ACA Individual Mandate Struck Down! (Page 5)

So what does the rise of people going from the US to India and Thailand mean in terms of the care we provide? Those are not close enough to drive as the US is to Canada, and require enough money to pay out of pocket for the airfare.

I also don't know why you assume that the quality of care will decrease. Most medical people are pretty devoted to providing good care (which is why you can get quality care in developing nations that have some infrastructure devoted to it). If you don't think most care isn't already highly managed and monitored, then you have not been paying attention and probably don't work in the field. The thing that will hopefully one day make the biggest difference is having a single payer system with a single set of rules and reviewers to work with. I am sure we will still have a "for pay"
option, to provide all the elective work you want. But basic medical care should not have be gamed by either gouging some people to pay for others, or forcing people to choose between reasonable care and groceries. 

Most are suggesting a decreased level of care as a side effect of the healthcare law.  What is this decreased level of care you speak of??????  Is my doctor going to do a crappy job on my appendectomy now that Obamacare is in place?  Is he not going to sew me all the way up after my bipass?  Will she not be able to rest my broken arm now?

Or are you referring to my access to care?  Such as dying of skin cancer because I couldn't get in to see a dermatologist?  Having to pay my MRI out of pocket because my insurance has deemed an MRI unnecessary for a twisted knee?  Or not being able to get my corn removed because we have a corn epidemic?

Or is it just that we rich people have to have some kind of reason to be upset that the poor people are going to be in the waiting room with us now instead of us being able to pay to get ahead of them?

Because I don't understand how my "level of care" is going to drop off thanks to Obamacare?  I don't think my doctor is going to be any better or worse (as it pertains to knowledge and implementation thereof) after all this.  I really don't know what people are referring to when they talk about this.

Any Doctors out there find themselves inexplicably dumber after the law passed?

EDIT:  I don't know why I bother.  Seems Gearboy has been preposting me here recently with the same concepts.......  

You are going to compare healthcare to slavery and civil rights?  That is a huge leap.

Slavery was immoral and wrong, trampled peoples civil rights, life, liberty and pursuit of happiness.  No one chose to be a slave.   They were forced to be a slave, even under laws of the US at the time.  They did not have the freedom that society offered.  Same with the civil rights issues.  Those were both horrible instances in our countries past, which were thankfully banished.  And, to point out, the issues of slavery were very much almost the end of our republic, from the very start of our country up to the end of the Civil War.

Explain the argument to me, how healthcare is trampling your rights as a US citizen?

I guess, as long as we feel that it is okay, we can now make all US citizens purchase a service under penalty of tax.  Does that not trample on peoples rights as a US Citizen, and the free choices thereof?

I'm in favor of reforming healthcare and the way that we administer it, because it is not sustainable in the long term.  But, we should not give up rights and freedom's, and forced under penalty of tax (or mandate) by our federal government to purchase a service.  There are better ways to frame it, to accomplish a more desirable outcome for everyone.  I still think we opened a door with this, that might never get closed.  Of course, what makes the US great, is that we can have conversation on what might be behind that door, good or bad.  I tend to believe it is bad, and tramples the citizen, just like many feel the Patriot Act trampled peoples rights.

On the social security aspect, there are many people calling for the dismantling of social security, as it is unsupportable long term.  Eventually, it will dismantle itself, or become a shell of itself, and we will be back where we were 150 years ago when it happens.

Us 20 somethings will still be going uninsured as it stands now. I checked into insurance for my wife and I, it would be around $3,500 a year right now and going up.

According to what I have been able to find my penalty "tax" would be $1,400 a year. The exchange has to take me even if I am dying, I just have to drag myself to the hospital and sign up for coverage. So what do you think I am going to do until I get sick? I'm going to save $2,100 a year and go without.

And we all know how great the government is at holding on to money, it's not as if they are going to save my yearly penalty so that when I do get sick and sign up they have a slush account that will cover it. 

Health insurance is no longer insurance with the forced coverage of pre-existing conditions and price setting by the government. It is a single payer system. They knew they couldn't get that through so they called it regulating private insurance companies. But there is no way private companies will be able to survive with the rules put in place, which is I think exactly how this law was designed.

Once the private companies are bankrupt there will be no choice but to go to a government run single payer system. 

So much for "if you like your plan, you can keep it".

Becuase their services are crap compared to ours.  Not to pick on our neighbor to the north but back 2010 there was a news article that went around showing the city of Philadelphia had more MRI machines than all of Canada.  The avg wait for a MRI in the US was 36 hours.  Avg wait in Canada 39 days.

I had an opportunity to move to Finland a few years back.  They told me the state would pay for my HC as part of my 45% taxes.  However *EVERYONE* I spoke to had a private policy in addition to the state policy.  They told me I'd wait 3-4 weeks for a basic appt to see a doctor.  It was BASIC services for the poor.  If you wanted real HC you bought a private policy and went to the front of the line.

I got a happy birthday note from BCBS. Happy 50th, you're rates are going up 45% since you're in a new age tier. Oh, and we have a 9% increase across the board for all members. So you're rates will now be a total of 54% higher.

I for one was surprised and pleased to see the court ruling.

And yete, half the country was willing to go to war with the other half in order to maintain that system; and there were strong arguments made that without slaves, the economy of the south would collapse, much like the arguments about the economic impact of the ACA.

You could make this argument about anything that gets funded by taxes. But like infrastructure and protective services (police, fire, military), we all benefit when we can get access to things because those services are working. When everyone gets at least basic healthcare, we can spend less money providing for prolonged periods of illness which saps the GDP and frees up money spent caring now for the very sick and uninsured.

