I previously stated I was throwing my hat in with Obamacare. That it had some good things to offer. And while this is still true, I took a closer look at the numbers... If someone has more information on HOW we will pay for all this, please let me know. Right now my biggest problem is that this is unsustainable. Im still for age limit 25 remaining on family insurance and no exemptions for preexisting conditions. Im also for taxing smokers and the medically non-compliant more heavily. Ok, so time to clear up misconceptions and provide some public education. Politicians have no idea what they are doing. They are not students of economics or healthcare and are ruining this country with policies they do not understand. Observe the following facts and then I will dispel the ideas that obamacare will force more people to pay for insurance, that it is sustainable, that the poor cannot afford it (they probably can, it is the lower middle class that cannot), and that anything government does is a good idea. Government cannot be the solution, government is the problem. 1) A conservative estimate of medicare/medicaid spending in 2011 put it at 18% of the american GDP. For those unfamiliar the Gross Domestic Product is the sum of EVERYTHING the United States produces in 1 year. That means that EVERY time you make $5, $1 goes to medicare. This does not include other healthcare costs. Think about that for 1/2 a second and you should be screaming in terror realizing that america is so sick, fat, and lazy that we spend more than 20% of our money trying to fix health issues. For comparison the american military is 4.4%-13% of the GDP depending where you get your numbers. The good news is that we are spending more money trying to stay alive than killing other people. Silver lining. (source: usgovernmentspending/). 5% of the population uses 50% of the healthcare costs in this country. The lower 20% use 80% of the healthcare dollars. Medicare spends 30% of its dollars in the last 6 months of a patients life. Medicaid and other agencies (private insured) are higher at over 50% of costs on futile and stupid treatments in the last 6 months of life trying to extend life 1-2 miserable days rather than saying goodbye with dignity. *Please do not skim those last statistics... Absorb them* *This means that we NEED to stop spending on end of life care (focus on pain management and quality of life instead of spending millions on tests and treatments that dont matter, and no CPR for people with terminal conditions.)* 2) Obamacare expands medicaid coverage to millions of uninsured. Again, conservative estimates put the number of new medicaid enrollees at 5 million in the next year with more coming after that. *50 million people are uninsured in the USA. Understand that increased coverage will result in increased utilization, with fewer doctors than ever available, and not enough money to go around* 3) Doctors do not take medicaid as medicaid reimbursements are about 40% of what treatments are actually worth. I personally know kindhearted doctors put out of business by accepting medicaid patients. Pediatrics and primary care are the most affected, they are the ones most needed by low income families. It cost a pediatrician friend of mine $40 to administer a vaccine, he was reimbursed $14. He gave thousands of those a year paying for them out of his own pocket, he now is part owner of a small mexican restaurant and sold his practice. Hospitals who are forced to take over a certain percent of medicaid patients only keep their doors open due to government grants. The amount of these grants given to each state is fixed. These grants are trickled down from larger hospitals taking the bulk of the money until it gets to small rural hospitals. Many times there is not enough money for these smaller hospitals to run well or stay up to date. Hospitals shift these costs to insurance companies by charging more money for surgeries and such (a knee surgery in the US is about $15-$30k more expensive than in england and taiwan respectively). Insurance companies then refuse to pay the whole cost but if they are a large insurer (blue cross) they can force a hospital to take less than the asking price by showing that 80% of their patient pay source comes from them. The hospitals agree in order to keep the business. The uninsured do not have this luxury but most hospitals give a 20% discount to help them pay it off. *This is not usually enough. This drives up healthcare costs OR puts hospitals out of business and in many cases BOTH. If you are wondering why your premiums are going up its because insurance companies have now lost their collective bargaining power. With a larger percentage of hospital income coming from the obamacare group, hospitals will be sticking them with a higher percent of the bill if they want to be able to send customers of their insurance to that hospital. This will happen for 2 reasons, the hospital will be trying to keep its doors open, AND many people will likely switch to obamacare or stop paying for insurance altogether due to high premiums... Which will spiral further out of control.* 4) Obamacare forces people to pay for health insurance. A tactic I wholeheartedly agree with... However, I cannot figure out WHO is being forced to pay for this. Medicaid will be expanded to cover those making less than 138% of the poverty line. People will receive tax credits if they make 250% of the poverty line to lower their out of pocket costs for health care. Those making less than 400% of the poverty line will receive subsidies. (these benefits stack, so the 250%ers also receive the subsidies). For your information a family of 4 making $90,000 per year is 400% of the GDP. So who pays the taxes? The Middle class. I assume that most families making over $90,000 per year have insurance, if they do not they will be taxed to the max which will be up to 2.5% annually or $695 per individual. If you make less than $27,800 you are exempt from this tax. So people BELOW $60,000 get health care for almost nothing, and up to $90,000 you get subsidies... while ABOVE this line people are taxed, but not enough to sustain these programs. *This is a tax on the MIDDLE class.* A class that is rapidly disappearing thanks to liberal policies. But then again.... what is the percentage of households who make $90,000 (or $45,000 for each spouse), that doesnt have health insurance? Is it enough to cover for the million of additional patients getting medicaid level care??? *The middle class will pay for millions of new people who abuse the system at no cost to themselves, while, at the same time there doesnt seem to be enough people who will be taxed for this!?* 5) Most of the disease in the united states is LIFESTYLE related. Smoking, obesity and hypertension. More than 80% of disease is preventable and quite simple to prevent. Heart disease is the leading killer in this nation with over 90% of it being lifestyle related. So basically, you have a group of large group of people with self inflicted disease that you want ME to pay for. Typical american voters desiring to avoiding personal responsibility. If you want to HELP people and not just enslave them to the liberal party to continue their benefits, TEACH them responsibility and educate them. I personally take care of many patients on medicaid that smoke 1-2 packs of cigarettes a day. I would say that this is actually the norm for that population. That equates to over $300/month depending on the brand. They can buy insurance for less, but instead they are now expanding medicaid to a larger group of people 80% of which are statistically causing their own disease. Thats like someone spending their whole paycheck on lotto tickets and demanding you pay their rent.... *What lesson is learned except that it is allowed? Healthcare is no different when you look at the amount we spend 1/5 of the GDP is UNSUSTAINABLE and those numbers were expected to climb BEFORE obamacare! Now we have WAY more people on a medicaid type system, accountable for nothing, with the government deciding how much hospitals get paid for a higher percentage of clients, We will tax the middle class INTO the lower class bracket to pay for it, and it will STILL not be enough. Healthcare is THE largest percentage of the GDP in the United States. Being 18 trillion dollars in debt is not the time to INCREASE your largest expenditure. Thats like making $1000/ month and having an $800 car payment then trading it in for a $900 payment per month.* The key to lowering health care costs is education and stopping excess spending on futile end of life care. Tax heavily or deny care to those who abuse the system and then we can take care of those who deserve it with impunity. We would additionally cut 1/5 of the US government spending and possibly fix this country... And look at that, all it took was a little conservative thinking and personal responsibility... Lopez for president, 2016
Posted on: Tue, 15 Oct 2013 04:12:30 +0000
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