Obamacare, Is it worth it?

[Kobuk]

http://obamacarefacts.com/obamacare-facts.php

It's supposed to help get people affordable health care, plus offer lots of other incentives, etc. But here's the thing: Will it work? Do Americans really need it?

Shouldn't we all be allowed to choose our own health care and insurance? What gives the government the right to dictate to Americans that we MUST have it or we face a penalty/fine?  Who the hell are they to tell the American citizens what we need and don't need? As an American citizen, I should have the right to choose whether I want health insurance or not, as well as what type of insurance. The gov't be damned and they can butt out! 

It's lucky that I do have health insurance from my work place right now. Otherwise if I didn't, I would have been fined $100 when doing my taxes today, and that $100 would have come out of my refunds.

[Mylo]

I think another question to ask as well is this.  If a person who doesn't have health insurance gets hurt severely, then what should society do, if anything, should he not be able to afford medical care?

[Alsek]

I think another question to ask as well is this.  If a person who doesn't have health insurance gets hurt severely, then what should society do, if anything, should he not be able to afford medical care?

     People like to imply that if we didn't use force and violence to make people pay into a specific program they may or may not agree with,  than no-one would ever voluntarily help another human being.  I disagree.  I have nothing against helping my fellow man,  i just think it out to be set up in such a way where i'm not forced to be apart of it,  or to pay for things i'm strongly morally opposed to.

     There are many who believe that the whole reason healthcare is so expensive is simply because hospitals know that people will pay whatever they have to in order to get treatment,  and if they can't pay it themselves the government will step up and pay it.  If this wasn't the case,  maybe prices would lower.

Just look at the difference in cost between veterinary medicine and human medicine.  It's the same exact materials,  procedures,  techniques,  requirement of time,  money,  and effort for training to become a vet,  and running costs.

Why is veterinary medicine exactly the same thing as human medicine,  but usually 1/10th of the cost?

Why do our doctors use expensive,  patented painkillers that cost an absolute fortune when there are much cheaper alternatives that work in many of the same situations like ketamine?  Ketamine is cheaper than dirt.

[Mylo]

Why is veterinary medicine exactly the same thing as human medicine,  but usually 1/10th of the cost?

Why do our doctors use expensive,  patented painkillers that cost an absolute fortune when there are much cheaper alternatives that work in many of the same situations like ketamine?  Ketamine is cheaper than dirt.

Capitalism.

[Alsek]

Capitalism.

Healthcare is one of the markets in the US where we /don't/ have real capitalism,  Mylo.  We have constant government interference and favoritism,  and a massive amount of lobbying.  The existence of the FDA is proof of that.

That is to say,  capitalism is why veterinary medicine isn't 20 times more expensive.  No-one would take out a mortgage to pay for their hampster's cancer surgery.

[Mylo]

Capitalism.

Healthcare is one of the markets in the US where we /don't/ have real capitalism,  Mylo.  We have constant government interference and favoritism,  and a massive amount of lobbying.  The existence of the FDA is proof of that.

I guess I was thinking more of corporatism than capitalism.  Whoops...  

So, ... EDIT:


Corporatism

[Alsek]

Corporatism

Eexxxxactly.

     Corporations are the creation of the government.  They're hypothetical persons to whom blame can be assigned that are created when the government gives businesses this protected status.  Those businesses then easily get away with things like massive amounts of lobbying,  and offering decision-makers jobs in the future if, "their political views happen to align at that time as is shown by their voting record,"  and sending former employees to go work for the FDA.

The government is given the power to make the choices.  Corporations take advantage of that power and corrupt it for their gain.  So, the proposed solution to this problem is to...  Increase government involvement and power in this market?  Remove capitalism,  the part that's keeping the comparable industry of veterinary medicine cheap and accessible?

[McMajik]

I've seen people use a comparison with our NHS in the UK as a "worst case scenario: for the outcome of obamacare. While I don't know the details of Obamacare, I want to mention that I've heard some shocking things about the state of healthcare in the US (mainly relating to extortionate bills for essentially doing nothing or saying "you're fine"), and that we are overall ~very~ happy with our system. :|

[Narei Mooncatt]

What gives the government the right to dictate to Americans that we MUST have it or we face a penalty/fine?

Nothing does. And apparently the Supreme Court was about to rule that way too, until Justice Roberts switched sides. Many think he caved to political pressures because it's known he keeps an eye on the media during a case, unlike many of the others to limit outside influences.

