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Obamacare upheld


Jamie_B

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Being a woman is not considered a universal pre-exisiting condition; that's liberal spin. Health care reform has to be comprehensive. Overuse and unnecessary procedures, tests etc. is a huge part of the costs, over-regulation in some cases, people not taking responsibility for their own health, not changing their behaviors etc. I would support a supplemental public option that would provide emergency coverage for catastrophic and unexpected conditions. While we want the same things, we disagree on how it can be solved.

there are a lot of tests for woman that are not needed..it is actually costs more money taking all these tests!

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So many variables contribute to all of those 'sick people'.  Perhaps it's because we have a disease treatment system instead of a healthcare system since there is more money to be made treating sick people than keeping folks healthy.

 

Just food for thought... :mellow:

 

Point taken. For instance both examples I used above (sleep apnea and high triglycerides) are things that would have gone unchecked for many many years if it weren't for the insurance I had. The sleep apnea might be a bad example because I was able to do that because I hit my out of pocket max. But for my high triglycerides, I would have never known about that without free preventitive health care. I feel no different whether I take my meds or not. It didn't affect my life but I guarentee over the long haul, it would have caused heart problems for me. So basically I am treating the problem now so I don't have to fix/control it later.

 

Doesn't mean that HSA's saved my life here, just means that free preventative health care saved massive amounts of money because I would have almost definely been one of the 'sick people.' I want to make that point because although I don't think you and I would agree on everything as far as the ultimate solution with health care goes, there are certainly many things we can come together on. I would support aprogram that ensures everyone gets preventative health care for free. And I am sure that if we sat down (politics aside) we could come up with a huge list of very benefical things that would help the health care system. Hell, some things in obamacare I agree with, I just don't like it being stuck down our throats and I don't have much confidence in the organizational skills of the gov't to run it.

 

But to your point, fixing problems pays a lot more than treating them so I am guessing the lobbyists would fight tooth and nail against that legislation.

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  • 2 weeks later...

http://thinkprogress.org/health/2013/07/17/2313111/thanks-to-obamacare-new-yorkers-health-insurance-premiums-will-plunge-50-percent/?mobile=nc

 

Here’s why health insurance premiums are tumbling in New York

By Sarah Kliff, Published: July 17 at 10:12 amE-mail the writer

health_ins.jpg

Nearly all stories about the health-care overhaul and insurance premiums tend to be about the cost of health insurance rising. That’s what makes this front page story in the New York Times all the more unexpected: “Health Plan Cost For New Yorkers Set to Fall 50 Percent.

 

“Individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly,” Roni Caryn Rabin and Reed Abelson report. “With federal subsidies, the cost will be even lower.”

 

The Times posted all the insurance rates, both inside and outside the new health law marketplace, here.ny-rates-800x320.png

A headline about the health care law driving down premiums, by this level of magnitude, is a rarity. But it shouldn’t be shocking: New York has, for two decades now, had the highest individual market premiums in the country. A lot of it seems to trace back to a law passed in 1993, which required insurance plans to accept all applicants, regardless of how sick or healthy they were. That law did not, however, require everyone to sign up, as the Affordable Care Act does.

 

New York has, for 20 years now, been a long-running experiment in what happens to universal coverage without an individual mandate. It’s the type of law the country would have if House Republicans succeeded in delaying the individual mandate, as they will vote to do this afternoon. The result: a small insurance market with very high insurance premiums.

 

For years New York has had one of the most heavily regulated insurance markets in the country. The 1993 reforms not only required insurers to accept all customers; they also mandated that insurers charge everyone the exact same price. Young or old, healthy or sick, it doesn’t matter in New York: Everyone gets the same deal.

This is great for someone who is sick and old who, in other states, might get charged a sky high rate or rejected altogether. It’s not great though for the young and healthy, who end up footing a bigger chunk of the bill for all those more expensive beneficiaries.

 

“Current non-group premiums are extremely high,” consulting firm Deloitte concluded in a recent report. “These high premiums are a result of the age of this block of business, guaranteed issue, pure community rated market, no income-related subsidies, and the small size of this market.”

 

As recently as 2009, it cost an average of $6,630 to purchase health insurance on New York individual market. That’s more than $1,000 higher than any other state in the country.

 

While insurers in states such as Maryland predicted the general mix of people they cover to become significantly less healthy, as those with pre-existing conditions flooded into the individual market, the Deloitte report predicted the exact opposite. Analysts expected all the healthier people, previously scared off by the high premiums, to come into the system.

 

A less sick population generally means a less expensive population, as insurers calibrate their premiums to the amount of claims they expect to pay in the next year.

“The expected increase in the size of the non-group market post-ACA could introduce a much more typical distribution of health care needs to this market,” the Deloitte paper predicted, “Thus leading to significantly lower premiums.”

 

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http://money.cnn.com/2013/08/21/news/economy/obamacare-subsidies/index.html?iid=Lead

 

Your income: Anyone earning up to 400% of the poverty line will be eligible for a subsidy, which is up to $45,960 for an individual and $94,200 for a family of four.

