Join Early Retirement Today
Reply
 
Thread Tools Search this Thread Display Modes
Old 11-03-2014, 12:15 AM   #161
Moderator Emeritus
 
Join Date: Oct 2007
Posts: 4,929
Quote:
Originally Posted by daylatedollarshort View Post
...I do think affordable medical care should be a basic human right, like police or fire protection or education...
It's a bit of a philosophical quibble, but a breakdown that others might be more willing to contemplate would be natural rights, and social rights and responsibilities. Some folks think of human rights as being natural rights, as in the Universal Declaration of Human Rights.

Social rights are human rights agreed to by members of a society, resulting from the implications of the social contract. Entities of a society have a social responsibility to ensure that these social rights are made available.

Those rights which require the cooperative action of other entities in a society are social rights. Rights which persist with or require inaction of others, such as freedom of speech, freedom of worship, or freedom from slavery are usually considered to be natural rights.

Of course any such weighty philosophical discussion will have multiple sides to it, and is likely to be debated through the heat death of the universe, or at least until a really, really big computer can be built.
__________________

__________________
M Paquette is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 11-03-2014, 12:19 AM   #162
Recycles dryer sheets
 
Join Date: Aug 2013
Location: Cocoa Beach
Posts: 406
Quote:
Originally Posted by M Paquette View Post
Of course any such weighty philosophical discussion will have multiple sides to it, and is likely to be debated through the heat death of the universe, or at least until a really, really big computer can be built.
Um....42?
__________________

__________________
Lucantes is offline   Reply With Quote
Old 11-03-2014, 06:08 AM   #163
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2004
Posts: 11,615
Quote:
Originally Posted by M Paquette View Post
It's a bit of a philosophical quibble, but a breakdown that others might be more willing to contemplate would be natural rights, and social rights and responsibilities.
Daylate--the road that MPaquette has laid out is a useful one to explore. There is considerable friction between natural rights and social rights (and between "negative rights" and "positive rights"). I strongly prefer the protection of natural rights for philosophical and very pragmatic reasons, and I think you differ from me on this. But the distinction is important to understand before declaring a passel of great-sounding new "rights."

Frederic Bastiat was a noted proponent of the preservation of natural rights. He wrote the following:
Quote:

“ M. de Lamartine wrote me one day: "Your doctrine is only the half of my program; you have stopped at liberty; I go on to fraternity." I answered him: "The second half of your program will destroy the first half." And, in fact, it is quite impossible for me to separate the word "fraternity" from the word "voluntary." It is quite impossible for me to conceive of fraternity as legally enforced, without liberty being legally destroyed, and justice being legally trampled underfoot.[2]
__________________
"Freedom begins when you tell Mrs. Grundy to go fly a kite." - R. Heinlein
samclem is offline   Reply With Quote
Old 11-03-2014, 07:23 AM   #164
Thinks s/he gets paid by the post
 
Join Date: May 2014
Location: Utrecht
Posts: 2,211
Quote:
Originally Posted by samclem View Post
They are just reading the inaccurate accounts of the terrible "dog eat dog, winner-take-all" culture as portrayed in the media.
I personally do my own research.

Quote:
Originally Posted by samclem View Post
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).
I am not going to argue how to best measure the effectiveness of a healthcare system. I've done statistics for a living for a while, so I know those waters are really muddy and are tough to discuss in a forum. Just as an example: should you take into account years lost as a result of obesity, or not? What do we do with drug overdose cases? Infant mortality is another favorite of many: when do you register a baby as still-born vs. non-viable, what do you do with different abortion rates (and related laws)? Euthanasia and culture around death is similar: some cultures have a greater taboo on death and nurse otherwise brain-dead people, while others look more at quality of life and emphasize right to choose your own ending.

Anyway, the issue is not that the best care is available in the US, it is! The two issues are 1) that the US seems to be overpaying for it and 2) that large groups of people have limited access.

Just one chart regarding costs
http://upload.wikimedia.org/wikipedi...ollars_PPP.png

The second thing is an equality item, where in the EU there is a general tendency to be socialist in terms of giving everyone access on a roughly equal footing. The US has a more individualistic tendency.

The weird thing about the US system though: look at this forum and the discussions here. When discussing financial independence the single biggest factor in the US that is crucial is having decent healthcare coverage. The hoops an american citizen has to jump through and the sometimes strange ways to obtain it is frankly mind-boggling at times. That for an item that everyone needs, in some way or another.

It is hard to comprehend a value system where a big decision to join or stay with an employer is the healthcare package.

