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Election 2020 Issues: Health Care

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Leon 2 minutes ago




San Diego, California
#1New Post! May 27, 2019 @ 09:41:41
Okay, here is the the most important of all issues among voters, according to recent polls.

If you were President and had a House majority and a Senate supermajority on your side, how would you fix the nation’s health care crisis and, if spending is involved, how would you pay for it.

For a summary of the issue, read below...

In 2016, approximately 67% of the US population was covered by private health insurance companies, with 56% being covered under an employer-sponsored plan and 16% being covered under a directly purchased plan. Medicaid, a government sponsored health insurance program for those living in poverty, covered 19%, Medicare, a government sponsored health insurance program for individuals over 65, covered 17%, and the US military covered 5%.

Approximately 9%, or 27 million, were uninsured in 2016. This marked the lowest point in a decline that began after the 2010 Patient Protection and Affordable Care Act took effect, also known as Obamacare, which included an individual mandate that required everyone to have insurance or face a tax penalty. The rate of uninsured Americans was at 16% in 2010. Recently, in 2017, however, this individual mandate was lifted, resulting in an additional 4 million Americans coming off health insurance since then. The United States is the only industrialized nation in the world that does not have universal health coverage for all its constituents.

The primary reason for the lack of coverage for millions is due to the rising costs of health care, which has far outpaced the rate of inflation and worker pay. Employer-sponsored health insurance premiums rose 160% from 2000 to 2010 and rose 19% from 2011 (after Obamacare took effect) to 2016, resulting in an overall increase of 213% from 2000 to 2016. Whereas, by comparison, inflation had an increase of only 44% and worker pay increase of only 60% from 2000 to 2016.

While the rate of increase in premiums has slowed down since Obamacare took effect (even though the rate remains higher than the rate of inflation and worker pay increases), the rate of increase in deductibles (what an individual must pay out of pocket for care before the insurer covers the cost of care) has increased 63% from 2011 to 2016.

Today it is estimated that employer based plan premiums are an average of $6000 per year for individuals and $18,000 per year for families, with workers contributing $1000 and $5,000 respectively towards that figure and employers covering the rest (and likely tamping down wage increases). Yearly deductibles in these plans average $1,500 for individuals and $3,000 for families.

Individually purchased plans average $5000 per year for individuals and $14,000 for families in premiums, with additional out of pocket costs maxing out at $7,350 for individuals and $15,800 per family in these plans. Obamacare provides subsidies to individuals earning less than 400% of the poverty level to help offset these costs. Obamacare also provided subsidies to insurers as well, but that was discontinued in 2017, resulting in an increase to average premiums by 20%.

Drug prescription prices have increased as well in a rapid fashion, and now average over $1,000 per year for an individual, double what it was in 2000, and even higher for those on Medicare.

Overall, health care costs are approximately $10,000 per person in the US, far higher than that of any other country in the world, about $3,000 more per year than the next highest country. The higher costs in the US are attributed to the administrative costs associated with the private insurance industry, lack of negotiated prices of care and drugs, high salaries of medical professionals, and larger spending practices in the US.

Despite having the highest per capita expenditure of health care, the life expectancy of Americans is 34th in the world at 78.6, which has itself been going down from its high point in 2014. Obesity rates have tripled in the US from 13% in 1962 to 40% today. And while smoking has decreased at the same rate in that time span and alcohol consumption has gone down as well, prescription opioid addiction has increased dramatically in the past several years, with sales and overdose deaths each quadrupling since 2000. Daily dosage per capita is almost double that of the next highest country. Illicit drug use has decreased in recent years with the exception of heroin and marijuana, although the latter has been legalized in many states.
mrmhead On about 1 hour ago




NE, Ohio
#2New Post! May 27, 2019 @ 14:38:25
Obamacare tried (tries) to address the situation via insurance.

I think it's the healthcare industry and big pharma that are a bigger problem.

Nationalize health insurance, then use market pressures to keep the costs down.

For example: Insurance will cover $x cost of a procedure - which would reflect, say 90% of the average cost (i.e. 10% deductible) But with "universal" insurance, the patient can go anywhere.

The costs by different providers must be easily viewed and understood, and none of this 15 different bills for one procedure or visit. - One bottom line cost.

If the patient wants "Premium Care", then there will be a higher cost to them.

Of course insurance companies will piss off, and probably so will providers. And I haven't thought through the down-stream effects.

This will be paid for by increased wage deductions - much like social security is now.
Leon 2 minutes ago




San Diego, California
#3New Post! May 30, 2019 @ 14:58:50
While competition breeds quality and all that, when it comes to something we all need to survive, healthcare should not be controlled by for-profit corporations. It is time to remove private insurers from the equation, as that is 25% of the cost of healthcare, almost making up for the difference between us and the next most expensive country-wide healthcare system. This does not mean we have to get rid of current providers of healthcare (doctors, medical centers, hospitals). A single payer system simply means that the government will act as the insurer rather than private companies - customers still get to choose who they want to provide the services. This is the way Medicare works. The government can also better help negotiate down costs, including prescription. It can be paid for by tax increases, namely getting rid of the Trump corporate tax cuts (which have now been proven to be a zero in terms of new jobs and investments - it all went to profits and bank accounts), as well as eliminating other loopholes that result in entities like Amazon and Trump paying zero in tax dollars. If more is needed at that point to fund it, then taxes can be raised for others, but it will be minimal, and actually result in more money in our pockets due to the elimination of premiums, deductibles, co-insurance payments, co-payments, and prescription costs.

