[blueash]

Originally Posted by goodtimesintv

I like what you wrote. But the real problem is that under your proposed system, Aetna and all the others like it are going to keep on charging as they wish, because their most lucrative business will still come from the federal government and Congress employees who fought tooth and nail (during ACA mandate making)......to keep their 20+ PRIVATE plans with us paying about 70% of their premiums for them.

See plan comparison list here, and then see "Premiums" in the menu:

Health & Insurance : Plan Information - OPM.gov

.

No, Aetna could only charge the rate the government established as its cost to provide coverage, and that payment would come from the government just as Medicare Advantage plans are paid now. Except no networks, no excluding Mayo, none of that. They could of course have a higher cost plan where instead of 800/mo, they offer a 1000/mo plan where they get 800 from the gov't and 200 from you. No tax benefit to you or an employer for that additional cost.
And yes, we need to vigorously prosecute Medicare frauds and yes we need to allow the Gov't to negotiate drug prices. None of that alters the basic arguments in favor of universal coverage, which was not allowed into the ACA at the insistence of the big insurance companies.
For more information on it perhaps read:
United States National Health Care Act - Wikipedia, the free encyclopedia

[Paper1]

Originally Posted by dbussone

We have a diversity of comments for the most part. I'm hoping we hear from many more of our fellow posters. Good stuff, and interesting as well. Thanks for participating.


Sent from my iPad using Tapatalk

With so many recieving health care at little or no cost with others picking up tab through income tax UHC is inevitable. IMO

[Cedwards38]

Originally Posted by rubicon

Indeed a complex topic and one too large for these pages.

One poster views healthcare as a right. I find it convenient when people invent rights for themselves. there is no legal or constitutional basis for such a right, no more than saying people have a right to own a home. We saw what that sort of thinking did to the housing industry with lax underwriting and we see how we are in multi-trillion dollar debt for student loans that many students believe they have a right not to pay back...........................and another dimension to this issue of "my right" is the fact that I am entitled to a lot of right ...its the American way

As to funding the short of it is that the federal government is too big too complex too under educated to handle managing 1/6th of our economy.

The central issue in the OP's topic is funding. The ACA laws were passed with the option to let people in or out at their leisure. Insurance is a pooling of resources by many for the benefit of some especially when it comes to catastrophic losses that the average family cannot absorb. so we have people who get sick buy insurance treat get better drop out. We have young people who being healthy will never opt in until they have a need. etc etc.

Again with sensible regulations and underwriting private insurers can do a better job both managing benefits vis a vis premiums and the fraud and abuse associated with this funding because it all means profit. and keep in mind insurance laws are written that contain the expense component of premium remain fixed. Premium are calculated on an ongoing basis to reflect what is occurring in the economy (marketplace) ACA insurance companies bleeding money are going to individual policies not in ACA to subsidized their losses . Tell me where or when the government worried about expenses or spending. I mean its someone else's money and it is low lying fruit to be picked at any time

This is an issue for us now because we are affected by it now. ACA instigated the mess we are in now. It has reverberated across the healthcare spectrum. My company because of ACA stopped negotiating insurance for its retirees because ACA removed the insurability option. so now the company offers an annual stipend and we do our own search . Ironically we chose the same health care plan as was offered by our company. the kicker is they tell me if we opt out then we are subjected to insurability. The reasoning is obvious and stated above.

ACA has been a disaster and it was meant to be because its authors really wanted a single payer system and so they intentionally have placed a lot of people in harms way to get their political agenda. IMHO people will rue the day they concede to government control vis a vis free enterprise for this large portion of our economy.

It's true that, oftentimes people conveniently invent "rights" for themselves that are not prescribed for them by the government, but are you suggesting that American citizens do not have a unalienable right to life that is endowed by our Creator? And if we do have this right to life, does that not imply that adequate healthcare for all citizens is required?

I know that it is the Declaration of Independence, duly adopted by the Second Continental Congress in July 1776, that states that, "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness." Aren't rights established by the Declaration, because if not then we are all still British citizens. If this thinking is wrong, then is the right to liberty and the pursuit of happiness in question as well? The right to life, from the Creator, is self-evident rather than conveniently invented.

