is, why is it ineffective?

 

Answer: Because Medicare is so big and impersonal that it's not really all that subject to pressure.

 

How we could do worse: Right now medical services for Medicare recipients are subsidized by medical services provided to others at higher rates. Hence, if we forced in Medicare for all, no such subsidies would be available, so service levels would drop. And there would be no recourse for this--you can't really sue the government, so that's not hanging over anyone's head anymore, and you can't go look for a job with better medical so that admittedly limited safety valve is taken away, and you can't pressure nonexistent state insurance commissions. No, your only recourse would be to pressure the federal government. I don't see that as an effective recourse on any level.

I think it would be quite different if everyone were under the same system because then everyone would be in it together and applying presssure. Right now we have Medicare, Medicaid, VA, Tricare, private insurance, etc. Other countries make it work. One important factor is that many, if not all of them, use some form of price controls and negotiating with pharmaceutical, medical products companies, etc. Companies are basically guaranteed a certain amount of business, but the government is only willing to pay so much for each pill or knee joint or whatever. Right now in the US lots of the healthcare dollars are going to insurance company profits and other for-profit medical companies. And in many cases, we are subsidizing the rest of the world.
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Ha. Lack of empathy? Really? I'm expressing my own experiences and being told all the reasons I'm wrong about it and I'm the one lacking empathy? There are two sides to this. It isn't just those with pre existing conditions and concerns who matter in the calculation as to what the government needs to do for the entirety of the public.

 

If I understand you correctly, you've opted out of the ACA altogether.  So why do you begrudge it if it is helping thousands of other people?  

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I somehow doubt that you saved that much if your NICU bills are not reimbursed. "Negotiations" or not.

Yes, we did. If they don't pay a penny of what we have currently spent we are money ahead of what our old plan would have provided by a fair margin. It will be painful to work through that debt when we already had medical debt we were paying off, but it's still tenable when we are not paying those premiums and deductibles.

 

Again with this telling me what my experience is. Real families are really hurt by that bad legislation and worse implementation. Probably more than have been helped, if the overwhelming negative public sentiment on the ACA in polling is the be believed. Why would we have ditched our insurance if it actually benefitted us to maintain it in any form or we even feasibly could? We literally couldn't pay the premium, all massive deductibles aside.

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No, you're not understanding what I said. I saved money by ditching our ACA ruined policy. We haven't submitted a single bill to our health share yet from any of this, except a midwifery plan for prenatal and birth that we must reimburse back because we didn't use it.

 

All the money we saved is strictly due to the untenable cost of our ACA plan and the going strictly cash pay on all this. The health share will reimburse the rest eventually, maybe, but there is no guarantee of coverage. And yet we still save money compared to trying to continue under the plan we liked that the ACA razed.

 

We aren't the only family in that boat.

I don't disagree that the ACA is not perfect. I just haven't seen anything from the right that provides affordable healthcare for all. What is your ideal plan?

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Yes, we did. If they don't pay a penny of what we have currently spent we are money ahead of what our old plan would have provided by a fair margin. It will be painful to work through that debt when we already had medical debt we were paying off, but it's still tenable when we are not paying those premiums and deductibles.

 

Again with this telling me what my experience is. Real families are really hurt by that bad legislation and worse implementation. Probably more than have been helped, if the overwhelming negative public sentiment on the ACA in polling is the be believed. Why would we have ditched our insurance if it actually benefitted us to maintain it in any form or we even feasibly could? We literally couldn't pay the premium, all massive deductibles aside.

 

But you are effectively paying the deductibles anyway if you don't get a health share reimbursement.  Unless you are getting the cheapest NICU care I have ever heard of, I suspect your accounting is faulty.

 

Correction: thinking back to what you originally posted, you likely are correct as I forgot that the hospital also aided you from its charitable trust or something like that.

Edited by ChocolateReignRemix
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And really, when you are in extremis, are you in any shape to negotiate? It's ridiculous.

