Let Lower Income "Pay Their Fair Share"!

[Anonymous]

Anonymous wrote:

Anonymous wrote:Amazing how iberals bend over backwards to ensure that the poor don't have to contribute a cent to their care while not giving a flying F about the middle class struggling to make ends meet. For example....

When Obamacare was being rammed down Americans' throats, I told my neighbor I was against it. She called me "heartless," and then proceeded to tell me about a poor friend of hers, earning $20 an hour, who couldn't afford health insurance. She told me that if this friend has a medical situation, she MIGHT HAVE TO SELL HER HOUSE. (She bought the house years ago, when she had a good job.) When I asked if she was looking for a better job, I was met with complete disdain and told how she couldn't find a better job.

Flash forward. Her friend now has free insurance and medical care, and is still in her house. I, on the othe hand, am crashing under an overpriced insurance plan (they've got to charge middle class more to make up for the total coverage they're providing the low esrners), plus thousands of dollars of medical bills the insurance doesn't cover. It's adding up to nearly 30% of my moderate tske-hime pay, and I can't continue indefinitely. Probably within a year or so, I'll need to sell my house. When I told that same neighbor that my medical costs were so high I might have to sell - she said, with a hint of contempt...."well, instead of complaining, just get a higher-paying job."

All the defense for the lower class and to Hell with the middle class. We will see more of it under Hillary, as she shifts even more money from the middle to the lower.

Again: you are attacking the wrong people. Why try to get $10 out of a homeless person seeking medical care when you could have the wealthy pay more? Redirect your anger towards the wealthy.

Reply:

The Anderson model of healthcare utilization is dependent on three factors: predisposing factors, enabling factors, and need. Studies in MediCARE patients show when access is unrestricted and completely free (an enabling factor) elective procedures increase while producing NO corresponding changes in health status, morbidity, or mortality. This was demonstrated across all ethnicities and incomes and in patients who had insurance prior to accessing Medicare benefits.

In other words, completely free care tends to drive utilization up with unnecessary treatment and little corresponding increases in patient health.

A small payment helps shift accountability for healthcare utilization to the final healthcare consumer, which is necessary when healthcare is delivered in a for profit system - which is why Medicare users who were insured before age 65 tend not to get elective procdures prior to the more generous coverage of Medicare. When users don't have incentives to shop and make careful decisions, free market forces are removed from the system. When sellers are rewarded for selling more healthcare instead of wellness, another free market driver is removed. Furthermore, not only are there no rewards for wellness, there are no incentives, penalties, or requirements for compliance on high utilizers who have chronic conditions which are amenable to management. These are some of the factors for increasing healthcare costs.

Conversely according the the Anderson model, barriers and access (enabling factors) have been removed for one class of patients and increased for another group of patients, through premiums, increased cost sharing, and high deductibles. Ideally, Obamacare adds access, or enables care for ALL groups, but this has not been the result of the legislation.

Adding access for one group and effectively disabling access for another group is NOT providing effective universal healthcare for our citizens. Obamacare is a failed system and will never be able to work in a free market-for profit healthcare industry.

Thank you for your intelligent contribution to this discussion.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:http://www.politifact.com/truth-o-meter/article/2015/mar/20/federal-health-care-law-what-came-true-and-what-di/

From politifact. Debunks some myths.

Politifsct leans liberal. They're not the be all and end all.

Wrong.

Did you miss the Cato quotes? Do you not know what Cato is? Hint: it's not liberal.

Nice reminder of how clueless conservatives are.

And the "smart" liberals are the ones that passed Obamacare.

Actually, it was watered down by the clueless conservatives. Remember? Of course not...because you are a clueless conservative.

Fortunately it was watered down or it would be a bigger disaster. The doofuses who thought people without health insurance were young and healthy created the problem.

All of my formerly uninsured friends are young and healthy. Other uninsured people were people who couldn't get coverage for pre-existing conditions. Wouldn't it be nice if there were a Medicare option for all?

And where will the money come from for that?

