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Old 10-13-2018, 07:31 AM   #121
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I find mind blowing that many don't seem to realize if their employer wasn't paying 15K a year for their gold plated HI plans they would have more cash in their pockets.
I wouldn't go that far. I think it much more likely that money would go to shareholders or management, not to the paychecks of ordinary workers.
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Old 10-13-2018, 07:34 AM   #122
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My understanding is:


Pre-ACA:

If you had a pre-existing condition, you were often refused coverage on the private market. Some could get into a high-risk pool, and pay for coverage if they could afford it. Others could not get into a high-risk pool (there were waiting lists and in some cases high risk pools were closed to new members). Many chose to continue working until age 65 for healthcare only. Some rolled the dice and went without healthcare coverage. Some moved overseas for cheaper healthcare coverage.

The lucky ones had retiree health insurance or retired before developing a pre-existing condition, and were able to purchase insurance on the private market. They hoped their insurance would not close or boot them off if they developed an expensive healthcare issue.

Post-ACA:

If you have a pre-existing condition, you cannot be refused coverage on the private market. Underwriting is no longer occurring. High risk pools no longer exist.

If you can manage your MAGI for subsidies, you pay markedly less than those who cannot. Subsequently, those who cannot lower their MAGI must pay much more for healthcare. They may have to continue working until 65 if they cannot afford unsubsidized healthcare.

So both pre and post ACA some had to/have to continue to work until age 65 for healthcare.

Pre ACA the reason typically was because coverage was denied for pre-existing conditions and/or high risk pool coverage was too expensive or the pool was closed.

Post ACA the reason is typically because one cannot afford unsubsidized ACA premiums.

I would rather have option B, post ACA, regardless of whether I received subsidies or not. I'd rather have the option of expensive healthcare than no access to healthcare at all, as in pre-ACA days.

There are inequities in ACA coverage that need to be resolved but that is a whole other issue. The preexisting issue affects EVERYONE eventually. The ACA protects us all from being denied the right to purchase healthcare coverage.
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Old 10-13-2018, 07:38 AM   #123
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I believe we all do have a right to AFFORDABLE healthcare. In the same way we have a right to affordable food and shelter. No matter what rung on the social economic ladder one is on. ...
Then you need to consider moving. The only rights that you have are those set forth in the U.S. Constitution, and the U.S. Constitution doesn't include a right to health care (affordable or not) nor a right to food and shelter (affordable or not).
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Old 10-13-2018, 07:38 AM   #124
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I know nothing about ACA insurance. It happened after I retired and was on Medicare. I’ve seen some people talk about free insurance though, or free healthcare. In countries where this is available, they have higher taxes to cover it. Personally, I’d be happy to pay the higher taxes and have a better health safety net for all.
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Old 10-13-2018, 07:39 AM   #125
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I wouldn't go that far. I think it much more likely that money would go to shareholders or management, not to the paychecks of ordinary workers.
Will they get a 100% of the money in their pockets? probably not, but they certainly would get some or a lot of back, what do you think has been a driving costs in holding down wages increases the last few years....it's healthcare..
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Old 10-13-2018, 07:47 AM   #126
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Then you need to consider moving. The only rights that you have are those set forth in the U.S. Constitution, and the U.S. Constitution doesn't include a right to health care (affordable or not) nor a right to food and shelter (affordable or not).
Not quite true. The Bill of Rights enumerates only certain rights that the founders thought were particularly important. It is not exclusive, as the Ninth Amendment itself recognizes

"The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people."

During the debates over ratification of the Constitution, the Federalists argued that a bill of rights was unnecessary. They pointed out that since it would be impossible to list all rights, it would be dangerous to list some and thereby lend support to the argument that government was unrestrained as to those rights not listed. Better, they felt, to say that the government was one of strictly delineated powers and leave it at that.

The Ninth Amendment was James Madison's answer to that argument.
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Old 10-13-2018, 07:49 AM   #127
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I know nothing about ACA insurance. It happened after I retired and was on Medicare. I’ve seen some people talk about free insurance though, or free healthcare. In countries where this is available, they have higher taxes to cover it. Personally, I’d be happy to pay the higher taxes and have a better health safety net for all.
It is NOT Free if you pay higher taxes. But I agree with you. It is better for all if all are covered and the load is spread across the whole population (Citizens and legal immigrants, just as in other countries all others should pay for their own private insurance).
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Old 10-13-2018, 08:09 AM   #128
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Will they get a 100% of the money in their pockets? probably not, but they certainly would get some or a lot of back, what do you think has been a driving costs in holding down wages increases the last few years....it's healthcare..
There are a lot of things holding down wages, which could include the cost of health insurance. However, elaborating on that would go far afield from the main topic of the thread. Suffice it to say that the "labor market" is nowhere near what economists would consider a free and competitive market.
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Old 10-13-2018, 08:10 AM   #129
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Then you need to consider moving. The only rights that you have are those set forth in the U.S. Constitution, and the U.S. Constitution doesn't include a right to health care (affordable or not) nor a right to food and shelter (affordable or not).

