Affordable Health Care Law under review by SCOTUS

[cardboardbox]

For the last time, understand what you're reading, and perhaps we can have a conversation. As long as you don't understand, and seemingly can only communicate in one sentence posts, we really have no common ground to have a dialogue.

Its hard to converse with you since you wont answer a question I have about your statement.

[Hornsby]

Not angry at all--i understand your game

None of you are interesting enough to "play a game" with, I don't do that anyway. What tires me out is snarky responses that are designed to elicit "gotcha!" moments. I want nothing more than a sincere discussion of the issues, hopefully leading to some little glimmer that I may not have seen before. With you, I know that you're smart enough, and when challenged, you come up with solid responses. It's having to challenge that gets tiresome. I'm no day at the beach myself, but I try to stay above the fray, but sometimes, I allow myself to be taken into it...that's on me, nobody else. There are people here who are simply not worth the time to respond to, they simply have nothing to add to any conversation. You are not one of those people.

If you read my posts, and I understand that they can be tiresome at times, I try to answer any legitimate question posed to me, and those that are just designed to be trolling, I try to ignore. Sadly, I fail at that sometimes. I also know where I have a wealth of knowledge, and where I don't. And if you read what I actually write, you'll see numerous instances where I clearly state that I'm NOT an expert, but I have opinions on the subject.

I post here because it's an outlet for me, a way to let go of the thoughts rattling around in my head and focus on things I can control. I also hope to spark a dialogue, and exchange of ideas. Sometimes it works, most times it doesn't, but I'm a stubborn SOB, and I'll keep slamming my head against the wall.

[Bernie Brewer]

I have actually looked into this question. I was a juvenile/drug court prosecutor for ten years, and wanted to know the answer, too.

There is a long history and a lot of factors. Up through the Viet Nam war, the Armed Forces provided tons of skilled workmen for the U.S., especially during WWII. Guys who had little or no skills learned valuable trades and took them back to civilian life. After Viet Nam, however, the military's contributions to our skilled work force lessened.

High schools have historically provided strong vocational training. They did so in conjunction with local companies who provided machinery, materials, and trained instructors. The vocational training was very selective. The high schools made it available only to those students who displayed the greatest aptitude. By the 70s, though, attitudes in education had changed, and the prevalent belief was that all kids who wanted to should have a chance to participate in the vocational programs. This was egalitarian, but not what the companies who participated were looking for. It diluted the talent pool and increased their costs, so they began to back out. The schools couldn't afford the replace the equipment as it broke down or wore out, so programs were eventually discontinued or reduced to the point of being relatively useless.

Many high schools still have programs where they let kids out to go and work jobs, but that isn't really a vocational program. Many have shop classes, but again...a mere shadow of that they had in the past.

There are basically two types of post-secondary type of vocational education...career colleges and vocational colleges. Career colleges are things like cosmetology school, which are often a year or so, usually private, and don't give you credits that can be transferred to other educational institutions. You can, however, get certain certifications from the State. The other is vocational college. These are usually state institutions, two years, give you a degree, and credits transfer. Forestry, welding, auto-diesel, a variety of skills. The problem is that these are declining rapidly, not necessarily from lack of interest, but from lack of funding. They are an easy thing to cut since there is not much of a lobby.

Unions get pretty heavy into the vocational training business through apprenticeship programs, but unions have been in a precipitous decline for the last 50 years or so. Unions also used to partner with schools in vocational programs before they became enemies of the state.

(A point about college not being for everyone...of course it isn't, but now more than ever it is important. The work force demands more and more in terms of cognitive and other skills one should learn in college. Statistics prove that college graduates make more than non-graduates and have a much higher employment rate, just as skilled workers make more than unskilled workers. So, more people are going to go, even thought it isn't necessary to succeed in life.)

It is interesting to note that many other countries (like Japan) who kick our ass in all measures of productivity spend huge amounts of time, money and energy on vocational education for their citizens, especially their young. Japan is a good example. We don't have to do that because, well...'Murica.