[Anonymous]

Anonymous wrote:Remember when Hitler demonized Jewish people? Scary how the republicans manipulate their followers to demonize the poor. They're fostering class and racial divides...which never ends well.

And the blame can be shared by the liberals who have failed to implement tax reform to make the wealthy pay more and who have failed to push back on the medical and pharmaceutical lobby. Shame on everybody.

Nobody's demonizing the poor (and quite a leap to compare Republicans to Hitler). Is anyone here saying cut off food stamps, welfare (which is abused on the black market), school breakfasts and lunches, subsidized housing, and Medicaid? No. A poster explained how when people got their medical care completely free, they were unappreciative, entitled, and demanding - and how when there's some small investment (like $10), they stopped taking the doctor's services for granted.

I do find it odd that so many people think it horrible for a low-income person with all sorts of government assistance pay $10 to see a doctor, yet have no qualms that a middle income person is being saddled with thousands of dollars in medical bills he can't afford. It's been pointed out that for some, that could even mean the poor person might miss a meal. Well, I feel more sorry for someone who saved 5 years for a down payment for a house on a moderate salary, paid the mortgage for years, and now may lose it because they don't have the $15,000 it now costs them annually for health care under Obamacare. Where's the compassion for that person?

I go along with those who say everyone should have some skin in the game. Kids can see the doctor free, but adults - $10. They might have to sacrifice a meal? Well, the middle class makes sacrifices for their health expenses, too. I had $4000 of medical bills this summer, despite my expensive insurance, so I had to cancel my plans to replace my 17-year-old car - and am praying it lasts another year. People with moderate incomes have to make sacrifices all the time.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Amazing how iberals bend over backwards to ensure that the poor don't have to contribute a cent to their care while not giving a flying F about the middle class struggling to make ends meet. For example....

When Obamacare was being rammed down Americans' throats, I told my neighbor I was against it. She called me "heartless," and then proceeded to tell me about a poor friend of hers, earning $20 an hour, who couldn't afford health insurance. She told me that if this friend has a medical situation, she MIGHT HAVE TO SELL HER HOUSE. (She bought the house years ago, when she had a good job.) When I asked if she was looking for a better job, I was met with complete disdain and told how she couldn't find a better job.

Flash forward. Her friend now has free insurance and medical care, and is still in her house. I, on the othe hand, am crashing under an overpriced insurance plan (they've got to charge middle class more to make up for the total coverage they're providing the low esrners), plus thousands of dollars of medical bills the insurance doesn't cover. It's adding up to nearly 30% of my moderate tske-hime pay, and I can't continue indefinitely. Probably within a year or so, I'll need to sell my house. When I told that same neighbor that my medical costs were so high I might have to sell - she said, with a hint of contempt...."well, instead of complaining, just get a higher-paying job."

All the defense for the lower class and to Hell with the middle class. We will see more of it under Hillary, as she shifts even more money from the middle to the lower.

Again: you are attacking the wrong people. Why try to get $10 out of a homeless person seeking medical care when you could have the wealthy pay more? Redirect your anger towards the wealthy.

Reply:

The Anderson model of healthcare utilization is dependent on three factors: predisposing factors, enabling factors, and need. Studies in MediCARE patients show when access is unrestricted and completely free (an enabling factor) elective procedures increase while producing NO corresponding changes in health status, morbidity, or mortality. This was demonstrated across all ethnicities and incomes and in patients who had insurance prior to accessing Medicare benefits.

In other words, completely free care tends to drive utilization up with unnecessary treatment and little corresponding increases in patient health.

A small payment helps shift accountability for healthcare utilization to the final healthcare consumer, which is necessary when healthcare is delivered in a for profit system - which is why Medicare users who were insured before age 65 tend not to get elective procdures prior to the more generous coverage of Medicare. When users don't have incentives to shop and make careful decisions, free market forces are removed from the system. When sellers are rewarded for selling more healthcare instead of wellness, another free market driver is removed. Furthermore, not only are there no rewards for wellness, there are no incentives, penalties, or requirements for compliance on high utilizers who have chronic conditions which are amenable to management. These are some of the factors for increasing healthcare costs.

