Debate thread (Sept. 10)

[TexasTiger 14,310]

35 minutes ago, auburnatl1 said:

The point being the entire system is a bloated overhead crazy mess.

And it’s insurance based, right? That’s the system.

[homersapien 12,245]

49 minutes ago, wdefromtx said:

It absolutely got worse for many. 

Costs immediately started to rise when it went into effect.

Go ask people that had really good plans that lost them because they were banned. Essentially to help some get coverage it forced people to give up great coverage. 

And it got better for many more, including me and my wife who were uninsured for several years before it passed.

[wdefromtx 3,611]

2 minutes ago, homersapien said:

And it got better for many more, including me and my wife who were uninsured for several years before it passed.

So, do people who it got worse for have a reason to be unhappy with it? 

[AU9377 6,037]

51 minutes ago, auburnatl1 said:

I don’t want to derail thread and I’m no expert - but WHY are health care costs so high?  Before people go down their muscle memory greedy pharma, PEs, insurance companies, ect  paths - their  % (ebit) profits are no higher than 50 years ago. However, because it’s become so complex to manage the sheer administration of medicine - the overhead costs are proportionally exploding. Go into any any drs office or hospital today - what are the number/ratio  of people managing gov and insurance forms/regulations/processes  ect vs actual … dr’s? What do you think it was in the 70s?  It’s not purely as simple as this but the inefficiency of that industry is incredibly obvious to the eye and is self inflicted crazy. Just a thought.

That is absolutely a problem and needs to be addressed, but that is a problem separate and apart from issues of access. 

We have laws that prohibit negotiation of prices by the government that is paying for these products to be developed and then paying again for their use.  Insurance companies have medical coding, not all of which is uniform, that requires constant training and education on the part of billing in order to get paid. 

As an example, my father uses a bed side ventilator at night.  It is basically a c-pap or bi-pap machine with a few additional breathing monitoring capabilities.  The machine has prevented him from being admitted to the hospital for the past 5 years.  He is prevented by law from purchasing the machine.  The cost of the machine for a home health care provider is approximately $8,500 new.  His insurance pays $1,200 per month for the device and he is responsible for another $240. That is one hell of a return on investment for a machine that the home health group monitors once every 3 months. It never fails, every 8 or 9 months the insurance company denies the coverage for the device and then claims that it was coded wrong, even though the code was the same that was coded for the previous year.  That begins another process of an additional doctor's visit, additional documentation and then finally another approval.

I researched and discovered that the same device in the UK is provided at no cost and the health system pays approx $200 per month until a total of $5,000 has been paid, at which time it converts into a purchase.  Congress, due to lobbying efforts, decided that in the U.S., medicare would forever pay.

In a hospital setting, you no longer have a nurse and a tech or assistant.  You have a group of 5 or more per patient.  In addition to the doctor over seeing your care, you also have a hospitalist that reviews your doctor's orders, a care plan administrator and host of other positions.  I could spend a week in a hospital and cut duplicate work in half.  Hospitals don't because they are billing for every bit of it.

Edited September 13 by AU9377

[homersapien 12,245]

50 minutes ago, JMWATS said:

So she's free to change them and "flip-flop" again on Nov 6.  

That's also true of Trump - and any human - who runs for POTUS, so what's your point?

Edited September 13 by homersapien

[homersapien 12,245]

1 minute ago, wdefromtx said:

So, do people who it got worse for have a reason to be unhappy with it? 

No, they should complain to their congressman.  Let him/her count the votes.

[auburnatl1 6,182]

Just now, homersapien said:

FWIW

https://www.washingtonpost.com/opinions/2024/09/13/harris-trump-deficit-debt/

How would Trump and Harris affect U.S. debt? The difference is huge.

Trump’s plans would add $4.5 trillion to the deficit; the vice president’s are more fiscally responsible.

In the first presidential debate in the 1992 election, the word “deficit” came up 13 times. Each candidate was pressed on their substantive plans to bring the U.S. fiscal house in order. The victor in that race — Bill Clinton — is the only president to have achieved budget surpluses in the last half-century.

At this week’s debate, the deficit was referenced just twice.

That’s unfortunate, because the issue is pressing. The national debt is on an unsustainable path: Federal debt relative to gross domestic product is on track to surpass its post-World War II record by 2027, according to the Congressional Budget Office. It won’t stop there. The country will almost certainly need more government investment in the years ahead because of national security concerns, an aging population and the existential threat posed by climate change.

Of course, there has not been a presidential candidate in the 21st century who presented a fully satisfying plan to fix the debt.

