Who Obamacare has helped the most

[gauss]

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Originally Posted by John Galt III I wonder what would happen to one's credit rating if there were some late / unpaid medical bills. My car insurance uses my credit rating among other things to determine my rate. Recently I was considering simply not paying for a $75 medical bill I received. Fortunately, when I called the provider, they said it was their mistake, and to not pay it. But it seems the ""take to it collections, I don't ever need credit again anyways" tactic may be what many of us will be forced to use against the "gotchas" that are so prevalent in healthcare billing.

In addition to the credit rating impact, remedies could include all those available to unsecured creditors: seizing financial assets, garnishing wages and placing liens on assets depending on state law.

I am no attorney so please correct me if anything is incorrect/misleading.

-gauss

[daylatedollarshort]

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Originally Posted by Totoro Whether or not a single payer or universal healthcare system is your best solution, I wouldn't dare say. Fact remains that most countries that have much better outcomes do have such a system. So if Obamacare helps millions get healthcare and in the long run streamlines the administration a bit, I'd say the whole of the US wins. Sorry for the rant.

I am always happy when people from outside the U.S. post on this subject. I've never read a single post from anyone in Canada, England, Australia or any English speaking, comparable standard of living country wishing they had our health care system. Here is another comment from a non-U.S. resident:

"Americans have Stockholm syndrome. The rest of the world has efficient and universal health care as the norm, and here you are gushing over the pathetic scraps that you are tossed as a result of the ACA."

From a Reddit thread called thanks Obamacare:
Thanks "Obamacare" : politics

with lot of anecdotal reports of how the ACA has helped people with no insurance, pre-existing conditions, insurance caps, etc.

[samclem]

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Originally Posted by daylatedollarshort I am always happy when people from outside the U.S. post. Here is another comment from a non-U.S. resident:

Please, don't blame them for their misconceptions. They are just reading the inaccurate accounts of the terrible "dog eat dog, winner-take-all" culture as portrayed in the media. It's the same way with many other issues: I'm sure many outside the US believe every American is packing a gun, works 90 hours per week, takes 2 days of vacation per year, worships 30 hours per week at a church in the woods, and that 50% of us are illiterate. It's what the US media like to report, and it's what the foreign media likes to pass along.

Overall health and health care? Americans have longer life expectancies than our EU friends when adjusted for premature death due to non-health related injuries (we spend a lot more time in cars in the US than people do in Europe. And, there is more violence, but that's hardly a commentary on the US health care system).

[daylatedollarshort]

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Originally Posted by samclem Overall health and health care? Americans have longer life expectancies than our EU friends when adjusted for premature death due to non-health related injuries (we spend a lot more time in cars in the US than people do in Europe. And, there is more violence, but that's hardly a commentary on the US health care system).

Life span is one criteria to measure for ranking country-wide health care systems, but most non-partisian organizations' rankings take into account many factors, including number of uninsured and equitable access to health care among the citizens.

Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally - The Commonwealth Fund -

"The U.S. ranks last of 11 nations overall. Findings in this report confirm many of those in the earlier four editions of Mirror, Mirror, with the U.S. still ranking last on indicators of efficiency, equity, and outcomes." But we're first in cost - Twenty-one graphs that show America's health care prices are ludicrous: http://www.washingtonpost.com/blogs/...are-ludicrous/.

We spend the most by far per capita on health care, but have lower life expectancy than countries like Lebanon and Slovenia: http://en.wikipedia.org/wiki/List_of...ife_expectancy

In the last WHO report we were first in cost and 38th in overall performance metrics: World Health Organization ranking of health systems in 2000 - Wikipedia, the free encyclopedia

[M Paquette]

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Originally Posted by samclem Please, don't blame them for their misconceptions. They are just reading the inaccurate accounts of the terrible "dog eat dog, winner-take-all" culture as portrayed in the media. It's the same way with many other issues: I'm sure many outside the US believe every American is packing a gun, works 90 hours per week, takes 2 days of vacation per year, worships 30 hours per week at a church in the woods, and that 50% of us are illiterate. It's what the US media like to report, and it's what the foreign media likes to pass along.

That's OK. Please bear in mind that it is not just the foreigners that are exposed to this.

Plenty of USAians are soaking in the US media reports, too. Add in voluntary memetic filtering ("I get all my news from WND.com/PBS.org/Onion.com, because I don't trust any other source."), and a tendency to form fairly exclusive affinity groups, and we have plenty of folks within the US with their own truthiness baselines, not necessarily bound by outmoded concepts like facts.