I've also negotiated employer healthcare packages in European countries and in the US. Again, the complexity is a world apart. The only people that the US is making happy with that is the administrating entities and related consulting firms.

When I now read on this forum that the Obamacare will not simplify that whole system, it makes me a bit sad. Sounds like a missed opportunity.

Again, just the view from across the pond.
__________________
Totoro is online now   Reply With Quote
Old 11-03-2014, 07:33 AM   #165
Thinks s/he gets paid by the post
 
Join Date: Aug 2005
Posts: 2,056
Looks like Obamacare is helping the insurance companies. It's open season here at w*rk, and I just ran the numbers. My insurance premium is going up about 10%. Stark contrast to what the 1.7% increase those on Social Security are getting.

Gotta love the fuzzy math on this "low" inflation! Still, in my case it comes out to an increase of about $216 per year, and I have a pretty good plan. Plus, in my tax bracket I can write off about 1/3 of that. Actually, I think it's more like 40%, because, IIRC, doesn't what you pay in health insurance reduce the amount of your income they tax for SS?
__________________
Andre1969 is offline   Reply With Quote
Old 11-03-2014, 07:55 AM   #166
Moderator
MichaelB's Avatar
 
Join Date: Jan 2008
Location: Rocky Inlets
Posts: 24,424
Quote:
Originally Posted by Totoro View Post
When I now read on this forum that the Obamacare will not simplify that whole system, it makes me a bit sad. Sounds like a missed opportunity.
It's hard to disagree there was missed opportunity. Something that represents 17% of the GDP and affects every person is not so easily changed, and that's probably a good thing, despite our current disappointment.

Healthcare reform in the US is best summarized by the term "The Triple Aim". Here is one link to a paper discussing it The Triple Aim: Care, Health, And Cost

Quote:
Improving the U.S. health care system requires simultaneous pursuit of three aims: improving the experience of care, improving the health of populations, and reducing per capita costs of health care.
While there is much room for disagreement regarding the path and pace of specific change, the ACA has clearly measurably initiatives and metrics to advance all three objectives. Health care reform is probably more generational than election cycle.
__________________
MichaelB is offline   Reply With Quote
Old 11-03-2014, 08:03 AM   #167
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
pb4uski's Avatar
 
Join Date: Nov 2010
Location: Vermont & Sarasota, FL
Posts: 16,411
Quote:
Originally Posted by Andre1969 View Post
Looks like Obamacare is helping the insurance companies. It's open season here at w*rk, and I just ran the numbers. My insurance premium is going up about 10%. ....
What did your premiums increase in 2012 and 2013? My point is that premiums increased annually before Obamacare so it is not right to blame the whole 10% on Obamacare.

Actually, since Obamacare prescribes that a certain percentage of premiums must be paid out in policy benefits, it isn't the insurers that these increases are going to, it is the healthcare providers that the insurers pay claims to.
__________________
If something cannot endure laughter.... it cannot endure.
Patience is the art of concealing your impatience.
Slow and steady wins the race.
pb4uski is offline   Reply With Quote
Old 11-03-2014, 08:11 AM   #168
Recycles dryer sheets
Theseus's Avatar
 
Join Date: Aug 2013
Posts: 484
Quote:
Originally Posted by Mulligan View Post
The local newspaper here recently had an article about the high rack rate costs. The answers by the local hospitals was long and convoluted, but they all said in unison clearly that no one ever pays anywhere close to those prices for the services whether it be insured or cash payers...
I've had the notion that the contractual write-offs applied when insurance is involved are more or less a balancing act the providers do when dealing with various insurance companies. When no insurance is involved perhaps a settlement that nets no, or even some fractional level of payment leaves an inflated number to use when stating charitable write-offs. While the insurance company negotiated rates are benchmarked, if rack rates lack that level of checks and balances I could imagine there being a temptation to set them higher than necessary, leading to more grief for the uninsured.
__________________
Theseus is offline   Reply With Quote
Old 11-03-2014, 08:25 AM   #169
Thinks s/he gets paid by the post
 
Join Date: Aug 2005
Posts: 2,056
I'm not sure about 2012 or 2013; I'll have to research that. For 2014, the health portion didn't go up much...$83.54 every two weeks vs $81.34. That's only about 2.7%. However, there was one doctor visit I had where I had to cough up an extra $63. Normally I just did a $30 copay and that was it. However, I can't remember if there was anything extenuating about that particular visit.