But here, as in most arenas, the gap between Vice President Kamala Harris and former president Donald Trump is large. Trump’s proposals would add at least $4.5 trillion to the deficit over the next decade. In contrast, Harris could actually achieve some deficit reduction depending upon how much of the GOP tax cuts she opts to extend. At worst, her plan would increase deficits only modestly, by less than one-fifth of the Trump total.

Trump would add at least $4.5 trillion to the deficit if he's elected

Table with 2 columns and 6 rows.

Extend Trump tax cuts	$4.6 trillion
Reduce corporate tax rate to 15% for some firms	$0.2 trillion to $0.6 trillion
No tax on tips	$0.15 trillion to $0.25 trillion
No tax on Social Security benefits	$1.6 trillion
Tariffs	-$2 trillion
Total deficit impact	$4.5 trillion to $5 trillion

Source: The Budget Lab at Yale, the Committee for a Responsible Federal Budget, and author's calculations

 

Harris has a clear plan to be fiscally responsible

Table with 2 columns and 7 rows.

Extend Trump tax cuts for taxpayers earning below $400k	$2 trillion to $3 trillion
No tax on tips for service and hospitality workers	$60 billion
Expand tax credit for low-income taxpayers	$800 billion
Decrease housing costs	$100 billion
Deficit reduction in the Biden budget	-$3.3 trillion
Lower capital gains rate than Biden	$50 billion
Total deficit impact	-$290 billion to $710 billion

 

Source: The Budget Lab at Yale, the Committee for a Responsible Federal Budget, and author's calculations

 

The gulf between Trump and Harris is the byproduct of two fundamental policy differences.

First, Harris supports raising taxes on high-earners and large corporations. Trump supports lowering them.

Harris has been clear that she embraces essentially all of the tax increases outlined in President Joe Biden’s budget, with the exception of his capital tax changes. (She would raise capital gains rates for high earners by less than Biden has proposed.) Overall, these proposals would generate around $5 trillion in additional tax revenue from the wealthy and corporations over the next decade.

In contrast, Trump would lower taxes on these groups by trillions over this period. He would keep the rate cuts going for those at the top and give corporations an even bigger tax cut by lowering their tax rate to 15 percent (down from 21 percent today) for firms that he classifies as “American producers.” (Who qualifies is unclear, and consequently, so is the deficit impact of this measure.)

I suspect Trump and his advisers would contest my calculus. They would argue — and have argued, repeatedly — that these tax cuts pay for themselves, in the form of increased economic growth. It’s true that cutting taxes can lead businesses to invest in themselves in ways that grow the economy, such as when a firm uses its tax savings to buy a new factory or launch a product line. But it’s not enough of a boost to come close to offsetting the costs.

Trump’s tax cuts — and our historical experience more generally — have proved how costly this policy can be. The best empirical evidence on the impact of the 2017 Tax Cuts and Jobs Act is that economic growth offset just two percentage points of the 41 percent decrease in corporate tax collections that resulted from the legislation. Doubling down on those approaches will be just as problematic for our nation’s finances.

The second key difference between the candidates? Harris is more committed to tax cuts for low- and middle-income earners.

Her campaign has paired tax increases on the top with cuts for the bottom, in the form of new and expanded credits for families, small businesses and new homeowners.

In contrast, the only real revenue raiser Trump has embraced is a tax increase on most Americans in the form of global tariffs that would substantially raise the cost of imports. To be sure, tariffs would decrease the deficit. Estimates from the Peterson Institute for International Economics suggest they would raise around $2.75 trillion over a decade, likely closer to $2 trillion when you take into account the fact that other countries will retaliate with tariffs of their own.

But how deficit reduction is achieved matters. Trump’s $2 trillion of tariff revenue would be raised by forcing Americans of all income levels to pay thousands of dollars extra for the goods they buy.

Any fair fiscal comparison shows this election is not a close call. If the deficit is your top issue, Harris is the clear choice.

I tend to agree but it’s still lesser of 2 evils thinking. Her red meat lib 101 trope of only taxing “rich” and corporations (the classic “pay their fair share”)  mathematically isn’t close to enough (the debt is $35 trillion) - just sounds good because theyre the easy to make bad guys - and will have consequences to the economy.  I’m hoping she can be an adult and say 1) many of us may have to pay more and end the free stuff mindset - it’s killing us 2) gov has to become more efficient and effective 3) we have to have a plan to attack it with a date. It’s how things actually happen 

Otherwise - it’s let our kids deal with the crisis we created thinking. Which imo is sick.

[wdefromtx 3,611]

Consider this before the ACA pharmacies were required to inform you if the cost of a prescription was less than your copay. Which often they would automatically charge you the lower amount.