It can be interesting. Discussing the effects of policy and practice with some folks who insist on their own reality can also be frustrating. (Mr. Ray is an extreme case, but I seem to run across folks on this road every week. They usually want money...)

I'm not entirely sure that the media's partitioning and polarization around and for exclusive affinity groups is helping our society as a whole. Of course, that could be the whole point...

[Mulligan]

Sam, this could be one of my all time favorite threads if we could discuss guns and Obamacare in same thread and Porky not shut it down.


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[gauss]

Gotta agree with Sam on this one.

When I dug into the details on this, I found many of the items that were pulling the US down in the health care ratings were other social problems like infant mortality due to poverty and gun violence.

Don't infer from this that I am satisfied with our current HC system or the price that we pay for it, but a critical reading of the OECD documents shows that they are taking a larger social view on measuring health than we are accustomed to.

-gauss

[samclem]

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Originally Posted by daylatedollarshort In the last WHO report we were first

We're number one! We're number one!

To talk about quality of health care, we need to do a LOT of parsing out of other conflating issues. Obesity, lack of exercise, "poor health choices" (the US life expectancy numbers will be paying the price for very high US smoking rates through the mid-1980s for decades more to come), wide variances in counting infant mortality, larger number of accidents on the road, etc. The more these non-health care issues are weeded out, the better the US health care system is shown to be.

The point remains: Access to health insurance is not the same as timely access to high-quality health care. There are many people living under "universal care" in highly developed countries that get health care inferior to that delivered, on average, in the US. Really. Tell your foreign pals to spare their tears, we're doing fine. It's true we are paying too much for our health care, but luckily our GDP per capita is also doing fine (another issue--but thank you Mr Free Market. Having resources is a good thing--adding years to lives and life to years).

I am NOT an apologist for the present US health care "system" (pre- or post-ACA), but it is amusing the way some US citizens portray the experiences of real Americans, and how the cross-Atlantic echo-chamber of reinforcement encourages more of the same.

[samclem]

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Originally Posted by Mulligan Sam, this could be one of my all time favorite threads if we could discuss guns and Obamacare in same thread and Porky not shut it down.

Hey, I squeezed guns, Obamacare and religion in there! If we can get some talk about sex, mortgages, and SS filing strategies in here before the pig shows up we might set some sort of new record.

[daylatedollarshort]

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Originally Posted by gauss Gotta agree with Sam on this one. When I dug into the details on this, I found many of the items that were pulling the US down in the health care ratings were other social problems like infant mortality due to poverty and gun violence. Don't infer from this that I am satisfied with our current HC system or the price that we pay for it, but a critical reading of the OECD documents shows that they are taking a larger social view on measuring health than we are accustomed to. -gauss

The link I posted was from the Commonwealth fund rankings. The U.S scored low on items that were not mainly sociological, such as cost, access to care and efficiency of care.

[samclem]

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Originally Posted by M Paquette I'm not entirely sure that the media's partitioning and polarization around and for exclusive affinity groups is helping our society as a whole. Of course, that could be the whole point...

I'm with you on this. Though it was far from perfect, when people got their news from the three TV networks (each hewing fairly close to the middle and worried about maintaining a reputations for accuracy) as well as a single local newspaper, everyone started with at least a very similar set of basic facts about what was happening. Today, we can shop for our own preferred truths and minimize cognitive dissonance. It's harder to have a civil conversation--we're not just arguing about what we should do, but even about what actually happened in the past.
A "civics", logic, and current events test for voters? (Just kidding!)

[daylatedollarshort]

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Originally Posted by samclem The point remains: Access to health insurance is not the same as timely access to high-quality health care. There are many people living under "universal care" in highly developed countries that get health care inferior to that delivered, on average, in the US. Really. Tell your foreign pals to spare their tears, we're doing fine.

I've never heard of any agency ranking a country's health care system and excluding major factors like cost, efficiency or access to care. That would be like ranking a country's educational system but ignoring the fact that only higher income people or those with jobs in large companies were able to afford to educate their kids.

Some people in the U.S. are doing fine. We still have 13.4% of the population in a country with 316 million people lacking basic health insurance, and millions more even with insurance going bankrupt or in financial difficulty because of the cost.

