Judge rules Obamacare unconstitutional, endangering coverage for 20 million

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I still think it comes down to whether people are to be expected to share the cost of their own care even if it’s difficult, or expect someone else to pay it all for them.
Difficult is one thing. Impossible is another.
 
How many people do you think cannot pay any part of their medical care, and who are not already on Medicaid?
 
How many people do you think cannot pay any part of their medical care, and who are not already on Medicaid?
I can’t give you a precise number. Obviously, therefore, you win. I must now support the repeal of the ACA, without replacement.
 
I’m not (I won’t say the name) so I don’t quibble with trifles or expect metaphysical certitudes. 🙂
 
Again, I must return to the fact that every singe industrialized country has universal healthcare and they do it at less cost according to W.H.O. statistics. And the main reason, but not the only one, is that ours is a for-profit system largely based on making profits.

So, if you watch t.v. today, note how many commercials are directly or indirectly tied up with the medical field, and then ask yourself who ultimately pays for this? Also, look at nearby hospitals that may look like medical Taj Mahals, and ask yourself who pays for all this ultimately? And then ask yourself if you are having a heart attack, are you going to shop around for the best deal?

It seems to stand to common sense that if some others are doing a better job with better results, then maybe it’s a smart thing to find out what they’re doing that works so well and then maybe implement some of those items.
 
Mostly the government pays for the Taj Mahals and the breathtakingly expensive drugs one sees on TV. At one time in my life I negotiated costs for an insurer with providers, and I always got a discount to Medicare rate. All medical costs are in one way or another. Government determines what it takes to “cover costs” in a “not-for-profit” medical system, not insurance companies.

Some insurers are “not for profit” too, of course.
 
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How do you get people to dedicate their lives to being doctors? You force them? You pay them more than citizens? The government controls the hospitals? The workers there work for??? I heard of a place called Shangri-la (sp) one time in HS but it was make believe where all people worked for the good of others… Maybe it was in Russia? China? India? Heaven?
 
How about Canada? the UK? France? Japan? They all have universal healthcare with better outcomes and with less cost than us here in the States.
 
How do you get people to dedicate their lives to being doctors? You force them? You pay them more than citizens? The government controls the hospitals? The workers there work for??? I heard of a place called Shangri-la (sp) one time in HS but it was make believe where all people worked for the good of others… Maybe it was in Russia? China? India? Heaven?
This is not an issue. It is a made-up boogeyman. I was curious if there was any evidence of your point, so I looked up the number of doctors per capita, and the United States is behind developed countries with universal healthcare in Europe, and a little ahead of Canada. The politics of the situation do not seem to affect career choices.

https://www.nationmaster.com/country-info/stats/Health/Physicians/Per-1,000-people
 
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I’m not surprised. In at least some of those countries, if not all, medical school is free, or nearly so. Furthermore, in France for example, the government determines the size of med school admissions. They expand and contract the number of doctors to correspond with the expected number of patients.

In the U.S., medical schools determine the number of doctors, and the government (and private insurers) pay for medical schooling in arrears, in effect, in high medical costs, instead of in advance. Lots of those countries don’t have jury trials in med mal cases either, but specially trained judges and special courts. Again, in France, lawyers in med mal cases can only charge by the hour. They can’t get a big payday by winning a big jury verdict. But the government pays for all of that, and the malpractice premiums too.

One should be careful about believing everything one reads about how lame our system is compared to others. A good part of the time, it’s just a matter of what you count and when.

And, of course, the U.S. outcomes are worse in some things but the best in some others. The U.S. outcomes are best when it comes to most cancers. Less so for some other things including maternal care. But then, lots of systems don’t provide free care to an illegal immigrant population whose early care and self-care were primitive or misguided.
 
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One should be careful about believing everything one reads about how lame our system is compared to others. A good part of the time, it’s just a matter of what you count and when.
The evidence is broad and the points are numerous that we have serious issues. So since I provide some number, that included, the world, not just selected statistics, the counter would be to provide other evidence, like where socialism is causing a serious shortage, not just poo-poo that which I have given.

So back up to the poster a few posts ago, what country did this dire situation occur?
 
never did I say that socialism has caused a shortage of doctors anywhere. I don’t know what post you are talking about “a few posts ago”.

I do not recall your providing any kind of number about anything. I do recall your citation in which the number of physicians per 1000 population is shown. I would readily admit the U.S. should have more physicians; though I will add that none of those numbers is meaningful without knowing their level of efficiency and how many collateral personnel there are, such as NPs and PAs.