There's a lot more in play than money, too. Quality of care hasn't even been considered. Given the choice beteeen two providers, it doesn't always follow,that we should choose the least expensive option. Experience and outcomes matter.

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The ultimate irony being that even preACA we spent more per capita in tax dollars to provide healthcare just to poor people, elderly people and congresspeople than counties like Canada and the U.K. spend per capita to provide care for ALL of their citizens. We have the money to care for everyone but we basically insist on getting fleeced.

 

 

I have to agree with us getting fleeced on healthcare items, but I have to wonder how much of it is the "frills" that we've come to expect.  I'm older than many on the board.  I remember health insurance as being "hospitalization" which covered hospital stays.  There were still wards in some hospitals  ( I remember my sister -in-law recuperating in a ward after giving birth in the mid-eighties.)  as well as semi-private and private rooms.  Vaccinations were fewer and received at the health department.  I have no desire to start a vaccine debate, but we give more vaccines to our infants than other countries.  While I would never call vaccines a frill, are we contributing to costs with our heavy vaccination schedule?  Would our money as a country be better spent subsidizing moms at home for the first three years so that infants weren't in group care environments which spread germs and illnesses  at a higher rate?  Would our children be healthier if we chose this route?

 

 

Another thing that helped to keep costs down:   Prescriptions were paid by us and then reimbursed by insurance.  While there would need to be provisions for those on medicare and medicaid,  many of us could pay first which would lead to more price shopping which in turn would lead to lower costs.   There was no prescription birth control coverage through our insurance so I went to the health dept to get it for free.  I never really understood why they wouldn't pay for birth control.  It was certainly cheaper than paying for a delivery!  Basically, insurance has insulated us from the cost of healthcare until we have a medical crisis which forces us to see the cost.

 

A personal example:  MIL had hip surgery this past year and Medicare covered her walker and potty chair for the toilet.  Medicare was charged over $400 for these items.   A quick search of Amazion showed the same items for about $80.   The walker was almost $30 and the potty chair was about $50.   The difference was that these folks could come to the hospital to deliver and instruct her on its use and charge for that "instruction".   I'm okay with the hospital or gov't, since it's Medicare, delivering the items and the instruction even if it took a couple of extra days.   Why not hire someone to do this job and cut out the private company?   Yes, we may have to wait a day, or cut out the "instruction", but Isn't an approx 50% cost decrease worth it. 

 

End of life decisions:  Yes, it's complicated and personal.  I've sat by more than a few relatives in the past ten years as they've drawn their last breaths.   Being the one family member who stays at home seems to give me that privilege.  In my humble opinion, there no overarching guidelines or counseling to help folks make this decision.  

 

IMHO, we need to have a comprehensive, i.e. well thought out system , which gives folks the support they need instead of waiting for them to appear at the emergency room.  Hopefully, this would both reduce costs and care more fully for our citizens. 

Edited by Artichoke
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Ha. Lack of empathy? Really? I'm expressing my own experiences and being told all the reasons I'm wrong about it and I'm the one lacking empathy? There are two sides to this. It isn't just those with pre existing conditions and concerns who matter in the calculation as to what the government needs to do for the entirety of the public.

 

Why should anyone feel sorry for you, when you've managed to obtain health care, and some form of health care coverage? And you seem to be pretty sure you're at no risk of going without either? Empathy is for people who need it...there are people who will be without cash and health share options and other insurance, if some of the parts of the ACA are repealed as both the house and senate telegraphed that they wished to do.

Edited by Tibbie Dunbar
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From what I understand there are 8-10 million people who still don't have insurance. I don't get the love for the ACA.

 

OMG

 

No one loves the ACA.  We all deserve better. But it's better than what is in the works to replace it with...which is NOTHING AT ALL.  Repea- and-replace is in reality, repeal-full-stop.  

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From what I understand there are 8-10 million people who still don't have insurance. I don't get the love for the ACA.

 

And no, I'm not happy about the changes that passed. 