Now they don't have to inform you and for example your copay is $20 but the cost of the medication is $4.56, but you don't know it is $4.56. Some insurance companies and pharmacies have agreements in place to charge you the $20, the pharmacy keeps the $4.56 or maybe even a little more and refunds the copay to the insurance company. Insurance companies make so much money this way. 

[wdefromtx 3,611]

4 minutes ago, homersapien said:

No, they should complain to their congressman.  Let him/her count the votes.

Fair enough, complain to their congressman that democrats f-ed them over. 

So, what you are saying is its people need to give up their stuff so someone like you can have the same....got it. 

[wdefromtx 3,611]

6 minutes ago, auburnatl1 said:

I tend to agree but it’s still lesser of 2 evils thinking. Her red meat lib 101 trope of only taxing “rich” and corporations (the classic “pay their fair share”)  mathematically isn’t close to enough (the debt is $35 trillion) - just sounds good because theyre the easy to make bad guys - and will have consequences to the economy.  I’m hoping she can be an adult and say 1) many of us may have to pay more and end the free stuff mindset - it’s killing us 2) gov has to become more efficient and effective 3) we have to have a plan to attack it with a date. It’s how things actually happen 

Otherwise - it’s let our kids deal with the crisis we created thinking. Which imo is sick.

The problem is, once you start with the handouts and various spending on whatever you can't really reign it back in. It's like immigration. 

Everyone focuses on taxes one way or another, but rarely does anyone talk about spending. 

[TexasTiger 14,310]

4 minutes ago, wdefromtx said:

Consider this before the ACA pharmacies were required to inform you if the cost of a prescription was less than your copay. Which often they would automatically charge you the lower amount.

Now they don't have to inform you and for example your copay is $20 but the cost of the medication is $4.56, but you don't know it is $4.56. Some insurance companies and pharmacies have agreements in place to charge you the $20, the pharmacy keeps the $4.56 or maybe even a little more and refunds the copay to the insurance company. Insurance companies make so much money this way. 

Then why Republicans approached Democrats to fix that? 

[wdefromtx 3,611]

Just now, TexasTiger said:

Then why Republicans approached Democrats to fix that? 

Same reason Democrats haven't approached Republicans. 

[AU9377 6,037]

1 hour ago, wdefromtx said:

ACA took costs that were high and sent them through the roof. 

And made insurance worse for many people that had good insurance. 

ACA helped politicians line their pockets. That door went wide open even more so than before, reeling it in is now much harder. 

We need a plan that provides coverage for everyone, while controlling the cost of coverage.  Providing preventive care and treatment before conditions progress to a life threatening point would save hundreds of millions every year, but many states refuse to expand medicaid, even though they would be reimbursed by the Federal govt.

What does that mean?  If you are poor, you aren't eligible to be treated until you qualify.  For many, qualifying means you have to be very sick, to the point of being admitted to a hospital. If you are a minor or a pregnant woman, you qualify immediately.  If you are 30 and male, you actually need to have a heart attack before being treated for high blood pressure.

[homersapien 12,245]

1 minute ago, wdefromtx said:

Fair enough, complain to their congressman that democrats f-ed them over. 

So, what you are saying is its people need to give up their stuff so someone like you can have the same....got it. 

I am saying everyone is entitled to healthcare and healthcare insurance. 

If "some" have to "give up stuff" in order to provide that healthcare/insurance to everyone, so be it. I have to "give up stuff" (my money) to fund our government.  It's part of the dues I owe as a citizen. 

Finally, if you don't like the plan Democrats passed, then you should try to get Republicans to pass one.  (I heard they have the "concept of a plan" in mind. )

Meanwhile, I hope Democrats come to recognize that a universal plan - such as our peers have - is better for everyone and cheaper to boot.  Of course, Republicans will fight it every inch of the way. 

 

[wdefromtx 3,611]

Just now, AU9377 said:

We need a plan that provides coverage for everyone, while controlling the cost of coverage.  Providing preventive care and treatment before conditions progress to a life threatening point would save hundreds of millions every year, but many states refuse to expand medicaid, even though they would be reimbursed by the Federal govt.

What does that mean?  If you are poor, you aren't eligible to be treated until you qualify.  For many, qualifying means you have to be very sick, to the point of being admitted to a hospital. If you are a minor or a pregnant woman, you qualify immediately.  If you are 30 and male, you actually need to have a heart attack before being treated for high blood pressure.

I agree, but you aren't arguing the same thing. 

I am only talking about ACA, it made things worse for a lot of people and solved very little of what you mentioned or changed it from what it was. It helped people and hurt people. 

