RickyP,
A great question about Medicare and should everyone have it. It should be available for everyone. So should food stamps, and basic housing stipends et al. The only problem would be who is going to pay for it. Certainly the US government would not be able to fund the equal payments to all US citizens?

I would love to get $400 in food stamps, $350 in housing and an addition into my medical benefits. But wait, we need to couple that with my family of 7. I need to get about a $1000/ mo. per person. So do I get my $7000/mo.? After all, equality and such means that everyone should receive equally, right? You don't want to discriminate do you?

Please note that you did not answer the EMTALA government payments. DOES the US Government reimburse hospitals for all non-paying patients?

Thank you for explaining that you were not talking about political socialism (in the political forum), ut a cooperative or loose conglomerate of friends. I see how I missed it by expecting a different definition of Socialism.

BTW,
I do NOT think the government should be paying for all things. Just showing the inequality of it all.

bbauska

The only problem would be who is going to pay for it

This is aburd. .There are savings moving to a Universal system. Not increased costs.
Medicare for all is essentially provided by every other western nation.
And total costs for health care in those countries is anywhere from 8 to 5 points of GDP less than what the US spends on health care now.

Show me how MY costs will go down. I posted my insurance costs and asked you to show me how it is cheaper for me to have a universal system (let alone Obamacare, which even you do not like).

Do I need to re-iterate my current insurance plan so you can show how much cheaper it will be for me?

Will Obamacare be good for the economy? Employers don't think so:

Obamacare may cost more than experts previously thought, according to a survey of 900 employers released Wednesday. As companies scramble to prepare for a wave of new health care rules that go into effect next year, an increasing number have become pessimistic about the cost, according to Mercer, a benefits consulting firm.

Roughly one in five employers (19 percent) now expect that health care costs will rise by more than 5 percent as the result of the law. When asked the same question two years ago, only 14 percent of respondents thought the Affordable Care Act would significantly raise costs. Moreover, just 9 percent of employers still think the law will have little or no impact on costs. When asked the same question two years ago, a quarter of the respondents thought the impact would be minimal. Almost a third of employers say they still can't predict the impact.

This confusion is understandable, says Mercer President and CEO Julio A. Portalatin. Even though employers can calculate how many workers will be newly eligible for coverage, they can only guess at how many will choose to buy coverage.

All individuals are required to have health coverage in 2014, but the penalty for failing to enroll in an insurance plan is a relative pittance in 2014 -- just $95 per individual or 1 percent of household income, whichever is greater. Since that penalty is likely to be far smaller than even the employer-subsidized cost of insurance, employers speculate that many workers who didn't choose to get coverage in the past will remain uninsured.

By the same token, employers may be making the choice more difficult by opting to pass on an increasing amount of the cost. Nearly one-third say they will require a bigger contribution for dependent coverage next year and 13 percent will hike the contribution for employee-only coverage. As a result, just 17 percent of employers are budgeting for an increase in health care enrollment.

So, they're going to charge their employees more and they say it's creating uncertainty . . . so, how are those things "good for the economy?"

Doctor Fate wrote:Yes, shame on me for seeking to limit rights to those that are actually defined as such.

Defined by whom? What definition are you using? To assist you.in aswering the question, you may want to review the Wikipedia page on rights, and in particular the section 'definitional issues' Link:

There is considerable disagreement about what is meant precisely by the term rights. It has been used by different groups and thinkers for different purposes, with sometimes opposing definitions, and the precise definition of this principle, beyond having something to do with normative rules of some sort or another, is controversial

I think you are applying a very restricted definition of the word, perhaps deliberately to argue a restricted range of rights. I've no view on whether you ought to be ashamed.

On the rest, I see you have abandoned the false dogma that any newly expressed right has to be explicitly referred to in the Constitution, necessitating and Amendment, but can actually be enumerated by the legislature and confirmed (if challeged) by judicial review. The consequence of this is that until any challenge is raised and heard by the judiciary, any rights established in law still stand.

The rest, well, I'll try to avoid rising to the bait, I think. Suffice to say that even in the 18th Century, it was known that healthcare had some relationship to life and quality of life, that the hippocratic oath was already well known, and that logic itself is timeless.

danivon wrote:

Doctor Fate wrote:Yes, shame on me for seeking to limit rights to those that are actually defined as such.

Defined by whom? What definition are you using? To assist you.in aswering the question, you may want to review the Wikipedia page on rights, and in particular the section 'definitional issues' Link:

There is considerable disagreement about what is meant precisely by the term rights. It has been used by different groups and thinkers for different purposes, with sometimes opposing definitions, and the precise definition of this principle, beyond having something to do with normative rules of some sort or another, is controversial

I think you are applying a very restricted definition of the word, perhaps deliberately to argue a restricted range of rights. I've no view on whether you ought to be ashamed.

I'll take the Constitution over Wikipedia.

