If you like your health insurance, you can keep it your insurance. Period

zzrider · Dec 25, 2013

The observation that "Every other developed country in the world pays between about 5 and 12% of GDP on healthcare, we spend about 18%." is utterly meaningless in the context of Obamacare or single payer for a number of reasons:

1) Other countries aren't the US, do not have our population with our rather complicated demographics and enculturated health care problems. You can't point to a small European country and compare it to the US. Besides, with the exception of Germany, Europe is in far worse economic condition than the US thanks to their socialist welfare states, their health care systems being a prime contributor.

2) There is no evidence whatsoever to suggest that Obamacare will do anything at all to reduce our healthcare expenditures. In fact, we have a perfect example of exactly the opposite experience to draw from: Massachusetts, whose universal plan was pretty much the template for Obamacare.

Seven years after its implementation, MA still has the highest per-capita health care expenditures in the country.

And yes, I also vehemently oppose any form of government-run single payer system as well.

Single payer system are based on the feel-good notion that health care is a basic human right. I dispute this with a simple observation: at the end of the day, health care is a collection of goods and services, that's it. Important goods and services, but goods and services nonetheless. Goods and services are the product of human labor (our labor). How you can you define goods and services - the labor of humans - as a RIGHT than can be claimed by others?

People love the idea of government run healthcare because it creates a fog in the payment mechanism between the patient and payer, and you all just assume you'll get paid because government has the power to take money from others.

So whose right is more important? The person who wants to claim your services as their birthright, or you, for wanting to be paid for your labor?

MunoRN, RN · Dec 26, 2013

The observation that "Every other developed country in the world pays between about 5 and 12% of GDP on healthcare, we spend about 18%." is utterly meaningless in the context of Obamacare or single payer for a number of reasons:
1) Other countries aren't the US, do not have our population with our rather complicated demographics and enculturated health care problems. You can't point to a small European country and compare it to the US. Besides, with the exception of Germany, Europe is in far worse economic condition than the US thanks to their socialist welfare states, their health care systems being a prime contributor.

If we didn't already know why our system costs more then it could be suggested that the differences aren't ones that can be fixed by how we manage our health insurance and delivery, but we know what the problems are and that it's far more than just demographics or culture.

U.S. versus European healthcare costs: the data | [ EpiAnalysis ]

If you're concerned that other countries are being dragged down by healthcare systems that are too costly, why wouldn't you be even more concerned that ours costs about twice as much?

2) There is no evidence whatsoever to suggest that Obamacare will do anything at all to reduce our healthcare expenditures.

While we could do a lot more to reduce healthcare expenditures, Obamacare has already altered to rate of healthcare inflation; 2013 saw the lowest rate of healthcare inflation in 50 years, thanks in part to Obamacare, which isn't bad considering Obamacare does relatively little to control costs compared to what is possible.

In fact, we have a perfect example of exactly the opposite experience to draw from: Massachusetts, whose universal plan was pretty much the template for Obamacare.
Seven years after its implementation, MA still has the highest per-capita health care expenditures in the country.

MA had the highest per capita spending before Romneycare, and like Obamcare it's a pretty minimal start to reform, but even so it flattened the rate of inflation in MA significantly.

And yes, I also vehemently oppose any form of government-run single payer system as well.
Single payer system are based on the feel-good notion that health care is a basic human right. I dispute this with a simple observation: at the end of the day, health care is a collection of goods and services, that's it. Important goods and services, but goods and services nonetheless. Goods and services are the product of human labor (our labor). How you can you define goods and services - the labor of humans - as a RIGHT than can be claimed by others?

Whether you think it should be or not, the fact of that matter is that in the US it is considered a basic right. Prisoners have all their rights taken away except for the most basic, and yes, they get full healthcare coverage. We have laws that reinforce these rights, primarily EMTALA. And everyone is guaranteed at least some for of coverage, although, oddly, not until you turn 65. It's the fact that we legally designate health care as a right, but then try to pretend it's a commodity that is the root of most of our problems.

People love the idea of government run healthcare because it creates a fog in the payment mechanism between the patient and payer, and you all just assume you'll get paid because government has the power to take money from others.
So whose right is more important? The person who wants to claim your services as their birthright, or you, for wanting to be paid for your labor?

You lost me on this part; who's not paying who?

elkpark · Dec 26, 2013

Single payer system are based on the feel-good notion that health care is a basic human right. I dispute this with a simple observation: at the end of the day, health care is a collection of goods and services, that's it. Important goods and services, but goods and services nonetheless. Goods and services are the product of human labor (our labor). How you can you define goods and services - the labor of humans - as a RIGHT than can be claimed by others?

