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The Great ObamaCare Debate, Part 237: Back to Court The Great ObamaCare Debate, Part 237: Back to Court

12-07-2011 , 03:09 PM
Quote:
Originally Posted by mikeinyonkers
Most people think doctor="millionaire" and have the life. Most people=dummies.
Average GP makes, according to brief googling, $161k/yr and average specialist makes $230k/yr. I mean, it's no union teacher job, but it seems like it's a living.

Quote:
Originally Posted by renodoc
Bingo.

Again, I'll ask the resident experts--this gets "fixed" under the ACA, right?
Setting aside all the other issues, why are you asking us? You're a doctor. This **** is your livelihood. Obamacare passed like 18 months ago. I know it's SO MANY PAGES but you've had over a year. We've had like three or four threads where you've furiously whined about how hard your life is, us resident experts have patiently explained why all the things you read in your AAPS pamphlets and hear on talk radio are wrong...

How do you not already know the answer? Shouldn't you be capable of explaining Obamacare to us?
12-07-2011 , 04:01 PM
Quote:
Originally Posted by ikestoys
This will be fun
Probably because you weren't actually in trouble
I was in trouble. I used to have a condition where my heart would race 200 beats per minute. Sat there for prob 2 hours.

and I didn't chop my finger off, but I chopped the end off and was passing out from blood loss. Still had to wait a long time and this was at a huge hospital.
12-07-2011 , 04:11 PM
I'd like to reiterate this from my mostly overlooked post about the lead plaintiff in the SCOTUS case on mandates filing for bankruptcy:

Quote:
Small business owners frequently struggle to find decent health benefits, particularly as they get older, because the market for both individuals buying on their own and small businesses is extremely dysfunctional. Insurers jump in and out of the market, broker fees drive up premiums, and plans tend to have spotty benefits. Most important of all, carriers are practice aggressive forms of “risk selection” – that is, altering coverage, raising premiums, or simply denying coverage to people with pre-existing conditions and other signs of medical risk.
Conservatives itt, do you deny that the private insurance market for individuals and small business, particularly with people over 50 - is pretty grim?

If you agree the market is pretty ugly - do you think these people will somehow be worse off under Obamacare - or do you just not think it's worth the cost to give them real insurance as enjoyed by people who work for corporations or govt (or once they hit the magic 65)?

I mean I just want to define what we're arguing here - is Obamacare going to screw small businesses, or is it too much of a free pony to give to them?

Or both somehow (please specify)?
12-07-2011 , 04:29 PM
Quote:
Originally Posted by suzzer99
I'd like to reiterate this from my mostly overlooked post about the lead plaintiff in the SCOTUS case on mandates filing for bankruptcy:



Conservatives itt, do you deny that the private insurance market for individuals and small business, particularly with people over 50 - is pretty grim?

If you agree the market is pretty ugly - do you think these people will somehow be worse off under Obamacare - or do you just not think it's worth the cost to give them real insurance as enjoyed by people who work for corporations or govt (or once they hit the magic 65)?

I mean I just want to define what we're arguing here - is Obamacare going to screw small businesses, or is it too much of a free pony to give to them?

Or both somehow (please specify)?
I'll go on record as saying the individual and small business markets are completely ****ed, and there is very little Obamacare could do to make them much worse.
12-07-2011 , 04:44 PM
My uncle is a general contractor who's 55. His self-employed private insurance premiums are beyond what he can currently pay because he shattered his ankles 15 or so years ago and has occasional ongoing complications. For the next 10 years his two options are - go without health insurance or find some corporate job. Obamacare will mean a world of difference to him.

In before "Why do you want to destroy small businesses with duh free ponies?"

Last edited by suzzer99; 12-07-2011 at 04:50 PM.
12-07-2011 , 04:59 PM
Quote:
Originally Posted by Bluffzorz
I was in trouble. I used to have a condition where my heart would race 200 beats per minute. Sat there for prob 2 hours.

and I didn't chop my finger off, but I chopped the end off and was passing out from blood loss. Still had to wait a long time and this was at a huge hospital.
I'd suggest not lying any further. You need to lose a ton of blood to be passing out from blood loss. That doesn't happen from a finger wound.
12-07-2011 , 05:00 PM
Quote:
Originally Posted by suzzer99
My uncle is a general contractor who's 55. His self-employed private insurance premiums are beyond what he can currently pay because he shattered his ankles 15 or so years ago and has occasional ongoing complications. For the next 10 years his two options are - go without health insurance or find some corporate job. Obamacare will mean a world of difference to him.

In before "Why do you want to destroy small businesses with duh free ponies?"
Our small business has about 20 people with health insurance. Since 2004, every year except one has had an increase of 12% (most often around 16%) or more, and the one year that we only got a 4% increase, the following year's increase was 55%. When we shopped for a better price, the next cheapest would've been an 85% increase.

And we have a young employee base. I can't imagine having an older set with multiple long term issues. Actually, I can. I can imagine having to drop health insurance as an option.
12-07-2011 , 05:09 PM
Quote:
Originally Posted by suzzer99
My uncle is a general contractor who's 55. His self-employed private insurance premiums are beyond what he can currently pay because he shattered his ankles 15 or so years ago and has occasional ongoing complications. For the next 10 years his two options are - go without health insurance or find some corporate job. Obamacare will mean a world of difference to him.