The lower your income, the larger your subsidy. For instance, those making $17,235 a year will pay no more than 4% of income, or $57 a month, while those with incomes between $34,470 and $45,960 will pay a maximum of 9.5% of income, or $364 a month. The federal government will cover the rest.

Anyone earning more than $45,960 would be responsible for the entire tab on the Obamacare health plan of his choice.

In addition to premium subsidies, those making less than 250% of the poverty line, or $28,725 for a single person and $58,875 for a family of four, are eligible for extra subsidies to defray out-of-pocket costs, such as deductibles and co-payments.

When signing up for Obamacare, enrollees can apply for an advanced subsidy by estimating their income. Payments go directly to the insurer. Their subsidy level is then adjusted once they file a tax return with their actual income for the year, so in many cases they may have to repay some of the subsidy if they underestimated or get a refund if they thought they'd earn more than they actually did.

Enrollees can also opt to pay the entire premium up front and get a refund at tax time.

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Problem is they rewrote the bankruptcy laws that it doest hurt business as bad as it used to.

RTFA, Jamie. The problem is that so many folks have to declare bankruptcy for medical reasons--even though a good proportion of them HAVE medical insurance. This has been the ruination of many a family.

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I was looking over the numbers for Germany's single-payer system. Here are the basics:

 

  • everyone must have health insurance
  • if you make under 4,050 EUR per month, you have to be in the public system
  • if you make over 4,050 EUR per month, you can chose to have private health insurance
  • once you go private, you can't switch back to public
    • because private insurance is cheap when you are young
    • but then they rape you if you get old or sick or have a family
  • public covers your non-working dependents
  • private requires payment for every person covered
  • public covers you when you are out of work
  • private requires payment when you are unemployed
  • Privately insured patients get better care on paper and often in real life.
  • Publicly insured people are insured through private insurance companies
    • who compete for your business via speed of processing/efficiency, rebates
    • they also take a serious stance on trying to keep you healthy, as do the private insurers
  • FYI right now, 1 Euro buys $1.35

[attachment=1308:Screenshot from 2014-01-31 09:10:16.png]

 

So I say again, I can't hear you over the sound of my privately administered socialized medicine. :265:

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I was looking over the numbers for Germany's single-payer system. Here are the basics:

 

  • everyone must have health insurance
  • if you make under 4,050 EUR per month, you have to be in the public system
  • if you make over 4,050 EUR per month, you can chose to have private health insurance
  • once you go private, you can't switch back to public
    • because private insurance is cheap when you are young
    • but then they rape you if you get old or sick or have a family
  • public covers your non-working dependents
  • private requires payment for every person covered
  • public covers you when you are out of work
  • private requires payment when you are unemployed
  • Privately insured patients get better care on paper and often in real life.
  • Publicly insured people are insured through private insurance companies
    • who compete for your business via speed of processing/efficiency, rebates
    • they also take a serious stance on trying to keep you healthy, as do the private insurers
  • FYI right now, 1 Euro buys $1.35

attachicon.gifScreenshot from 2014-01-31 09:10:16.png

 

So I say again, I can't hear you over the sound of my privately administered socialized medicine. :265:

 

Out of curiosity, what are the income tax rates in Germany ?  While in Iceland they were near 50%.  Can't imagine they could be much different in Germany, maybe in the 40s.  With that in mind, how heavily is healthcare subsidized in Germany ? 

 

I'm trying to get a picture of a set of scales in which a person can use to judge how much a person pays out on the average here in the US versus some place in Europe like Germany.

 

1.  Is the amount taken out of the income taxes equal to the amount you would pay for healthcare had that money not come out of income taxes ?

2.  Am I blinded to the people who do not have income taxes taken out ?  As anything that taxes a person to support someone who does not pay taxes would be an obvious plus.

3.  I understand that some people need assistance and as such would not have a problem with a slight increase to support them but only if they were somehow unable or incapable or temporarily out of work.

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I ran some numbers through a German tax calculator.  this is for someone in the highest tax class (single, no children), and the salary is right at the threshold for the public/private healthcare system. 

 

Result                                     Year
     
Gross Salary                          48.600,00 €
    
Tax    
Solidarity Tax (for East Germany)        502,20 €
Church Tax (optional)                    730,64 €
Income Tax                             9.132,96 €
     
Total Taxes                           10.365,80 €
     
Social Contributions    
Social Security                        4.592,70 €
Unemployment Insurance                   729,00 €
Health Insurance                       3.985,20 €
Old-person care                          619,65 €
     
Total Social Contributions             9.926,55 €
     
Net                                   28.307,65 €

 

I couldn't say exactly how healthcare is subsidized as you'd have to include university subsidies for training doctors, nurses, etc.  Plus I don't have numbers for direct subsidies, although here are the budgets for various German ministries, with health leading the pack (3x that of defense!). 

