Clue: We All Get Old Someday

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Health Care, Obama Administration

Ben Smith warns that President Obama is about to “screw his base.”

The passionate supporters are the youth, who voted for him by a margin of 60% to 36%, according to exit poll samples of people 29 and under. His enemies are the elderly: Mitt Romney won 56% of the votes from people 65 and over. And while one of ObamaCare’s earliest provisions was a boon to the young, allowing them to stay on their parents’ insurance through the age of 26, what follows may come as an unpleasant surprise to many of the president’s supporters. The provisions required to make any sort of health insurance plan work — not just ObamaCare, but really any plan of its sort — require healthy young people to pay more in health insurance than they consume in services, while the elderly (saved by Sarah “Death Panels” Palin from any serious attempt to ration expensive and often futile end-of-life care) consume far more than they pay in. There is always a push and pull, however, and this year will be spent laying plans to shift the burden further toward the young.

Before I go on to the main point, I want to say that I find the use of the word “enemies” a bit jarring. I don’t think a rational politician thinks of voters who vote against him as his “enemies,” but rather as a pool of people he wasn’t able to reach. Ben Smith also seems to be implying that the President should heap bennies on the young for voting for him and kick the old to the curb, rather than just do the right thing for everybody.

A larger point is that conservatives persist in supporting the idea of paying for health care through the private insurance industry, yet they also persist in being ignorant of how insurance risk pools work. If everybody only paid in what they received back in services, it wouldn’t be insurance any more, would it?

The main point is that we all get to take our turns being young people, then middle aged people, and then old people. Unless we die young, of course. Assuming an average life span, today’s hunky young dude is tomorrow’s shriveled old geezer. As individuals, we move around in the risk pool — sometimes we’re in the shallow end, sometimes we’re in the deep end — which is why risk pooling is preferred to just making people pay for stuff. In the course of a lifetime, we all take turns being givers and recipients. This is how insurance works.

Rick Ungar at Forbes explains the situation:

According to AHIP, the average premium paid by a 24 year old in the individual marketplace is $1200 a year. Using AHIP’s numbers, the price of making the cost of heath insurance more equitable for a 60 year old will potentially cost that 24 year old, on average, an extra $45 a month.

While I don’t mean to minimize this increase, as I recognize that every dollar counts when one is young and getting started, it is important to keep the actual price tag in perspective and weigh the equities when considering that those at the older age range have been overcharged for many years.

The reality is that the young have been paying unreasonably low premium rates for for a very long time—it being in the health insurance company’s profit interest to bring in as many young and healthy people as possible in the door by charging artificially low rates. The problem is that they make up for it by charging artificially high rates to the older people the insurance company would rather not have in the first place. What the ACA seeks to do is correct this situation so that 60 year olds are not precluded from gaining health insurance coverage by being priced out of the market.

I did some checking and found out that in some states, insurance companies are allowed to charge their older policy holders ten times more than the younger policyholders. When Obamacare fully kicks in next year, insurance companies will be allowed to charge their oldest policy holders no more than three times more than they charge the youngest ones.

Naturally, the Right frames the change as screwing the young. What’s sad is that so many older people have been bamboozled into thinking that the Right is on their side, when it plainly isn’t.

Next year, insurance companies must also stop charging women higher premiums than men just because they are women, as they do now. By the Right’s logic, Obamacare is unfair to men.

And, of course, it occasionally happens that a young person gets cancer or gets hit by a bus. By the Right’s logic, older people facing multiple health problems must kick in higher premiums to pay for that person’s care, but not the other way around.

It’s also the case than when an uninsured 50-year-0ld runs up a staggering medical bill before he dies, his 20-something children will be stuck with the bill. Paying $45 a month more to help Pops keep his insurance policy is a bargain in comparison.

If we want to help young people, how about doing something toward lowering the cost of higher education and student loan debt? And if you want to make health care as equitably low-cost as possible, how about single payer?

Update: Zandar comments,

Holy crap, Ben Smith has discovered ACTUARIAL SCIENCE. Healthy people paying for premiums and not consuming health care pays for sick people who are consuming health care. ALERT THE INTERNETS.

Update: Sarah Kliff explains why young people probably won’t be hurt by a spike in insurance premium cost.