Red/Lucky and MJ And others begin a great discussion of vocational training, the stigmas of it, and our societal focus against it. We really should require "shop" in High School again. We've told kids that the only way to real income is by a college degree but I have met many people without college degrees that own their own businesses and are doing quite well financially (not FU wealthy, but summer home and nice vacation wealthy) that began swinging a hammer or turning a pipe. Others have taken technical training like info tech or med tech and are doing well. College isn't for everyone.

[Bernie Brewer]

Agreed.

[In the Corn]

I also agree that the ACA as CURRENTLY constructed, is failing. That doesn't mean that you can't keep the framework and tighten up the loopholes that allow insurance companies to drop out randomly. Make them sign up for a longer time frame, and give them an incentive to do so. A carrot and stick approach. As I shared in a previous post, the GOP model as currently proposed will hurt hardest the very people that need the insurance the most, the poor and the elderly. It does better for young people, people who are less likely to need health insurance, and of course, for the wealthy, where it provides a nice tax brake.

Horns - My understanding is there were incentives in the ACA to keep insurers in the pool, but they haven't been good enough and run out at the end of this year.

It's a disaster.

The only real solution at this point is single payer. Level the playing field for everyone. I'm not a big government guy, but when you give this so many mice a slice of cheese, you can't take it back.

[GwynnInTheHall]

Horns - My understanding is there were incentives in the ACA to keep insurers in the pool, but they haven't been good enough and run out at the end of this year.

It's a disaster.

The only real solution at this point is single payer. Level the playing field for everyone. I'm not a big government guy, but when you give this so many mice a slice of cheese, you can't take it back.

You're correct. But make sure you note, those subsidies were cut/ended, by the GOP congress. There were many issues with the ACA, but the GOP added to them by pretty much ensuring providers would drop out.

I agree with a single payer system.


So much easier and cost effective.

[Sour Masher]

Horns - My understanding is there were incentives in the ACA to keep insurers in the pool, but they haven't been good enough and run out at the end of this year.

It's a disaster.

The only real solution at this point is single payer. Level the playing field for everyone. I'm not a big government guy, but when you give this so many mice a slice of cheese, you can't take it back.

I agree, single payer is the solution to this mess, but is there any shot in heck of that happening now, or anytime soon?

[baldgriff]

I also agree that the ACA as CURRENTLY constructed, is failing. That doesn't mean that you can't keep the framework and tighten up the loopholes that allow insurance companies to drop out randomly. Make them sign up for a longer time frame, and give them an incentive to do so. A carrot and stick approach. As I shared in a previous post, the GOP model as currently proposed will hurt hardest the very people that need the insurance the most, the poor and the elderly. It does better for young people, people who are less likely to need health insurance, and of course, for the wealthy, where it provides a nice tax brake.

Here is the thing - from a business perspective as a health insurer - the poor and elderly exhibit the most risk as it pertains to health. So you have a government forcing a business to provide a service that the client for all intents and purposes cant afford - and the business cant afford to offer them the service. Its really quite the conundrum - how over-regulation of markets is not in the best interest of the market (or likely the consumer).

[GwynnInTheHall]

I agree, single payer is the solution to this mess, but is there any shot in heck of that happening now, or anytime soon?

If only we had a candidate who advocated Single Payer.............

[GwynnInTheHall]

Here is the thing - from a business perspective as a health insurer - the poor and elderly exhibit the most risk as it pertains to health. So you have a government forcing a business to provide a service that the client for all intents and purposes cant afford - and the business cant afford to offer them the service. Its really quite the conundrum - how over-regulation of markets is not in the best interest of the market (or likely the consumer).

The health industry should not be a for profit enterprise, there's an inherent conflict of interest and this one costs people their lives.

If you're not about giving a shit when it comes to the quality of life, why spend all those dollars on National Defense to protect it?

[DMT]

Here is the thing - from a business perspective as a health insurer - the poor and elderly exhibit the most risk as it pertains to health. So you have a government forcing a business to provide a service that the client for all intents and purposes cant afford - and the business cant afford to offer them the service. Its really quite the conundrum - how over-regulation of markets is not in the best interest of the market (or likely the consumer).

Which is exactly why it shouldn't be a market in the first place.

[In the Corn]

You're correct. But make sure you note, those subsidies were cut/ended, by the GOP congress. There were many issues with the ACA, but the GOP added to them by pretty much ensuring providers would drop out.

