Affordable Health Care Law under review by SCOTUS

[The Feral Slasher]

I like free markets but when companies are hurting people we obviously need govt to step in. Other than that, I'm not sure what you're getting at.

Maybe a law the says if the hospital is in network, everything that happens in the ER is in network?

My thinking is that there is enough evidence to show that the American health care system is a failure and is designed specifically to generate profits for large corporations and/or special interests. So in my opinion there are two options:

1) Figure out a way to eliminate the power of corporations/special interests which allows them to obtain excessive profits off of people's health care. Ideologically I don't dismiss this approach, however, I don't think it is reasonable given the situation in our country.

2) Adopt a government sponsored universal health care system -- while you or I may not think this is efficient, how efficient are the large insurance corporations ? What value do they ad ? Or are they just an unnecessary cost that benefits no one ? When you look at our health care spending vs. other countries which do you conclude is more efficient ?

My opinion used to be very close to what I believe yours and Baldgriff's probably are. Not trying to attribute any particular views to either of you, just saying I used to believe more in the efficiency of the free market compared to the government bureaucracy (man I butchered that word before I got it right). But in practice I don't see how our current system, or the pre-ACA system is good at all.

[The Feral Slasher]

I like free markets but when companies are hurting people we obviously need govt to step in. Other than that, I'm not sure what you're getting at.

Maybe a law the says if the hospital is in network, everything that happens in the ER is in network?

I guess another question would be - what government do you think is going to step in and fix this ? This happened after ACA was passed, so that apparently didn't deal with this situation. Do you expect Donald Trump and the Republicans are motivated to fix stuff like this ? I have a hard time understanding how you think our government is motivated to fix this. It's more likely that laws are written specifically to allow this or create situations where insurance companies or medical providers can profit off of people's misfortune. But maybe that's just the cynic in me. Either way this is going to continue for quite a while. If your answer is for the government to step in I'd be interested in how you think that is going to happen.

[baldgriff]

what does this have to do with free market health care?

Posting this for the third time - Ben Shapiro says this really well - maybe this time someone will watch this.

[Hodor]

Posting this for the third time - Ben Shapiro says this really well - maybe this time someone will watch this.

I've watched it, he's wrong. Free market does not work for the poor when it comes to health care.

Period.

[baldgriff]

I've watched it, he's wrong. Free market does not work for the poor when it comes to health care.

Period.

Here is a question that I guess hasnt been discussed. When we discuss "health care" for the poor, what kind of coverage are we talking?

I get that if Joe poor guy gets strep throat and needs a prescription for antibiotics that he should have access to that

What if Joe poor person has smoked and drank hard for 20 years and now needs heart and liver transplant - is that covered?


I guess I am curious to what degree you want to cover everybody?

[swampdragon]

Here is a question that I guess hasnt been discussed. When we discuss "health care" for the poor, what kind of coverage are we talking?

I get that if Joe poor guy gets strep throat and needs a prescription for antibiotics that he should have access to that

What if Joe poor person has smoked and drank hard for 20 years and now needs heart and liver transplant - is that covered?


I guess I am curious to what degree you want to cover everybody?

what do you think as a libertarian?

[baldgriff]

what do you think as a libertarian?

All to often it seems I get to say what i like or dont like - and then have the shit kicked out or me. I want to hear others opinions, before I present mine.

[DMT]

Here is a question that I guess hasnt been discussed. When we discuss "health care" for the poor, what kind of coverage are we talking?

I get that if Joe poor guy gets strep throat and needs a prescription for antibiotics that he should have access to that

What if Joe poor person has smoked and drank hard for 20 years and now needs heart and liver transplant - is that covered?


I guess I am curious to what degree you want to cover everybody?

Anytime you have a benefit, there is going to waste and abuse. Look at how much money is flushed down the toilet on military expenditures that never come close to being used. My wife works at the VA, and she deals with patients every day who are just gaming the system so that they don't have to go and get a job. You simply have to accept that about 10-15% of recipients of any program benefits are going to abuse them.

If we have single-payer, then everyone gets treated. Should this person who's abused his body for two decades be first on the donor list? Of course not, and as far as I know hospitals have methods to prioritize recipients of donor organs. Placing this kind of moral judgment on who deserves health care is less morally offensive than making the judgment based on their ability to pay, but it's still offensive IMO. Health care is a benefit that should be provided to everyone, not just those we deem worthy.

[swampdragon]

OK - I believe that we dont need to have a morality clause for health insurance for the poor - making everyone healthier benefits our society as a whole

[baldgriff]

Anytime you have a benefit, there is going to waste and abuse. Look at how much money is flushed down the toilet on military expenditures that never come close to being used. My wife works at the VA, and she deals with patients every day who are just gaming the system so that they don't have to go and get a job. You simply have to accept that about 10-15% of recipients of any program benefits are going to abuse them.