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37 Comments

37 Comments

  1. SteveAR  •  Feb 11, 2013 @12:03 pm

    Before I go on to the main point, I want to say that I find the use of the word “enemies” a bit jarring. I don’t think a rational politician thinks of voters who vote against him as his “enemies,” but rather as a pool of people he wasn’t able to reach.

    Only two types of people would make this statement: people who have been asleep since 2004 when Obama began his campaign in earnest; or, a pathological liar like their god, Obama.

    I tend to think it’s the latter, based on this statement:

    A larger point is that conservatives persist in supporting the idea of paying for health care through the private insurance industry, yet they also persist in being ignorant of how insurance risk pools work.

    No we don’t. We don’t want health insurance tied to our employers. We don’t want health insurance to pay for every little mundane thing related to health care. We want health insurance that is actual insurance, to pay for those things we know we can’t pay for (ie., hospitalization due to severe illness or injury, catastrophic care, etc.).

    But based on everything else you’ve written here, it doesn’t matter what the truth is. It would undermine the Democrat narrative, so it is better to lie than do that.

  2. c u n d gulag  •  Feb 11, 2013 @12:08 pm

    Yeah, on top of not knowing jack about math and science, the righties also know nothing about insurance – which shouldn’t be amazing at all, since comprehending insurance actuarial tables requires a working knowledge of both math and science.

    It might also help those of us who are for it, if, instead of using terms like, “Single payer,” or “Universal Coverage,” we called it “Medicare For All” – since pretty much everyone with a functional brain knows what Medicare is all about.
    Now, I know that that doesn’t include a whole lot of righties, but everyone else will know what the hell we’re talking about – just not most of FOX’s audience, who, you know, are actually ON FECKIN’ MEDICARE!!!

  3. maha  •  Feb 11, 2013 @12:28 pm

    Only two types of people would make this statement: people who have been asleep since 2004 when Obama began his campaign in earnest; or, a pathological liar like their god, Obama.

    Wow, projection, much? You appear to suffer from way too much bile. A doctor might help.

    No we don’t. We don’t want health insurance tied to our employers. We don’t want health insurance to pay for every little mundane thing related to health care. We want health insurance that is actual insurance, to pay for those things we know we can’t pay for (ie., hospitalization due to severe illness or injury, catastrophic care, etc.).

    What you suggest works well for relatively healthy people who have disposable income to pay for office visits, lab tests, and the like. Real-world experience (I know; real-world stuff isn’t your thing) shows us that less affluent people with insurance such as you describe do without health care until they become dangerously ill, and what they’ve got has grown more difficult and expensive to treat. And, of course, without government subsidies and regulation, old folks and people with pre-existing conditions wouldn’t be able to get insurance at any price. The insurance companies won’t touch them.

    Seriously, there are no industrialized countries on this planet where health care isn’t regulated or subsidized somehow. Even when “Obamacare” fully kicks in next year, the United States will have the least regulated, most privatized health care system outside of the Third World. If you can point to somewhere in the real world where your system is in place and actually working, you might have an argument. But you can’t, because there is no such place. So you don’t.

  4. c u n d gulag  •  Feb 11, 2013 @12:35 pm

    SteveAR,
    How are ya, buddy?
    How’s it shakin’?

    I can see that your IQ hasn’t gone up since the last time I saw you comment on a Liberal blog.

    Where were you?
    Taking a break after President Obama beat Mittens like a red-headed step-mule?

    Jail?
    Or, were you part of “The Witless Protection Program?”
    Yeah, I bet it was was that, since the only time people mention the word “wit” around you, is if they add “nit” are a prefix, or “less” as a suffix, and there’s no such thing as a “Nitwit Protection Program” – which is too bad, because you’d qualify for that, too!

    Bye!

  5. joanr16  •  Feb 11, 2013 @12:36 pm

    I remember all the mindless barking from the Right (sounding a lot like SteveAR’s comment) right after the 2012 election, that Obama only won because he promised quid pro quo to those who voted for him.

    The problem with Ben Smith’s perspective is it’s essentially the same view, later on: that quid pro quo is somehow owed.

    And as for Steve AR, who must have been asleep 2001-2009 when a real “pathological liar” was in the White House, he clearly has no idea what real working people in the real world think, or how the hell they’ve paid for their medical care the past 40 or so years. I work with hundreds of red-state folks who call themselves “conservatives,” but try to take away their employer-based health insurance that pays for pretty much everything outside of the annual deductible and co-pays, and they will bite your hand.

