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Old 09-16-2009, 03:09 PM   #141
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Wtf does going on a vacation have to do with this? If you are poor you don't get vacations? He lives in California. Doesn't own a home. Gets laid off frequently because of the nature of his work. Divorced. No savings to speak of--rent is high and income is low. He even has roommates to share expenses. Has health problems so he can't buy insurance on the individual market. Owns an older vehicle free and clear, as a car is necessary to find and keep a job in LA.

Come on, do you know people who have unskilled jobs and who make $20,000, $25,000 a year? I know many in that position. They work hard, rent, have cars that have problems or payments. There isn't room to save for months and months of unemployment.

I also know people who have jobs that offer no insurance and due to preexisting conditions they can't buy any. Minnesota has Minnesota Care, which subsidizes health insurance for the working poor, with the poorhe need to paying a sliding fee. Is that so bad? Minnesota has one of the lowest percentages of uninsured in the US (after MA with its reforms).

The polarization on this issue in the country is tough. You and I are so far apart on our world views that there likely will be no way that we will ever be able to discuss the issues without being just irritated with each other. I feel so strongly about people being accused of irresponsibility when bad things happen to them that it is hard for me to even type this and maintain a modicum of politeness.
take it easy we are all getting old and you don't wont to pull something
I do agree that some folks have fallen through the cracks. but we don't need a trillion dollars and change everyone's insurance to pay for that do we? people need to make insurance a priority before they spend money on things like vacations. as for your friend he would qualify for medicaid. FOR SURE.
We do seem to be on polar opposite sides of this issue. but sorry i think just you are dead wrong.
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Old 09-16-2009, 03:12 PM   #142
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I don't disagree at all... I saw the same program about McAllen... I think they do a lot since it is one of the poorest counties in the nation... so a lot are on Medicaid... and why not charge the government more procedures... you don't want to be discriminatory against the Hispanics do you (yes, this is a bit of a rant... probably will be edited)...


The real problem is where is the line between rationing out the unneeded medical procedures and the needed ones...
Remember, El Paso is cheaper and has better outcomes, yet their demographics are similar.


I agree the real problem is how to get best practices and evidence based medicine working well, while acknowledging individual differences. The pay per service model doesn't help, we need to allow some experimentation with different models.
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Old 09-16-2009, 03:30 PM   #143
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Martha your friend in Cali probably should have figured out several years ago that he needs to change jobs if he's getting laid off often. That is no way to live. Survive yes, but not live. It's good for someone in their 20's but by the time you are in your thirties you should have figured something out.
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Old 09-16-2009, 03:32 PM   #144
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take it easy we are all getting old and you don't wont to pull something
I do agree that some folks have fallen through the cracks. but we don't need a trillion dollars and change everyone's insurance to pay for that do we? people need to make insurance a priority before they spend money on things like vacations. as for your friend he would qualify for medicaid. FOR SURE.
We do seem to be on polar opposite sides of this issue. but sorry i think just you are dead wrong.

He is not eligible for Medicaid. I suggest you get your facts before stating that he is eligible FOR SURE. This is a misunderstanding that many people have. Medicaid doesn't cover you just because you are poor and out of work. The federal government does require certain groups get medicaid and certain minimum benefits but my friend does not fall into those groups. The states can add more groups and benefits, but it is tough for them to do so because state budgets are tight and they have to balance.


Here is what California Medicaid version offers to poor individuals: Find Out if I Qualify


If you are enrolled in one of the following programs, you can get Medi-Cal:

  • SSI/SSP
  • CalWorks (AFDC)
  • Refugee Assistance
  • Foster Care or Adoption Assistance Program
  • In-Home Supportive Services (IHSS)
You can also get Medi-Cal if you are:


  • 65 or older
  • Blind
  • Disabled
  • Under 21
  • Pregnant
  • In a skilled nursing or intermediate care home
  • On refugee status for a limited time, depending how long you have been in the United States
  • A parent or caretaker relative or a child under 21 if:
    The child's parent is deceased or doesn't live with the child, or
    The child's parent is incapacitated, or
    The child's parent is under employed or unemployed
  • Have been screened for breast and/or cervical cancer (Breast and Cervical Cancer Treatment Program)
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Old 09-16-2009, 03:33 PM   #145
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The polarization on this issue in the country is tough. You and I are so far apart on our world views that there likely will be no way that we will ever be able to discuss the issues without being just irritated with each other. I feel so strongly about people being accused of irresponsibility when bad things happen to them that it is hard for me to even type this and maintain a modicum of politeness.
I think you were pretty polite...