The same argument could be made about police and fire-fighting services, and, yet, we don't individually contract with private police and fire-fighting companies; if a crime is committed against you or your house catches fire, you call 911, they come and do what is needed, and you don't get a bill, because we all pay taxes so that those services will be there when they are needed. Whether or not healthcare is the same as that, or more like buying a washing machine or a car, is a matter of philosophy and personal belief.

zzrider · Dec 27, 2013

The same argument could be made about police and fire-fighting services, and, yet, we don't individually contract with private police and fire-fighting companies; if a crime is committed against you or your house catches fire, you call 911, they come and do what is needed, and you don't get a bill, because we all pay taxes so that those services will be there when they are needed. Whether or not healthcare is the same as that, or more like buying a washing machine or a car, is a matter of philosophy and personal belief.

Not true. You do not have a RIGHT to police or fire protection. The Supreme Court found in Warren Vs. District of Columbia that the police do NOT have a DUTY to protect you, thus, you do not have an automatic "right" to their labor.

elkpark · Dec 27, 2013

Not true. You do not have a RIGHT to police or fire protection. The Supreme Court found in Warren Vs. District of Columbia that the police do NOT have a DUTY to protect you, thus, you do not have an automatic "right" to their labor.

Please show me where I said, in my statement, that anyone has a "right" to police or fire services. And, apart from your misattributing a reference to "rights" to me, what is untrue about what I said?

zzrider · Dec 27, 2013

Please show me where I said, in my statement, that anyone has a "right" to police or fire services. And, apart from your misattributing a reference to "rights" to me, what is untrue about what I said?

My apologies for misinterpreting your response. My post was addressing the perception of health care as a right and how this perception is what is largely behind the drive for universal single-payer coverage. Since you took issue with my post, I thought you were drawing a parallel between police and fire services and healthcare in the context of assumed basic rights.

Since we're on the same page regarding these sorts of things NOT being rights, that simplifies the discussion.

If you're just illustrating one possible view of healthcare as being analogous to unionized monopolistic municipal services (which is what police and fire departments are), then your not "wrong" insofar as you are entitled to that opinion. But for my part, no thanks. I want no part of such a system.

MunoRN, RN · Dec 27, 2013

Not true. You do not have a RIGHT to police or fire protection. The Supreme Court found in Warren Vs. District of Columbia that the police do NOT have a DUTY to protect you, thus, you do not have an automatic "right" to their labor.

That was actually a district court but they didn't actually find police don't have a duty to protect you it was that they don't have a duty to protect your property (the problem in that case was that it was incorrectly reported as a burglary instead of an assault.

There was also the "pay to spray" controversy that came up with one case in particular where a fire department refused to protect property on fire, it was agreed however that if human health or well-being was in jeopardy that they would have to intervene if able.

Unlike Police or Firefighters, there are actually laws that specifically require healthcare to be provided, so it's not just the ethical/more obligations that Physicians and Nurses are required to follow as a condition of their license, it's specific laws as well.

That doesn't mean that all aspects of healthcare are legally defined as "rights", there are some true commodities as well such as plastic surgery.

MunoRN, RN · Dec 27, 2013

My apologies for misinterpreting your response. My post was addressing the perception of health care as a right and how this perception is what is largely behind the drive for universal single-payer coverage. Since you took issue with my post, I thought you were drawing a parallel between police and fire services and healthcare in the context of assumed basic rights.
Since we're on the same page regarding these sorts of things NOT being rights, that simplifies the discussion.
If you're just illustrating one possible view of healthcare as being analogous to unionized monopolistic municipal services (which is what police and fire departments are), then your not "wrong" insofar as you are entitled to that opinion. But for my part, no thanks. I want no part of such a system.

The right to healthcare isn't just a "perception", it a right that is defined by law, do you disagree that those laws and program exist or that they don't actually define healthcare as a right?

liberated847 · Dec 27, 2013

It's funny that the people arguing that healthcare is not a right are usually the same people attending churches while completely disregarding what Jesus taught in the bible about how to treat your fellow human beings, and sorry, the "we can't afford it" argument does not fly specially when we are spending billions fighting a war of choice.

Overland1, RN · Jan 1, 2014

Obamacare is so good that...

Families USA received $1.1M grant to 'produce' Obamacare success stories amid litany of setbacks and glitches | Mail Online

Hey... I'm convinced.