    Conservatives who don’t work for a living might be as confused as SteveAR, but to represent that as a mainstream opinion is, well, lying. Old, tired, transparent, pathological lying.

  6. c u n d gulag  •  Feb 11, 2013 @12:38 pm

    Oh, yeah, and “dim” as a prefix too.
    But equally sadly, there’s no such thing as a “Dimwit Protection Program” either.

  7. Bill Bush  •  Feb 11, 2013 @12:56 pm

    Where does the shortsighted view come from that premiums this year are only for this year’s costs? Don’t insurance companies have to have rather large cash reserves to deal with future costs they know are going to come? I have figured out that time is passing and I am getting older. Shocking, I know, but look around! It may be happening to you, too. If you have an aging group in your insured population, you have upcoming expenses you should be planning for. This is where the conflict between dividends and committed reserves comes in. For-profit health care is well known. For-insured health care is unknown. I’ve never seen the phrase used till I just now used it. That may be a problem.

  8. SteveAR  •  Feb 11, 2013 @12:59 pm

    Even when “Obamacare” fully kicks in next year, the United States will have the least regulated, most privatized health care system outside of the Third World.

    Wanna bet? There are 50 state governments that also have their say in how health care is regulated, on top of the federal government. So maybe on a national level what you say might be true, it completely ignores how things really are when you drill them down to the state and local level.

    What you suggest works well for relatively healthy people who have disposable income to pay for office visits, lab tests, and the like.

    The reason office visits are expensive is because individuals who are uninsured or who don’t want a claim filed for their visit are the only ones who are required to pay full price for services. It is a fact that what a doctor charges for visits and lab tests have to take into account how much they aren’t going to get from Medicare, Medicaid, and private insurance plans since they all are able to extract a lower fee for the doctor’s services. In most cases, nobody actually even knows what is being charged since they don’t have to pay for it, or pay so little it’s not in their interest to know.

    And, of course, without government subsidies and regulation, old folks and people with pre-existing conditions wouldn’t be able to get insurance at any price. The insurance companies won’t touch them.

    This is a crock. I’ve had a pre-existing condition all my life, and I’ve never been turned down for coverage or been denied a treatment that was covered. My wife also has a pre-existing condition as well and before we got married and she was put on my plan, she had a policy that covered her condition as well. The only reason you and other Democrats are able to peddle such garbage is because you are never challenged on it.

    Neither is Obama. Remember that story he told about his mother being denied part of her coverage because she had cancer? Except it was a lie. Her health insurance covered her just as it was designed to. But she had gotten some kind of extra coverage AFTER she was diagnosed with cancer, which is what was denied.

    See? I wasn’t projecting. Obama is a pathological liar, and a quite disgusting one at that. But it doesn’t matter to you if what I say is true, does it?

  9. dan  •  Feb 11, 2013 @1:06 pm

    Ben Smith also seems to be implying that the President should heap bennies on the young for voting for him and kick the old to the curb, rather than just do the right thing for everybody.

    If you look at the record, that is exactly what George Bush’s administration and the Republican Congress did, 2001 through 2006+: heavily rewarded states and groups that voted for him (with votes and/or money) and ‘withheld support’ from those that did not.

  10. c u n d gulag  •  Feb 11, 2013 @1:31 pm

    “I’ve had a pre-existing condition all my life…”
    Well, if being stupid can be called a ‘pre-existing condition,’ than you, my friend, certainly have one.

    SteveAR, in all of the comments I’ve seen you leave on Liberal sites over the years, none has ever proven to be correct – so, pardon me if I don’t immediately have a “Come-to-Jesus” moment, like you’re E.F. Hutton or something.

    So, basically, according to you, no one’s ever been denied insurance policies for pre-existing conditions in your world, eh?
    Or, at least not very often.
    Nice world you live in.
    But, that’s world ain’t named “Reality.”

    I’m sure I could pull-up some statistics in a minute or less – but you’re not valuable enough for me to do anything but call you a moron.

    Go home where you’re appreciated, troll.

  11. Swami  •  Feb 11, 2013 @1:43 pm

    In most cases, nobody actually even knows what is being charged since they don’t have to pay for it, or pay so little it’s not in their interest to know.

