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A serious question about Obamacare

Posted on 1/18/17 at 2:58 pm
Posted by Eurocat
Member since Apr 2004
15035 posts
Posted on 1/18/17 at 2:58 pm
Over the past two weeks I have talked to a couple of what I would call "sharp cookies". Guys who are lawyers or work on Wall Street. Not dummies.

However - important clarification - none work day to day or even tangentially in the health care industry. They are not doctors.

That having been said, I asked them isn't a way we could solve many of Obamacare's problems simply by letting Medicare be something for people not 65 and up but, say, 55 and up? They all take a sip of their whiskey or tea or whatever and say, you know, you may be on to something thetre.

Then you would have three tiers of care (talking in a general sense here).

* Zero age to 25 years of age. You can stay on parents plan, which is part of Obamacare and everyone thinks this is good and wants to keep it.

* 25-55. You do insurance.

* 55 and up - Medicare (currently starts at 65 if I recall correctly).

The thing about this is that it would take all the people aged 55-65 out of the insurance market. THESE are the people that make insurance policies so expensive for the most part. While of course obviously there are exceptions, it is the 57 year old with Glaucoma and the 61 year old with heart issues and the 63 year old with early onsent dementia - that are driving costs up.

Would not Obamacare actually work pretty good if Medicare were lowered?

And yes, I know this would increase Federal Budget Costs, but I am for the moment putting that aside just to ask if I am missing something about the theory.

Just down below someone posted his health care costs 18k a year and he has a huge deductible. I am just wondering if you take some of the geezers out (and I am one of them so I am allowed to say that), if costs would not radically go down for health plans.
This post was edited on 1/18/17 at 3:00 pm
Posted by Eurocat
Member since Apr 2004
15035 posts
Posted on 1/18/17 at 4:24 pm to
Does really no-one want to talk about this possible "out"?

Bump.
Posted by The Spleen
Member since Dec 2010
38865 posts
Posted on 1/18/17 at 4:26 pm to
I think it is a viable plan, but would require a tax increase to fund.


Honestly, I think Medicare should be offered to everyone regardless of age. But say from 27-55 from your scenario, you have to pay for it.
Posted by mikebdatiger76
Marrero
Member since Jan 2005
93 posts
Posted on 1/18/17 at 4:31 pm to
The issue with Medicare is not the coverage part, but more the payment of services part. Currently doctors are receiving way less than what they charge, and usually not on time from the government. They up the charges in order to receive enough to cover costs. If you include 55-67 into the pool, you run the risk of making the pool so large that doctors start dropping out of the system all together, or practices becoming too large to properly gain approvals for procedures, treatments, medication, etc. That is why government run healthcare is such a flawed system. If you want examples, look to the issues veterans have with VA.
Posted by Eurocat
Member since Apr 2004
15035 posts
Posted on 1/18/17 at 4:49 pm to
Maybe the doctors are charging too much?

Posted by Taxing Authority
Houston
Member since Feb 2010
57074 posts
Posted on 1/18/17 at 5:03 pm to
quote:

The thing about this is that it would take all the people aged 55-65 out of the insurance market. THESE are the people that make insurance policies so expensive for the most part
So unload their expenses on the taxpayers?

You're still paying for them.

Ultimately that is the problem with your plan--and almost all healthcare plans.

You're trying to get something for nothing.

In the end if you're not expecting people to pay for their own care--you must be expecting someone else to pay for it.

There is no magic.
Posted by Taxing Authority
Houston
Member since Feb 2010
57074 posts
Posted on 1/18/17 at 5:04 pm to
quote:

Maybe the doctors are charging too much?
@ Medicare reimbursement rates?
This post was edited on 1/18/17 at 5:05 pm
Posted by RobbBobb
Matt Flynn, BCS MVP
Member since Feb 2007
27856 posts
Posted on 1/18/17 at 5:10 pm to
quote:

* 55 and up - Medicare (currently starts at 65 if I recall correctly).

Who the frick is gonna pay for that?

The 0-25 year olds not paying into their parents plan?

The 26-54 year olds struggling to pay their own ins?

The reason its even offered to 65 year olds is most aren't working, and cant afford the advanced healthcare they require

Its a dog eat dog world. Millenials expect way too much free stuff. Its getting ridiculous
Posted by Eurocat
Member since Apr 2004
15035 posts
Posted on 1/18/17 at 5:15 pm to
So what is the solution?