I agree with you in some ways... but also disagree in others... mostly from the snippits I see here and there...

I have a BIL whose exteded family are not that great... many on welfare or in jail.. some took to many drugs when they were young... very few brain cells left... and the sister of the BIL is taking care of a nephew and niece while their father is in jail... so she is strapped for money even though she is getting some from the state... but buys both of them cell phones at $50 per month (I think 10 and 14 are the ages)... then she buys a HORSE.. because she lives in the country and it would be good for the kids... and someone gives her another.. so there is more money feeding a big animal... she has zero money sense... and never will... she goes from one crisis to another..

I have a friend who's sister is a teacher and gets paid reasonably well... but also goes from one crisis to another... picks the 'bad boy' boyfriends who cheat on her and steal her money (if she has any)... has car repoed and gets kicked out of her house... now, she was married twice, and was living nicely... but got divorced for whatever reason... (I never heard)...

When my sister did audits for the state of California for welfare.. she said there were so many people who gamed the system it was a joke... the knew the rules and how to get around them... this was many many years ago, so I do not know if it still is there... but I would bet it is..

True... I do know of people who work hard and live paycheck to paycheck... and are not blowing their money on drugs or drinking.. and I do not mind helping them... but it is hard for me to want to help people who have the means, but are so stupid in how they handle money they are always in trouble and want a handout....
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Old 09-16-2009, 03:46 PM   #146
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Remember, El Paso is cheaper and has better outcomes, yet their demographics are similar.


I agree the real problem is how to get best practices and evidence based medicine working well, while acknowledging individual differences. The pay per service model doesn't help, we need to allow some experimentation with different models.


Did not remember that... but I am sure it is in the program...


But, here is the crux IMO... we CAN require insurance companies to cover everyone who wants a policy... and pay for this and pay for that... and we CAN say we are not going to pay for every procedure you want to do... because it is outside the best practices and is not adding to health care... and we can do all of this without spending billions of dollars to cover the uninsured...

So, the policy that is being proposed is to cover the uncovered... and it will cost us a lot of money to do that... I would much prefer to fix the system on the cost side and make insurance available to everybody... but if you do not want to pay... so be it... but if you do... and you come to the doctor and get cancer... sorry, that is not covered (yes, it is a pre-existing condition... but the law should have it that if you decide to go it alone.... you go it alone forever for anything that happens to you if you do not buy insurance.....)
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Old 09-16-2009, 04:02 PM   #147
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Martha your friend in Cali probably should have figured out several years ago that he needs to change jobs if he's getting laid off often. That is no way to live. Survive yes, but not live. It's good for someone in their 20's but by the time you are in your thirties you should have figured something out.
Cripe, don't you realize that there are people who are doing the best they can and that is what they end up with? Small town clerks in a hardware store. Taking inventory in a small factory. Secretaries in small offices. Drivers of delivery vehicles. Etc.

We aren't all going to have the good jobs and not everyone is going to "figure something out."