Conversely according the the Anderson model, barriers and access (enabling factors) have been removed for one class of patients and increased for another group of patients, through premiums, increased cost sharing, and high deductibles. Ideally, Obamacare adds access, or enables care for ALL groups, but this has not been the result of the legislation.

Adding access for one group and effectively disabling access for another group is NOT providing effective universal healthcare for our citizens. Obamacare is a failed system and will never be able to work in a free market-for profit healthcare industry.

Thank you for your intelligent contribution to this discussion.

Yes, exactly. We now have a system that enabled the lower-income to get all the care they need, and disabled it for the middle class via unaffordable premiums. And yet we have people upset that the newly "enabled" class might have to pitch in $10, while showing no sympathy for the newly "disabled" class.

[Anonymous]

Anonymous wrote:^^^ because Obamacare decreases access to care for the "just enough they don't qualify for subsidies" group, they are effectively uninsured. Because they have a small amount of assets (probably only their house) they have a good chance of losing that to the combination of healthcare costs and disruption in employment. So yes, then they'll have free healthcare. Yay.

I don't see why, if you support Obamacare, why you have such a problem seeing that the just enough group often goes without care now. It's disingenuous to claim 20 million people now have care, when many more don't have adequate care as a result of the changes. Now 31 million people are underinsured without adequate care according to Commonwealthfund.org which surveys insurance trends.

I don't think that's right. However, I'm not attacking the newly covered. I'm attacking the legislation which created the gap as not very equitable.

Agreed. In fact there's an article that describes "the reversal of fortunes" in which the previously uninsured lower class is coming in for all their medical needs while the previously insured middle-class is skipping appointments, exams, and treatments because it is THEY who now can't afford it. Why was there such an uproar about the lower class not having medical access and the "oh well" attitude toward the middle class who now are in the place the lower class was?

http://www.usatoday.com/story/news/nation/2015/01/01/middle-class-workers-struggle-to-pay-for-care-despite-insurance/19841235/

[Anonymous]

I see the where the OP is coming from. And, yes, a small fee might be a effective way to address inefficiency.

However, I believe the problem that the OP is having...ballooning health care costs...can be better addressed in tweaking Obamacare, or even replaced it with their own plan that ensures Americans and be insured. That's been a massive failure of the Congress to do for the middle class.

Health care in this country is massively fucked up, but squeezing the middle class isn't the answer. Rather applying pressure on your representatives in Congress to take on big health insurance companies. Make sure they are paying their fair share and are not getting rich off the middle class's back.

[Anonymous]

There is a simple fix: mandate coverage (not just a tax penalty) so that every one has to buy in, even the young invincibles--> this lowers premiums for every one.

[Anonymous]

Anonymous wrote:There is a simple fix: mandate coverage (not just a tax penalty) so that every one has to buy in, even the young invincibles--> this lowers premiums for every one.

What if they still refuse to pay? Civil penalties? Criminal penalties?

[Anonymous]

I think everyone should be entitled to basic Medicaid, with nominal fees paid for service. $10-50 based on HHI. Remove the illusion of choice and just tax. Reform medicare so that we aren't spending a ton of money to keep old people alive. Death panels, if you will. If you want to give your 92 year-old grandmother new knees than you have to pay for it.

Employer-sponsored private insurance will still exist, as well as FSA to incentivize citizens to pay for their own services if Medicaid isn't to their liking. And companies that offer private insurance will be able to reduce their Medicaid tax burden.

Set it up where Medicaid is competing against private insurance.

Tell me why this wouldn't work.

[Anonymous]

What exactly do people think is a fair percentage for a person to pay?

[Anonymous]

Anonymous wrote:I think everyone should be entitled to basic Medicaid, with nominal fees paid for service. $10-50 based on HHI. Remove the illusion of choice and just tax. Reform medicare so that we aren't spending a ton of money to keep old people alive. Death panels, if you will. If you want to give your 92 year-old grandmother new knees than you have to pay for it.