[bob47]

I wish I understood this subject better. Here are a few observations and thoughts.

When I retired, my company provided health insurance until we received medicare, at which point all support stopped. The company claims to have contributed the first $10,800 per year for premiums, and my wife and I paid an additional $7,000 per year. $18,000 per year for premiums for 2 people, with a large deductible. How many Americans can afford that?

Any universal coverage will have to have limits and make compromises that will disappoint some folks. To pick one example, is fertility treatment coverage a necessity? These decisions will will cause some heated discussions.

It seems like Medicare is government run universal health care for old folks, and it seems to work pretty well for those that have it. I don't know if it's sustainable. I do know that my health care costs have gone down a lot since we are on Medicare, and we have no complaints about what is covered.

We are fortunate here in The Villages to meet a lot of folks from Canada and I often ask them what they think of their medical system up there. Not one has had personal complaints about how their system works.

No answers here. Just some personal observations.

[Paper1]

Originally Posted by graciegirl

Most of the times your posts are great, but this one is brilliant.

I have to disagree that this post is brilliant, it just says we would rather leave mess to our grand children. We should address it. IMO

[rivaridger1]

Like it or not the senior citizens of this country are already enrolled in a " Universal Health Care " program called Medicare. Rich or poor, it does not matter, all are participants. The rich can opt out and pay for private health care, but they can not opt out of paying basic Medicare insurance premiums or at least that is my understanding. Curiously, for something administered and managed by the Federal Government it seems to work, the cost issues and sustainability of the program aside for the moment. If you really want to start an interesting thread on this forum submit an argument the Medicare program should be disbanded and that we need to revert to the private health care system which existed in this country in the 1940-50s when if you were not rich, did not have access to employer sponsored health care, or simply did not have he money to pay for the generally limited private health insurance then available, if you got sick good luck. In those decades your illness went untreated until you were admitted to the hospital to die. Prior to then, it was even better, since you simply died at home after lots of painful suffering.

How any senior enjoying the benefits of this " Universal Health " care program can argue in good conscience the younger "citizens " of this country no matter their economic circumstances or state of health should not have similar access to health care escapes me.

I know some will feel differently but at least start your argument, if it indeed has substance, with the proposition the current Medicare program should be legislated out of existence and that all those dependent on it should in the future rely on their own financial resources and/or the charity of their friends and neighbors for their health care needs.

As to costs, which really control the sustainability of any " Universal Health " care program, they must be regulated in some fashion. Do you regulate the cost of medical services and drugs and risk losing the advances in health care the profitability those services and drugs profits create ? Do you regulate the profitability of the services and drugs to allow for the advances in medical science to continue ? Do you tell the citizens they live in a capitalistic society and they need to willingly absorb whatever costs result from that decision ? Who else can do any of these things other then the Federal Government ?

Who other then the Federal Government has the power and ability to both mandate participation in a " Universal Health " care program and to regulate the cost of the program itself ? I personally do not wish that was the case, but private enterprise would not appear to be up to the task of doing so and would be need to be empowered by the government to do so as well bringing us back to square one.

[fraurauch]

Originally Posted by rivaridger1

Like it or not the senior citizens of this country are already enrolled in a " Universal Health Care " program called Medicare. Rich or poor, it does not matter, all are participants. The rich can opt out and pay for private health care, but they can not opt out of paying basic Medicare insurance premiums or at least that is my understanding. Curiously, for something administered and managed by the Federal Government it seems to work, the cost issues and sustainability of the program aside for the moment. If you really want to start an interesting thread on this forum submit an argument the Medicare program should be disbanded and that we need to revert to the private health care system which existed in this country in the 1940-50s when if you were not rich, did not have access to employer sponsored health care, or simply did not have he money to pay for the generally limited private health insurance then available, if you got sick good luck. In those decades your illness went untreated until you were admitted to the hospital to die. Prior to then, it was even better, since you simply died at home after lots of painful suffering.

How any senior enjoying the benefits of this " Universal Health " care program can argue in good conscience the younger "citizens " of this country no matter their economic circumstances or state of health should not have similar access to health care escapes me.