[Yip]

Question 1: if someone requires medical attention but cannot afford to pay, how should this be handled?
A) let 'em die.
B) give them medical attention anyway

I hope we can all agree that "A" is a horrible solution.  So, we give them medical attention anyway. Well, SOMEONE has to pay for that. Use of the medical equipment and supplies and the time of the medical staff are not unlimited, and they are not free. Thus...

Question 2: How do we pay for the medical care of those that cannot pay for themselves?

In order for someone's complaints about Obamacare to be taken seriously, they have to have a good answer for Q2 or have answered "A" for Q1.  Otherwise their complaints can be safely ignored as they do not help us towards a solution. And most of the complaints I've heard fall squarely into that "useless" territory.

[Narei Mooncatt]

The answer to Q2 is obviously complex, but I think it can boil down to some simple concepts that others smarter than me can flesh out into workable situations.

Right now, there are programs in place that I think most hospitals can help people get the financial aid they need in worst case scenarios. Not sure how prevalent they are, but I've heard some hospitals have a "charity department," for lack of a better term, for just these situations. For relatively smaller bills, hosptials are also able to work out payment plans and perhaps substantially reduced rates. Unless you're going to the ER for every little sniffle and sneeze, a person's typical yearly medical bills shouldn't be all that high unless they're getting up in age or have a chronic condition. Take out the needless excesses likes these, and I think the number of people actually needing the kind of help Q2 is implying is actually fairly small and easily managed.

For those that would abuse the ER system (I could explain some stories I've heard in the past of people using it and the ambulance service as a free taxi), many small clinics are now opening up that you can get more affordable care for common issues and preventative care like vaccinations. Many are also open extended hours and weekends so you aren't forced to the ER if your regular doctor's office is closed. There's also free "ask a nurse" hotlines set up that you can call for advice on issues so you may be able to treat yourself either with OTC meds or a cheap clinic visit instead of an urgent care place.

Then there's cost control of the industry in general. I don't think government can step in and try to regulate cheaper prices like Obamacare is attempting, or in any other industry. I think they should step out of it and actually relax some regulations. Same goes for how litigious our society is. Doctors and hospitals are so hamstrung with regulation and fear of lawsuits, they tend to perform a lot of tests that don't really accomplish anything and their insurance rates are through the roof. Education and responsibility on the part of the patient is also needed. Prime example: When we had our first kid, it was your standard hospital delivery and 3 day or so stay to the tune of US$12k with everything going normal. Fast forward to our third and after lots of personal research on our part, we decided to do a home birth with a midwife that cost a fraction of that amount and was a much more pleasant birth. One big deciding factor was the hospital tried to force a lot of things on us that we didn't want, even to the point of malpractice due to a "doctor" that seemed more concerned about beating a snowstorm home than how she treated Allie during labor and causing complications in what should have been a normal birth. The midwife could do most of the same prenatal checkups as a regular OBGYN, and even had all the neccesities for the delivery minus some of the more elaborate tools that a hosptial has that you really don't need. Obviously something like that isn't for everyone, but simply going along with status quo isn't helping the cost issue either. I'd probably rank getting people to simply be more responsible with their healthcare choices at the top of the list of things that need changing.

Or, we could simply go the Facebook route and try to get a million "Likes" any time we need care so a hospital will do it for free.  ...

[Yip]

The answer to Q2 is obviously complex, but I think it can boil down to some simple concepts that others smarter than me can flesh out into workable situations.

This is why Obamacare is absolutely a good thing. Sure, it's not a perfect solution, but it's a start and it gets people working on finding better solutions to fix it.  Simply wailing over not liking it isn't good enough. We need real solutions here.

...and perhaps substantially reduced rates.

There is a hidden problem there that you seem to miss. This stuff isn't free so they can't simply reduce the rates. That extra money has to come from somewhere. I think the common way it's handled is by jacking up the price for everyone else. So if you use the medical facilities for any reason you are being forced to pay for the medical care of others. And being forced to pay for the medical care of others is exactly the same argument I've heard against Obamacare. (from you I might add)  Its as though you are fine with that sort of thing as long as it's hidden.

Also, charity is nice, but if that was enough to pay for these things, I don't think we'd have a healthcare problem in the first place. So obviously we need something more than just charity here.

...Take out the needless excesses likes these, and I think the number of people actually needing the kind of help Q2 is implying is actually fairly small and easily managed.

Actually, Q2 is a simplified version of the issue. So what it's implying is actually much, much larger than you'd like to think. It's not something you can just write off.