 

But roughly 20 million more had access because of it.  Seems to me the logical step to help the 8-10 million without is figuring out how to plug the gap rather than removing coverage from the other 20 million,

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Why should there be empathy for you, when you've managed to obtain health care, and some form of health care coverage? And you seem to be pretty sure you're at no risk of going without either? Empathy is for people who need it...

 

 

Not nice, Tibbie.  I've been on a couple of different boards where you've posted, and you've not ever come across this way.  You've always been a wonderfully giving person.   I think Arctic Mama knows she's been blessed with her costs, which have still been substantial.  Her point ( I think) is that her ACA approved plan would have cost her more than the cash discount.  What we need to ask ourselves is why the costs are so different and can we sustain our healthcare on the lower costs? 

Edited by Artichoke
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Not nice, Tibbie.  I've been on a couple of different boards where you've posted, and you've not ever come across this way.  You've always been a wonderfully giving person.   I think Arctic Mama knows she's been blessed with her costs, which have still been substantial.  Her point is that her ACA approved plan would have cost her more than the cash discount.  What we need to ask ourselves is why the costs are so different and can we sustain our healthcare on the lower costs? 

 

Not nice is the insect on the leaf pronouncing on the too much life among his hungry brothers in the dust. (Dickens, A Christmas Carol.) I am genuinely shocked at anyone who has health care wanting pity for not having the plan she prefers, while she argues for others to have none at all.

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Not nice, Tibbie. I've been on a couple of different boards where you've posted, and you've not ever come across this way. You've always been a wonderfully giving person. I think Arctic Mama knows she's been blessed with her costs, which have still been substantial. Her point is that her ACA approved plan would have cost her more than the cash discount. What we need to ask ourselves is why the costs are so different and can we sustain our healthcare on the lower costs?

Thanks, and yes, we are grateful we had a credit card on which to put the massive expenses we have had to pay out and some hope of reimbursement on them. And for qualifying for hospital charity for the first time ever - huge blessing. That doesn't mean the financial blow of having piles of medical debt more expensive than a new van doesn't still stink. And being priced out of our insurance coverage entirely and having to pick up a health share as an option of last resort also stinks, especially since someone pointed out the true fact that there is *no* guarantee of reimbursement and not much recourse if denied, though thankfully they rarely do.

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Not nice, Tibbie.  I've been on a couple of different boards where you've posted, and you've not ever come across this way.  You've always been a wonderfully giving person.   I think Arctic Mama knows she's been blessed with her costs, which have still been substantial.  Her point ( I think) is that her ACA approved plan would have cost her more than the cash discount.  What we need to ask ourselves is why the costs are so different and can we sustain our healthcare on the lower costs? 

 

No, I think you've misread Arctic Mama's posts somewhere along the line.  She clearly said she wanted to shred the ACA because it didn't work for her family.  Even though she dropped her plan.  And anyone who disagrees is a bleeding heart sentimentalist.  That just comes off as vindictive, no matter how you spin it.  

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Have your OWN end of life discussions. Why does the government have to mandate, control, and handle EVERYTHING in our lives?

 

Do it yourself. We have, on both ends. WE decide, not them, when its our parents (with them) and ourselves.

Honey, they aren't. All the ACA provides for is reimbursement for your physician if you should choose to make an appointment to get guidance on different end of life treatment scenarios. In other words, the doctor will get paid for his time. It is there to encourage physicians to take the time to have these important discussions with their patients. Because, whether or not you realize it, these discussions are important. In the end, the patient and family decide. Period, full stop.

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Why do you trust the government with this, in the face of evidence to the contrary?

Seriously, why?

 

Because I would like to, but I just can't. Not with what I've seen.

 

They are just never responsible. They can't be sued. There's no recourse. And they have no idea how to manage funds.