I know some will feel differently but at least start your argument, if it indeed has substance, with the proposition the current Medicare program should be legislated out of existence and that all those dependent on it should in the future rely on their own financial resources and/or the charity of their friends and neighbors for their health care needs.

As to costs, which really control the sustainability of any " Universal Health " care program, they must be regulated in some fashion. Do you regulate the cost of medical services and drugs and risk losing the advances in health care the profitability those services and drugs profits create ? Do you regulate the profitability of the services and drugs to allow for the advances in medical science to continue ? Do you tell the citizens they live in a capitalistic society and they need to willingly absorb whatever costs result from that decision ? Who else can do any of these things other then the Federal Government ?

Who other then the Federal Government has the power and ability to both mandate participation in a " Universal Health " care program and to regulate the cost of the program itself ? I personally do not wish that was the case, but private enterprise would not appear to be up to the task of doing so and would be need to be empowered by the government to do so as well bringing us back to square one.

I couldn't agree more!

[spuds51]

Originally Posted by Cedwards38

It's true that, oftentimes people conveniently invent "rights" for themselves that are not prescribed for them by the government, but are you suggesting that American citizens do not have a unalienable right to life that is endowed by our Creator? And if we do have this right to life, does that not imply that adequate healthcare for all citizens is required?

I know that it is the Declaration of Independence, duly adopted by the Second Continental Congress in July 1776, that states that, "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness." Aren't rights established by the Declaration, because if not then we are all still British citizens. If this thinking is wrong, then is the right to liberty and the pursuit of happiness in question as well? The right to life, from the Creator, is self-evident rather than conveniently invented.

If I'm following you you're saying that in the Declaration of independence the word LIFE means all entitled to health care be cause it is a necessity of LIFE. Maybe we should add food to that as well after all we all need food for life.
What do you think would happen if the government had a universal food plan? I had a friend that owned a grocery store..he said you could always tell the ones that had no money. They were the ones with the most food. Guess what the store is going to do when the government is paying for all food. Yep, jack up the prices.
One poster says a universal health care plan is doable by charging a fee to the employer and employee. As of the end of 2015 almost 40% of the country was not working, most were on some government assistance already. Besides, haven't we already done that? It's called Medicare. As for people getting more than they payed in..that's how all insurance works. If you pay $150. a month for your car insurance and wrap it around a tree you are getting more out of than you payed in.
Right now the federal government is paying between 6 and 7 % of the federal budget for just the interest on the national debt. Interest rates are at historic low rates. If it would rise to more normal levels that amount would rise substantially. Our national debt has now surpassed our gross domestic product. And here is another little sobering thought if you add the national debt, liabilities, ( such as government pensions and retirements), other unfunded obligations that figure at the close of the 2015 fiscal year was 76.4 trillion dollars. That represents 90% of the combined net worth of all holdings. That is every single thing in this country. All buildings, cars, banks accounts, TV's everything. Yet people want to start more social programs. I don't get it. Oh well, I'm going to go play golf...I'm sure it will all take care of itself.

[PTennismom0202]

We have am employment-based model. We're the only one in the world. If you're lucky to work for a company big enough and generous enough to offer health insurance, you've seen your portion of the cost shifted in your direction lately. That's because it's going up due to technology, and little bit because of defensive medicine. And people expect to have the best! There is no law that requires employers to offer health insurance, so why should they? Young people have a hard time getting jobs and many don't get health insurance even if they work full time. When they get sick they often go to the ER (which is way more expensive than the PCP) and then either the hospitals writes it off as bad debt, some states have insurance companies subsidize the uninsured, or the patient goes deeply into debt. What are we going to to do make sure every American has adequate health insurance so that the costs aren't subsidized by someone else, or drive them into debt?

