Question about Universal Health Care

[CTLawGuy]

Let us assume for this OP, that both Hillary and Barack would pay enough subsidies to everyone so that it becomes affordable in the estimation of all people. Let's also assume that both candidates would effectively insure, in some effective fashion, all "uninsurable" people.

Based on these assumptions, all people who want insurance but could not previously get insurance, for which ever reason, would be able to get it. Anyone not covered after this would be people who, despite being able to afford it, and despite being insurable, would refuse to buy insurance. Hillary has said that people in this group number 15 million, or 1/3 of all the uninsured.

Do you believe that 1/3 or 15 million people of all uninsured would consciously refuse to buy health care they could afford and could obtain? If so what is their motivation?

[TygrBright]

1. Define "afford." n/t

[CTLawGuy]

2. afford means

that money is not a problem.

See the issue is not whether your subsidies are big enough, the question is: is the mandate necessary? Who are these people who, despite having all the money in the world (essentially) would refuse to buy health insurance?

[MagsDem]

11. No, that is not what afford means

Do you know ANYTHING about this subject? I have to wonder. Afford in MA means that if you are single person with an income of $26K your monthly premium is $109 per month. My car insurance is more than that. Can you either research this a bit or just stop posting about it. Spreading ignorance is not a virtue.

[BadgerKid]

33. Is there a web site for MA?

One that gives income breakdown with premium amounts, etc.?

[CTLawGuy]

34. so the problem with Obama's health care plan

is there is not enough subsidies???

Would more subsidies get rid of the need for a mandate?

and no need to be rude.

[nonconformist]

3. Yes, they would.

What would their motivation be? Procrastination, irresponsibility, naivety, ignorance (in the uninformed sense), and stubbornness.

There are millions of people that currently qualify for Medicaid or other assistance, yet don't partake. Sure, it seems logical to say that if it's affordable, people will get it, but historically that's not the case.

[CTLawGuy]

35. so 1/3 of the uninsured

are lazy freeloaders?

[gateley]

4. I never got health insurance through work when I was younger -

didn't think I'd need it. Only needed Excedrin and lots of water for hangovers. nt

[WillYourVoteBCounted]

5. insurance isnt Universal health care...

I suppose this is a sort of pathway. Didn't Edwards suggest a plan that
lets people choose "govt insurance" (like medicare or better, like medicaid)
or private insurance?

And I guess there would be a subsidy there.

But insurance isn't UHC. Its insurance, and like Medicare Part D, it will hike
the costs of service. The ins. companies will take advantage.

[nonconformist]

6. Edwards' and Hillary's plans are basically identical. nt

[MagsDem]

15. Clinton's plan lets you do that as well

Is there a single Obama supporter on this board that knows what they fuck they are talking about on this issue? I haven't seen one yet. The blind devotion to him coupled with the absolute ignorance on the issues is really asounding.

[WillYourVoteBCounted]

7. Its dicey, see what Mass is doing, increasing the fines

Remember, whether you can afford the insurance will be determined by a formula
set by the govt. If its like Medicaid, then you can't own much of anything and be eligible.

Some people might not be willing to sell their house, but just get by paying the mortgage,
so they forgo medical insurance. Sometimes people get stuck in the "working poor" hell.

But read whats going on in Mass:


Penalties for not buying insurance in Massachusetts:

Discussion here in Mass State DU forum

"I am a new resident of Massachusetts and am currently relying on the charity of family to pay the rent
and other expenses while I look for work. I consider myself lucky because without my family I would be on the street.
I moved here in November because I was unable to find work where I had been living and have been largely
unemployed now for over two years. The idea of being fined because I don't have health insurance is insulting.

I heard a radio discussion of the issue last month and the indication was that if I manage to find work which provides
insurance in June I would be fined $100 a month for the five months I went without. This makes me incredibly angry..."

[MagsDem]

9. The quoted post is bullshit

People without an income are not being fined. This is just more Obama bullshit. Stop it already.

[WillYourVoteBCounted]

16. over-reacting a bit? go to the link and attack the person in Mass. State, not me

You can attack the original poster -

Click on the link I provided you, and then post your venom there.

I provided a quote, the person said this was what they were worried about,


Take it up with them.

They didn't mention Obama.

Also, read the news article.

[MagsDem]

17. You're spreading ignorance

[ContinentalOp]

10. So what happens if don't buy insurance but I have an emergency?

Will Massachusetts cover me? Because $912 a year fine is nothing compared to what I'm paying now for my HMO. Maybe Clinton's plan would actually work out for me after all. I'll just dump my $800 a month HMO and pay the yearly fines. :P

[MagsDem]

13. Your insurance wouldn't cost anything near what it is costing you...

now. Are you an Obama supporter? I hate to make assumptions, but I'm getting used to the idea that most of the people on this board that don't have any grasp of the actual issues are indeed Obama supporters.

The monthly premium in MA for a single person making $26K a year is $109 dollars a month, or less than most car insurance premiums. And once you get everyone in the pool nationwide, the costs will come down even more. Don't spread ignorance.