On the rest, I see you have abandoned the false dogma that any newly expressed right has to be explicitly referred to in the Constitution, necessitating and Amendment, but can actually be enumerated by the legislature and confirmed (if challeged) by judicial review. The consequence of this is that until any challenge is raised and heard by the judiciary, any rights established in law still stand.

And yet, while reading good ol' Wiki, I see [url]nothing that resembles a "right" here:[/url]

The Emergency Medical Treatment and Active Labor Act (EMTALA)[1] is a U.S. Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions. Participating hospitals may only transfer or discharge patients needing emergency treatment under their own informed consent, after stabilization, or when their condition requires transfer to a hospital better equipped to administer the treatment.[1]

EMTALA applies to "participating hospitals." The statute defines "participating hospitals" as those that accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program.[2] However, in practical terms, EMTALA applies to virtually all hospitals in the U.S., with the exception of the Shriners Hospitals for Children, Indian Health Service hospitals, and Veterans Affairs hospitals.[citation needed] The combined payments of Medicare and Medicaid, $602 billion in 2004,[3] or roughly 44% of all medical expenditures in the U.S., make not participating in EMTALA impractical for nearly all hospitals. EMTALA's provisions apply to all patients, and not just to Medicare patients.[4][5]

The cost of emergency care required by EMTALA is not directly covered by the federal government. Because of this, the law has been criticized by some as an unfunded mandate.[6] Similarly, it has attracted controversy for its impacts on hospitals, and in particular, for its possible contributions to an emergency medical system that is "overburdened, underfunded and highly fragmented."[7] Charity Care or care provided to the uninsured represent an industry average of 20% of total cost of care provided[citation needed]. The uncompensated or non-reimbursed amounts are written off as bad debt thus becoming a tax write off and the unpaid bills are also sold to third party collection agencies for an average of 20 cents per dollar

1. The Federal government places obligations on hospitals.

2. The Federal government does not pick up the costs (even a tax write-off is nowhere near adequate compensation).

When I say "right," I mean a fundamental, non-changing, permanent, essential right. You seem to mean something that may be issued and revoked. I mean something the Founder's intended, or something that has gone through the Amendment process. You seem to mean something that may be inferred by those seeking to create new "rights" out of laws passed. Not every law grants a right; some merely obligate. I would argue the EMTALA is primarily (at least) one of obligation.

The rest, well, I'll try to avoid rising to the bait, I think. Suffice to say that even in the 18th Century, it was known that healthcare had some relationship to life and quality of life, that the hippocratic oath was already well known, and that logic itself is timeless.

Right, but in the 20th and 21st Centuries, laws have been passed making it legal for doctors to commit murder.

Have a nice day.

Doctor Fate wrote:
I'll take the Constitution over Wikipedia.

Ok, so where does it define what a right is (as opposed to enumerating a non-exhaustive set of rights)? And how does it address the definitional issues that the wikipedia article explains?

And yet, while reading good ol' Wiki, I see [url]nothing that resembles a "right" here:[/url]

Perhaps you are not looking closely, or find it hard to interpolate and derive the outcome. What it means is that any hospital with an ER that takes Medicare has a duty to treat any emergency patient regardless of ability to pay. The logical corollary to that is that any person is entitled to emergency care at such hospitals if they need it. An entitlement that is universal is, by many definitions, the same as a right.

When I say "right," I mean a fundamental, non-changing, permanent, essential right. You seem to mean something that may be issued and revoked. I mean something the Founder's intended, or something that has gone through the Amendment process. You seem to mean something that may be inferred by those seeking to create new "rights" out of laws passed. Not every law grants a right; some merely obligate. I would argue the EMTALA is primarily (at least) one of obligation.

Of course not evey law creates a right. However, obligations (or perhaps responsibilities) are often tied to rights (or perhaps to limited entitlements).

Of course rights can be issued and revoked. This can be done by Amendment, by Judicial review, or through legislation. Similarly, the scope of rights can be altered. Rights are clearly not 'non-changing' or 'permanent', as over time and across the world (even across the United States) there are differences that can be seen in what is held to even be a fundamental or essential right. There are also rights that are not fundamental or essential, although I would argue that access to healthcare should be seen as such a right if we view the right to life as being fundamental and essential.

Right, but in the 20th and 21st Centuries, laws have been passed making it legal for doctors to commit murder.

Have a nice day.

It is a lovely day, thanks, although the cricket from yesterday is still getting down. A friend is coming up tonight for a beer festival so I am sure it will end well.

On the preceding point, this is illogical. By definition, murder is unlawful and deliberate killing. If something is legal, it cannot be murder. I guess you are referring to abortion, but either way it is not the point. You were suggesting that the inference that healthcare related to life could not have been made by the Founders. My response is that they could - particularly any who had come through medical institutions which had adopted the Hippocratic Oath over the 18thC - and that it being a logical inference means 'intent' is irrelevant. Not that logic was beyond them, as it was also well known and forming part of the basis of the Enlightenment of which the American Revolution is a key moment.