The opiate crisis needs to be addressed and regulated via oversight of the medical profession and better education of consumers - limit the criteria for prescription to acute pain, and prosecute those who fail to adhere to these guidelines. The obesity crisis needs to be addressed in the same manner that smoking was addressed in the final decades of the 20th century, with product warning labels, education, and focus & prevention in the medical practice.
mrmhead On about 1 hour ago




NE, Ohio
#4New Post! May 30, 2019 @ 15:09:11
Another high cost for healthcare providers is their own malpractice insurance.

Not sure where to go with that. Some checks and balances need to be in place, but I also think there are a lot of frivolous lawsuits - many times pushed by over zealous lawyers / ambulance chasers.


"Do you suspect you were injured at birth? Give us a call and we'll find someone to sue!"
chaski On about 2 hours ago
Stalker





Tree at Floydgirrl's Window,
#5New Post! May 30, 2019 @ 15:09:17
The ACA has some good parts and some parts that didn't/aren't working as well has hoped.

Rather than reinventing the proverbial wheel, Republicans & Democrats should be working on fixes the the ACA.

1. Republicans should want to find the weak parts and fix them, so they can claim that they are the one's who fixed the problem.

2. Republicans should not want to get rid of the ACA, as it will actually cause more problems.

3. Democrats should want to fix the weak parts of the ACA, because it was (at least arguably) their plan... they should own and want to make it better.

4. Both Republicans & Democrats should want to work together to fix the weak parts of the ACA because they should want to do what is best for our country.

5. Neither Republicans nor Democrats should want to get rid of the ACA because A) neither has a realistic alternative, and B) the idea of starting from scratch is at best counter productive to all.

So if I were the president, I would sit down with both parties and ask, "realistically how can we work together to fix the flaws in the ACA?" It is a win-win for all. Let's do it."
mrmhead On about 1 hour ago




NE, Ohio
#6New Post! May 30, 2019 @ 15:11:19
@chaski Said

The ACA has some good parts and some parts that didn't/aren't working as well has hoped.

Rather than reinventing the proverbial wheel, Republicans & Democrats should be working on fixes the the ACA.

1. Republicans should want to find the weak parts and fix them, so they can claim that they are the one's who fixed the problem.

2. Republicans should not want to get rid of the ACA, as it will actually cause more problems.

3. Democrats should want to fix the weak parts of the ACA, because it was (at least arguably) their plan... they should own and want to make it better.

4. Both Republicans & Democrats should want to work together to fix the weak parts of the ACA because they should want to do what is best for our country.

5. Neither Republicans nor Democrats should want to get rid of the ACA because A) neither has a realistic alternative, and B) the idea of starting from scratch is at best counter productive to all.

So if I were the president, I would sit down with both parties and ask, "realistically how can we work together to fix the flaws in the ACA?" It is a win-win for all. Let's do it."


Chaski - Wake Up!!

I think this should have been posted in the "Dreams" thread.
chaski On about 2 hours ago
Stalker





Tree at Floydgirrl's Window,
#7New Post! May 30, 2019 @ 15:21:44
@mrmhead Said

Chaski - Wake Up!!

I think this should have been posted in the "Dreams" thread.


Well, it is a recurring dream of mine that our political parties will both try to work together more frequently and that our President(s) regardless of political party would often take the roll of mediator.

I can dream can't I?
Leon 2 minutes ago




San Diego, California
#8New Post! May 30, 2019 @ 15:33:37
@mrmhead Said

Chaski - Wake Up!!

I think this should have been posted in the "Dreams" thread.


Besides, everyone does agree on one point: Everyone hates the ACA.

But everyone also doesn’t want nothing in its place since it was worse before then. And the only reason its proposed GOP placement didn’t pass is because it was worse as well.

The public is ready for us to join the rest of the developed world on this.
chaski On about 2 hours ago
Stalker





Tree at Floydgirrl's Window,
#9New Post! May 30, 2019 @ 16:22:04
@Leon Said

Besides, everyone does agree on one point: Everyone hates the ACA.

But everyone also doesn’t want nothing in its place since it was worse before then. And the only reason its proposed GOP placement didn’t pass is because it was worse as well.

The public is ready for us to join the rest of the developed world on this.


I don't think that everyone or even most people hate the ACA, and the ones that do don't really even know what is good or bad about it so don't even know what they hate... but rather jump on buzz words and catch phrases and allow themselves to be duped into their opinion without actually knowing anything about it.

We could argue that point, but I certainly won't... I'll just leave that part there as my opinion.

Regardless: The GOP never really wanted to get rid of the ACA.

If they had, then they would have done it in the 1st two years of Trump.