There are 700,000 physicians, millions of other providers, and 5,000 hospitals in the country. They want to be paid fairly (or maybe fairly +) for the care they give. We've had 2 serious attempts to build a way to get everyone covered. One was back in Clinton's first term. The second one is the ACA. How can we use these professional providers and hospitals, keep them private, and cover everyone? Every other first world country in the world has national health insurance -- not an employer-based program. I think we've got to go this way. I am sure that will be a very unpopular idea in TV, but how else are you going to rearrange the deck chairs (patients, employers, professional providers, institutional providers and insurance companies) to get to universal coverage? BTW, Medicare is a national health service. Any national health program will need tight medical policy/Utilization Review program (what's covered?, under what conditions?, who can perform the services? how often?...+more controls), and probably an annual aggregate budget shared by all providers. Right now there is no stomach for this -- only taking the ACA away.

[justjim]

An old thread that I found not only interesting but also informative. We seniors with our Medicare are sort of like a "snug bug in a rug". It's pretty easy for us to say let's abolish the ACA while we are "snug as a bug in a rug" with a hybrid form of Universal health care known to us as Medicare. Arguably we seniors are more healthy and are living longer because we have health care.

Now Medicare is not perfect and certainly ACA is far from perfect. Neither are substainable without some changes. Perhaps painful changes.

It's true our employers provided most of us some form of health care insurance during our working years. Because of great changes and global competition many of our former employers either went out of business or moved elsewhere some even out of the United States. In order to remain competitive in a global economy, many companies have cut back on benefits that includes retirement and paid health care. Even government employees are being required to contribute more to their benefits (especially health insurance) and Billions are owed to pension systems and are no longer sustainable. Pensions are definitely another topic for discussion in another Thread.

The next several years many challenges in health care are going to take place
and how we embrace the changes will determine what type of hybrid system we end up with here in TV and across the country. How we are going to pay for our health care is yet to be determined.

[BK001]

Originally Posted by NYGUY

We can quit saying we will never vote for Universal Healthcare. We will be dead. Those coming after us will vote for it. This is an interesting conversation, but 20 year old's should be having it.

Yes they should ... but will they?

I was fortunate, throughout my HR career, to have worked at several fine (and generous) NY professional practice firms in both the legal and accounting industries.

And while the firms' contribution for employees was a generous percentage of the medical premium, they all had some sort of an employee contribution. Young people starting out have many competing desires for their entry level salaries ... first car, apartment, clothes, vacations, tuition loan repayments, etc.

I can not count how many times I counseled a new employee who chose not to participate in the medical -- even using scare tactics such as "... I know you are healthy and invincible ... but what if, god forbid, your appendix bursts without warning. Who is going to help you? Do you really want to put your parents at risk and possibly have to ask them to spend their retirement savings, or worse, sell their home because you didn't signup for medical coverage?"

Occasionally my tactic was successful. (Same was true with 401K signups where the company had a match program!) Try convincing this population that it is the best financial move available to them.

They can be a difficult demographic for discussions about healthcare and retirement issues.

[Paper1]

Originally Posted by rubicon

Indeed a complex topic and one too large for these pages.

One poster views healthcare as a right. I find it convenient when people invent rights for themselves. there is no legal or constitutional basis for such a right, no more than saying people have a right to own a home. We saw what that sort of thinking did to the housing industry with lax underwriting and we see how we are in multi-trillion dollar debt for student loans that many students believe they have a right not to pay back...........................and another dimension to this issue of "my right" is the fact that I am entitled to a lot of right ...its the American way

As to funding the short of it is that the federal government is too big too complex too under educated to handle managing 1/6th of our economy.

The central issue in the OP's topic is funding. The ACA laws were passed with the option to let people in or out at their leisure. Insurance is a pooling of resources by many for the benefit of some especially when it comes to catastrophic losses that the average family cannot absorb. so we have people who get sick buy insurance treat get better drop out. We have young people who being healthy will never opt in until they have a need. etc etc.

Again with sensible regulations and underwriting private insurers can do a better job both managing benefits vis a vis premiums and the fraud and abuse associated with this funding because it all means profit. and keep in mind insurance laws are written that contain the expense component of premium remain fixed. Premium are calculated on an ongoing basis to reflect what is occurring in the economy (marketplace) ACA insurance companies bleeding money are going to individual policies not in ACA to subsidized their losses . Tell me where or when the government worried about expenses or spending. I mean its someone else's money and it is low lying fruit to be picked at any time

This is an issue for us now because we are affected by it now. ACA instigated the mess we are in now. It has reverberated across the healthcare spectrum. My company because of ACA stopped negotiating insurance for its retirees because ACA removed the insurability option. so now the company offers an annual stipend and we do our own search . Ironically we chose the same health care plan as was offered by our company. the kicker is they tell me if we opt out then we are subjected to insurability. The reasoning is obvious and stated above.