    SteveAR …I’ll call bullshit on that one. That goes in the same category as welfare queens.

  12. maha  •  Feb 11, 2013 @1:47 pm

    Wanna bet? There are 50 state governments that also have their say in how health care is regulated, on top of the federal government. So maybe on a national level what you say might be true, it completely ignores how things really are when you drill them down to the state and local level.

    You’re on, dude. Even considering state regulations, after next year the U.S. will still have the most privatized and least regulated health care system outside of the Third World. If you don’t believe me, prove me wrong. Find an example that is actually working to provide health care. (Clue: It ain’t Switzerland. What Switzerland has is Obamacare on steroids. Just about everyone else has some kind of national health care system supported by taxpayers, in which private insurance companies play a very limited role.))

    The reason office visits are expensive is because individuals who are uninsured or who don’t want a claim filed for their visit are the only ones who are required to pay full price for services.

    One of the biggest reasons health care and health insurance is expensive, period, is that there are so many uninsured people who don’t seek medical care until they are in serious trouble. Then they go to emergency rooms for expensive treatment they can’t pay for. and the hospitals crank up everybody’s bills to cover their losses. (No, emergency room treatment is not “free.”) It’s been estimated — and, interestingly, the governor of Arizona recently admitted this — that in recent years the insurance companies have been charging about $2000 a year average for a family policy to cover uninsured people. Without Medicare and Medicaid, that “hidden charge” would be a lot higher.

    Also: There is no rational reason for anyone with insurance to not file a claim for an office visit, unless they are going out of network and it wouldn’t have been paid, anyway. Hardly anyone files their own claims anymore, but even if they did, the insurance companies don’t crank up your premiums because you went to a doctor for a routine office visit. They want you to get treated for minor problems while they are still minor. It saves them money.

    This is a crock. I’ve had a pre-existing condition all my life, and I’ve never been turned down for coverage or been denied a treatment that was covered.

    That’s because of government regulations. The HIPAA (Health Insurance Portability and Accountability Act), passed in 1996, limits pre-existing condition exclusions for employee benefit insurance. Before that, people who were new enrollees on a company plan often got turned down. However the HIPAA doesn’t apply to not-employee-benefit insurance, so in some states people who try to get a private policy find it impossible. So if you have employee benefit insurance but become self-employed or take a new job with a company that doesn’t offer insurance, and you have to buy your own, in most states you’re out of luck.

    And the whole reason Medicare came into existence was that growing numbers of retired people couldn’t get insurance. Put it another way — without Medicare and Medicaid (Medicaid pays for most long-term care for the old folks), care for your aging parents will eat you alive someday.

    So you can pout and call people names and liars all you like. I have the facts. You don’t.

  13. joanr16  •  Feb 11, 2013 @1:55 pm

    I’ve had a pre-existing condition all my life

    I’m sorry, but “ignorant” doesn’t count. I have specific instances of denied coverage for pre-existing conditions among my family and friends, as does everyone else here. You are living in a sad, hate-fueled fictional world, one that thankfully is passing into history.

    she had gotten some kind of extra coverage AFTER she was diagnosed

    Wow, Rush and Fox News are usually a bit more creative with the details. That one must be original with you, “some kind of extra coverage….” It makes you sound so knowledgable!

  14. Swami  •  Feb 11, 2013 @2:45 pm

    joanr16…What! You’ve never heard of an applied retrofit policy? In the industry they’re known as ARP’s.. They’re an excellent little item for chronic preexisting conditions.

  15. SteveAR  •  Feb 11, 2013 @2:50 pm

    You haven’t refuted one single point I made. Yes, people who are uninsured go to emergency rooms for regular care are helping kick up the cost of emergency room and hospital care. What does that have to do with routine office visits?

    Also: There is no rational reason for anyone with insurance to not file a claim for an office visit, unless they are going out of network and it wouldn’t have been paid, anyway.

    That’s because you’re not thinking outside the box. You’re stuck in this myopic view insurance is what provides health care, when in fact it doesn’t. The main reason for the existence of health insurance is for paying for catastrophic care and for paying those items that are expensive (new drugs, new treatments, etc.). But not everything related to health care is expensive, especially things like normal office visits, nor does everything related to health care need to be paid by a health insurance policy.