What you are talking about is something that should have been fixed before the ACA. The ACA just added gasoline to a dumpster fire. Which is what many like me knew would happen. 

You can be mad with both partied for not fixing it correctly the first time and mad at one for making it worse. 

[wdefromtx 3,611]

1 minute ago, homersapien said:

I am saying everyone is entitled to healthcare and healthcare insurance. 

If "some" have to "give up stuff" in order to provide that healthcare/insurance to everyone, so be it. I have to "give up stuff" (my money) to fund our government.  It's part of the dues I owe as a citizen. 

Finally, if you don't like the plan Democrats passed, then you should try to get Republicans to pass one.  (I heard they have the "concept of a plan" in mind. )

Meanwhile, I hope Democrats come to recognize that a universal plan - such as our peers have - is better for everyone and cheaper to boot.  Of course, Republicans will fight it every inch of the way. 

 

Democrats will never come up with a sustainable universal healthcare system, neither will republicans. 

Why did people have to sacrifice something they had when they didn't?

My insurance through work should be unrelated to what insurance you were able to get from the ACA. But nice try comparing this to taxes.

You can't answer that honestly. 

[homersapien 12,245]

2 minutes ago, wdefromtx said:

I agree, but you aren't arguing the same thing. 

I am only talking about ACA, it made things worse for a lot of people and solved very little of what you mentioned or changed it from what it was. It helped people and hurt people. 

What you are talking about is something that should have been fixed before the ACA. The ACA just added gasoline to a dumpster fire. Which is what many like me knew would happen. 

You can be mad with both partied for not fixing it correctly the first time and mad at one for making it worse. 

https://www.commonwealthfund.org/publications/issue-briefs/2017/feb/how-affordable-care-act-has-improved-americans-ability-buy

How the Affordable Care Act Has Improved Americans’ Ability to Buy Health Insurance on Their Own

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698736/

The Affordable Care Act: The Value of Systemic Disruption

 

https://www.americanprogress.org/article/10-ways-aca-improved-health-care-past-decade/

10 Ways the ACA Has Improved Health Care in the Past Decade

 

https://www.rsfjournal.org/content/6/2/1

The Social, Political, and Economic Effects of the Affordable Care Act: Introduction to the Issue

 

https://www.nationalaffairs.com/publications/detail/what-has-become-of-the-affordable-care-act

What Has Become of the Affordable Care Act?

 

 

[homersapien 12,245]

2 minutes ago, wdefromtx said:

Democrats will never come up with a sustainable universal healthcare system, neither will republicans. 

Why did people have to sacrifice something they had when they didn't?

My insurance through work should be unrelated to what insurance you were able to get from the ACA. But nice try comparing this to taxes.

You can't answer that honestly. 

You can't handle the truth.  All you think about is yourself.

[homersapien 12,245]

3 minutes ago, wdefromtx said:

Democrats will never come up with a sustainable universal healthcare system, neither will republicans. 

 

As a nihilist, why bother with this forum?

[wdefromtx 3,611]

1 minute ago, homersapien said:

You can't handle the truth.  All you think about is yourself.

There it is. 

I think we know why you won't answer. 

[TexasTiger 14,310]

5 minutes ago, wdefromtx said:

Democrats will never come up with a sustainable universal healthcare system, neither will republicans. 

Why did people have to sacrifice something they had when they didn't?

My insurance through work should be unrelated to what insurance you were able to get from the ACA. But nice try comparing this to taxes.

You can't answer that honestly. 

Your insurance thru work had both annual and lifetime caps which could easily bankrupt you if you encountered the sudden misfortune of cancer or other serious illness many families do each year.

[TexasTiger 14,310]

19 minutes ago, wdefromtx said:

Same reason Democrats haven't approached Republicans. 

You just want to bitch about Democrats. You have no real interest in solving anything.

[homersapien 12,245]

7 minutes ago, wdefromtx said:

There it is. 

I think we know why you won't answer. 

I did answer.  You just refuse to accept it.

Tying health insurance to your employee is antiquated and irrational.

[wdefromtx 3,611]

Just now, TexasTiger said:

Your insurance thru work had both annual and lifetime caps which could easily bankrupt you if you encountered the sudden misfortune of cancer or other serious illness many families do each year.

My policies back then had such high limits I would have never met them. They had some that did if you wanted to pay less premium. 

Did insurance companies force lawmakers to make people give up certain plans in order to have this provision? 

[TexasTiger 14,310]

4 minutes ago, wdefromtx said:

My policies back then had such high limits I would have never met them. They had some that did if you wanted to pay less premium. 

Did insurance companies force lawmakers to make people give up certain plans in order to have this provision? 

How high? Millions?