That is around 40 million people without basic health insurance, more than the entire population of Canada. Medical bills are the main reason for 3 out 5 bankruptcies in the U.S, even for many with health insurance because of expensive premiums and high deductibles.

[samclem]

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Originally Posted by daylatedollarshort Medical bills are the main reason for 3 out 5 bankruptcies in the U.S, even for many with health insurance because of expensive premiums and high deductibles.

Nope, this chestnut has been discredited for awhile, but it will apparently keep being re-cycled as long as there are elections.

From an award-winning UC Davis research paper:

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Zhu used the SCF’s data to compare the spending patterns of households that filed bankruptcy to those which had not. He found that credit card debt and spending on durable goods, such as housing and automobiles, spur the greatest number of bankruptcy filings. While unexpected medical expenses have an impact on households, Zhu found it only accounts for five percent of bankruptcies. Similarly, unemployment leads to only 13 percent of bankruptcies.

And about that paper, a "The Atlantic" author said:

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According to Zhu, having a serious medical condition makes you 50% more likely to file for bankruptcy, but not because of medical bills; medical bills are only a very small percentage of the overall debt of bankrupts, and are not significantly correlated with higher credit card debt, which one would expect if people were keeping down their medical bills by charging them to Visa. Presumably it's the income effect of disability or caretaking responsibilities.

[daylatedollarshort]

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Originally Posted by samclem Nope, this chestnut has been discredited for awhile, but it will apparently keep being re-cycled as long as there are elections.

Other sources, such as a survey by Nerdwallet and researchers from Harvard, have come to different conclusions:

How to escape the medical care debt trap - LA Times

Medical Bankruptcies are Still a Problem, Here's What to Expect | Fox Business

Medical bills as an issue in home foreclosures:
"Get Sick, Get Out: The Medical Causes of Home Foreclosures" by Christopher T. Robertson, et al.

Many posters here are millionaires and still worried about the high cost of health care. It is a huge problem for the lower and middle income classes in the U.S.:
http://www.early-retirement.org/foru...ent-74259.html

"Over 64 million consumers have a medical collection on their credit report, according to the credit bureau Experian....According to a recent Commonwealth Fund report, 28 million American adults burned through their savings to pay off medical expense in the last two years."
Source:
http://www.forbes.com/sites/christinalamontagne/2014/08/26/medical-debts-will-soon-weigh-less-on-your-credit-score-but-theyre-still-a-problem/

[samclem]

In the interest of advancing an informed exploration of the issues, please take the time to carefully read the information in the links you are providing.

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Originally Posted by daylatedollarshort Other sources, such as a survey by Nerdwallet and researchers from Harvard, have come to different conclusions: How to escape the medical care debt trap - LA Times

The article says:

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An analysis this year by NerdWallet Health found that about 60% of all bankruptcies are health related. And a comprehensive study by Harvard researchers who examined a large sample of 2007 bankruptcy filings found that, "using a conservative definition, 62.1% of all bankruptcies … were medical."

That's entirely consistent with the information I provided. Folks trying to make a point often deliberately cite "medical bankruptcies" as being the same as bankruptcies due to medical costs. They are not at all the same. If you get injured and lose your job, or have to quit work to take care of a sick relative, that can contribute to a "medical bankruptcy." No health care insurance in the world would protect against this.

I can't get to the undoubtedly highly reputable and prestigious "NerdWallet"
Institute, but if you can send me a link I'd appreciate it.

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Originally Posted by daylatedollarshort "Get Sick, Get Out: The Medical Causes of Home Foreclosures" by Christopher T. Robertson, et al.

Did you get a chance to read the article's abstract? Medical bills were not cited as the leading cause of foreclosures. They weren't a factor at all in most foreclosures.

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Originally Posted by daylatedollarshort Many posters here are millionaires and still worried about the high cost of health care. It is a huge problem for the lower and middle income classes in the U.S.

Anecdotal. People worry about all kinds of things. I'm worried about government spending, post about that for awhile.

There's no doubt we need to address the cost of health care in the US, and that there are advantages to helping people reduce the uncertainty of high medical bills. This site is a treasure trove of informed debate on this because we've been discussing it for years. You'll find tons of interesting viewpoints (the same and different from yours--the best way to learn things) through use of the search function.

