Supreme Court Ruling on Health Care

[EmperorNapoleon]

By almost any standard, Costa Rica has some of the best health care in Latin America. Not only that, but the country’s public and private health systems are constantly being upgraded—new hospitals, new equipment, and improvements in staff training.

Despite the advancements, costs are low in comparison to those in the U.S. and even some European countries. Health care costs are about a third to a fifth of what you’d pay in the U.S., depending on the treatment Doctors, for instance, rarely charge more than $60 a visit, even for house calls. Many doctors, especially in private practice, speak English and have received training in Europe, Canada, or the U.S. Drugs are also much less expensive.

Private health care is also available, which is affordable and high quality. There are three large, private hospitals that most expatriates use: CIMA hospital in Escazú, Clinica Biblica in San José, and Hospital La Católica in San José-Guadalupe.

Costa Rica’s Private Health Care System
Many of the country’s highly trained physicians and some dentists work in the mornings for the CCSS and operate their own offices and clinics in the afternoons and evenings. While private health care in Costa Rica is more expensive than that offered by the same doctors and surgeons through the CCSS, the price is still far below that of the average office visit in the U.S. For example, a private office visit to almost any medical specialist costs around $$80 – $100. Continued treatments for diagnosed problems will vary, but will almost always be considerably less than comparable treatment in the United States. Dental work, too, is provided at a much lower cost than in the U.S.– prompting a phenomenon known as “medical tourism.”

Three well-known private hospitals, Clinica Biblica, Hospital CIMA, and Hospital La Catolica, where many CCSS doctors practice in the afternoons and evenings, offer first-class, ultra-modern services. Affiliated with U.S. hospitals, these three private providers have costs somewhat higher than the public providers but still considerably below anything found in the U.S.

Many expats elect to use a mix of public and private care due to the wait times for certain procedures and treatments in the public system.

"Costa Rica’s Government-Run Health Care System
**
With a government-sponsored network of more than 30 hospitals and more than 250 clinics throughout the country, the Caja Costarricense de Seguro Social (CCSS) has primary responsibility for providing low-cost health care services to the Costa Rican populace.** Although sometimes overburdened, this system has worked well for Costa Ricans for the past 60 or so years. Foreigners living in Costa Rica – legal residents only – can join the CCSS and get free treatment (everything from check ups to prescription drugs to major surgeries) by paying a small monthly fee–based on income. Tourists and visitors can use Caja facilities only in emergencies.

**Health insurance from the state monopoly Instituto de Seguro Nacional (INS) is also available to legal residents, valid with over 200 affiliated doctors, hospitals, labs, and pharmacies in the private sector. In 2010, the government made it mandatory for residency applicants to become members of La Caja. **The average price is generally less than $50 a month."

So let me get this right. You guys want to leave the United States over an insurance mandate and small step towards universal healthcare and move to a country with an insurance mandate and universal healthcare.

 

[_Abyssinia]

White House Statement on Obamacare Mandate Tax Contradicts Supreme Court Ruling

cnsnews.com/news/article/white-house-statement-obamacare-mandate-tax-contradicts-supreme-court-ruling

They are ignoring the Supreme Court’s own ruling. Shows the White House does not want to acknowledge it is a tax.

 

[_Abyssinia]

Obamacare Mandate Forces EWTN to Pay ‘Fine on Faith’

The leading Catholic media organization in the world, Eternal Word Television Network, is prepared to pay a “financial fine on faith” likely to exceed at least $600,000 per year rather than comply with Obamacare’s anti-conscience mandate.

EWTN is suing the federal government over the anti-conscience mandate, which requires religious institutions to provide “preventative” services — including abortion-inducing drugs, contraceptives and sterilization — in its health plans, regardless of the institution’s moral or religious objections.

This global company — comprised of Catholic Television, Catholic Radio and Catholic News Network — faces significant penalties but won’t violate its principles, according to EWTN counsel Kyle Duncan of the Becket Fund for Religious Liberty.

“We are agreeing to violate the mandate as we are preaching it,” Duncan explained. “This is probably the case for other religious broadcasting stations that we don’t represent, but it’s particularly the case with EWTN.”

This non-profit, tax-exempt organization receives no funding from the Catholic Church or from the cable systems and satellite providers that carry it. Since EWTN relies solely on its viewers for funding, the $600,000 minimum fine threatening the organization under Obamacare’s anti-conscience mandate may especially impact the network.

“The whole mission of EWTN is to propagate and popularize the Catholic faith,” Duncan said. “Its religious faith is intertwined with its mission. If it had to comply with the mandate, it would essentially be destroying its own ability to comply with its mission. It would be labeling itself as a hypocrite if it said, ‘We exist to promulgate the Catholic faith, and yet, we are acquiescing to practices that violate the Catholic faith.’”