Employer-sponsored private insurance will still exist, as well as FSA to incentivize citizens to pay for their own services if Medicaid isn't to their liking. And companies that offer private insurance will be able to reduce their Medicaid tax burden.

Set it up where Medicaid is competing against private insurance.

Tell me why this wouldn't work.

This is exactly what I want to happen as well. Basic care covered, expensive end of life care coverage eliminated.

[Anonymous]

Middle class people feeling squeezed: why is your beef with the poor?
Clinton would increase taxes for the rich, not for you.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I think everyone should be entitled to basic Medicaid, with nominal fees paid for service. $10-50 based on HHI. Remove the illusion of choice and just tax. Reform medicare so that we aren't spending a ton of money to keep old people alive. Death panels, if you will. If you want to give your 92 year-old grandmother new knees than you have to pay for it.

Employer-sponsored private insurance will still exist, as well as FSA to incentivize citizens to pay for their own services if Medicaid isn't to their liking. And companies that offer private insurance will be able to reduce their Medicaid tax burden.

Set it up where Medicaid is competing against private insurance.

Tell me why this wouldn't work.

This is exactly what I want to happen as well. Basic care covered, expensive end of life care coverage eliminated.

First, how are we going to pay for Medicaid for everyone? As it is, the program is bankrupting the states. If you say switch the burden to the federal government, well again....where's the money going to come from? Taxing the wealthy more - the liberal solution to everything - in no way would raise enough revenue to give everyone Medicaid.

Second, the Obamacare exchanges are a step up from Medicaid. It's almost a Medicaid program that provides free insurance for a good segment, and then a "buy-in" for people with modest incomes. The problem is that reimbursements are so low to doctors that many refuse to take the plans at all, and when you do find one, the wait is excruciating. Once Hillary fast-tracks the millions of illegals to citizenship, it will be even worse.

As far as the death panels, is there an age we should just let people die? And will we refuse aid for everything (just painkillers), or for major diseases? For example, if an 85-year-old breaks a hip, but is otherwise healthy, csn she get it fixed? Or should she just stay bedridden, which will bring on pnemonia and death? The only way I'd support this if it were limited to someone with a terminal illness, in the end stage with 3 months left, no hope of recovery, with no quality of life left, and age 90+.

[Anonymous]

Anonymous wrote:Middle class people feeling squeezed: why is your beef with the poor?
Clinton would increase taxes for the rich, not for you.

it's not the taxes I'm worried about. It's the bankrupting cost of Obsmacare insurance the middle class has to pay in order to provide totally free care for the poor people who act as if they're entitled to it.There is absolutely no appreciation for what other people give them, and an abuse of the free stuff, too. There are plenty of welfare recipients with six kids who live better than a hard-working retail employee.

They had an article in which a welfare recipient was complaining to the reporter that the government (it's always the "government"....never "hard-working taxpayers) provides, and that she needs more food stamps. She pointed to the Fritos she was serving her kid for lunch. Then the reporter pointed to the flat-screen TV she had and said she was able to buy THAT. She got all huffy and said, "you have no right to tell me how to spend my own money!" Well, news flash lady....it's not YOUR money. It's other people's money.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Middle class people feeling squeezed: why is your beef with the poor?
Clinton would increase taxes for the rich, not for you.

it's not the taxes I'm worried about. It's the bankrupting cost of Obsmacare insurance the middle class has to pay in order to provide totally free care for the poor people who act as if they're entitled to it.There is absolutely no appreciation for what other people give them, and an abuse of the free stuff, too. There are plenty of welfare recipients with six kids who live better than a hard-working retail employee.

They had an article in which a welfare recipient was complaining to the reporter that the government (it's always the "government"....never "hard-working taxpayers) provides, and that she needs more food stamps. She pointed to the Fritos she was serving her kid for lunch. Then the reporter pointed to the flat-screen TV she had and said she was able to buy THAT. She got all huffy and said, "you have no right to tell me how to spend my own money!" Well, news flash lady....it's not YOUR money. It's other people's money.

Well said. Thank you.