    Hardly anyone files their own claims anymore, but even if they did, the insurance companies don’t crank up your premiums because you went to a doctor for a routine office visit. They want you to get treated for minor problems while they are still minor.

    That’s true for everything that is insured. Yet, homeowners insurance doesn’t pay for routine maintenance on my house. Auto insurance doesn’t pay for routine maintenance on my car. Homeowners insurance and auto insurance could provide payments for upkeep on these items because it would be more expensive for them later. But they don’t. Because it’s insurance; what they are doing for health care is not insurance, but subsidies.

    That’s because of government regulations.

    But you said earlier we don’t have enough regulations. Fancy that.

    Before that, people who were new enrollees on a company plan often got turned down.

    Wanna bet? I’m fifty. I’ve had my pre-existing condition for more than 45 years. I’ve had employer-provided health insurance for 29 years. I don’t know anybody who was ever turned down for the same coverage.

    So if you have employee benefit insurance but become self-employed or take a new job with a company that doesn’t offer insurance, and you have to buy your own, in most states you’re out of luck.

    My wife, who also has had a pre-existing condition for decades, still had coverage in her policy before we were married. She was self-employed.

    Let me know when you get some facts. Because all you have are Democrat talking points, which are more accurately described by another word, but not the word “facts”.

  16. joanr16  •  Feb 11, 2013 @2:59 pm

    Nope, Swami, but I have heard of applied retrograde intelligence, which I think is what we’re really dealing with here.

    Honestly, I haven’t seen that much collected drool since my brother owned a Saint Bernard.

  17. joanr16  •  Feb 11, 2013 @3:04 pm

    More drool: You’re stuck in this myopic view insurance is what provides health care, when in fact it doesn’t.

    Of course, “helps pay for” is not at all the same as “provides.” We know the difference; Steve appears to be the one who does not.

    Democrat talking points

    Ding ding ding! “Democrat,” not “Democratic,” direct from the Fox & Fiends crib sheet.

    Banhammer? I would cite: “Not your monkeys.”

  18. joanr16  •  Feb 11, 2013 @3:08 pm

    what they are doing for health care is not insurance, but subsidies

    This is stuck in the mindset that health care should be a free-market commodity, like cable TV or expensive running shoes. In fact, health care is a necessity comparable to food, clean water, a basic education, and police protection. The government subsidizes all these things.

    All these basic assumptions are wrong, and arise from the self-centered view that, “If it didn’t happen to me, it didn’t happen.”

    Bored now.

  19. maha  •  Feb 11, 2013 @3:33 pm

    You haven’t refuted one single point I made. Yes, people who are uninsured go to emergency rooms for regular care are helping kick up the cost of emergency room and hospital care. What does that have to do with routine office visits?

    I was trying to get you to see the bigger picture, but I suppose that was foolish of me, as you are not capable of seeing it. So let’s keep this small. Trust me when I say that paying for routine office visits is not running up the cost of health care. It’s widely believed just the opposite is true; that not paying for routine office visits would end up costing the insurance companies more money in the long run. It’s like why my insurance company gives me a free flu shot every year — it’s cheaper than treating me in the hospital with complications from a bad flu. See what this doctor has to say — “I would argue, in contrast to the Cochrane analysis, that the routine office visit may in fact be the most cost effective therapy in medicine today.”

    That’s because you’re not thinking outside the box. You’re stuck in this myopic view insurance is what provides health care, when in fact it doesn’t.

    Actually I’m thinking way more outside the box than you are, because I consider Obamacare to be a poor substitute for what we really need — a national health care system supported by taxpayers. Medicare for All, if you will. Eliminate private insurance entirely.

    That’s true for everything that is insured. Yet, homeowners insurance doesn’t pay for routine maintenance on my house. Auto insurance doesn’t pay for routine maintenance on my car. Homeowners insurance and auto insurance could provide payments for upkeep on these items because it would be more expensive for them later. But they don’t. Because it’s insurance; what they are doing for health care is not insurance, but subsidies.

    There are a whole lot of reasons why the private insurance model does not work efficiently to pay for 21st-century health care. For one, health care costs have no limits. The most your car insurance would ever have to pay is replacing your car with one of similar value. The most your homeowners insurance would ever pay is building you a new house. And most people go through their whole lives without totaling their cars or losing their homes to disaster.