This is what is polarizing: You folks are talking about my family and some of my friends. Some of you post about what they should have done or claim that they lived irresponsibly. It is painful when people think your relatives and friends are losers when I know them to be hard working caring people.
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Old 09-16-2009, 04:08 PM   #148
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So, the policy that is being proposed is to cover the uncovered... and it will cost us a lot of money to do that... I would much prefer to fix the system on the cost side and make insurance available to everybody... but if you do not want to pay... so be it... but if you do... and you come to the doctor and get cancer... sorry, that is not covered (yes, it is a pre-existing condition... but the law should have it that if you decide to go it alone.... you go it alone forever for anything that happens to you if you do not buy insurance.....)
I understand. I favor an insurance mandate to drag in all those young people who never believe that they might wake up with leukemia someday or have a car accident.
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Old 09-16-2009, 04:35 PM   #149
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Did not remember that... but I am sure it is in the program...
I didn't see the program, but the point Martha is talking about was made in the New Yorker article.
McAllen, Texas and the high cost of health care : The New Yorker
I'm going to go out on a limb here and paraphrase from memory without re-reading the article and say that the author was trying to make the point that healthcare costs have skyrocketed, at least in part, because of out-of-whack incentives.
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Old 09-16-2009, 04:37 PM   #150
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Cripe, don't you realize that there are people who are doing the best they can and that is what they end up with? Small town clerks in a hardware store. Taking inventory in a small factory. Secretaries in small offices. Drivers of delivery vehicles. Etc.

We aren't all going to have the good jobs and not everyone is going to "figure something out."

This is what is polarizing: You folks are talking about my family and some of my friends. Some of you post about what they should have done or claim that they lived irresponsibly. It is painful when people think your relatives and friends are losers when I know them to be hard working caring people.
I do see that this is a very personal issue for you. but we cant take care of everyone. not everyone will be covered if this plan was to go through and it for sure will not be free so your friend might still fall through the cracks. unfortunately the world and mankind are not perfect
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Old 09-16-2009, 04:41 PM   #151
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I do see that this is a very personal issue for you. but we cant take care of everyone. not everyone will be covered if this plan was to go through and it for sure will not be free so your friend might still fall through the cracks. unfortunately the world and mankind are not perfect
It is one thing to say that people will fall through the cracks, it is another thing to say that it is all their fault.
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Old 09-16-2009, 06:47 PM   #152
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This thread is starting to make me cringe. There are some substantial differences between people's opinions on this issue, to be sure. I'd like folks to consider the other viewpoints, though, rather than pipe them through some ideological filter. If I want that, I can turn on 'talk radio'.

I'm pretty big on personal responsibility, but I also realize that not everyone is, or is capable of being a rational, independent Randian hero figure. I also recognize that being a member of a society implies a certain degree of functional interdependence. A common theme of societies is that they serve to aid individuals in time of crisis. When an individual requires aid, other members of that society will band together to render aid in some form.

Our society is currently considering changes in the way we render aid to those in need of medical assistance. The current institutionalized model is seen as having grown in an ad hoc manner, nudged this way and that by various legal constructs and tax policies. There has been a desire to rationalize this model for some time.

Now, we stand on the brink of making changes that might improve the way we render medical assistance to those in need. There are various parties who would bend these changes so as to favor themselves, or their constituents. I'd encourage everyone to back away a bit, turn off the radio, and think, for themselves and others, how our society might best alter the way it renders medical assistance to those in need. Try and consider how your proposal affects others, and society at large, not just yourself. Look at models that other countries have adopted.

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Old 09-16-2009, 07:09 PM   #153
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It is one thing to say that people will fall through the cracks, it is another thing to say that it is all their fault.
Absolutely. I really like this forum, and I personally tend towards libertarianism and personal responsibility. However, I've noticed that as a group we tend to be relatively successful and relatively well off. People forget that there are people out there busting their humps for very little, and just as we don't necessarily deserve our good fortune, they don't necessarily deserve their bad fortune. I know them, I've been them, and they don't deserve to be marginalized. I will respect anyone's well thought out opinion, whether I agree with it or not. But simplistic finger pointing I will ignore. Doing it reflects very poorly on one's humanity and intelligence.
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Old 09-16-2009, 07:27 PM   #154
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I do see that this is a very personal issue for you. but we cant take care of everyone. not everyone will be covered if this plan was to go through and it for sure will not be free so your friend might still fall through the cracks. unfortunately the world and mankind are not perfect
Most adults would agree that the world is not perfect. However, there is a theme in this thread that continues to ignore the potential for insuring more Americans. The proposals include tort reform, no underwriting, no pre-existing conditions, and no claim denials (except for fraud). If all of those proposals are implemented, we should see a reduction in the premiums we all pay, and that should help out those who don't currently have coverage by making it more affordable. The insurance carriers are willingly going along with removing these restrictions because they know they can drop rates and attract those who could not afford coverage before. They also know they can provide information to potential members to help them improve their health, and thereby continue to reduce the number of claims presented.