And it is not the Constitution of course but 'the preservation of life, and liberty, and the pursuit of happiness' seems to suggest that the founders were thinking along those lines. On Maslow's hierarchy these are pretty much the foundation of the basic needs. Seems the founding fathers were ahead of there time. Revolutionary even.
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Old 10-13-2018, 08:21 AM   #130
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There are a lot of things holding down wages, which could include the cost of health insurance. However, elaborating on that would go far afield from the main topic of the thread. Suffice it to say that the "labor market" is nowhere near what economists would consider a free and competitive market.
Employer provided HI does contribute 2 things important to this discussion. It insulates employees to the actual 100% of HI, so many don't realize what it actually costs and it does hold down wages to some degree, which means when you quit working you have less savings to pay for HI...
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Old 10-13-2018, 09:58 AM   #131
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Not quite true. The Bill of Rights enumerates only certain rights that the founders thought were particularly important. It is not exclusive, as the Ninth Amendment itself recognizes

"The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people."

During the debates over ratification of the Constitution, the Federalists argued that a bill of rights was unnecessary. They pointed out that since it would be impossible to list all rights, it would be dangerous to list some and thereby lend support to the argument that government was unrestrained as to those rights not listed. Better, they felt, to say that the government was one of strictly delineated powers and leave it at that.

The Ninth Amendment was James Madison's answer to that argument.
Interesting point, but off-point. While the ninth amendment may implicitly grant individuals the right to seek health care or obtain food or shelter, it doesn't give them any right to obtain those things... just the freedom to pursue them.... but certainly not at taxpayer expense.
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Old 10-13-2018, 10:00 AM   #132
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And it is not the Constitution of course but 'the preservation of life, and liberty, and the pursuit of happiness' seems to suggest that the founders were thinking along those lines. On Maslow's hierarchy these are pretty much the foundation of the basic needs. Seems the founding fathers were ahead of there time. Revolutionary even.
Of course you are free to pursue health care, food and shelter.... but on your own dime and not at taxpayer expense.
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Old 10-13-2018, 10:08 AM   #133
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Employer provided HI does contribute 2 things important to this discussion. It insulates employees to the actual 100% of HI, so many don't realize what it actually costs and it does hold down wages to some degree, which means when you quit working you have less savings to pay for HI...
I actually would like to see employer provided health insurance prohibited. I probably made more sense back when it first started in that people stayed with employers for long times and employers were much more paternalistic.

It makes no sense that someone's entire health care/health insurance situation should be totally discheveled just because they got laid off or changed jobs. That doesn't happen with other personal insurances like car insurance or home insurance, why should it happen with health insurance

Prohibiting employer provided health would create a giant pool of people that insurers and medical service providers would be forced to compete for that would have more pricing leverage than just current individual insurance market.
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Old 10-13-2018, 10:12 AM   #134
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Interesting point, but off-point. While the ninth amendment may implicitly grant individuals the right to seek health care or obtain food or shelter, it doesn't give them any right to obtain those things... just the freedom to pursue them.... but certainly not at taxpayer expense.
You may believe that a right to food, shelter or health care (not merely a right to seek them) is not a fundamental human right owed to citizens of this country, and therefore not an obligation of the state or federal government. And the courts ultimately may agree with you; in fact, I suspect they will. However, the fact that those things are not specifically enumerated in the Constitution or the Bill of Rights is not dispositive of the issue. There are such things as unenumerated rights specifically contemplated by the Ninth Amendment. Health care may turn out to be one of them, or not.
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Old 10-13-2018, 10:18 AM   #135
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That's my point since you brought up death panels. At a certain age it wouldn't be in your hands whether you have a surgery or not. The "guidelines" would simply say you are too old, in other words they don't want to spend the money on you, it has nothing to do with possible outcomes. Certain countries with universal healthcare already practice a form of this where they just stop doing things at certain ages.
They donít always know the problem. For example, in the UK, they told my FIL to go in for surgery at age 89, something about his throat, no cancer was diagnosed yet, then in surgery he had a heart attack, at his age, surgery was a big deal to his body. It took them 8 weeks before they could stabilize him and he was released to be home. His health was never the same after that, then he died within 2 years.