These exact same objections apply to the private sector exponentially. People die in droves on private sector insurance. The care is rationed, the insurance company decides who lives and who dies, and some how the 40 million dollar bonus that is the incentive to let people die is all okay so long as it ain't the gubmint choosing to kill. Dying to enrich someone else is somehow moral and heroic in this country. My husband has worked for two non profits and four multi-nationals none of which could manage a penny properly.

 

I don't get it. I am never going to get it.

 

I understand the argument but it simply does not hold up in the face of the wretched truth of corporate America.

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Not nice is the insect on the leaf pronouncing on the too much life among his hungry brothers in the dust. (Dickens, A Christmas Carol.) I am genuinely shocked at anyone who has health care wanting pity for not having the plan she prefers, while she argues for others to have none at all.

 

Tibbie, I think we'll have to disagree. I see Arctic Mama as offering a cash pay solution that may help others not as someone wanting pity.  She's also pointing out some of the flaws with healthcare and consumers. IMHO. 

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No, I think you've misread Arctic Mama's posts somewhere along the line. She clearly said she wanted to shred the ACA because it didn't work for her family. Even though she dropped her plan. And anyone who disagrees is a bleeding heart sentimentalist. That just comes off as vindictive, no matter how you spin it.

Slight difference - I'm pretty positive whatever comes in it's place, even if it is just the free market scrambling, will be better in terms of cost and quality than what we are seeing now. And the massive inflation in costs for services that has happened in acceleration under the ACA also affects us profoundly. Not being able to afford insurance anymore affects us. This all profoundly affected us and we have been suffering under medical debt since the original problems with our plan. We still haven't paid all of it down, but we were close before all this happened.

 

No doubt some of my tone is from frustration and being ignored when trying to explain the other side of the coin for consumers who hate that legislation and what it has cost their families, but the fact remains that not everyone is upset about repeal and replace. I was feeling very insulted and attacked on an area we are struggling mightily with and I'm sorry for not maintaining my cool. But it's not idiocy, a lack of compassion, or no personal stake that explains this position. This is why myself and several other posters are trying to say - maintaining some of these ACA provisions may or may not happen but it isn't like trying something different is the end of the world, given how hard this has failed many families even as it has helped others.

 

Most of the proposals I've heard for health care reform proposed on the right have been great - a number of presidential candidates floated them on their websites and I liked most of what I saw. They were worlds better in my own estimation than what we see in the present market. Giving congress and the president a fair shake to try, just as the last administration and congress had, is what I'd like to see. But that's as much pie in the sky as anything around here.

 

Round and round.

Edited by Arctic Mama
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I love how you believe everything occurs in a vacuum.

 

 

No, it's the people who think that everyone should get Medicare only that think that everything occurs in a vacuum.  Because, as I've said earlier, medical services to Medicare patients are subsidized by medical services to non-Medicare patients.  Once those subsidies are gone, either Medicare costs would go up, or medical services would go down.  

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Slight difference - I'm pretty positive whatever comes in it's place, even if it is just the free market scrambling, will be better in terms of cost and quality than what we are seeing now. And the massive inflation in costs for services that has happened in acceleration under the ACA also affects us profoundly. Not being able to afford insurance anymore affects us. This all profoundly affected us and we have been suffering under medical debt since the original problems with our plan. We still haven't paid all of it down, but we were close before all this happened.

 

No doubt some of my tone is from frustration and being ignored when trying to explain the other side of the coin for consumers who hate that legislation and what it has cost their families, but the fact remains that not everyone is upset about repeal and replace. And it's not idiocy, a lack of compassion, or no personal stake that explains it. This is why myself and several other posters are trying to say - maintaining some of these ACA provisions may or may not happen but it isn't like trying something different is the end of the world, given how hard this has failed many families even as it has helped others.

 

Most of the proposals I've heard for health care reform proposed on the right have been great - a number of presidential candidates floated them on their websites and I liked most of what I saw. They were worlds better in my own estimation than what we see in the present market. Giving congress and the president a fair shake to try, just as the last administration and congress had, is what I'd like to see. But that's as much pie in the sky as anything around here.

 

Round and round.