In before "Why do you want to destroy small businesses with duh free ponies?"
death panels though...
12-07-2011 , 05:18 PM
Quote:
Originally Posted by Ineedaride2
Our small business has about 20 people with health insurance. Since 2004, every year except one has had an increase of 12% (most often around 16%) or more, and the one year that we only got a 4% increase, the following year's increase was 55%. When we shopped for a better price, the next cheapest would've been an 85% increase.

And we have a young employee base. I can't imagine having an older set with multiple long term issues. Actually, I can. I can imagine having to drop health insurance as an option.
I used to work for a small computer consulting firm of like 25 ppl - 2 women and the rest young healthy males under 40, most under 30. My boss was pulling her hair out at how much her premiums went up each year. Also the insurance she could afford was getting crappier and crappier.

On the flip side a couple years later I went to work for a very large IT consulting/contractor firm that is also mostly young males - had killer insurance for zero out of my pocket and the company was paying $250/month for me.

The status quo in group health plans is really hosing small businesses to the benefit of large companies.
12-08-2011 , 07:54 PM
Quote:
Originally Posted by MrWookie
PPACA didn't really do that at all.
12-08-2011 , 09:21 PM
Quote:
Originally Posted by suzzer99
I'd like to reiterate this from my mostly overlooked post about the lead plaintiff in the SCOTUS case on mandates filing for bankruptcy:



Conservatives itt, do you deny that the private insurance market for individuals and small business, particularly with people over 50 - is pretty grim?

If you agree the market is pretty ugly - do you think these people will somehow be worse off under Obamacare - or do you just not think it's worth the cost to give them real insurance as enjoyed by people who work for corporations or govt (or once they hit the magic 65)?

I mean I just want to define what we're arguing here - is Obamacare going to screw small businesses, or is it too much of a free pony to give to them?

Or both somehow (please specify)?
I acknowledge that the health insurance market for individuals and small businesses is grim, and that Obamacare will likely make many people in that situation better off. But I think that even if Obamacare makes nearly everyone better off and is a huge net benefit to society, it still is not justified because it violates peoples' rights (via the individual mandate, etc.) I guess this question wasn't directed to me though, because I am a libertarian, not a conservative.
12-08-2011 , 09:29 PM
Do you believe in taxation at all? Because the mandate is just a new tax with a full tax break for compliance. I mean you could say "we're raising taxes for Obamacare and giving people a tax break for getting health insurance" and it would function the exact same way as a mandate.

I mean unless you're one of those all taxation=theft AC-types, it seems kind of silly to say you oppose a program - even if it showed a huge net benefit to society - because of the wording of a new tax. It would be different if by "forcing people to get health insurance" we meant by arresting them if they didn't comply. Then you're talking rights issues. But a modest tax penalty for not doing something is really hard to argue as some kind of egregious trampling of rights imo.

Forcing people to get car insurance is much much more intrusive because you could go to jail for driving w/o insurance (I think - maybe after a few violations?). Either way it's a misdemeanor violation vs. a tax penalty. Big big difference.

Also how do you reconcile the fact that plenty of people are gaming the system right now by using the fact that hospitals have to treat anyone in critical condition, combined with US bankruptcy courts, as discount catastrophic health insurance?

Last edited by suzzer99; 12-08-2011 at 09:46 PM.
12-08-2011 , 10:46 PM
Hr Bill 3200 RFId Chip?
12-08-2011 , 10:58 PM
Quote:
Originally Posted by suzzer99
Do you believe in taxation at all?
No. I am one of those AC-types. I agree that the individual mandate is no more onerous than being forced to save for my own retirement (Social Security), or any number of other similar programs.

Quote:
Also how do you reconcile the fact that plenty of people are gaming the system right now by using the fact that hospitals have to treat anyone in critical condition, combined with US bankruptcy courts, as discount catastrophic health insurance?
This is a separate issue. I think hospitals should be able to turn away people who can't pay, for one thing.
12-08-2011 , 11:04 PM
Quote:
Originally Posted by MrWookie
That act made health care more expensive, not less. The health insurance companies aren't eating the extra cost.
12-08-2011 , 11:06 PM
MRI cost

Can anyone explain this? How times a day can a MRI machine be used(without damaging the machine)?
12-09-2011 , 12:08 AM
Quote:
Originally Posted by jogsxyz
That act made health care more expensive, not less. The health insurance companies aren't eating the extra cost.
You don't even know what these alleged extra costs are.
12-09-2011 , 12:41 AM
Quote:
Originally Posted by MrWookie
You don't even know what these alleged extra costs are.
So you're telling me that a person with a preexisting condition isn't costing the insurance company money. Is that it?
12-09-2011 , 04:06 AM
Quote:
Originally Posted by sards
No. I am one of those AC-types. I agree that the individual mandate is no more onerous than being forced to save for my own retirement (Social Security), or any number of other similar programs.