Then, do your own research into "Families USA" and its connections to ACORN.

SL2014 · Jan 1, 2014

Seriously. My insurance copayments through my work insurance doubled. My out of pocket maximums doubled. My cost of benefits increased 29%...Whether that is directly due to Obamacare, I don't know. I'd assume so. The bottom line is that the ACA did not actually address the issue- the COST of healthcare. It is an insurance stimulus. Access to healthcare isn't a problem, it's the cost of that accessible healthcare. And since when is a $10,000 deductible affordable? Oh- and did anyone hear about companies being penalized for "Cadillac Insurance Plans?" Meaning that if they contributed more than a certain amount of the cost of an employees' insurance premium... They get PENALIZED... If your company pays... Too much... On behalf of their employees... They get penalized. Wowness...

Overland1, RN · Jan 3, 2014

Um... where are all those valiant defenders of ObamaCare that were here a year ago? Totally flaming anyone who dared to have any doubts about how Democrat promises square with reality.
Debacle.
Train wreck.
Disaster.
Total fail.
Incomprehensible.
Illogical.
Impossible.
Unrealistic.
Just some of the adjectives applied to the roll out by radical Tea Party news outlets like the Washington Post and the New York Times, CBS and NBC.

And then there is this:

[h=1]Non-Partisan Study Predicts Obamacare's Next Broken Promise[/h] Jan. 2, 2014 2:16pm Fred Lucas
Just last November, President Barack Obama praised Obamacare as a money-saver by keeping folks out of emergency rooms.
"It means that all the providers around here, instead of having to take in folks in the emergency room, they suddenly have customers who have insurance," Obama said. "That means those of you who already have health insurance, your premiums will not be subsidizing folks who don't have health insurance. People will get preventive care, which means that people are likely to be healthier."
President Barack Obama waves to the crowd watching him play golf of the 18th green at the Mid Pacific Country Club, Wednesday, .Jan. 1, 2014 in Lanikai on the island of Oahu, in Hawaii. (AP/Marco Garcia)
Just like "you can keep your health care plan," it now appears that yet another selling point of the Affordable Care Act-that pouring more money into Medicaid would reduce the number of emergency room visits, make people healthier and save money - may not pan out.
That's the decisive verdict of a study of new Medicaid residents in Oregon, where expanding Medicaid actually increased emergency room visits and did not improve the health.
The study compared 25,000 low-income individuals with and without Medicaid. It found those with Medicaid ended up in the ER 40 percent more than those without insurance. In most cases, their conditions were classified as "primary care treatable," and not warranting emergency treatment.
The Oregon Health Insurance Experiment conducted by the National Bureau of Economic Research, a nonpartisan research group, began the study in 2008 of the expansion of the Medicaid roles in the state, the Daily Beast reported. The Oregon residents were picked through a lottery, who had lower incomes but not able to qualify for Medicaid.
Obama has long made the argument that this would reduce health costs through prevention.
"What happens is, you don't have health insurance, you go to the emergency room," Obama said in 2010. "You weren't getting a checkup; something that might have been curable with some antibiotics isn't caught. By the time you get to the hospital, it's much more expensive ... we're a lot better off if we are making sure that everybody is getting preventive care."
In 2009, Obama said: "There's been almost a doubling of emergency room care in a relatively short span of time, which is putting enormous strains on the system as a whole. That's the status quo, and it's only going to get worse. If we do nothing, then families will spend more and more of their income for less and less care."
Senate Majority Leader Harry Reid (D-Nev.) made the argument last year opposing House Republican efforts to defund Obamacare, which he said would "force millions of American families to once again rely on expensive emergency room care--or go without care at all."
Two dozen states have declined the Medicaid expansion, citing cots. But the administration believes that will change.
"Five million peple who would have been eligible for Medicaid are left uninsured," White House Deputy Senior Adviser David Simas said on a press conference call Thursday. "This is too important from an economic perspective. It's the right thing to do. We expect more states to approve it going forward."
The sampling in the study reportedly mirrors the expanded pool of the 13 million to be added to the Medicaid roles under Obamacare. The records showed no improvement in tests for manageable medical conditions such as diabetes, high cholesterol and hypertension.
Nationally, Medicaid patients make up just 16 percent of the population but make up one-third of emergency room visits, according to the Centers for Disease Control and Prevention.
(This story has been updated to included a comment from White House Deputy Senior Adviser David Simas.)
(H/T Daily Beast)