The last I heard the 'public option' would not be available to anyone who was currently covered. Yet to be determined is what the benefit design of the public option would be, and how it would compare to the other plans available. The House bill on the public option authorized $2 trillion in start the plan. But there is no infrastructure established to administer the plan and the $2Tr will probably all go into setting up infrastructure. IMO, the public plan is designed to be a stop gap, not to provide 'competition.' It will take a lot more than $2Tr to cover the 45M Americans who don't have access to health insurance now, and who would demonstrate diminished financial capacity to pay premiums -- the 'entry fee' for the public option.

In fact when you look at the content of the two paragraphs above, what we have is a marginalized population.

So as Martha has said, all of this would lead to adverse selection. But I suspect that the adverse selection would be moderated by the lifting of restrictions such that there wouldn't be a large increase in claims. Of course, if we changed how we pay providers, that would help too (I'm not giving up on this one, friends).

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Old 09-16-2009, 08:13 PM   #155
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Most adults would agree that the world is not perfect. However, there is a theme in this thread that continues to ignore the potential for insuring more Americans. The proposals include tort reform, no underwriting, no pre-existing conditions, and no claim denials (except for fraud). If all of those proposals are implemented, we should see a reduction in the premiums we all pay, and that should help out those who don't currently have coverage by making it more affordable. The insurance carriers are willingly going along with removing these restrictions because they know they can drop rates and attract those who could not afford coverage before. They also know they can provide information to potential members to help them improve their health, and thereby continue to reduce the number of claims presented.

The last I heard the 'public option' would not be available to anyone who was currently covered. Yet to be determined is what the benefit design of the public option would be, and how it would compare to the other plans available. The House bill on the public option authorized $2 trillion in start the plan. But there is no infrastructure established to administer the plan and the $2Tr will probably all go into setting up infrastructure. IMO, the public plan is designed to be a stop gap, not to provide 'competition.' It will take a lot more than $2Tr to cover the 45M Americans who don't have access to health insurance now, and who would demonstrate diminished financial capacity to pay premiums -- the 'entry fee' for the public option.

In fact when you look at the content of the two paragraphs above, what we have is a marginalized population.

So as Martha has said, all of this would lead to adverse selection. But I suspect that the adverse selection would be moderated by the lifting of restrictions such that there wouldn't be a large increase in claims. Of course, if we changed how we pay providers, that would help too (I'm not giving up on this one, friends).

-- Rita
Love the way you just say 2T like its not real it is and are kids will pay the bill for it its going to take 2T to insure 15 million people love the math
how about we just give them all $100,000 for insurance and save 1.999999999999 T
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Old 09-16-2009, 08:36 PM   #156
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I have some questions;

1, did he save for emergence's?
2. does he have a car payment?
3. dose he have a home or other assets?
4. has he been on vacation in the last 10 years?
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Wtf does going on a vacation have to do with this? If you are poor you don't get vacations? He lives in California. Doesn't own a home. Gets laid off frequently because of the nature of his work. Divorced. No savings to speak of--rent is high and income is low. He even has roommates to share expenses. Has health problems so he can't buy insurance on the individual market. Owns an older vehicle free and clear, as a car is necessary to find and keep a job in LA.
+1
It always comes back to a toss of the dice. What if you lose your job? What if your employer provided insurance tosses your wife out when she gets cancer because she forgot to mention she had a heart murmur when she was 10 years old? These issues always take me back to my nephew's situation. Just graduated college, back home for the summer while he waited to start a job, and the toss of the dice came up with cancer. Whoops, the school health policy ended two weeks ago. If this happened to your kid what would you do- let him fend as best he can, blow your nest egg to give him the best you can afford? Personal responsibility - it is your family, you should have anticipated this and made sure he had a short term policy for those two weeks. Tough luck you didn't think about the possibilities - take out a second mortgage and cash in the 401K, or just let your kid go.
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Old 09-16-2009, 08:46 PM   #157
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When I think of someone like my housekeeper (white trailer trash mentality) who tells me she has never purchased health insurance, because "It's FREE", my skin crawls. And the thought of her trailer trash kids having to purchase it now, puts a smile on my face.

