The Caravan

[One Brow]

I agree. If their willing to actually go through the process of seeking asylum and not just forcing themselves across the border, like they've already been seen doing.

The current caravan is over 1,000 miles from our border. Do you think they have really long legs?

Using the military isn't against the rule of law.

I'm pretty sure sending our troops into Mexico without permission or a declaration of war is, in fact, illegal.

 

[One Brow]

Like I said to Bullet, It's not just Obamacare. Government was getting involved in the medical industry before this. I'm sure there other reasons, but I bet that the majority all tied to government regulation. Willing to hear what you believe though.

We had seminars about this back in 2001, when I was working for Anthem BC/BS. The four largest contributors:

1. Improved technology -- CAT scans cost more than X-rays, MRI machines cost still more, etc. Everyone wants the best possible.
2. Increasingly obese population
3. Defensive medicinal practice -- extra tests, etc.
4. Newer, more specialized drugs

None of these come from government regulations, although I suppose you could blame government-sponsored research for #1 and #4.

 

[str8line]

The ACA clearly raised premiums to a level higher than without the ACA:
https://www.forbes.com/sites/theapo...are-act-that-increased-premiums/#6690888411d2


The ACA was a misguided attempt to make insurance better, but it actually made it worse. Classic example of a party doing something just to do something, even though they knew there were major flaws. Rather than attack the problem (cost being charged for care), we try to get more people covered to the providers can make ever more money. (same thing happened with college education--increase the amount of gov't guaranteed loans, and cost of tuition when through the ****ing roof). Prior to the ACA, hospitals had massive write offs (many hospitals are required to see many critical/emergency patients). The ACA has reduced those writedowns extensively, but the fees charged by these facilities have gone up, not down. The idea was to get healthy people to sign up, but the penalty/incentives didn't work, and were largely neutered by the court. As it stands now, if you get cancer without insurance, you can apply and still get it. It is akin to buying homeowners insurance after your house burns down. Why pay all the premiums when they can't exclude you later on? It could bite you if you can't deal with the short waiting period if you have a sudden serious accident, but the majority of young and healthy Americans would get free/written off care for most of those treatments anyway, as the pool is comprised of young people without a lot of capital...

The issue is we are the only 1st world country that doesn't have some sort of socialized medicine with cost caps. I don't have the data in front of me, but I posted a link to the research before on here--IIRC, something like 70% of big pharma profits are derived from U.S. patients, but we only make up something like 15-20% of their customer base. Most countries have caps on the fees pharmaceutical and medical equipment providers can charge, and some limit the amounts that a Dr. or surgeon and/or facility can charge.

In regards to durable medical equipment and pharma, we subsidize the rest of the world. I want us to go single payer with caps. The rest of the industrialized world will have a huge increase in the cost of medications and equipment, or the medical companies won't provide drugs and services to those countries. I actually think that by removing all the middle men in the industry field, that healthcare would be one area where the Government may be slightly more efficient than keeping things private. However, I do think the quality of care would go down as the demand from free health care goes up. I would like to see a program where everyone has free base care, and you can pay for priority service (similar to Canada's system).

I believe in having a capitalist society with social programs that provide a reasonable safety net. However, this does not work in a globalized society where we are the only ones paying ridiculous pricing.

Edit: Another problem with the ACA is it required insurance to provide good coverage that was affordable, but only to the employee of the employer (and most small employers are exempt). So most companies have low cost insurance for employees, and for a family it is astronomical. I pay $25 a month for me. If I add my family (two other people) it goes up to $1100 a month!

Great post. Thanks for spelling it out so well.

 

[One Brow]

The ACA clearly raised premiums to a level higher than without the ACA:
https://www.forbes.com/sites/theapo...are-act-that-increased-premiums/#6690888411d2

While not disputing what is in that article, I will note that is did not address the comprehensiveness of the insurance packages sold. If you compare the costs of plans that did not include coverage of, for example, mental health, to plans that did, the ones covering mental health will naturally suffer.

The ACA was a misguided attempt to make insurance better, but it actually made it worse. Classic example of a party doing something just to do something, even though they knew there were major flaws. Rather than attack the problem (cost being charged for care), we try to get more people covered to the providers can make ever more money.

The ACA made insurance better for millions of people, but I agree that it was, and continues to be, highly flawed.

(same thing happened with college education--increase the amount of gov't guaranteed loans, and cost of tuition when through the ****ing roof).

College has been getting more expensive for a large number of reasons. Loans may be one reason, but they are hard to disentangle from everything else.

As it stands now, if you get cancer without insurance, you can apply and still get it. It is akin to buying homeowners insurance after your house burns down. Why pay all the premiums when they can't exclude you later on?

It's not quite that simple. Even if that were a rational course of action, leaving cancer untreated for 6 months (the average time between discovery and the start of coverage) can make the difference between life and death.

However, your point stands for more chronic, less life-threatening conditions. I agree with most of the rest of your post.

Edit: Another problem with the ACA is it required insurance to provide good coverage that was affordable, but only to the employee of the employer (and most small employers are exempt). So most companies have low cost insurance for employees, and for a family it is astronomical. I pay $25 a month for me. If I add my family (two other people) it goes up to $1100 a month!

This is another thing that precedes the ACA. I saw large disparities in the 1990s.