    But health care cost has no limits, because you’re trying to save a life. That costs whatever it takes. If your body gets totaled, they can’t guy you a new life. Saving it costs what it costs.

    Further, unlike the car owner or the home owner, most of whom never need to file a claim, with health insurance only those who die young suddenly and accidentally will not file claims. Everybody gets old, and sick. So everybody is going to be a big cost to the system, sooner or later. For that reason, paying for health care through a private, for-profit insurance system is stupid. All it does is add a middle man, the insurance company, which takes it’s cut to make a profit. But without risk pooling, most of us would be stuck with bills we can’t pay. So — go with one big publicly supported risk pool.

    But you said earlier we don’t have enough regulations. Fancy that.

    I never said we had no regulations; I said we have the least regulated, most privatized health care system outside of the Third World, and Obamacare won’t change that.

    What we do have a bleeding system being barely held together by a bunch of regulatory band-aids, and that’s one of them. Whenever part of the private insurance system is about to hemorrhage, Congress applies another band aid. So we’ve got this mess of little regulatory props and band aids holding together the old system, when we need a whole new system. Comprehensive reform.

    That particular law is shielding you from the harsh realities of relying on the tender mercies of the private insurance companies. I provided a link to an article about the problems with pre-existing conditions, which you obviously ignored.

    And, while the insurance companies don’t provide health care, do try getting health care without insurance. It would open your eyes, I think.

    The fact remains that the United States has the most privatized and least regulated health care system outside of the Third World. You couldn’t find an example that proves me wrong, so I win.

    My wife, who also has had a pre-existing condition for decades, still had coverage in her policy before we were married. She was self-employed.

    You provide an anecdote; I provided a link to an article about the problems of pre-existing conditions. Basically, I have facts and you have fantasies.

    Let me know when you get some facts.

    I’m providing links to information, and you aren’t. I have facts; you have half-baked opinions. I win.

    Good bye.

  20. c u n d gulag  •  Feb 11, 2013 @3:44 pm

    And so, SteveAR gets the boot from yet another Liberal website.

    He’s probably lonely, because I’m sure even some not-too-totally-stupid Conservative sites have given him the boot as well.

    He’s THAT “Teh Stoooopid!”

    And I loved the post he chose to have a comment battle on, with the blogger who knows the ACA and our health care system better than probably any other blogger, and better than most, if not all, Senators and Congresscritters – and certainly any with an “R” next to their names.

    Buh-bye – chump!

  21. maha  •  Feb 11, 2013 @3:45 pm

    More drool: You’re stuck in this myopic view insurance is what provides health care, when in fact it doesn’t.

    Of course, “helps pay for” is not at all the same as “provides.” We know the difference; Steve appears to be the one who does not.

    I run into that statement al the time. People intone it as if they were making a serious point. But what point? Anyone who is not independently wealthy and who has had to go without health insurance for more than a few weeks knows that if you don’t have insurance, you’re cut off from getting most health care.

  22. maha  •  Feb 11, 2013 @3:47 pm

    Banhammer?

    I just banned him, but there are ways around the ban. Let’s see if he’s persistent enough to find them. Generally the more ignorant they are, the more likely they will insist on continuing to post comments here.

  23. joanr16  •  Feb 11, 2013 @3:57 pm

    Generally the more ignorant they are, the more likely they will insist on continuing to post comments here.

    I call that the “Weaaaahh, I’m lonely and I want attention!” pathology.

    That’s what daytime TV is for, imo. This guy seems an excellent candidate for one of those shows about guys wrestling gators.

  24. erinyes  •  Feb 11, 2013 @8:26 pm

    I may have mentioned this previously, but I’ll do so again. We have a young lady from the UK staying with (college student). Several months ago, she complained of a blazing headache and numbness on one side of her body. I got her into my truck and to emergency. Upon arrival, she had an initial exam, then 2 mri’s, a pregnancy test, a drug test, a series of blood tests, and several injections.
    Luckily, she was not seriously ill, and she DOES have health insurance. The bill arrived last week. For three hrs at emergency the bill totaled $19,000.00.
    That’s right, nineteen thousand dollars. Her portion is $900.00.
    SteveAR is so much like the guys I work with. He operates on emotion and not facts.
    Steve, quit believing the talking heads, and find the truth.