[ContinentalOp]

19. Yes, I am an Obama supporter.

I trust that my insurance will be cheaper under either plan but since I'm self employed and make a lot more than $26k a year I bet it's not going to be a huge savings. Personally I support a single payer system. I just don't see where the "competition" comes from if most Americans will still be buying into for-profit insurance plans.

If the rates are the same nationwide I will benefit greatly though. We pay some kind of insane markups due to living in Los Angeles County.

[MagsDem]

21. well it's unfortunate that your candidate has been....

deliberately misleading you on this issue. Like Medicare, and FEHBP (both non-profit govt controlled plans) the goverment will negoiate the rates for you. When the risk is spread out over the entire pool of the population the costs of providing the coverage goes down, even for the commerical payers. In addition, you will be given subsidies in the form of tax credits that will offset even your reduced cost. Under Obama's plan the pool is not as wide, so the costs do not decrease as much. It's basic economics.

[ContinentalOp]

24. Is FEHBP really a non-profit plan?

The government purchases the insurance on behalf of millions of government employees but it's still purchasing it from private, for-profit corporations.

The more I search for information about FEHBP the more reports I find from conservative and free market groups, praising FEHBP as a great free market solution to the evil specter of "socialized medicine." Here's a quote from some place called centrists.org.

"The Federal Employees Health Benefits (FEHB) Program, A Centrist Model for Health Reform: The FEHB system is a public-private partnership. The public roles are organization, pooling, premium and benefit negotiation, risk-management, and oversight. FEHB enrollees have choices of several private insurance plans, ranging from strict HMOs (in urban and suburban areas) to looser “PPO” or fee-for-service health plans that are available nationwide."

[MagsDem]

27. I've already explained this in my response down thread

Did you read it? Try reading and responding there, please.

[ContinentalOp]

37. Man you are full of it.

I posted that several minutes before you made the reply down below. Reading is not really your strong point though is it?

[MagsDem]

8. You don't understand the issue, clearly

You can't get to affordable health care unless everyone is in the pool. This is basic economics.

[ContinentalOp]

12. What is "the pool"?

Won't insurers just start dumping high risk customers onto the public system? How can we have any true competition or reduced costs without a real single-payer system?

[MagsDem]

14. The Clinton plan lets you opt into the non-profit

govt programs such as Medicare or FEHBP right from the start. You don't have to use a commerical insurance provider, and actually the FEHBP plan, which is the one provided to govt workers and congress is actually superior to most commercial insurance plans.

The pool is 350 million people, so of course the costs will decrease when the risk is spread out that wide. As for a single payer system, Obama says "No, we can't" so you'll have to ask him about that.

[ContinentalOp]

18. FEHBP is a private plan

As far as I can tell it's simply a program through which government employees purchase insurance from HMOs. Can I choose to buy Medicare or is that only for low income families?

[MagsDem]

20. No it is NOT

Would it help if I tell you this is what I do for a living?

[ContinentalOp]

23. It would help if you explained a bit.

I have been asking about this on several threads and Clinton supporters never clarify. I have done some reading but am still not clear on exactly how FEHBP works. As far as I can tell though it's a plan which purchases insurance from private, for-profit corporations. In fact, as I posted on another thread this evening, FEHBP has been praised by The Heritage Foundation as being a superior alternative to Medicare, presumably because it still puts profits in the pockets of big insurance.

[MagsDem]

25. FHEBP are govt plans....

Where fees are negotiated by the govt for govt employees. It is competively bid like most govt expenditures. In reality, the "profit" is no more than the administrative fees that the govt incurs for its own Medicare program. Economies of scale and the wide pool offered by the large number of govt employees make it "profitable" for commercial payers, but in practice it is basically outsourcing of the administration of a benefit plan.

Some real numbers -- the average profit margin for a commerical insurance payer is over 30%. For FHEBP plans it is more like 7%, and the administrative costs of Medicare are about 5%.

[ContinentalOp]

38. No they aren't.

FHEBP might drive insurance company profits down to 7% and if so that's a great thing. But it's disingenuous to say that it's a government plan.

Here's some more information that you probably won't read:

"FEHB is NOT a governement health insurance plan!

FEHBP is a private insurance program that the Federal government, as an employer, offers to its employees. Just like some other very large employers, the Federal government makes available a choice of private health insurance plans. Federal employees can choose from among plans offered by Blue Cross/Blue Shield, Aetna, and other such insurers....

Thus, as in all private insurance plans today, under FEHBP a private, often for-profit, insurance company will decide:

* which physicians you can see,
* which drugs your physician can prescribe,
* whether you can see a specialist, and
* whether and where you can be hospitalized.

Indeed, you can be turned down for treatment. You then can appeal a service denial, but first to the private insurance company before asking the Office of Personnel Management for a second appeal.

If the FEHBP were to be offered through private employers, would they be willing to pick up the same nearly three-quarter share of the insurance premium as the Federal government’s does for its employees? If they did not, or if a self-employed (or unemployed!) individual were to buy into this plan, the annual premium for the standard Blue Cross/Blue Shield plan alone — without any out-of pocket medical costs — would be $4,539 for an individual and $10,482 for a family. Kerry has suggested tax subsidies to help pay these costs; they would have to be quite substantial to make this truly affordable for low-income individuals and employees of small businesses.