And this is a good thing? I really don't understand what point you are trying to make.

And??? It seems to me that is exactly the point. Right now, those basic services are either unavailable, or funded by the shell game of uninsured patients getting services without any reimbursement to the provider, except for the profits made from other sources. Back when I started my training, this was more or less the model. Insurance paid the most, which helped fund the gap of the uninsured and underinsured. Then the HMO's and managed care started to cut the payments to the bone, resulting in massive losses to bigger providers that had to serve all comers.

First people on the right complained that somehow this was akin to giving everyone a Mercedes or Cadillac. Now you are complaining that it is like giving everyone access to a Yugo, and if you want more, you pay for more?

Like I said, I fully expect that the American solution will be to have the basic plan that people who don't anticipate needing services will take, and a "cadillac plan" that people who can afford it will buy. Some docs will provide one level of service, some another, and some both. 

As for the Canadian wait times, this article from a Canadian think tank looking at the problem looks not to the US for the solution, but to European countries that have reasonable wait times. So the problem is not inherent in universal coverage, but rather to the specific application therein.

Where did the money come from before to cover these uninsured patients...the taxpayers (or via inflated premiums for those with plans)

So where is the magic money coming from to fund this new plan...the taxpayers (and via inflated premiums to cover those who are chronically ill who must be covered).

It's still a shell game.  It's not like we found a couple of billion under the mattress to fund this.

The initial question was how can every other industrialized nation afford HC.  That's the answer.  Low standard of care and higher taxes.  I'm not arguing (right now) the merits of if we should or not.  I'm just telling you what we'd have to do to provide the same thing.

Your forgot lower GDP growth, Higher systemic unemployment and reduced standard of living.

I am insured and wait 2 - 4 weeks for a dr. appt, unless I am lucky and happen to call right after a cancellation.  And don't even get me started on the lead time for a gyno appt...I usually have to call 2 to 3 MONTHS in advance.  I don't think ACA fixes this problem, but private insurance certainly has no effect.

I know in Omaha there are doctors that are booked out several weeks and there are doctors who have openings same day.  I don't think I've ever had to wait even a day to get my kids in to see a Dr, but I know when I researched a really good sports Dr. to get a routine physical earlier this year I had to wait a couple weeks for her next opening.  There's also a big difference between routine stuff and urgent stuff. I'm sure there are a dozen places you can go in an emergency and get in very quickly.

However, I think the big difference when it comes to care is once you're at the doctor.  For example if you go to an urgent care or emergency room facility and something comes up requiring an MRI or a test of some kind they just do it.  They have the people and the equipment pretty much everywhere.  If you google MRI wait times in Canada you'll see it often takes several months on the waiting list just to get a "routine" diagnostics scan.

Good point. I realized I am in the same position - I set up an appointment with my PCP for having a birthday with a "0" at the end. Even as a doc in the same hospital, with decent insurance, who routinely interacts with him, my appointment was scheduled for 5 weeks out.

wannabefaster - 2012-06-29 8:47 AM

hamiltks10 - 2012-06-28 11:10 AM This makes my decision about my vote in November more difficult.  Being "in the middle", someone who is socially liberal but fiscally conservative...I've really been leaning towards voting for a 3rd party candidate to make a point.  I don't like Romney at all.  But I am 100% against the health care mandate.  I almost feel like I HAVE to vote Republican now.

And this is the (evil )genius of John Robert's vote. Republicans should be dancing in the streets over his decision to vote with the liberals. He may have helped Obama win a battle but he may have helped the Republicans win the war. Many people who were undecided about the Presidential election will now swing to the right because of the overwhelming unpopularity of the ACA. Calling it a tax is another stroke of genius. there are very few things more polarizing than a new tax on Americans. Especially an unpopular one. Things just got more interesting. Don't get me wrong. I think our health care system needs some serious overhauling. I have to respect Obama's willingness to attack something that was near political suicide but I am disappointed that he burned so much political capital. I don't think what he has come up with is going to work. It certainly is not going to reduce health care costs. It may very well actually reduce many people's access to health care or at least delay it--but that is a discussion for a different thread.

I think we've been beating that horse very thoroughly in this thread.  

I've highlighted TriR's posting where I believe we are comparing apples to apples.  (Which is a really fun board game, BTW. My kids and I play it whenever we are together.)

apples to apples is an awesome game!  and i read triR's post the same as you, gear, "a basic dr. appt" i interpret as a general wellness/vaccine/checkup.

Must be a popular doctor.  I can get in usually in 1-2 days.

And in reply to Gearboy I'm talking about basic visits like a rash or a cold.  No tests involved.  Weeks.  Most say the problem is gone by the time they get in to see the Dr. (sorry you are saying it was a basic visit..)

I don't understand those wait times you are seeing.  Maybe it's due to the # of doctors in FL but the longest I have EVER waited for a Dr appt is 2 weeks.

Just wait until millions more are insured and start going to the doctor.  You'll be waiting 3 months.

Just to play devil's advocate, but if it's gone by the time they get in to see the doctor, did they really need to go to the doctor in the first place?  Isn't that somewhat the root of the problem?

To answer the question at hand you can see a "cliff's notes" version of a few different countries and their health care systems through canadians eyes:  http://www.canadians.org/healthcare/documents/BKS/BKS_6.pdf

Edit: And if you are REALLY serious about wanting to know the answer to your question, here's a good read on a study conducted by the OECD:

http://www.oecd.org/dataoecd/15/52/35028282.pdf