Edit to add:
https://ldi.upenn.edu/brief/effects-aca-health-care-cost-containment

SUMMARY: This brief reviews the evidence on how key ACA provisions have affected the growth of health care costs. Coverage expansions produced a predictable jump in health care spending, amidst a slowdown that began a decade ago. Although we have not returned to the double-digit increases of the past, the authors find little evidence that ACA cost containment provisions produced changes necessary to “bend the cost curve.” Cost control will likely play a prominent role in the next round of health reform and will be critical to sustaining coverage gains in the long term.

 

[JAZZGASM]

While not disputing what is in that article, I will note that is did not address the comprehensiveness of the insurance packages sold. If you compare the costs of plans that did not include coverage of, for example, mental health, to plans that did, the ones covering mental health will naturally suffer.



The ACA made insurance better for millions of people, but I agree that it was, and continues to be, highly flawed.



College has been getting more expensive for a large number of reasons. Loans may be one reason, but they are hard to disentangle from everything else.



It's not quite that simple. Even if that were a rational course of action, leaving cancer untreated for 6 months (the average time between discovery and the start of coverage) can make the difference between life and death.

However, your point stands for more chronic, less life-threatening conditions. I agree with most of the rest of your post.



This is another thing that precedes the ACA. I saw large disparities in the 1990s.

Edit to add:
https://ldi.upenn.edu/brief/effects-aca-health-care-cost-containment

I agree it is difficult to disentangle, but the markers are there to largely show the correlation exists, especially when you lump in other Federal funding (increase in pell grants for example). Increase supply of students that are able to attend, and you logically should see a direct correlation in the cost to attend. None of the major studies lump the two together (The Bennett Hypothesis, which appears to be the most reasoned of those I have read). Yes, it is hard to find a causal relationship when everyone has access to funding, but there was a clear increase after the caps on student loans were abolished.

When the NDEA was enacted in 1958, we started seeing higher inflation trends. The largest increase in tuition occurred between 78 and 86. The period when caps were loosened, loans were guaranteed, plus loans became available, and it became nearly impossible to discharge loans in bankruptcy. I do think at some point we started seeing some normalization, as demand did not continue to increase. However, for years these institutions had to wrestle with tuition amount, and number of students admitted, and the effect continues to a degree (a lot of unnatural cost is permanently built in at this point). The government loan programs were the cause. So yes, more people can go to college, but at the same time, many people will not ever be able to repay their loans. The solution? Obama's student loan forgiveness program, that will add what is projected to be multiple trillions to the deficit over time (we won't see the full impact until 25 years of qualifying payments for these individuals (many loans only increase over time with very small payments). It will be a huge issue in about 10 years.

 

[Brsn]

The current caravan is over 1,000 miles from our border. Do you think they have really long legs?



I'm pretty sure sending our troops into Mexico without permission or a declaration of war is, in fact, illegal.

Please tell me where I said to send troops in to Mexico. Not once did I say that.

 

[JAZZGASM]

Please tell me where I said to send troops in to Mexico. Not once did I say that.

You said it right there. Boom!

 

[One Brow]

Please tell me where I said to send troops in to Mexico. Not once did I say that.

So, your think we should send US troops to the southern border, so they can sit on their hands while the members of the caravan walk up the border gates and request asylum? If not that, where were you planning on sending them?

 

[Brsn]

So, your think we should send US troops to the southern border, so they can sit on their hands while the members of the caravan walk up the border gates and request asylum? If not that, where were you planning on sending them?

Yes, I think troops should be sent to our border to aid and help border patrol. It's pretty obvious that most of these guys will try to rush the border. Again, if some can go through the proper channels and find asylum, then that's fine.

 

[One Brow]

Yes, I think troops should be sent to our border to aid and help border patrol. It's pretty obvious that most of these guys will try to rush the border. Again, if some can go through the proper channels and find asylum, then that's fine.

What makes it obvious, to you? Historically, the members of all such caravans claim asylum.

Still, no harm in sending the troops, except the waste of money. I suppose you one of those people that support increasing federal spending?

 

[RJF]

Refugees go through a vetting process... facts matter

What’s the alternative? Building a wall and shooting people who try and cross into the country? Ban countries who don’t do business with the trumps?

Again, history seems to be a lost art, especially for Trumpers. You realize the Berlin Wall imprisoned those that it was trying to protect, right? Is that what Americans want? To build walls and come up with such draconian laws that their own freedom and economc opportunity becomes hindered?

I’m not referring to immigration has a whole. I welcome legal immigration. Although even that has its negatives because we take the best and brightest from the countries that need them to stay home and fix their own country. Just got clarification: who is vetting the caravan? Chances are they’re all going to be to detained while they are vetted and then the left it’s gonna come out with their pitchforks saying trump is a Nazi for detaining them.

So, your think we should send US troops to the southern border, so they can sit on their hands while the members of the caravan walk up the border gates and request asylum? If not that, where were you planning on sending them?

Do you think it’s going to be 100% peaceful? You’re not that naive.

 

[Brsn]

What makes it obvious, to you? Historically, the members of all such caravans claim asylum.

Still, no harm in sending the troops, except the waste of money. I suppose you one of those people that support increasing federal spending?

When they're told they can't enter, do you honestly think that they will just quietly walk away? Also your assumption is wrong. I'm definitely for slashing the federal budget. Using troops to protect our border to me is more important than troops occupying countries around the globe. (Which I am against)