From 2013-2014, the dental insurance went from $8.01 to $9.39 per paycheck. That's a 17% jump! However, that portion isn't going up at all for 2015. Vision isn't going up either. However, from 2013-2014, it jumped from $1.94 per paycheck to $3.97. A small dollar amount, but a 104% increase!

I do remember, a few years back, trying to save some money by switching from the $250 deductible plan to the $500. At the time, the $250 was about $80 per paycheck, and the $500 was only $50. Can't remember which year I did that. But then, I think it was the following year, our company got rid of the $250 plan, making the $500 the best plan, and it went up to about $80...same as what the $250 plan had been.

So, yeah, my insurance had been going up, in general over the past few years. Hard to say if Obamacare made it worse or not. Who knows...if it wasn't for Obamacare, maybe it would have gone up worse than it already has!

Kinda makes me miss the mid 90's though...my insurance was $10 per week with Kaiser Permanente, and there was no co-pay. And you could see the doctor, get an X-ray, and hit the pharmacy all in one place.
__________________
Andre1969 is offline   Reply With Quote
Old 11-03-2014, 08:52 AM   #170
Thinks s/he gets paid by the post
 
Join Date: May 2014
Location: Utrecht
Posts: 2,211
Quote:
Originally Posted by MichaelB View Post
Healthcare reform in the US is best summarized by the term "The Triple Aim". Here is one link to a paper discussing it The Triple Aim: Care, Health, And Cost
Thank you for that link, looks interesting. Going to read it later this week.
__________________
Totoro is online now   Reply With Quote
Old 11-03-2014, 09:35 AM   #171
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Feb 2013
Posts: 5,326
Quote:
Originally Posted by M Paquette View Post
It's a bit of a philosophical quibble, but a breakdown that others might be more willing to contemplate would be natural rights, and social rights and responsibilities. Some folks think of human rights as being natural rights, as in the Universal Declaration of Human Rights.
I am not sure what the best semantic label is, but I support the position of the U.N. on health care:

http://www.washingtonpost.com/blogs/...l-healthcare/:
"a system where health insurance is either attainable and affordable for all, or the federal government picks up the tab for health care costs."

And WHO:
"Universal coverage is firmly based on the 1948 WHO Constitution, which declares health a fundamental human right and commits to ensuring the highest attainable level of health for all."
WHO | Universal health coverage (UHC)
__________________
daylatedollarshort is offline   Reply With Quote
Old 11-03-2014, 10:10 AM   #172
Recycles dryer sheets
 
Join Date: Mar 2014
Location: Laguna Hills
Posts: 137
It is a gross oversimplification but fundamentally there are only two "fair and practical" ways to structure healthcare as a right in a democracy. The first is a government run single payor system with clear and concise declaration of what is and what is not covered, ages, criteria for eligibility etc.. The second is free market economy with less regulation, more competition to drive down costs and enough profit to greatly expand charitable care. In either system the rich would be able to purchase experimental and cutting edge services unaffordable to the masses. Same is true with cars, education and real estate.

The worst possible solution is our current hyper bastardized system where the primary winners are big business, redundant and usually ineffective regulatory agencies and a slew of paramedical interests like pharma, lawyers, so called nonprofit healthcare entities and so on. We are about as far away from both socialized and free market economy based medicine as is possible.
__________________
longranger is offline   Reply With Quote
Old 11-03-2014, 10:50 AM   #173
Thinks s/he gets paid by the post
 
Join Date: May 2008
Posts: 3,421
Quote:
Originally Posted by Andre1969 View Post
I'm not sure about 2012 or 2013; I'll have to research that. For 2014, the health portion didn't go up much...$83.54 every two weeks vs $81.34. That's only about 2.7%. However, there was one doctor visit I had where I had to cough up an extra $63. Normally I just did a $30 copay and that was it. However, I can't remember if there was anything extenuating about that particular visit.

From 2013-2014, the dental insurance went from $8.01 to $9.39 per paycheck. That's a 17% jump! However, that portion isn't going up at all for 2015. Vision isn't going up either. However, from 2013-2014, it jumped from $1.94 per paycheck to $3.97. A small dollar amount, but a 104% increase!

I do remember, a few years back, trying to save some money by switching from the $250 deductible plan to the $500. At the time, the $250 was about $80 per paycheck, and the $500 was only $50. Can't remember which year I did that. But then, I think it was the following year, our company got rid of the $250 plan, making the $500 the best plan, and it went up to about $80...same as what the $250 plan had been.

So, yeah, my insurance had been going up, in general over the past few years. Hard to say if Obamacare made it worse or not. Who knows...if it wasn't for Obamacare, maybe it would have gone up worse than it already has!