[Mulligan]

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Originally Posted by samclem Nope, this chestnut has been discredited for awhile, but it will apparently keep being re-cycled as long as there are elections. From an award-winning UC Davis research paper: And about that paper, a "The Atlantic" author said:

I would imagine if a lot of the general population had a serious injury or illness with a zero deductible health insurance policy would still find themselves near bankruptcy from extended work absence.
I have a good friend who is pushing towards 100k CC debt and refuses to reign in excessive spending. If he ever had a serious extended illness and could not work for 3 or 4 months I guarantee you he would blame his bankruptcy on the health issue. Keep in mind I am not saying this to justify how great our system is, just other issues definitely could come into play and some may just blame the "final straw" as the reason. And looking back, my finances were not always the best and I could have wound up in that situation myself....


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[daylatedollarshort]

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Originally Posted by samclem There's no doubt we need to address the cost of health care in the US, and that there are advantages to helping people reduce the uncertainty of high medical bills. This site is a treasure trove of informed debate on this because we've been discussing it for years. You'll find tons of interesting viewpoints (the same and different from yours--the best way to learn things) through use of the search function.

I am glad we can agree on needing to address the high cost of health care in the U.S. I am not sure why you think I would not know how to use the search function or even if I didn't why that would pertain to this thread?

The other articles were to point out the issue of health care costs being big burden for the middle class and below in the U.S., bankruptcy studies or not. The Nerdwallet survey was picked up by news outlets such as Forbes, The NY Times, Time and Fox News so they found it credible. Nerdwallet is a new media company started by an economics major from Stanford. Their health VP behind the study was a health policy Fulbright Scholar in China and a graduate of Harvard Business School and Dartmouth: NerdWallet : Our Team

If you want a different study on medical debt other than bankruptcy numbers here is one from Kaiser:
"An estimated 1 in 3 Americans report having difficulty paying their medical bills – that is, they have had problems affording medical bills within the past year, or they are gradually paying past bills over time, or they have bills they can’t afford to pay at all."
Medical Debt Among People With Health Insurance | The Henry J. Kaiser Family Foundation

[aja8888]

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Originally Posted by daylatedollarshort Many posters here are millionaires and still worried about the high cost of health care. It is a huge problem for the lower and middle income classes in the U.S.: http://www.early-retirement.org/foru...ent-74259.html

This one always makes me chuckle...medical bills are not always the $250K question here. We are on Medicare and have a Plan F supplemental plan and Part D for drugs. I can assure you that if we both live 25 years in retirement that the cost of the above insurance alone will be more than $250K combined for both of us! And that's without ever visiting a doctor, dentist, buying hearing aids or paying our part of the prescription costs!

[samclem]

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Originally Posted by daylatedollarshort If you want a different study on medical debt other than bankruptcy numbers here is one from Kaiser: "An estimated 1 in 3 Americans report having difficulty paying their medical bills – that is, they have had problems affording medical bills within the past year, or they are gradually paying past bills over time, or they have bills they can’t afford to pay at all." Medical Debt Among People With Health Insurance | The Henry J. Kaiser Family Foundation

Do you appreciate why this isn't a strong indicator of excessive medical costs, of a medical cost crisis, etc? How many people "have difficulty" paying their rent? How many "have difficulty" paying their cable TV bill? And of those "having difficulty" paying their medical bills--what percentage of their income are they being asked to pay? What percentage of their income should we expect people to pay for their own medical care? The best medical care is going to cost something.

A lot of people are living very close to the line--many save very little and they have no reserve if they have a medical bill, a leaky roof or a failed transmission in their car.

[daylatedollarshort]

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Originally Posted by samclem Do you appreciate why this isn't a strong indicator of excessive medical costs, of a medical cost crisis, etc? How many people "have difficulty" paying their rent? How many "have difficulty" paying their cable TV bill? And of those "having difficulty" paying their medical bills--what percentage of their income are they being asked to pay? What percentage of their income should we expect people to pay for their own medical care? The best medical care is going to cost something. A lot of people are living very close to the line--many save very little and they have no reserve if they have a medical bill, a leaky roof or a failed transmission in their car.

I have to vote with the rest of the developed world and much of the U.S on this one and say I do think affordable medical care should be a basic human right, like police or fire protection or education. I can't really cover the subject any better myself than articles I have already posted like Bitter Pill: Why Medical Bills are Killing Us from Time and the Ezra Klein charts on healthcare costs in the U.S. showing we pay much more for the same drugs and procedures than every other country on the planet. Nerdwallet also has an updated poll (Harris Poll) showing that medical debt is worsening.