Mother Mary Angelica of the Annunciation, affiliated with the Poor Clares of Perpetual Adoration, recognized the influence that television may have in spreading the Catholic faith. She started EWTN in 1981 by converting a garage behind the cloistered monastery where she lived in Hanceville, AL, into a television studio.

Today EWTN is available in upwards of 150 million households in more than 140 countries and territories. It is notable for its holiday-specific programs, coverage of the Vatican, holiday Masses, and World Youth Day, among other noteworthy events in the Catholic Church.

EWTN is more than a news network. Pilgrims travel to its headquarters in Irondale, AL, to worship in the chapel and attend the televised daily Mass. They also visit the famous Shrine of the Blessed Sacrament and the Poor Clare Nuns of Perpetual Adoration, a cloistered community, one hour away in Hanceville.

“EWTN itself is a pilgrimage site for people,” Duncan said. “People go and visit the EWTN studios. EWTN has a chapel in its studio. It is a television radio ministry more than just a broadcaster.”

Now the Obamacare anti-conscience mandate threatens to hinder EWTN’s mission to spread the Catholic faith.

blog.heritage.org/2012/06/29/obamacare-forces-ewtn-to-pay-fine-on-faith

Some Catholics are still portraying ObamaTax as good?

 

[seekerz]

You’re mixing up Equalities. There is equality of opportunity and equality of outcome. The latter does require one to rob one to benefit the other, but the former does not harm anyone, unless it’s giving freedoms to those who seek to harm others freedoms.

Thanks for clarifying.

You do know that equal health care outcomes are not guaranteed by facilitating access right? Actually it is argued by some that health care outcomes are determined more by living conditions than by medical interventions. So how is equal access to health care an example of equality of outcome rather than of opportunity?

 

[Scott_Lafrance]

"Costa Rica’s Government-Run Health Care System
**
With a government-sponsored network of more than 30 hospitals and more than 250 clinics throughout the country, the Caja Costarricense de Seguro Social (CCSS) has primary responsibility for providing low-cost health care services to the Costa Rican populace.** Although sometimes overburdened, this system has worked well for Costa Ricans for the past 60 or so years. Foreigners living in Costa Rica – legal residents only – can join the CCSS and get free treatment (everything from check ups to prescription drugs to major surgeries) by paying a small monthly fee–based on income. Tourists and visitors can use Caja facilities only in emergencies.

**Health insurance from the state monopoly Instituto de Seguro Nacional (INS) is also available to legal residents, valid with over 200 affiliated doctors, hospitals, labs, and pharmacies in the private sector. In 2010, the government made it mandatory for residency applicants to become members of La Caja. **The average price is generally less than $50 a month."

So let me get this right. You guys want to leave the United States over an insurance mandate and small step towards universal healthcare and move to a country with an insurance mandate and universal healthcare.

Moving to Costa Rica is voluntary, so therefore joining there system is a voluntary act. You know, freedom to make that choice. Obamacare does away with that.

 

[_Abyssinia]

New Poll: Voters Dislike Supreme Court’s Obamacare Ruling

Voters are reacting in broadly negative ways to the Supreme Court’s decision to uphold the legislation known as Obamacare, a new Newsweek/Daily Beast poll finds, with a majority disapproving of the ruling, fearing health-care costs and taxes will rise, and preferring Mitt Romney to President Obama on the issue.

At the same time, voters scored the ruling a short-term political win for the president by a huge margin.

Overall, 50 percent of those polled said they disapprove of the court’s 5–4 decision, while 45 percent said they support it. Consistently, a majority of voters said that they oppose the individual mandate (53 percent); believe taxes will increase (52 percent); believe their personal health-care costs will increase (56 percent); and disapprove of Obama’s handling of health care in general (58 percent). Only 24 percent of those polled said that they believe the ruling will make the country better off.

Against Romney, Obama maintains a narrow lead in the presidential race, 47 percent to 44 percent. Twenty-one percent said that they were open to changing their mind. State-by-state polls are more useful in predicting the actual outcome of a presidential contest, but national horse-race numbers are something to talk about while the election is still months away. The president’s approval rating stands at 45 percent. Fifty-nine percent of poll respondents said they believe the country is headed in the wrong direction—down slightly from about a year ago, in May 2011, when 65 percent said the country was on the wrong track.

Even as those polled said that they prefer Romney to Obama on health care—as well as almost every other issue, with the exception of terrorism, foreign policy, and education—voters said that they trust Democrats more than Republicans overall on the major questions facing the nation, 37 percent to 32 percent.

The poll was conducted by Douglas Schoen, a Democratic pollster who has worked for the campaigns of Bill and Hillary Clinton, Michael Bloomberg, and other candidates. A national random sample of 600 likely voters was interviewed June 28, immediately following the announcement of the Supreme Court’s ruling on the Affordable Care Act. The margin of error was plus or minus 4 percent.

thedailybeast.com/articles/2012/06/29/new-poll-voters-dislike-supreme-court-s-obamacare-ruling.html

Poll was done by a Democrat, not a non partisan pollster, so it is likely higher than 50% dislike.