On the other hand, I would not say that or feel that way about someone else in the same economic moat, who would love to be able to afford to buy insurance for themselves or their family.

So my point is. How can we separate these people? Those who are deserving and those who are not. Do we even have a moral right to say who deserves health insurance and who doesnít? I know no one is too fond of slackers, who are always there ready to scam the system. They are not a pretty site, and I must admit there are times I wish we could rid the country of them.

But that same sentiment does not apply to all the rest of the less privileged people out there. The people with limited intellectual skills, education, the single women trying to raise children all by themselves. People working two and even three jobs to try and make ends meet and take care of their family.

At least with mandatory insurance, the slackers will be forced to contribute something into the pot, and the hard working will get a break and perhaps be able to afford some coverage.
As for younger kids, they will probably raise the age parents can keep them on their policy at a reasonable rate until they reach the age of 26.

To me justifying health insurance for everyone is simply a matter of priority as far as government spending is concerned. When you have a restricted amount of money to spend, and you canít buy everything you want or fund everything you want, what do you do. You prioritize.

In my book, health insurance goes to position #1, and all the rest can be cut, trimmed or eliminated until we can afford it again. If I had to cut my life style to the bone, my priorities would be 1. A roof over my head. 2. Food to eat. 3. Health Insurance
4. Transportation. (though Iíd ride a bike if I had to) All the rest is gravy. Now think of the federal government budget. Whatís more important? War, infrastructure, education, space exploration? Of course we want it all,(except for the war) but when you canít have it all, you prioritize.

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Old 09-16-2009, 08:59 PM   #158
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Most adults would agree that the world is not perfect. However, there is a theme in this thread that continues to ignore the potential for insuring more Americans. The proposals include tort reform...
I think meaningful tort reform is extremely unlikely. The Dems have 3 paymasters: unions (especially auto workers and teachers), Wall Street, and trial lawyers. It wouldn't be prudent to disobey one's employers. Republicans have theirs too, just a couple of substitutions.


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Of course we want it all,(except for the war) but when you can’t have it all, you prioritize.
Judging by the last 40 years or so, I'd say someone must want war pretty badly too.

Ha
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Old 09-16-2009, 09:00 PM   #159
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Cripe, don't you realize that there are people who are doing the best they can and that is what they end up with? Small town clerks in a hardware store. Taking inventory in a small factory. Secretaries in small offices. Drivers of delivery vehicles. Etc.

We aren't all going to have the good jobs and not everyone is going to "figure something out."

This is what is polarizing: You folks are talking about my family and some of my friends. Some of you post about what they should have done or claim that they lived irresponsibly. It is painful when people think your relatives and friends are losers when I know them to be hard working caring people.
Bravo Martha ! Very well put.
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Old 09-16-2009, 09:51 PM   #160
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God how I wish I could get every one to understand that the INSURANCE COMPANIES AND THE GOVERNMENT ARE THE SAME PEOPLE. The insurance companies pay staggering amounts to politicians to get them reelected. The Federal politicians pass thousands of laws that makes it impossible for there to be free and reasonable competition in health care. The cost of medicine has gone up every since and every time that the government gets involved. The result is this insane crisis we are in. Our country is being bankrupted and lives are being ruined every day.

Cosmetic Surgery is the only area of medicine that is not totally smothered by federal law and insurance regulations that are enforced by the government. And Guess what. The number of procedures have gone up and up. THE PRICES FOR PROCEDURES ARE THE ONLY THING IN MEDICINE THAT HAS GONE DOWN... Free market forces work.

We have to stop fighting with each other. The only rational way to behave is to go to the poles and vote to throw the corrupt politicians out of office. All of them. If they have been in office for more that two terms it is time for them to go. Let free markets and free men and women work.
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