I actually was going to make a comment about the GOP, but deleted it. It mirrors your comment almost exactly.

Health insurance (if you can call it that) creates huge disparity in this country. Most people can't afford to use the coverage they have as the deductible is so incredibly high. Mrs. ITC and I have a bronze plan with a $13,500 deductible. Just to put that into some perspective, if I needed to use all of that, I would need to use almost 30% of my annual income to pay those medical bills, while paying my mortgage, car payment, car insurance, etc. It is ridiculous.

To add a little more perspective, my 19 year old daughter works for a national drug store. She asked about insurance for this year, I told her, find out if your eligible for coverage from your employer. Well, she is. Her monthly premium for insurance with a $4,000 deductible is $15/month. I told her, it will cost me an extra $100 to add you to my policy. She's on her own.

I'd be interested if the RJ community would be willing to be completely transparent and share where they get coverage (exchange, employer, etc.), what their part of the premium is, annual income and who all that insurance covers. How satisfied they are and if their employer sponsored program causes them to pause in making a change in jobs.

Edit: just looked my deductible is $13,900 not $13,500. That $400 is going to come in handy while I make mudcakes for the wife and me to eat.

[cardboardbox]

Health insurance (if you can call it that) creates huge disparity in this country. Most people can't afford to use the coverage they have as the deductible is so incredibly high. Mrs. ITC and I have a bronze plan with a $13,500 deductible. Just to put that into some perspective, if I needed to use all of that, I would need to use almost 30% of my annual income to pay those medical bills, while paying my mortgage, car payment, car insurance, etc. It is ridiculous.

to have that high of a deductible you must not pay very much per month?

[umjewman]

I'd be interested if the RJ community would be willing to be completely transparent and share where they get coverage (exchange, employer, etc.), what their part of the premium is, annual income and who all that insurance covers. How satisfied they are and if their employer sponsored program causes them to pause in making a change in jobs.

Our family coverage is through my wife's employer (my wife, myself and two kids). He is extremely generous with health care and covers the premium 100%. There's actually no in-network deductible, but the out of network deductible is $5,000 for the individual or $10,000 for the family. We consider ourselves extremely fortunate as the health care costs through my employer are quite high and still come with a deductible (albeit lower than $5,000). We basically meet the deductible every year due to some out of network doctors my wife sees. Basically, I have absolutely no complaints given that we don't pay a premium. It is very generous of my wife's boss and helps so so much. It would probably give us pause if my wife was looking at a different job which she is currently not.

I know others are not nearly as lucky....or redbirdsfan, if you will....as we are and we are thankful every day that my wife's boss covers the premium entirely.

[baldgriff]

Which is exactly why it shouldn't be a market in the first place.

Lets be honest - as in just about everything in life - it comes down to "Who's going to pay for it?" This is the biggest issue with the existing plan - claiming something is free or discounted may be true, yet others are picking up the expense because someone has to pay for it (either in increased insurance premiums or more taxes). You can tell me that isnt true - but I know what my insurance cost has gone up the last few years.

ITC is getting an even worse deal here in MN than he was getting 3 years ago. Seriously, if you do the math you can figure out what he is making and he is stuck with a $13,500 deductible because that is what he can afford for a "bronze" package. Here is a guy doing well for himself paying for insurance that will possibly bankrupt him if he has to use it to the fullest, before even getting a penny from the insurance company. But hey - it meets the requirement set forth by the government.

Not to be crass - and Im pretty sure some here think I am - but at some point if someone cant pay for the service then unfortunately for them they may have to go without it.

My wife has psoriatic arthritis - currently she is on a medication that somewhat helps and is a manageable expense in our budget. Her doctor prescribed her a new medication that her insurance company turned her down for. If we want it outside of insurance it is $2000 a month - We had this conversation literally 30 minutes ago and as you can imagine agreed that we cant afford the medication.

Currently, it is just a fact of life. You may not like it, but health care is still a service provided to you by someone else who paid many school bills to get the education to provide you the service. They should be provided an incentive to provide that service to you - and do it well. Kind of a carrot on a stick thing....