Tip - Many of us don't want to live in a dog eat dog world, we want to find some way to take care of all of us.
Posted by 50_Tiger
Dallas TX
Member since Jan 2016
39951 posts
Posted on 1/18/17 at 5:17 pm to
That is not how the world works my friend.
Posted by Jax-Tiger
Port Saint Lucie, FL
Member since Jan 2005
24734 posts
Posted on 1/18/17 at 5:18 pm to
quote:

I am just wondering if you take some of the geezers out (and I am one of them so I am allowed to say that), if costs would not radically go down for health plans.


Why not keep it where it is and just spend a crapload more on subsidies?

Is putting people on Medicare really going to drive the total cost down? It might drive costs down for the people under the age of 55, but that would be offset by higher taxes - for everyone.

What can we do to drive down the cost of services? What you are proposing is simply cost shifting. How can we make an office visit less expensive? How can we make hospital visits cost less? Those are the questions we need to answer.

Smoke and mirrors is what we're doing now. We're telling poor people, "Hey, you've go insurance you can afford, now! Yay!". Of course, we're telling the middle and upper-middle class to suck it up and take one for the team.
Posted by NC_Tigah
Carolinas
Member since Sep 2003
123769 posts
Posted on 1/18/17 at 5:23 pm to
quote:

Honestly, I think Medicare should be offered to everyone regardless of age. But say from 27-55 from your scenario, you have to pay for it.


Perfect!









Here's a hint:

YOU ALREADY PAY FOR IT !

. . . . or at least someone does.


Posted by Aristo
Colorado
Member since Jan 2007
13292 posts
Posted on 1/18/17 at 5:25 pm to
You can't take care of everyone, plain and simple.
Posted by therick711
South
Member since Jan 2008
25057 posts
Posted on 1/18/17 at 5:26 pm to
quote:

What can we do to drive down the cost of services?


Make the end users pay for it. Provide "menus" which show the cost to see a doctor per increment of time and the cost of there most common procedures. Remove the AMA from its role in accrediting medical schools. Open a crap ton more medical schools. Enlarge the roles that certain nurses are allowed to play in primary care. Remove federal price floors, state barriers to entry for doctors, and the ability to charge different rates to different people for the same services without posting those differences publicly.

Just a few of the supply side and cost side measure we could consider taking.
Posted by Eurocat
Member since Apr 2004
15035 posts
Posted on 1/18/17 at 5:41 pm to
It's medicines that often are the most expensive, not labor.

How could John Doe average pay for Enrberl or Humira?
Posted by therick711
South
Member since Jan 2008
25057 posts
Posted on 1/18/17 at 5:43 pm to
I'd we didn't subsidize it, it'd be cheaper.
Posted by BBONDS25
Member since Mar 2008
48009 posts
Posted on 1/18/17 at 5:48 pm to
Tonsillectomy is $311 to the doc. $311 for a surgery. You think that is too much?
Posted by Jax-Tiger
Port Saint Lucie, FL
Member since Jan 2005
24734 posts
Posted on 1/18/17 at 5:55 pm to
quote:

Many of us don't want to live in a dog eat dog world, we want to find some way to take care of all of us.





Liberals don't trust the market. If the government is supposed to provide you bread, they will put price controls on it, and their will be shortages - you will have to do without bread sometimes. When bread is available, you will an exorbitant price for it in the time that you will stand in line waiting to buy the bread. How can that be? The government is taking care of you!

If we rely on the market to provide you with bread, you will end up with bread at the cheapest viable price. You will pay more when there are wheat shortages, and less when wheat is plentiful, but you will always have bread if you want it, and you won't have to wait in line for it.

Healthcare is so expensive because the government is taking care of you. You will have to either pay too much for it, or wait a long time for it.
Posted by NC_Tigah
Carolinas
Member since Sep 2003
123769 posts
Posted on 1/18/17 at 5:57 pm to
quote:

Maybe the doctors are charging too much?
You think so?
Just so you'll know, Medicare reimburses neurosurgeons less for spine surgery than most vet clinics charge for the same surgery performed on a dog.
Posted by zatetic
Member since Nov 2015
5677 posts
Posted on 1/18/17 at 6:21 pm to
quote:

The thing about this is that it would take all the people aged 55-65 out of the insurance market. THESE are the people that make insurance policies so expensive for the most part.


You are saying we need to get rid of the people with preexisting conditions and then the price of insurance will drop. This is what we had before and the price of insurance was a lot less.
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