This is a separate issue. I think hospitals should be able to turn away people who can't pay, for one thing.
Ok well at least you're consistent and logical.
12-09-2011 , 04:10 AM
Quote:
Originally Posted by jogsxyz
MRI cost

Can anyone explain this? How times a day can a MRI machine be used(without damaging the machine)?

MRIs cost $160 in Japan
. Reason? Government said it wouldn't pay any more than that, health tech companies found a way to make it work.

Quote:
JOFFE-WALT: Hear that number: $160. And just in case you forgot, Dr. Forman's MRI: $1,700. So, how does Japan work this incredible magic? By law. The government sets the prices. But how does that work? I mean, costs are costs, right. We have to buy MRI machines. So does Japan. We have to pay the electricity bill. So does Japan. There are staff and supplies. You can't just force cost to be low. If you could, you'd make it a dollar for an MRI. I mean, how is it possible that you're doing that procedure for so much less than what do it for?

Prof. YEKAGAMI: Two thousand dollars, I would think, is a state-of-the-art MRI, most expensive type.

JOFFE-WALT: So, we have better machines? They are different machines.

Prof. YEKAGAMI: Well, in general you have some more expensive types.

JOFFE-WALT: In the U.S., we tend to demand the best, state-of-the-art machines available. But they are not that much fancier. It doesn't explain the more than tenfold difference in price. So, another possible explanation can be found by typing MRI into a Japanese search engine. This is something I asked Dr. Michi Kokinora Bruno(ph) to do. She is a Japanese trained neurologist. And she gets all these ad results, including one that offers to satisfy your MRI needs in a spa-like environment.

In Japan, we can buy a less fancy MRI machine and then you can make up the cost fast because MRIs are incredibly popular. Now, it's unclear if MRIs are popular because they are cheap or if they are cheap in part because they are popular. So, I have two more quick theories for you. We here in the U.S. pay our radiologists much more than Japan does. So that's the cost. And then there is this from Professor Gerard Anderson at Johns Hopkins.

Professor GERARD ANDERSON (Health Policy and Management, Johns Hopkins University): I'm talking about the MRI machine. When you go and you buy it from Siemens or General Electric or any of the manufacturers, you will be paying about twice as much in the United States for the exact same machine.

JOFFE-WALT: Japan sets the price they pay for MRIs super low. And so to get into the Japanese market, the manufacturers lower their prices. They charge more here in the U.S. because we will pay more. How come? Well, I called a number of American hospitals and doctors and I got basically two reactions. The first and most popular: a shrug. We could never get those prices. That's just how it is. And the second: some were surprised. Just like that radiologist getting his first MRI. Health care prices even to them are something of a mystery.
Remember, govt can't control prices. Only the free market can do that for completely inelastic needs like most health care. All hail free market.
12-09-2011 , 07:27 AM
Quote:
Originally Posted by jogsxyz
Obamacare is government takeover of health insurance. And we all know how efficiently government operates. lol
Quote:
Originally Posted by jjshabado
Once again, I'll ask for claims to back this kind of statement up. There are many other countries with more government intervention than the US that spend significantly less money for more-or-less equivalent (and sometimes better) patient outcomes. What's your explanation for this?
Quote:
Originally Posted by jogsxyz
Where's your proof that your statements are accepted by all as fact?
Quote:
Originally Posted by jjshabado
I don't care if they're "accepted" as fact, but one example has already been well sourced in this thread.

Canada:
1) Greater intervention by the Government (not sourced - but I assume you'll accept this)
2) Significantly Lower per-capita spending (approximately half as much as the US)
3) No significant differences in patient outcomes (noted in a number of studies but I linked to one particular one earlier in this thread).

The same can be said for a number of other countries in the world.
jogs, now that you're back - would you care to follow up on this thread?
12-09-2011 , 09:48 AM
Quote:
Originally Posted by jogsxyz
So you're telling me that a person with a preexisting condition isn't costing the insurance company money. Is that it?
it's amazing to me that we are 2 years removed frmo the passing of "obamacare" and have debated it ad nauseum in this forum and yet this is still the train of thought you are operating with. it may actually help me understand all of the irrational hatred a little more.
12-09-2011 , 09:52 AM
Quote:
Originally Posted by suzzer99

MRIs cost $160 in Japan
. Reason? Government said it wouldn't pay any more than that, health tech companies found a way to make it work.

.
My own guess and it is only a guess is in the U.S. many MRI machines are often sitting idle, not in use very often. Every hospital wants to own their own MRI machine. Good for the hospital's rep. Good for the company that makes MRI machines. Bad for the patients who need to pay the high prices.
12-09-2011 , 09:56 AM
http://www.ehow.com/about_4731161_mu...ines-cost.html

Interesting cursory view into costs and profit potential of an MRI machine.
12-09-2011 , 10:08 AM
Quote:
Originally Posted by jogsxyz
My own guess and it is only a guess is in the U.S. many MRI machines are often sitting idle, not in use very often. Every hospital wants to own their own MRI machine. Good for the hospital's rep. Good for the company that makes MRI machines. Bad for the patients who need to pay the high prices.
Doesn't this actually go against traditional economics?

If there's a high supply of something - shouldn't the price go down?

      
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