 

There is a small segment of society here who will never get out of the welfare trap they are in.  They don't necessarily want to stay, although many (if not most) are happy to remain.  They have enough money for housing, food, beer, TV, and probably a few other things.  The best part is: they don't turn to crime -- except maybe for the drug addicts.  Society is better off paying these peoples ways as the alternative is clogged ERs full of people who should have seen a GP a month ago and stick-ups at knife point or worse.

 

 

 

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clarification: solidarity tax is paid by people living in the former West Germany, and the money goes to economic development in the former East Germany.  This tax was supposed to have been done away with a LONG time ago.  It's a sore point with many.

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I ran some numbers through a German tax calculator.  this is for someone in the highest tax class (single, no children), and the salary is right at the threshold for the public/private healthcare system. 

 

Result                                     Year
     
Gross Salary                          48.600,00 €
    
Tax    
Solidarity Tax (for East Germany)        502,20 €
Church Tax (optional)                    730,64 €
Income Tax                             9.132,96 €
     
Total Taxes                           10.365,80 €
     
Social Contributions    
Social Security                        4.592,70 €
Unemployment Insurance                   729,00 €
Health Insurance                       3.985,20 €
Old-person care                          619,65 €
     
Total Social Contributions             9.926,55 €
     
Net                                   28.307,65 €

 

I couldn't say exactly how healthcare is subsidized as you'd have to include university subsidies for training doctors, nurses, etc.  Plus I don't have numbers for direct subsidies, although here are the budgets for various German ministries, with health leading the pack (3x that of defense!). 

 

There is a small segment of society here who will never get out of the welfare trap they are in.  They don't necessarily want to stay, although many (if not most) are happy to remain.  They have enough money for housing, food, beer, TV, and probably a few other things.  The best part is: they don't turn to crime -- except maybe for the drug addicts.  Society is better off paying these peoples ways as the alternative is clogged ERs full of people who should have seen a GP a month ago and stick-ups at knife point or worse.

 

Thank you.  +1 Different perspectives on the various European programs helps formulate an informed opinion.  Still like comparing apples and oranges to a certain extent.  The one tax they pay in regards to former East Germany is not comparable but the subsidies to the universities and others are comparable.  Germany seems to operate off of a different funding model too.

 

Here is some other info I compiled on the various funding models of health care;  I'm trying to find out if it is sustainable in America without increasing taxes or other items.

 

http://en.wikipedia.org/wiki/Universal_health_care#Implementation_and_comparisons

 

Funding models

 

1.  Compulsory insurance:  The Swiss Healthcare system and U.S. Patient Protection and Affordable Care Act are based on compulsory insurance.

 

2.  Single payer:  Single-payer health insurance collects all medical fees, then pays for all services, through a "single" government (or government-related) source.

 

3.  Tax-based financing:  United Kingdom, Canada, Ireland, Australia, Italy, Spain, Portugal, Greece and the Nordic countries choose to fund health care directly from taxation alone.

 

4.  Social Health Insurance:  The system is decentralized with private practice physicians providing ambulatory care, and independent, mostly non-profit hospitals providing the majority of inpatient care. Approximately 92% of the population is covered by a 'Statutory Health Insurance' plan, which provides a standardized level of coverage through any one of approximately 1100 public or private sickness funds. Standard insurance is funded by a combination of employee contributions, employer contributions and government subsidies on a scale determined by income level. Higher income workers sometimes choose to pay a tax and opt out of the standard plan, in favor of 'private' insurance. The latter's premiums are not linked to income level but instead to health status.  (Germany)

 

5.  Private insurance:  In private health insurance, premiums are paid directly from employers, associations, individuals and families to insurance companies, which pool risks across their membership base. Private insurance includes policies sold by commercial for profit firms, non-profit companies, and community health insurers. Generally private insurance is voluntary in contrast to social insurance programs that tend to be compulsory.

 

6.  Community-based Health Insurance:  A particular form of private health insurance that has often emerged in environments where financial risk protection mechanisms only have a limited impact is community-based health insurance. Contributions are not risk-related, and there is generally a high level of community involvement in the running of such schemes.

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There is a small segment of society here who will never get out of the welfare trap they are in.  They don't necessarily want to stay, although many (if not most) are happy to remain.  They have enough money for housing, food, beer, TV, and probably a few other things.  The best part is: they don't turn to crime -- except maybe for the drug addicts.  Society is better off paying these peoples ways as the alternative is clogged ERs full of people who should have seen a GP a month ago and stick-ups at knife point or worse.

 

 

 

 

This is where welfare in the US varies from welfare in Europe (where many welfare champions here like to compare the US to in terms of "works for them, must work for us")... there is an exceptionally different dynamic here regarding an enormous segment of recipients being comfortable staying on welfare forever, having gangs of children to boost benefits, turning to crime etc etc etc and its a vicious cycle of government dependance rather than an assistance to get to a better place in life. Thats why the European systems and America cannot be compared as apples to apples when discussing welfare/healthcare and what is realistically fair to expect in comparison.

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