 

 

You have more faith than I do that there will be a replacement. I've heard it will happen simultaneously, as simultaneously as possible, as soon as possible, and we're going to go slowly and deliberately through most of 2017.  What I haven't heard is anything concrete at all.  No plan floated.  Lots of conjecture and backtracking and any time Ryan is questioned on it he trots out the phrase, "legislative mumbo jumbo."  It's not an encouraging picture. 

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These exact same objections apply to the private sector exponentially. People die in droves on private sector insurance. The care is rationed, the insurance company decides who lives and who dies, and some how the 40 million dollar bonus that is the incentive to let people die is all okay so long as it ain't the gubmint choosing to kill. Dying to enrich someone else is somehow moral and heroic in this country. My husband has worked for two non profits and four multi-nationals none of which could manage a penny properly.

 

I don't get it. I am never going to get it.

 

I understand the argument but it simply does not hold up in the face of the wretched truth of corporate America.

I know, it's horrible.

 

It's just that at least it's not all the power in one place right now, as single payer would be.

 

If we had the insurance companies but no more state insurance commissions, I'd be even more concerned.  Because then all the power would be in the hands of the insurers.  

 

The whole thing is a horrible mess, and there is no drastic proposal that will save it.  

 

I think that passing the ACA as it was formulated was a mistake, but rescinding it without an incremental alternative is even worse.  We are talking about frying pans and fires here.  Ugh.

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No, I'm quite sure that free market scrambling would be the worst possible thing we could have.

We need to have checks and balances or else the cost controls will mean that people will not get the care they need.  That is demonstrably clear.

 

Slight difference - I'm pretty positive whatever comes in it's place, even if it is just the free market scrambling, will be better in terms of cost and quality than what we are seeing now.

 

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No, I think you've misread Arctic Mama's posts somewhere along the line.  She clearly said she wanted to shred the ACA because it didn't work for her family.  Even though she dropped her plan.  And anyone who disagrees is a bleeding heart sentimentalist.  That just comes off as vindictive, no matter how you spin it.  

 

 

Barb, I think we'll also have to disagree.  I truthfully wrote about what I read.. My previous post is based on my reading/interpretation of her posts. It's a long thread, so if I've missed a post which  dealt with her shredding the ACA or her comments on bleeding hearts, please let me know. I'm not being snarky, i'm truly asking.  

 

Also, I  firmly believe that healthcare costs will not decrease until folks see the real bill and their real financial responsibility.  If no one can afford healthcare, then the costs will come down because  if you can't sell a product, then there is no profit. I know that seems simplistic, but we have to reconnect the consumer with the cost.  On a negative note, it's the same reasoning used to explain why rare concessions get no research money or time.  

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Also, I  firmly believe that healthcare costs will not decrease until folks see the real bill and their real financial responsibility.  If no one can afford healthcare, then the costs will come down because  if you can't sell a product, then there is no profit. I know that seems simplistic, but we have to reconnect the consumer with the cost.  On a negative note, it's the same reasoning used to explain why rare concessions get no research money or time.  

 

Yeah, but they can make profit off of some, and others will go without. I'm not okay with that. 

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So basically, people are saying there is no way to make sure everyone has healthcare that is of good quality. Except most other countries have it.

Why couldnt we have copied one of those countries? I don't get it and I remember being really disappointed in it when I heard about what it really was. We don't even "benefit" from it and it does hurt me as a person. It grieves me that people go without medical care.

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No, it's the people who think that everyone should get Medicare only that think that everything occurs in a vacuum. Because, as I've said earlier, medical services to Medicare patients are subsidized by medical services to non-Medicare patients. Once those subsidies are gone, either Medicare costs would go up, or medical services would go down.

Not necessarily. Price controls are part of most single payer health plans. And most of the new people on Medicare would be younger and healthier.

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Barb, I think we'll also have to disagree.  I truthfully wrote about what I read.. My previous post is based on my reading/interpretation of her posts. It's a long thread, so if I've missed a post which  dealt with her shredding the ACA or her comments on bleeding hearts, please let me know. I'm not being snarky, i'm truly asking.  