 

[seekerz]

"Costa Rica’s Government-Run Health Care System
**
With a government-sponsored network of more than 30 hospitals and more than 250 clinics throughout the country, the Caja Costarricense de Seguro Social (CCSS) has primary responsibility for providing low-cost health care services to the Costa Rican populace.** Although sometimes overburdened, this system has worked well for Costa Ricans for the past 60 or so years. Foreigners living in Costa Rica – legal residents only – can join the CCSS and get free treatment (everything from check ups to prescription drugs to major surgeries) by paying a small monthly fee–based on income. Tourists and visitors can use Caja facilities only in emergencies.

**Health insurance from the state monopoly Instituto de Seguro Nacional (INS) is also available to legal residents, valid with over 200 affiliated doctors, hospitals, labs, and pharmacies in the private sector. In 2010, the government made it mandatory for residency applicants to become members of La Caja. **The average price is generally less than $50 a month."

So let me get this right. You guys want to leave the United States over an insurance mandate and small step towards universal healthcare and move to a country with an insurance mandate and universal healthcare.

They want to try it out.

I agree. Why take Democrats’ word for it?

 

[EmperorNapoleon]

Moving to Costa Rica is voluntary, so therefore joining there system is a voluntary act. You know, freedom to make that choice. Obamacare does away with that.

No, you can choose to pay the tax instead in the United States. That is freedom to make a choice. Costa Rica does not have an opt-out option. If you’re leaving because of a mandated choice between insurance and taxation it makes zero sense to move to a country with mandated insurance period.

 

[seekerz]

Moving to Costa Rica is voluntary, so therefore joining there system is a voluntary act. You know, freedom to make that choice. Obamacare does away with that.

So let me get this straight, you want the right to decide whether you submit to a mandate or not? Theoretically then, you could emigrate to Costa Rica and from there exercise your choice to return to the US and submit to the mandate or remain an expatriate? Hm…I guess THAT makes sense, now that I think about it.

 

[_Abyssinia]

Ed Rendell: ObamaCare 'An Albatross Around Our Neck’

Fmr. DNC chair and Fmr. Gov. Ed Rendell (D-Penn.) says ObamaCare will be an “albatross” around the necks of Democrats if they do not defend it.

“Now I think the president can and will continue to point out the good things that are in this act because we’re not going to run away from it. They [Republicans] are going to make it a campaign issue. I have always said we make a mistake, we Democrats, when we don’t stand and defend. It’s going to be an albatross around our neck. Let’s stand and defend it.”

nation.foxnews.com/ed-rendell/2012/06/29/ed-rendell-obamacare-albatross-around-our-neck

Rendell also says repeal of ObamaTax will be one of the first things Romney would do in his admin.

 

[Jeffrey]

I will pay neither. I pay enuff in taxes already.

No, you can choose to pay the tax instead in the United States. That is freedom to make a choice. Costa Rica does not have an opt-out option. If you’re leaving because of a mandated choice between insurance and taxation it makes zero sense to move to a country with mandated insurance period.

 

[seekerz]

Nonsense. The consumer always dictates pricing. Simple supply and demand economics

More nonsense. Are we all dolts who don’t check costs? All the more reason to stop this “test everything because I have insurance” nonsense.

Supply and demand knows no market. It works for everything. I’d suggest an economics course.

I suggest a medical billing course. The (insured) person receiving the services is not the one deciding how much they are willing to pay for it, so what kind of consumer does that make him? Level of care (and therefore, final cost) is determined at the time of service. Basic health care economics.

 

[iamrefreshed]

I suggest a medical billing course. The (insured) person receiving the services is not the one deciding how much they are willing to pay for it, so what kind of consumer does that make him? Level of care (and therefore, final cost) is determined at the time of service. Basic health care economics.

Negative. All services are negotiable prior to service.

I’d suggest, besides an economics course, one on negotiating.

I’ve negotiated medical service.

 

[EmperorNapoleon]

I will pay neither. I pay enuff in taxes already.

You certainly can choose to do neither. The IRS can also choose to prosecute for tax evasion.

 

[iamrefreshed]

You certainly can choose to do neither. The IRS can also choose to prosecute for tax evasion.

At least we can agree it is a tax. As with most taxes, to be borne by those who choose to work.

 

[EmperorNapoleon]

At least we can agree it is a tax. As with most taxes, to be borne by those who choose to work.

Of course. I’ve been making the same argument Roberts did on the tax issue from the beginning. I’m also surprised that the detractors are screeching that Robert made it up out of thin air because it is also one of the arguments made by the Administration before the Supreme Court.