Kinda makes me miss the mid 90's though...my insurance was $10 per week with Kaiser Permanente, and there was no co-pay. And you could see the doctor, get an X-ray, and hit the pharmacy all in one place.
Are you sure your company is just paying the premiums or self-insured. Often big companies self-insure but get an insurance company to administer the plans, use their networks, etc.

In either case, they're probably paying increase provider costs to you, not pocketing extra profits.

Insurers are just a small piece of the pie in total health care costs. Yes some insurance CEOs make a lot of money but supposedly, the ACA limits how much in premiums they can get as profit.

Quote:
In the late 1990s, loss ratios for health insurance (known as the SeymourDumore loss ratio, or SLR) ranged from 60% to 110% (40% profits to 10% losses).[5] As of 2007, the average US medical loss ratio for private insurers was 81% (a 19% profit ratio).[6]

In an amendment written by Senator Al Franken, the Patient Protection and Affordable Care Act of 2010 now mandates minimum MLRs of 85% for the large group market and 80% for the individual and small group markets.[7] Insurers that do not spend 80-85% of their premiums in health care costs must now issue rebates to consumers.
Loss ratio - Wikipedia, the free encyclopedia
__________________
explanade is offline   Reply With Quote
Old 11-03-2014, 03:57 PM   #174
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: May 2004
Posts: 11,615
Quote:
Originally Posted by Totoro View Post
It is hard to comprehend a value system where a big decision to join or stay with an employer is the healthcare package.
Yes, the 70+ year link in the US between employment and health care insurance is bizarre. It's not good for our economy (hampering workforce mobility and thus the efficiency of the labor market). It's the result of a series of government actions going back to WW II (wage controls that exempted health care and some other benefits), and continued through our tax code, and now preserved in the present ACA. The ACA does reduce the "strength" of the linkage appreciably (since those without a job or with small employers can get insurance through the "exchanges"), but there was an opportunity to get rid of the employment-health care ties altogether that just could not be accomplished for various political reasons.
__________________
"Freedom begins when you tell Mrs. Grundy to go fly a kite." - R. Heinlein
samclem is offline   Reply With Quote
Old 11-03-2014, 04:12 PM   #175
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Mulligan's Avatar
 
Join Date: May 2009
Posts: 7,376
Quote:
Originally Posted by samclem View Post
Yes, the 70+ year link in the US between employment and health care insurance is bizarre. It's not good for our economy (hampering workforce mobility and thus the efficiency of the labor market). It's the result of a series of government actions going back to WW II (wage controls that exempted health care and some other benefits), and continued through our tax code, and now preserved in the present ACA. The ACA does reduce the "strength" of the linkage appreciably (since those without a job or with small employers can get insurance through the "exchanges"), but there was an opportunity to get rid of the employment-health care ties altogether that just could not be accomplished for various political reasons.

I like how it morphed to where employees can still either pay part of the premium or entire dependents with pretax dollars... Throw me that bone as a retiree and suddenly I'm not so mad about my 300% plus increase in premiums thanks to ACA. But that creates another separate "winners " and " losers" category I imagine based on your retiree income...but boy it would be sweet for me......


Sent from my iPad using Tapatalk
__________________
Mulligan is offline   Reply With Quote
Old 11-18-2014, 08:50 AM   #176
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
pb4uski's Avatar
 
Join Date: Nov 2010
Location: Vermont & Sarasota, FL
Posts: 16,411
Earlier in this thread there was a discussion concerning the lack of transparency with respect to pricing for medical services. just this morning I read about this website that has some pricing info that seems to me to be a good step in the right direction.

https://healthcarebluebook.com/page_Default.aspx

Wikipedia indicates that:
Quote:
Other web sites offering similar services are Changehealthcare.com, NewChoiceHealth.com, and OutOfPocket.com
__________________

__________________
If something cannot endure laughter.... it cannot endure.
Patience is the art of concealing your impatience.
Slow and steady wins the race.
pb4uski is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
You helped me make the decision to be FIRE'd. EastWest Gal Hi, I am... 76 08-07-2016 09:54 PM
Who helped you set up your 72t ? almost there FIRE and Money 5 08-15-2013 07:40 AM
Quit smoking helped by Bupropion or Champix? vicente solano Health and Early Retirement 14 10-20-2010 01:56 PM
Most Unbelievable thing a date has ever said to you......... FinanceDude Other topics 73 05-27-2010 03:39 PM

 

 
All times are GMT -6. The time now is 05:06 AM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.