SCOTUS Upholds Affordable Care Act!

One of the biggest issues in healthcare costs that the ACA totally fails to address are the discrepancies in what insurance companies pay vs. what private patients pay for the same treatment by the same staff at the same facility.  Private patients who pay out of pocket can pay 5 or 10 times what the insurance company pays. 

Sometimes the patient doesn't have insurance, but they may have insurance that doesn't cover that specific illness or treatment, or they may have chosen to go "out of network". 

That is why your insurance only pays a small percentage of the bill if you choose to use a doctor or hospital that is not one of their preferred providers.  They have negotiated contracts with those local providers to steeply discount (up to 90%) what the insurers are charged in order to be included in the network and have the insurers steer more of their clients to that facility.  When the insurance company pays that small percentage of your bill, they are actually paying what they would pay if the provider were part of their network, and just letting you pick up the rest of the tab. 

Requiring hospitals and doctors to charge the same to insurers and private patients would go a long way toward making access to care more affordable and accessible to everyone with or without insurance.  There could be an allowance for a volume discount if that volume translates to actual savings for the hospital or for upfront payment since that saves billing costs and could be extended to individual patients as well as to companies. 

Such a rule would not need to micromanage how much is charged, and hospitals and other providers could charge whatever they want and adjust their prices as needed to reflect changes in the cost of delivering services. That rule or legislation could just require that everyone pays the same for the same service with only limited discounts that reflect actual savings. 

That minor little tweak would not increase costs substantially, and should not involve substantially higher taxes, unlike the ACA which became more of a way for the government to stealthily add and increase taxes than a way to help people get access to quality affordable health care.

I pay a grand total of $300 a year for my healthcare.  It is tagged onto my tax return and is a percentage of my taxable income.

Patmom

What an argument for single payer.

1.  For the record, I don't like the fact that health insurance is tied to the job, either.

2.  Alexandria - Health care is a scarce resource, just like diamonds and all other economic goods.  An example of a resource that isn't scarce would be the air we breathe.  (Actually, air might be considered scarce, too.)

3.  Yorkiemom, Athena, Rosemary, All - There already are preventative "free" programs - where I live, anyway - for women to have mammograms and other tests.  And the ER will give mammograms; I was sitting in the ER last year and talking with a woman who was there to have one.  (I think she probably didn't have cancer, but she was there to have everything checked.)  I also know someone with no insurance who had to keep going to the ER for care and eventually had to have surgery.  No, it's not a perfect plan, but universal healthcare won't be, either.

4.  Akinto, all I do is show my card and sign some papers here in the U.S.  (I'm sure you have to fill out paperwork there, too; someone has to keep records of your care.)  There are different kinds of insurance policies available here.  Most people have HMO - yet another system that was supposed to solve all our problems - which is the plan that involves too much paperwork. But there are other types of plans, too, such as a PPO - which is more expensive but does not restrict you to certain doctors.  The doctor's offices were always thrilled whenever I showed my PPO card.  (Right before diagnosis, we switched to an HMO - what luck!)  The U.S. already really does not have a free market health care system now: States regulate what insurance we can buy, for example, and our politicians want to pretend that's not a factor.

5.  Kam, I don't know what needs to be clarified.

6.  Remember, all, we keep hearing that a great number of Americans are uninsured.  But that doesn't tell the whole story.  The uninsured usually don't stay uninsured forever.  Like I was, they usually are uninsured for a short time and then insured again.  Also, just because someone is uninsured does not mean they don't receive medical care (I know from personal experience).  And the number of uninsured doesn't tell us how many are ill.

This is a good discussion, but I can see that some of us are outnumbered.  I have other commitments, and I doubt I'm ever going to change your minds here.  Bye for now.

Your taxes might go up anyway when the Bush tax cuts expire, hopefully.

Once again, since it was missed

It is estimated that 26,000 Americans die every year from lack of health care, according to recent newspaper articles.  I doubt they got health coverage after they died. 