 

[seekerz]

Negative. All services are negotiable prior to service.

I’d suggest, besides an economics course, one on negotiating.

I’ve negotiated medical service.

Good. Now do you know of the term ‘level of service’?

The extent of the physical examination, the complexity of the medical decision making and the background information (history) obtained from the patient are evaluated to determine the correct level of service that will be used to bill the insurance. The level of service, once determined by qualified staff is translated into a standardized five digit procedure code drawn from the Current Procedural Terminology database. The verbal diagnosis is translated into a numerical code as well, drawn from a similar standardized ICD-9-CM (latest review being ICD-10-CM database). These two codes, a CPT and an ICD-9-CM (will be replaced by ICD-10-CM as of 10/1/2014) are equally important for claims processing.
Once the procedure and diagnosis codes are determined, the medical biller will transmit the claim to the insurance company (payer).

Source
(emphasis, mine)

So, unless your doctor is failing to follow insurance guidelines or has invented a magical way to determine complexity of the visit before he sees you, all that you can be offered beforehand is a ballpark figure.

 

[iamrefreshed]

Good. Now do you know of the term ‘level of service’?

Source
(emphasis, mine)

So, unless your doctor is failing to follow insurance guidelines or has invented a magical way to determine complexity of the visit before he sees you, all that you can be offered beforehand is a ballpark figure.

A ballpark? Are you serious?

A doctor can see you in exchange for a chicken. It does not obligate him/her to further service. It really is that simple although Democrats wold attemt to convivne otherwise.

The problem with healthcare in America is the co-pay and unrestriced advice for MRI’s, CT’s etc…

 

[Ridgerunner]

Much fewer people will go to the ER with common conditions treatable by a much cheaper family physician now that they will have insurance.

Actually modern Europe is a perfect example of how well this system works. Far fewer deaths due to amendable conditions and higher life expectancy than the United States.

I would dispute the first statement. I have read thousands of Medicaid recipients’ charts, and they are not only overutilizers of medical services, they go the ER far more than most people. Why wait to see the doctor on Monday when you can go to the ER on Saturday evening for the poison ivy you got on Saturday morning? Either way, it costs them nothing.
Expand the number of people who pay nothing or very little, and you’ll get more, not less, ER use.

I would dispute your second assertion as well. I have seen no persuasive evidence that this is so, because apples are never compared to apples. If you look at life expectancy, you find two things:

First, if you’re simply going by life expectancy at any time in life, the older a society is, the greater is the life expectancy. That’s just a statistical thing. An 80 year old has a higher life expectancy than a 10 year old because everybody, no matter how old, has a theoretical life expectancy beyond the day you look at it, whereas a young person is subject to all the hazards of life. Every developed country in the world has an older population than that of the U.S.

Second, if you look at life expectancy at birth, you have to realize that infant deaths are recorded differently in different countries. We count more “live births” in the U.S. than they do in most developed countries, because our definitions of “live birth” are different. We count as “live births” all births where the infant shows any signs of life at all. In other countries, if a child dies shortly after birth, or is significantly premature and dies within hours of birth, it’s counted as a “stillbirth”.

In addition, the U.S. admits to this country massively more people who come from primitive societies than do other developed countries. Japan, for example, admits virtually none. We admit them almost without limit. Such people often have primitive ideas about health, have experienced poor nutrition and often bring bad health conditions in with them. In addition, and particularly among Mexican immigrants, they can buy the most powerful medications imaginable over the counter in Mexico, and they bring them in all the time. Self-diagnosis and self-treatment are extremely common among them, often with very adverse results. It’s also interesting to read the commentaries on people from primitive societies in the Diagnostic and Statistical Manual of the APA. The beliefs about health and what to do about illness among immigrants can be not only bizarre, but widespread.

You really can’t use outcomes and life expectancies as yardsticks with which to compare the U.S. and the medical systems in other developed countries.

 

[Ridgerunner]

Of course. I’ve been making the same argument Roberts did on the tax issue from the beginning. I’m also surprised that the detractors are screeching that Robert made it up out of thin air because it is also one of the arguments made by the Administration before the Supreme Court.

And the “penalty” isn’t the only “tax” in Obamacare, either. There is the tax on Cadillac health plans. Unions are exempted from that, however. There is the tax on capital gains. There is the additional Medicare withholding tax. There is the tax on selling your house. There is the indirect tax on people who are not subsidized but are paying the cost of those individuals who pay the fine but can sign onto insurance only when they’re sick, and those with preexisting conditions and mandates like the contraceptive/abortifacient/sterilization/in vitro fertilization mandate.(and who knows how many more mandates there will be) That’s a de facto “tax” on higher earners, and a big one. But it’s not only on higher earners because even those who are subsidized but not by much are going to have higher premiums too.

Lots of taxes in Obamacare.