The GOP's claim of hating it and wanting to get rid of it has been a lie from the get-go. They only used "it" as a propaganda tool to make Obama look bad and divide the USA so they would win elections in 2016. However, as soon as the GOP maintained a majority in the H.R., won the majority in the Senate and won the Presidency, they dropped it like a hot potato.

The only ones still fighting it are Trump (to a point) and a few Judges. Even GOP governors and state legislators have largely dropped the Obama care is bad position except as light rhetoric to campaign against Dems.
mrmhead On about 1 hour ago




NE, Ohio
#10New Post! May 30, 2019 @ 16:25:11
@Leon Said

Besides, everyone does agree on one point: Everyone hates the ACA.

But everyone also doesn’t want nothing in its place since it was worse before then. And the only reason its proposed GOP placement didn’t pass is because it was worse as well.

The public is ready for us to join the rest of the developed world on this.



Part of the reason ACA is "less than expectations" is that portions keep getting repealed or de-funded.
mrmhead On about 1 hour ago




NE, Ohio
#11New Post! May 30, 2019 @ 16:29:48
@chaski Said

I don't think that everyone or even most people hate the ACA, and the ones that do don't really even know what is good or bad about it so don't even know what they hate... but rather jump on buzz words and catch phrases and allow themselves to be duped into their opinion without actually knowing anything about it.

We could argue that point, but I certainly won't... I'll just leave that part there as my opinion.

Regardless: The GOP never really wanted to get rid of the ACA.

If they had, then they would have done it in the 1st two years of Trump.

The GOP's claim of hating it and wanting to get rid of it has been a lie from the get-go. They only used "it" as a propaganda tool to make Obama look bad and divide the USA so they would win elections in 2016. However, as soon as the GOP maintained a majority in the H.R., won the majority in the Senate and won the Presidency, they dropped it like a hot potato.

The only ones still fighting it are Trump (to a point) and a few Judges. Even GOP governors and state legislators have largely dropped the Obama care is bad position except as light rhetoric to campaign against Dems.


I would love to see "Obamacare" improved with an amendment in honor of John McCain - and call it "The McCain Amendment" just to poke Trump in the eye again ... even if he's out of office by that time
Leon 2 minutes ago




San Diego, California
#12New Post! May 30, 2019 @ 16:59:50
@chaski Said

I don't think that everyone or even most people hate the ACA, and the ones that do don't really even know what is good or bad about it so don't even know what they hate... but rather jump on buzz words and catch phrases and allow themselves to be duped into their opinion without actually knowing anything about it.

We could argue that point, but I certainly won't... I'll just leave that part there as my opinion.

Regardless: The GOP never really wanted to get rid of the ACA.

If they had, then they would have done it in the 1st two years of Trump.

The GOP's claim of hating it and wanting to get rid of it has been a lie from the get-go. They only used "it" as a propaganda tool to make Obama look bad and divide the USA so they would win elections in 2016. However, as soon as the GOP maintained a majority in the H.R., won the majority in the Senate and won the Presidency, they dropped it like a hot potato.

The only ones still fighting it are Trump (to a point) and a few Judges. Even GOP governors and state legislators have largely dropped the Obama care is bad position except as light rhetoric to campaign against Dems.



@mrmhead Said

Part of the reason ACA is "less than expectations" is that portions keep getting repealed or de-funded.


Premiums keep rising. Granted, the rate of increase is slower since ACA was enacted, but it still outpaces wage growth and inflation, not to mention its cumulative effect.

Deductibles and out of pocket costs are even worse.
chaski On about 2 hours ago
Stalker





Tree at Floydgirrl's Window,
#13New Post! May 30, 2019 @ 21:28:42
@Leon Said

Premiums keep rising. Granted, the rate of increase is slower since ACA was enacted, but it still outpaces wage growth and inflation, not to mention its cumulative effect.

Deductibles and out of pocket costs are even worse.



That might be more of an issue with the economy.
Leon 2 minutes ago




San Diego, California
#14New Post! May 31, 2019 @ 00:20:57
@chaski Said

That might be more of an issue with the economy.


Explain further. Thanks!
chaski On about 2 hours ago
Stalker





Tree at Floydgirrl's Window,
#15New Post! May 31, 2019 @ 01:00:52
@Leon Said

Explain further. Thanks!



Please forgive me for oversimplifying this…

When the economy is strong typically a number of things go up. That is they go up in price. One example is Rent. When you economy stronger people charge more for rent.

Also when you can't to be a stronger other things go up...housing prices sometimes, interest rates sometimes go up... the cost of various goods from groceries to textiles.

Why do the prices or cost of these things go up? Because corporations believe people can now afford to pay more.

Insurance premiums are no different. Yes, sometimes insurance premiums go up because of things like: someone is making claims on accidents or household theft, or storms, hurricanes, blizzard's…

Other times premiums go up because economy is stronger and the insurance companies believe that people can pay more, and can't afford to pay more, and it won't hurt them so they won't complain or go to a new insurance company....

Healthcare is the same as all of these. The economy is stronger now... So premiums go up.

And yes, in part, the ACA has also allowed for these increases.

Again, sorry I way oversimplifed all of that.
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