When even a simple doctor's visit where the patient learns next to nothing ends up costing them a couple hundred bucks, that's a very strong incentive to make the person avoid seeing a doctor unless it's absolutely necessary.  This is exactly the situation I'm in, and I'm sure there are hundreds of others in the same situation. I have lots of things I'd like to get checked out, but don't because I can't afford throwing away so much money like that.

Preventative and consultation visits need to be extremely low cost so that it never acts as a barrier as it now does. But like I said, the doctor's time isn't free. Someone has to pay for it. And thus you get right back to Q2. It's not just about emergencies.

Or, we could simply go the Facebook route and try to get a million "Likes" any time we need care so a hospital will do it for free.  ...

What the hell is that even suppose to mean?  Yes, I know you meant this as a joke, but it ignores the core piece of this whole healthcare issue, so it's is not only not helpful (which I don't expect a joke to be anyway), but it's actually anti-helpful by drawing people away from the core issue here.
 
There is no such thing as getting it for free: someone has to pay for it.

[Aakosir]

I think another question to ask as well is this.  If a person who doesn't have health insurance gets hurt severely, then what should society do, if anything, should he not be able to afford medical care?

Pft. That's not really a question. If you don't have insurance and can't afford it the state will foot the bill. It happens all the time where I live. There are hundreds of immigrants who cannot speak English yet waltz right in to the ER for a runny nose and have the entire bill taken care of. And guess what, the tax payers have absolutely no say in it. Just like everything else the government has been passing.

As Kobuk said we should have a right to deny health care. For many reasons, the biggest being that we cannot afford it! My mom cannot afford health insurance and is self employed, but makes too much to receive state aid. But she will be fined next year because she does not have health insurance! Now... what makes the government think that she will be able to afford that fine?!

And as Asek brought up, healthcare does not have to be so expensive! There are tons of alternatives to the medicines that doctor's prescribe, but they choose the give us the most expensive type. My grandmother was paying over one hundred dollars for one prescription, her asthma medicine. And that was after her insurance covered some! Does it really need to be so expensive? I really doubt it.

Government healthcare could work. COULD. If 1, the entire country was not in a depression 2, if everyone was taxed equally and 3 if the unemployment rates were lower. Oh, and if there were less ILLEGAL IMMIGRANTS cashing in on our benefits! So yea, take care of those four issues and it may work.

[Mylo]

Government healthcare could work. COULD. If 1, the entire country was not in a depression 2, if everyone was taxed equally and 3 if the unemployment rates were lower. Oh, and if there were less ILLEGAL IMMIGRANTS cashing in on our benefits! So yea, take care of those four issues and it may work.

We aren't in a depression.  The recession ended years ago...

[Narei Mooncatt]

There is a hidden problem there that you seem to miss. This stuff isn't free so they can't simply reduce the rates. That extra money has to come from somewhere. I think the common way it's handled is by jacking up the price for everyone else. So if you use the medical facilities for any reason you are being forced to pay for the medical care of others.

Medical facilities negotiate lower rates all the time with patients paying for things themselves. Even if you take out the "being nice for the patient" part of it, it's still less hassle and paperwork they have to deal with and don't have the expense of working with the insurance company. If it comes to it, I think most people agree in reasonably higher rates to cover some of the otherwise unpaid for services (be it lack of charity or simply the patient not willing to pay a bill). What is "reasonable" would be worked out through regular market forces as people evaluate their options when it comes to needing services. It puts competition into the mix.

And being forced to pay for the medical care of others is exactly the same argument I've heard against Obamacare. (from you I might add)  Its as though you are fine with that sort of thing as long as it's hidden.

Here's where you're mistaken. A pricing system that builds in those aforementioned cases would be done on a facility by facility basis, allowing us to shop around. It's a common buisness practice and neccessity for pretty much every industry to cover a certain amount of theft and/or charitable giving. Obamacare would force us into paying higher rates, via our insurance without giving us a real choice when shoping around (not sure if it has affected actual service pricing yet). They want everyone in a cookie cutter plan, which is a concept that never works for a nation wide issue like this. The Hobby Lobby fight is a good example. If I didn't make that distinction clear in my prior debates on this, I hope it is now. I've heard a number of reports of rates already going through the roof, mine alone would now be about half of my take home pay through my company's family plan and has forced us off my good private coverage and onto a state subsidised plan. Yes it's cheap at someone elses expense, but I'm not happy about it and I want to do it my way without it making me go completely broke. Before Obamacare, it was a good workable plan.