If we have single-payer, then everyone gets treated. Should this person who's abused his body for two decades be first on the donor list? Of course not, and as far as I know hospitals have methods to prioritize recipients of donor organs. Placing this kind of moral judgment on who deserves health care is less morally offensive than making the judgment based on their ability to pay, but it's still offensive IMO. Health care is a benefit that should be provided to everyone, not just those we deem worthy.

So where do you draw the lines? I have been asked to put out my ideas - but I have refrained waiting to see what others think the care should be for everyone.

[DMT]

So where do you draw the lines? I have been asked to put out my ideas - but I have refrained waiting to see what others think the care should be for everyone.

I think I made it clear that I don't think lines should be drawn. Should we be doing heart transplants on 90-year-olds so they can live a bit better their last few years?

[In the Corn]

Once you let the genie out of the bottle on almost anything it is impossible to take it back. I think Health Care is included in that. As I stated earlier, I'm not a big government person, but what is going on with health insurance is ridiculous. I'll use Seth's example of his wife's employer. He's covering the entire firm and their families. I can't imagine that Seth and his wife even conceive of her even looking, but what happens to them if her employer closes shop. That's radically going to change his family's budget.

I think everyone knows there will be a certain amount of gaming the system, but that happens everywhere. Who doesn't have a coat-tail riding co-worker. You hate them, but not much you can do about it.

Moving to single payer puts everyone on an even playing field and will rein in the cost of test and prescriptions. An MRI, CT scan, X-Ray are all going to be the same cost, no matter who does it. The government sets the reimbursment rate and there is no negotiating. Can any of you tell me what the cost of an MRI is, and what they variety might be for different health plans?

Single payer is the only way to go on this. Remove barriers from people to access health care. People forego a simple annual physical because they would rather not find out they have something that needs more attention. All we have done for people is prolong the ER visit because of ridiculously high deductibles that in reality are nothing more than catastrophic policies. This is one area I think Democrats deserve some real heat, as they created something that was suppose to alleviate that, but it has become the only thing a lot of families cans afford.

Barbara Eden has left the bottle on this one.

barbara-eden-2.jpg

[baldgriff]

I think I made it clear that I don't think lines should be drawn. Should we be doing heart transplants on 90-year-olds so they can live a bit better their last few years?

You tell me?

[gcstomp]

We have seen you post that clip a few times. Just dead wrong, terrible video that could not be less useful. We have the world model, we know that coverage for all in a civilized society works well with many examples through the globe. The costs end up lower for everyone as the worst type of coverage, the most expensive are emergency visits. Of course doctors would use risk assessment on a 90 year old for a surgery, and most likely would decide for the good of patient that is a no go, but that has nothing to do with anything. Costs go down when everyone has the coverage they should have.

If we decided that every single person had to pay for their schooling k-12, or else not get it, what happens is you get huge pockets of pop with poor education, unable to read or process basic math with zero idea of science, and would rely on voodoo and prayer for their every answer rather than any kind of thought process. It ends up way more expensive as a society. Same here with health, the reptilian approach of looking out for only yourself and to hell with the poor, the sick, the old, who may require various levels of healthcare that you do not need is wrong. Thee right way to handle it is coverage, like a civilized nation.... The US, with highest per capita healthcare costs without the related coverage for all is madness, and a single payer system would help US climb out of 31st place on worldwide life expectancy.

[TranaGreg]

just thought I'd share something reflecting how we do it up here ...

on the other end are some issues which are classic conundrums in transplant ethics, such as the transplant of organs into those that have organ damage from poor lifestyle choices and unhealthy habits. These include, for example, whether alcoholics should be placed higher or lower in priority for liver transplants or whether smokers deserve lung transplants, or whether patients should be considered differently if they acquired their Hepatitis C infection from IV drug use (versus from a tainted blood transfusion). The analysis of these ethical conundrums cannot be made here, but it should be noted that the Canadian answer to these issues is a practical one that leaves most moral considerations out of the equation. Practically speaking, allocation criteria are established by transplant experts and are reflected in the transplant guidelines noted above. The eligibility criteria are decided upon by the need of the recipient, the availability of an organ, and the state of health of the recipient. The latter concern, in some respects, accommodates such things as smoking, alcoholism and drug use inasmuch as the ongoing participation in these lifestyle choices excludes people from transplant lists on the basis of their physical health and prospects of success, rather than their moral health. This, it should be noted, is commensurate with some of the fundamentals of the Canadian health care system: a system based on equity, a system that places need above ability to pay, but also a system that places need above the requirement to pay for past moral opprobrium.

reference: The Canadian Bioethics Companion