If you are.suggesting we cannot apply logic to the Constitution or other documents from the period that outline rights, then you would appear to be wishing to cast out over 200 years' worth of jurisprudence.

danivon wrote:It is a lovely day, thanks . . .

Excellent!

As for what is/is not a right, go ahead and fight. It's not central to me. The point is this: Obamacare is not good for the economy. It still leaves tens of millions without coverage, increases costs, damages quality of care, and will negatively impact the budget as it is implemented--not to mention what it will do to the States who take the up front cash and wind up holding the long-term bag.

One easy way to reduce medical costs would be to mandate that all health care providers publish their rates on the web. With individuals paying higher co-pays and deductible, this would create some market incentive to reduce costs. It's amazing that even such a simple change could not be contemplated with ACA.

Ray Jay wrote:One easy way to reduce medical costs would be to mandate that all health care providers publish their rates on the web. With individuals paying higher co-pays and deductible, this would create some market incentive to reduce costs. It's amazing that even such a simple change could not be contemplated with ACA.

It would be good consumer protection, and I tend to find in the US that some products / services are more opaque about costs / contents / tax.

We have a similar problem here with energy companies: they have to publish their rates, but it's very hard to compare like with like. Sometimes there will be a standing charge, sometimes there will be two usage rates, sometimes discounts, sometimes different charge periods...

And even then, not a lot seems to stop the companies from putting up the retail rates as soon as wholesale prices rise, but only slowly reduce them when the reverse happens. Hence our regulator regularly coming up with new rules for them to follow after consumer complaints.

I wonder how easy it is to compare health plans, once things get to the more complicated end (it's not just the co-pay and deductible, there's the question of what they do/do not cover which may be very hard to see as standard once you go beyond the mandated level.

I agree that cross-state competition should help too.

Danivon:

I wonder how easy it is to compare health plans, once things get to the more complicated end (it's not just the co-pay and deductible, there's the question of what they do/do not cover which may be very hard to see as standard once you go beyond the mandated level.

I'm not talking about posting insurance company rates (although I'm fine with that too). I'm talking about hospitals and doctors posting their costs. They are not posted now. In fact, throughout these organizations providers do not know what they charge for services. I'm sure some doctors would be more prudent with their recommendations if they actually knew the costs of the tests they recommend.

I'm sure there would still be confusion and difficulties in comparison. But it would be a start ...

By the way, I believe it was in this forum that I mentioned I was taking a hospital to small claims court for overcharging $2,000 on a colonoscopy. They conceded the matter and mailed me a check last week.

Requiring doctors and hospitals to do such rate comparisons is a bit difficult as each and every case will be unique. Age, gender, location, severity of the case, unexpected complications, allergies, it goes on and on and I doubt you could nail them down very well. As it is, insurance companies do this for your benefit and pay the doctor/hospital on such rates that they have already negotiated. It might be a good step but may be impossible to achieve in any relevant way? (but I aint no doctor, maybe I'm wrong)

ray

I'm sure some doctors would be more prudent with their recommendations if they actually knew the costs of the tests they recommend.

Depends on the way the doctors are compensated. Some of them actually own the medical imaging companies, or laboratories that their hospitals use... Most are compensated on overall billings... Driving up billings, where the insurance will pay, is part of the game.

Empowering consumers with information as much as possible usually has a positive effect. But, once a patient is in the middle of treatment, how comfortable would they be switching doctors or hospitals over price? And how easy would that be?
Besides, unless patients are uninsured or have a large co-pay or deductible, the motivation isn't there. The procedures and tests are going to be covered...

In order for a "market" to work efficiently the supplier - customer relationship has to be fairly uncomplicated. And the customer and the supplier both have to have the option to walk away. Neither can really walk away, at least not usually in health care scenarios. Usually the patient needs care, now. And doctors, for the most part shy away from being merchants of medicine...

Great news from the LA Times:

In the south Los Angeles County region, for instance, rates for a 40-year-old purchasing a Silver plan ranged from $242 a month through Health Net Inc. to $325 a month through Kaiser Permanente. Overall, Los Angeles County had the lowest premiums statewide for the Silver plans.

The average premium for individual plans sold through EHealthInsurance in California last year was $177 a month. Covered California said the average premium for the three lowest Silver plans statewide was $321 a month, albeit for more comprehensive benefits.

Overall, state officials said they can't estimate yet how much rates will rise on average. Blue Shield of California, one of the winning bidders in the exchange, said its existing individual policyholders would pay about 13% more, on average, for coverage in the state marketplace.

These rates "came in below what people legitimately expected them to be," said Paul Markovich, Blue Shield's chief executive.

That is sweet! Only a 13% increase!!!! And, that's less than expected!

Woo-hoo!