Originally when they told me he was going to surgery, I had some concern but afterwards I knew I was right. They didnít know what was involved thatís why they went willingly. I wouldnít, not at that age.
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Old 10-13-2018, 10:21 AM   #136
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You may believe that a right to food, shelter or health care (not merely a right to seek them) is not a fundamental human right owed to citizens of this country, and therefore not an obligation of the state or federal government. And the courts ultimately may agree with you; in fact, I suspect they will. However, the fact that those things are not specifically enumerated in the Constitution or the Bill of Rights is not dispositive of the issue. There are such things as unenumerated rights specifically contemplated by the Ninth Amendment. Health care may turn out to be one of them, or not.

Would you care to address very last part of my post? The at taxpayer expense part?

To my knowledge, no enumerated rights specifically provided imply that the government will provide them but are more enumerated personal liberties that have been specifically provided for in the Bill of Rights (freedom of speech, freedom of religion, etc)... none of these costs the person or government anything.

So even if it is ultimately determined that someone has the right to health care it would be at their cost... just like if someone wants to practice free speech by publishing their views they would need to pay for the printing... the government doesn't pay for it... and if you can't afford it then you just have to find people to talk to.
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Old 10-13-2018, 10:26 AM   #137
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I know nothing about ACA insurance. It happened after I retired and was on Medicare. I’ve seen some people talk about free insurance though, or free healthcare. In countries where this is available, they have higher taxes to cover it. Personally, I’d be happy to pay the higher taxes and have a better health safety net for all.
Not everybody pays the high taxes. Take my SIL, she often critized my husband for working, mostly for health insurance, while she has free health care, she said she could do volunteer work. As if her worth to society is more than my husband who had to toil for the HC. If UK has no free healthcare, she had to go out and hustle for money and pay into the system.
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Old 10-13-2018, 10:31 AM   #138
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That's my point since you brought up death panels. At a certain age it wouldn't be in your hands whether you have a surgery or not. The "guidelines" would simply say you are too old, in other words they don't want to spend the money on you, it has nothing to do with possible outcomes. Certain countries with universal healthcare already practice a form of this where they just stop doing things at certain ages.
I think this makes sense... the individual and/or even their family are not independent enough to make a decision about surgery at certain ages... in most cases they will always chose to try to prolong life of their loved ones.

If they can afford it and there is capacity in the medical system then by all means go for it... you should be free to spend/waste your money however you want... but if the taxpayers are paying for it then there will be certain situations where the cost/benefit isn't sufficient that you might be denied care and that's the way it is.
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Old 10-13-2018, 10:32 AM   #139
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I retired from mega-corp last July. Mega-corp is self insure, I am eligible for mega-corp health insurance, however, I have to pay the premium without any subsidy from mega-corp (basically, having access to mega-corp health insurance). Now if mega-corp only have one group of insurance, they instead have two groups : employee and retiree :-(

Therefore, for the first 18 months, I pay for cobra (employee group price) $370/month for a high deductible with HSA plan with $7500 max out of pocket. After that I would be in the retiree group, the same plan same deductible will cost me $780/month. And this just for me, DW is on medicare.

I have checked ACA in FLA, without subsidy is around $600-700 for comparable plan.

Since, I would like to have the freedom to do ROTH conversions in the next few years, I probably opt to stay with mega-corp (which probably wont go away anytime soon compares to ACA).

And yes, there is no surprise here, I know about this few years ago during the planing phase.
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Old 10-13-2018, 10:43 AM   #140
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Would you care to address very last part of my post? The at taxpayer expense part?
Like I said, a court faced with that question may very well rule as you suggest*. My particular dispute was with this specific statement you made

"The only rights that you have are those set forth in the U.S. Constitution."

That statement is just wrong, as expressly recognized in the Constitution itself.

And I haven't even gotten into rights you may have under your state constitution. The Connecticut Constitution, for example, provides the right to a free public elementary and secondary education (Article Eighth, Section 1) which the courts here have used direct changes to how schools are funded. The Constitution of Vermont has the specific right to hunt and fish (Sec. 67).



* But maybe not. Ensuring the rights enumerated in the 6th amendment requires the expenditure of taxpayer funds


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