I am in the category most likely to get a tax increase.  I would rather my taxes go up than people remain uninsured, that Medicaid is cut, etc.

I concur on the taxes.  I am absolutely willing to pay more taxes so that everyone has access to good healthcare.  And it isn't all altruistic.  It could some day be me or someone I love that would need that assistance.  I just would rather live in a world that demonstrates clear respect for life and living fully.

You think those problems have nothing to do with the recession?  They are all associated with the Bush tax cuts?  The recipe to get out of a recession...stimulate spending.  The worst thing to do during a recession...increase taxes.  

You think high speed rail is going to solve our problems?  The east coast has high speed rail...we are still in a recession. 

The Acela goes up to 150 mph, but averages about 70 mph.  It has not magically energized the economy of the northeast.  The terrain of the region and proximity of the major cities limits the opportunities for it to reach maximum speed.

I know what high speed rail is. I take it between Boston and NYC/Philly/DC a lot. As PatMom said, it's called the Acela. it's enormously expensive to run and not cheap to ride either. Flights to NYC are cheaper than the Acela.



Because I think that we, as a country, should control our spending doesn't make me a Tea Party member. Although your contractor identifies himself as a Tea Partier, how he pays his workers just makes him a scumbag. For the guy who blew his knee out, do you think his ways of fixing that knee are going to change because of ACA? I doubt it! Because you know what he is doing, doesn't that make you responsible too?



Conservatives don't mind paying taxes as long as its money we'll spent. Waste is what drives conservatives nuts.



I am the daughter of immigrants. My parents came to this country with two kids in tow and never once took a handout. Rather, they worked their a$$es off, never spent more than they had, educated 5 children in private schools, and put us all through college as well. In turn, we pay tribute to our parents by doing the same. Working hard and never expecting a handout, earning money, never over spending, and never expecting something for nothing. So, ya....you can call me a right wing conservative nut for expecting the government to do the same. Because I have done well does not mean its my responsibility to take care of others who have not. Now, that being said, that does not mean that I don't think people should have healthcare...I do! Just not ACA.



It's time to exit this conversation. It's going nowhere fast.

Mardibra, you pay 1200 a month or a year? If it is a year, who pays the rest of the cost of your insurance? Employer?

I just want to put in my personal history, because sometimes it seems like conservatives think that progressives are slackers who want to take advantage of hard working people.

My grandparents came here from Russia.  My father's father worked as a shoemaker; my mother's father sold insurance for pennies and was so poor he had to put two of his four children in foster care.  My father went through college on the g.i. bill after his W.W. II service, and would never have been able to afford it otherwise. I went to a city college because that's what we could afford. 

Any money my husband and I have was saved through long hard hours as attorneys - and we put ourselves through school by taking out loans.  (My husband often works 12-15 hours a day, sometimes 7 days a week - not because he wants to either. I have worked on Wall Street, for the Attorney General, for the Public Defender, and for myself.  If I work fewer hours than my husband now, it's because I have raised the kids and am taking care of elderly parents.) We are not in the 1 percent, because we do not have those kind of assets - but we are in a higher income bracket that was benefited by the Bush tax cuts, which we opposed, and which would probably get hit if the tax increases on higher earners was rolled back.

I resent waste as well.  the biggest example of waste I can think of: the Iraq War.  Funny how conservatives focus on the poor, on teachers, on firefighters as examples of how our government overspends and could cut back, but that War, which was unnecessary and cost billions upon billions - never mentioned.  I also note that the Ryan plan cuts every domestic program but increases military spending.

I believe in spending on infrastructure so our country will be competitive.  I believe in spending on finding and making more economical alternative energy, because I do believe that climate change in going on right now.   I believe that health care is a universal right  - and that the ACA, because of conservative opposition, is as good as we're going to get right now.   And if the Bush tax cuts, which I never wanted, disappear in order to help pay for it, so be it.