Also, charity is nice, but if that was enough to pay for these things, I don't think we'd have a healthcare problem in the first place. So obviously we need something more than just charity here.

I adressed several cost control/reduction strategies in my post that you quoted from. Perhaps I should have listed them first instead, but that post wasn't meant for people to look at each item idividually. It was meant to be a comprehensive plan, where everything should be considered as a whole. Otherwise, yes you could make the arguement that charity wouldn't solve the whole problem. With my other ideas in place, not only would you have less need for assitance of any kind, those that do need it wouldn't need as much to cover their expenses.

[Yip]

Here's where you're mistaken. A pricing system that builds in those aforementioned cases would be done on a facility by facility basis, allowing us to shop around.

With health care, you very often don't have many options for shopping around. In cases of emergencies, it's whatever place you can get to the fastest (or are taken to). And even when it's not an emergency, "shopping around" could end up costing you a fair amount in consultation fees. Most places won't discuss that stuff with you for free.

Obamacare would force us into paying higher rates, via our insurance without giving us a real choice when shoping around (not sure if it has affected actual service pricing yet).

To my knowledge, there is nothing about obamacare that forces you to go with a particular doctor or even to carry particular insurance. Yes, it says you have to have insurance, but it doesn't tell you which to have. You can whine that the cost of your normal insurance has went up so you can't afford it thus making you have to go with a cheaper option, but that's not written into the plan, and so it's not fair to blame it. Especially since there are certainly many other factors involved and it's quite possibly a temporary thing. Once things settle in, the prices might go down. In fact, if lots of people move away from this other insurance, it'll have to go down if it wants to stay competitive.

It was meant to be a comprehensive plan, where everything should be considered as a whole. Otherwise, yes you could make the arguement that charity wouldn't solve the whole problem.

I know you are not arguing for a purely charity system, but at the same time, you should be able to tell that I'm not arguing for a system free of charity. That's ridiculous. What I was saying is that there definitely has to be a non-charity portion of things and that is where the discussion should be focused.

With my other ideas in place, not only would you have less need for assitance of any kind, those that do need it wouldn't need as much to cover their expenses.

Wait... what other ideas? It sounded to me like you were just listing things that are driving up the prices and I mostly agree with you about that. However, you didn't include anything about what to do to combat these things other than an example of using a midwife, but that's specific to childbirth which is only a very small portion of healthcare, and besides, like you said even that isn't for everyone. That's hardly "other ideas" that can be put in place to solve the healthcare problem.


In talking with you, it seems to me like you want a system where everyone pays their own way. And while on the surface that sounds great, and so I can see why someone might want that. But when you dig a little deeper, it's actually supporting the "let 'em die" option from Q1 above. And so it is not a good solution.  It seems to me like much of the objection to obamacare, or pretty much any proposed healthcare system for that matter, is based primarily on a fear of socialism. But the thing is, the basic concept of socialism isn't a bad thing. Yes, a pure socialistic system is a bad thing, but so is eliminating it entirely.  Think of living conditions as a range, what socialism does is raise the floor on that range. This is a good thing. It only starts to be a bad thing when it removes the incentive for people to work to rise above that floor.  With the pre-obamacare system, the floor is essentially rock bottom, and that's a huge problem.

Like I was saying before, people should be able to go in to get things checked out without having to pay or with paying very little. Otherwise it acts as a barrier keeping many people from doing so, and this of course leads to a greater number of more serious health issues down the line since these things are not being caught early when they are most easily dealt with.  And while I dislike the "forced to get insurance" route they've taken with Obamacare, I recognize that a system where everyone is forced to pay into it is pretty much essential to make sure that everyone can afford the care when they need it, and that includes preventative care.

[Aakosir]

Government healthcare could work. COULD. If 1, the entire country was not in a depression 2, if everyone was taxed equally and 3 if the unemployment rates were lower. Oh, and if there were less ILLEGAL IMMIGRANTS cashing in on our benefits! So yea, take care of those four issues and it may work.

We aren't in a depression.  The recession ended years ago...