ACA has been a disaster and it was meant to be because its authors really wanted a single payer system and so they intentionally have placed a lot of people in harms way to get their political agenda. IMHO people will rue the day they concede to government control vis a vis free enterprise for this large portion of our economy.

My wife and I are both 64 and are paying for our own health insurance so are in the small group that is getting keelhauled by medical juggernaut. When one says medical care is not a right that means someone has to make a call on what to do with people who cannot afford it. Do you do nothing, do you give them pain meds until they die, do you treat them up to a certain dollar limit, etc. Healthcare costs are one of the major reasons our manufacturing sector is dying. I am a believer in the free enterprise system but medical care is in an unsustainable profit making frenzy. Count me as a single payer supporter.

[justjim]

Originally Posted by Paper1

My wife and I are both 64 and are paying for our own health insurance so are in the small group that is getting keelhauled by medical juggernaut. When one says medical care is not a right that means someone has to make a call on what to do with people who cannot afford it. Do you do nothing, do you give them pain meds until they die, do you treat them up to a certain dollar limit, etc. Healthcare costs are one of the major reasons our manufacturing sector is dying. I am a believer in the free enterprise system but medical care is in an unsustainable profit making frenzy. Count me as a single payer supporter.

Agree or not this is a honest post on the subject.

[ColdNoMore]

Originally Posted by Paper1

My wife and I are both 64 and are paying for our own health insurance so are in the small group that is getting keelhauled by medical juggernaut. When one says medical care is not a right that means someone has to make a call on what to do with people who cannot afford it. Do you do nothing, do you give them pain meds until they die, do you treat them up to a certain dollar limit, etc. Healthcare costs are one of the major reasons our manufacturing sector is dying. I am a believer in the free enterprise system but medical care is in an unsustainable profit making frenzy. Count me as a single payer supporter.

It's sad to think that the greatest nation this planet has ever seen, puts so many things ahead of looking after the health of its citizens.

Especially since most other developed nations...have already came to that conclusion.

Hopefully, one of these days soon...that will be a stress that you no longer have.

[l2ridehd]

Unfortunately we are fast becoming a nation of people who believe they are entitled to everything without having to pay for it. If it comes from the government it must be free. This includes health care. Until we move away from the entitlement way of thinking we will never solve this problem. Making a decision to not work or work less or let someone else take care of me has to have consequences. Those that can't help themselves should get help from all of us who can. Those that can but don't should not. Then and only then can we as a nation succeed with things like health care for all and retirement plans that work and other government social programs.

So what do we do about the current health care issues? There are several things that can be done but will be painful and expensive for all.

1. Get the government out of health care EXCEPT for a high deductible, catastrophic, supplemental plan with no pre existing limits. Maybe something like a 20K annual deductible with a multi million cap and an annual premium that is affordable and require everyone have it. This way private insurance can become competitive when they know they have some maximum expense. Lots of other details needed but something along this concept.
2. A limit on tort for medical malpractice along with a license removal when any doctor is sued X times. Get the bad ones out and a cap on total expense will again make the insurance more affordable and allow doctors to cut cost.
3. Allow drug companies a better way to expense drug development and testing to cut the total cost of new medicines. This is an area that adds significant cost to medical care, but is also required if we want to maintain a best of the best health care system.
4. Make medical school more affordable by providing interest free subsidized loans for those wanting to become doctors.

These four steps would be costly, but less then the current "affordable care act" is currently costing. It would cost all of us more then we now pay but would also provide access to excellent care and eliminate the fear of going broke when you have a serious illness. Again lots of details needed but this type of plan would work and cut total cost for all of us in the long term while still providing the best health care available. And there would always be the naysayers who will want the government completely out and the lawyers who will still want the large tort fees and will lobby against it, but if everyone supported something like this it would work.