 

Also, I  firmly believe that healthcare costs will not decrease until folks see the real bill and their real financial responsibility.  If no one can afford healthcare, then the costs will come down because  if you can't sell a product, then there is no profit. I know that seems simplistic, but we have to reconnect the consumer with the cost.  On a negative note, it's the same reasoning used to explain why rare concessions get no research money or time.  

http://forums.welltrainedmind.com/topic/634599-free-birth-control-children-up-to-26-pre-existing-conditions-free-mammograms-etc-if-these-matter-to-you/?p=7393545

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Why couldnt we have copied one of those countries? I don't get it and I remember being really disappointed in it when I heard about what it really was. We don't even "benefit" from it and it does hurt me as a person. It grieves me that people go without medical care.

 

Partisan stonewalling.  And that's all I have to say about that. 

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Why couldnt we have copied one of those countries? I don't get it and I remember being really disappointed in it when I heard about what it really was. We don't even "benefit" from it and it does hurt me as a person. It grieves me that people go without medical care.

Because of the insurance lobby and because many people don't want to help pay for others to get healthcare, as expressed on this thread, especially those they don't think are taking enough personal responsibility for their health.
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Not necessarily. Price controls are part of most single payer health plans. And most of the new people on Medicare would be younger and healthier.

 

This is a really good point.  Medicare only cares for the sickest.  Risk isn't spread around.

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Why couldnt we have copied one of those countries? I don't get it and I remember being really disappointed in it when I heard about what it really was. We don't even "benefit" from it and it does hurt me as a person. It grieves me that people go without medical care.

 

"Because *I* want to be in charge.  *I* can even choose which abx I need because I'm not stupid. I don't care if it means other people won't get healthcare - they should have made healthier choices. Personal responsibility means I have to choose everything and find the best price all.by.my.self."

 

Pretty much.

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Because of the insurance lobby and because many people don't want to help pay for others to get healthcare, as expressed on this thread, especially those they don't think are taking enough personal responsibility for their health.

 

I remember discussions about universal healthcare on these boards years ago. Many like Tibbie were against it until it became personal.  I remember more than half of us back then were claiming socialism.  That didn't happen.  A lot of people who are for better healthcare now were staunchly against it back then.

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"Because *I* want to be in charge. *I* can even choose which abx I need because I'm not stupid. I don't care if it means other people won't get healthcare - they should have made healthier choices. Personal responsibility means I have to choose everything and find the best price all.by.my.self."

 

Pretty much.

That's why Obama signed it? That's what I'm asking.

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I remember discussions about universal healthcare on these boards years ago. Many like Tibbie were against it until it became personal.  I remember more than half of us back then were claiming socialism.  That didn't happen.  A lot of people who are for better healthcare now were staunchly against it back then.

 

Yup - I'm one of those who was against it before.  We haven't even had any drastically bad health issues, but I'm now realizing how much I didn't know before.

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Everyone, I am done here, not going off in a huff but just feeling like we have aired all possible views and reluctant to spend any more time on the discussion, which has already been very lengthy.  

 

Thanks for hanging in!  This is something I've been hoping to have addressed on these boards for a while, but it always seems to degenerate.  I'm really happy we could all talk this through with a minimum of fuss.

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So basically, people are saying there is no way to make sure everyone has healthcare that is of good quality. Except most other countries have it. 

 

I'm not saying this. 

 

I think we as Americans will have to give up some of our frills and subsidize education for medical students.   I hate to be personal, but you've been very open about your recent surgery.  Should we as a country have to pay for your surgery as a group so that you can have another child?  I'm thinking it wasn't the main goal but your weight loss was a factor.  In a one payer system is this a frill or a necessity?  Again, I'm sorry to ask, but it's pertinent ( IMHO) to the discussion,  What are we as a nation able to provide to its citizens? 

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