And how not? Many business have gone broke and same with families. There have been hundreds of thousands of housing being foreclosed and hundreds of thousands of jobs being cut. Federal employees are being cut hours. My brother-in-law is a federal police officer and has had 8 hours cut from his work week. So has my brother who is also a Federal worker.

http://www.federaltimes.com/article/20130226/AGENCY01/302260004/Science-faces-sequestration-cuts

http://www.federaltimes.com/article/20130308/AGENCY01/303080002/Labor-Dept-employees-get-furlough-notices

http://www.federaltimes.com/article/20130304/AGENCY01/303040004/Agencies-begin-outline-furloughs-other-sequester-cost-cutting

And don't even get me started on the military cuts that have happened. But just to outline the Army has cut 50,000 soldiers and the Marines have been cut 20,000 troops. They cannot afford to serve three meals a day over in the Middle East and even here they cannot afford equipment for the general maintenance.

And the education budget has also been cut. I think that will be an easy one to see. Yet the politicians keep getting an even bigger paycheck.

[Mazz]

Question 1: if someone requires medical attention but cannot afford to pay, how should this be handled?
A) let 'em die.
B) give them medical attention anyway

I hope we can all agree that "A" is a horrible solution.  So, we give them medical attention anyway. Well, SOMEONE has to pay for that. Use of the medical equipment and supplies and the time of the medical staff are not unlimited, and they are not free. Thus...

Question 2: How do we pay for the medical care of those that cannot pay for themselves?

In order for someone's complaints about Obamacare to be taken seriously, they have to have a good answer for Q2 or have answered "A" for Q1.  Otherwise their complaints can be safely ignored as they do not help us towards a solution. And most of the complaints I've heard fall squarely into that "useless" territory.

Question 1:
Luckily the government didn't just let me die and after fighting I got government insurance to pay my cancer treatments.
Without them I could not afford the simple medication needed to literally make my body absorb calcium so I don't go into hypocalcemic shock and die.
Sadly the same government wouldn't give my brother in law help because a stray bullet from some gang fight that broke out in a bar he was celebrating a promotion at his job (contractor) at the same moment hitting his hand and totally making it useless and unable to do the job that he just got a promotion in. Broken sentence I know, he got shot in the hand because of wrong place, wrong time from someone he didn't know who missed someone else he didn't know in a public venue.

Because of Obama Care, I can get a full time job and the insurance company CANNOT tell me that cancer disqualifies me from having health insurance.
I AM NOT LONGER GOING TO BE PUNISHED FOR CHILDHOOD CANCER THAT WASN'T FOUND UNTIL I WAS 21. I'm 29 this year and I can finally get a full time job (when places start hiring again or when I get my Bachelors and go work in a lab or teach, to help our environment keep us as a species alive) and I cannot be told "oh pre-existing condition, lol no go away"

My brother in law can finally have the surgeries on his hand so he can move his fingers enough to hold a cup and hopefully be able to start typing on a computer so he can switch from hard labor to working with computers once his fingers can start bending enough to do so. He can help produce music like he was obviously born to do. Because of Obama care he finally can get help and his broken and useless hand can get the surgeries he needs.

We can both work towards being worth the money that was spent on us when tragedy struck and ruined us and made us useless...

i could care less how many people complain it's too close to socialism and horrible and the worst thing in the world or whatever else someone has told me the same day this new system has paid the money to keep me alive.

I can live, my brother in law can live.
MILLIONS OF OTHER PEOPLE CAN NOW LIVE.

I want healthcare that works for the people... we pay taxes when we're healthy but when we get sick we get help and survive and heal and even if we're in a wheelchair and broken as long as we're working and we pay the taxes we get health insurance without being told "no you cost too much to let live"

Question 2:...
We pay taxes when we're healthy and then those taxes pay for us to be ok when we aren't...

I promise, it's better to wait in line to see a doctor or get medications because of a "socialist ideal" than to sit at home and cry because my chest hurts from the illness attacking my body that will kill me rather quickly because I can't pay the $200 a month to get the medication that keeps me alive.

Argue it all you want... those of us this type of health care keeps alive hope daily it's not taken away.
--

P.s. we are far from a depression and far from a recession now... the country is still struggling but all the countries are... it doesn't mean you can just let someone who is sick die.

[Corvus Corone]

I'm on the front lines of Obamacare. Every day.

[Rocket T. Coyote]

Premiums are likely to skyrocket, precisely because of people with pre-existing conditions. The gummint could simply have just set up a program to deal with those special cases. Tort reform is another option which could lower costs, but the trial lawyers would fight that severely. There's big money in suing doctors and medical supply firms.
 
I don't like the idea of a government database on personal healthcare. Everything you tell your medical professional will go in there to later be accessed by some bureaucrat who someday may be deciding whether or not you will get vital medicine or treatment. That database could also be hacked or even used in unpleasant ways.