But this is not the worst of it: Those who advocate an "FEHBP solution" assume that the private insurers who participate in FEHBP would be willing to offer the same plan that is offered to Federal employees, at the same cost, to anyone wishing to purchase it. However, Federal government employees are healthier, more securely employed, and more "middle-class" than the average person in the population. It is highly unlikely that private insurers would be willing to offer the same deal to any small business or individual.

We know that insurance premiums for small businesses and individuals are much higher than for large employers, where the risk is spread far wider. If FEBHP were to be offered to the general population, either the premiums would be substantially higher, or fewer insurance companies would choose to join, or, more likely, both."

http://www.dailykos.com/story/2007/5/10/135933/928

[ContinentalOp]

39. So if this is true I'll end up paying the same amount I pay now.

"if a self-employed (or unemployed!) individual were to buy into this plan, the annual premium for the standard Blue Cross/Blue Shield plan alone — without any out-of pocket medical costs — would be $4,539 for an individual and $10,482 for a family."

$10,482 for a family, or $873/month is about what I pay now for a family plan through Blue Shield. So if this article is true, an FEHB plan would save me nothing.

[ContinentalOp]

40. In fact, looking at the premiums listed at the FEHBP site,

The same Blue Shield Access + HMO family plan that I pay about $800 a month for costs $984.34 under FEHBP. Which is great if the government pays 75% of it but doesn't really help if you're self-employed.

[Warren Stupidity]

28. They can regulate insurers so that they cannot dump high risk

patients, can't charge extra, etc. But I agree, get rid of the insurers entirely. Their entire motivation is to charge as much as they can for providing as little service as they can. For that 'service' they extract huge profits. In a mandatory 'everyone in the pool' system, which is the only way to make it both universal and affordable, the insurance industry serves absolutely no useful purpose.

[Johnny__Motown]

22. No way in hell. she is clearly inflating the estimate but Barack does not want to be dragged into

that fight over numbers. He stays above it and stays on the mandate issue. That is why we can't ever get off the subject. She keeps coming back to it trying to drag him into the place he won't go and he keeps going back to it to avoid the place he does not want to go.

Round and Round and Round we go.

[MagsDem]

26. He stays above it? LMAO -- he's full of shit

People's eyes glaze over when you try to explain this stuff to them, which is exactly what Obama is counting on. The reality is there is ABSOLUTELY no fucking way to reduce the costs of health care without widening the pool to include everyone.

Do you remember last night when he said people opt in to Medicare part B because it's cheap? He's either stupid or he's lying if he doesn't know it's cheap because Medicare part A pools huge numbers into the system. Health care regulation is what I do for a living, and is also the profession of the 3 people sitting in my living room watching the debate with me last night. The howl that went up in my living room when he made that ridiculous remark could have been heard down the block.

He is completely bullshitting you on this subject; something you should have figured out the day he starting sending the Harry and Louise republican style attack flyers out.

[Vinca]

29. There would no doubt be people who would refuse to buy coverage.

The solution for that is simple. Automatic coverage via universal, single payer, health care. You would be enrolled at birth and have a health access card that follows you through your life. Everyone gets the same coverage, paid for by an increase in taxes somewhere. If wealthy people want super duper policies that entitle them to private rooms with mink bed spreads, that's fine. The rest of us just want a cot in a ward as long as we get needed medical care. Legal aliens would need to purchase coverage. The only uncovered would be illegal aliens - another problem altogether. Some insurance company employees would lose their jobs, but since it doesn't bother them when they deny coverage and people lose their lives, I don't really care. Consider it outsourcing.

[MagsDem]

30. Dream on... Obama doesn't even have the guts to go for....

a universal coverage plan let alone what you describe.

[Vinca]

31. I didn't say he did. Despite being one of the "cult," I don't agree

lockstep with my candidate. Kucinich had the best plan, but he's not on the ballot anymore. Hillary's plan is every bit as bad as Obama's. She'll just add insult to injury when she takes grocery money out of your paycheck if you can't afford to sign up to support big insurance.

[LWolf]

32. What does that have to do with universal health care?

Having insurance doesn't guarantee care. First your insurance company has to agree to "cover" the care that you need. Secondly, you have to be able to pay the copays in addition to the premiums to actually receive that care.

Universal health care is a system that guarantees high-quality care to all, regardless of ability to pay. That's what makes it universal.

[mrreowwr_kittty]

36. Who and what is determining how I can afford something?

According to the state of AZ, as a single person with no children I am not eligible for state health aid if I make $850 a month. I am told there will be subsidies. I get the strong feeling that I won't be entitled to any.

After all, everyone knows that people who are not parents are flush with disposable cash and have nothing better to do with it than subsidize other people's kids. :sarcasm:

Yep, I'm guessing I'm one of those people who will be deemed "able to afford" the full cost, whatever it is.