I do remember this. Years ago I worked on getting visas for foreign health workers. It was interesting. Among other things, their educations had to pretty much parallel ours and there are companies that study their schools for that. In some countries I could get equivalency and in some I could not. Broadly speaking, the more primitive the society, the less likely the worker was to qualify.

And sometimes there are differences within countries. For example, medical graduates from the University of Santo Tomas in the Philippines almost always qualified. From other medical schools, no.
 
talking about “a few posts ago”.

I do not recall your providing any kind of number about anything. I do recall your citation in which the number…
That is because I was responding to another poster. But yes, numbers are numbers.
 
Outcomes vary, but in the most common forms of cancer, the U.S. is in the top three countries when it comes to survival rates.


When it comes to breast cancer, the U.S. is number one in survival rates.

http://www.bing.com/images/search?v...al+rates+by+country&ajaxhist=0&vt=0&eim=1,2,6

I realize many people are invested in “The U.S. has the worst outcomes and the most expensive system”. But comparisons are almost always selective information, and don’t include a lot of things.

For another example, France does not provide any kind of medical care for illegal aliens except what they can pay for themselves and up front. The U.S. provides a lot of it, which adds to the costs. If there really are 20 million illegal aliens in the U.S., mostly from primitive countries, that’s a significant cost addition.

Hanging it up now. Be of good cheer, all.
 
Did you see the news article today about doctor burnout? 40 % have thought about quitting because of the paperwork demanded by ACA in the USA!!!
 
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For another example, France does not provide any kind of medical care for illegal aliens except what they can pay for themselves and up front. The U.S. provides a lot of it, which adds to the costs. If there really are 20 million illegal aliens in the U.S., mostly from primitive countries, that’s a significant cost addition.
That’s a good point. It should be considered in the cost of healthcare.
 
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JonNC:
I think the combination of the market and charities can do far better than that.
They haven’t, so far. What do you think wil change to improve that situation?
I’m in my mid-sixies and can’t remember a time when the general government hasn’t been involved in healthcare.
Before the ACA expanded Medicaid in many states, there were lots of poor people, especially single adults, people without children, etc. who weren’t getting any medical care since Medicaid was often very restrictive in some states. So, why weren’t charities filling that gap and providing health care to those people if they are so good at doing that? And I’m not talking about emergency care.
 
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More to the point, do those who can’t afford to pay for their own insurance but don’t qualify for Medicaid, get a free ride at the expense of the rest of the middle class or do they have to “cost share” with the rest of the middle class by liquidating down to the bankruptcy exemptions?
Before the ACA expanded Medicaid, there were lots of states where Medicaid was mostly restricted to pregnant women and disabled people. So, some poor people couldn’t get ongoing medical care no matter how poor they were. If someone who is poor has a medical emergency, they could go to the emergency room. But what about someone, for example, who has diabetes and needs to take insulin on a daily basis. The price of insulin has skyrocketed so that paying for it out of pocket could cost up to $1000 per month for some people. So what do those people do?

There was a story recently in the New York Times about a guy who was about 24 or 25 when he was diagnosed with Type 1 diabetes. He was getting his medical care and his insulin through his mother’s insurance. But when he turned 26, he lost that coverage, but earned too much to qualify for Medicaid in his state. And his employer, a restaurant, didn’t provide insurance. His insulin cost went up from about $300 per month to over $1000 per month paying out of pocket. Within a month he was dead, because he was unable to afford his insulin and was skimping on it. The article said that about a quarter of diabetics, even those who have insurance, take less insulin than they should to save money, often with terrible consequences.
 
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Before the ACA expanded Medicaid in many states, there were lots of poor people, especially single adults, people without children, etc. who weren’t getting any medical care since Medicaid was often very restrictive in some states. So, why weren’t charities filling that gap and providing health care to those people if they are so good at doing that? And I’m not talking about emergency care.
No one, not even foreign nationals here illegally, could be turned down st an emergency room for care.
Governments tend to put up barriers to care, the ACA’s attack on churches and Christians through the HHS Mandate is just one example.
Additionally, charities need to be able to raise funds. When government sucks up significant amounts of money, particularly from those best able to contribute, it is difficult for charities to provide in a broad scale.
Let’s also remember that government restrictions in voluntary health associations also prevent free citizens from finding the care they want outside of government rules.
The problems you cite are caused by government. More government is not the solution.
 
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