  25. Doug  •  Feb 11, 2013 @10:30 pm

    Ignoring the troll for the moment…

    The comments and reuttal to the article on Buzzfeed misses the point of the article. I don’t think the article had much to do with health care or the effect of AHC on young people. The GOP has a fracture which resembles the San Andreas Fault. It’s not an ideological divide – but the old guard is fighting with the Tea Party about how to conceal tenets of the party which are not palatable to moderate voters. The split is serious and deep and no one in the GOP has the power to heal the wound.

    Answer: try to create an equivalent divide among democrats. The object of the article was not to seriously discuss actuarial science – the goal was to sow discontent among one of the strongest factions in the democratic party – young people. In no way did the article present an alternate way of distributing health care costs that would work better. They only wanted to discourage young voters because it’s a group the GOP does not want to vote in the next election.

  26. biggerbox  •  Feb 11, 2013 @11:05 pm

    SteveAR is not only badly informed, but he is clearly “hard of thinking”. He seemed to think he was making an argument, but all I was seeing as a disconnected set of assertions and ad hominem attacks. He was right that Maha hadn’t refuted a single point he had made, but that’s only because he hadn’t actually made any points. He’d thrown a lot of statements out, but none of them were actually points of a coherent argument, starting with his opening confusing bleat about who considers whom “enemies.”

    I can only intuit that Barbara’s life must be in a good place right now that she was able to calmly respond to such baffling nonsense with such grace and calm. Well done, (though there was never any chance of getting through to SteveAR, sadly.)

  27. c u n d gulag  •  Feb 12, 2013 @8:04 am

    SteveAr proved that not only was his condition pre-existing, it’s also terminal: You can’t cure “stupid.”

  28. c u n d gulag  •  Feb 12, 2013 @9:18 am

    And you almost can’t blame SteveAR for the way he turned out.

    It’s gotta be tough to walk around all of your life, with a name your parents picked out on “Talk like a Pirate Day” – Steve ARRRRRRRRRRRRRRRRR!

    Ok, I’m done with him now.

  29. maha  •  Feb 12, 2013 @9:40 am

    biggerbox — Seriously, anyone who thinks that insurance should just pay for “big stuff” like hospitalization and surgery has no idea what even routine blood tests cost, never mind X-rays or MRIs. It’s not at all difficult to run up a five-figure tab even before they figure out what’s wrong with you.

    With some of these wingnuts, I do wish we could just give them what they think they want. A little taste of the real world might cure them.

  30. joanr16  •  Feb 12, 2013 @9:54 am

    Well, it’s a typical false equivalence to compare home and automobile ownership to the ownership of a human body. But, as maha pointed out previously, there are legitimate arguments to be made that insurance, as a funding structure, is an inferior means of paying for health care. Universal single payer would be the alternative, since “free market” just kills people. I’m pretty sure Steve didn’t realize he was arguing for that. He just needed a place to barf up some bile, since the outcome of November’s election has obviously hit him pretty hard. I can only second what Biggerbox says in that last paragraph.

  31. goatherd  •  Feb 12, 2013 @9:54 am

    I certainly applaud your patience along with biggerbox.

    In my mind, Ben Smith’s article brings forward the disparate views of society that fall consistently to the left and right of each issue. For some, it seems Margaret Thatcher’s assertion that “there is no such thing as the common good, there is no such thing as the public, just individuals, living their lives.” (I may have this substantially wrong in the specific wording, but, her assertion echoed a sentiment voiced by Ayn Rand.)

    What is the meaning of a nation, if it is reduced to hordes of people simply occupying the same body of land? What is a family, if they are playing a zero sum game, in which the young and healthy have little stake in their parents’ wellbeing once they’ve flown the nest? Maybe I am stating their vision unfairly, but, I think my questions are fair.

    So far, I have not received any direct support from Social Security or Medicare. But, my parents did, and that made my life a lot easier. I didn’t have to choose between bankruptcy and watching my parents die painfully and before their time. They lived pleasant, simple lives and preserved their dignity to the end. That was a huge benefit to my whole family and to me personally.

    In broad strokes, one side sees commonality and interdependence and the other sees a society balkanized into demographics and individuals warring for limited resources. Our individual experiences vary and we put them in the context of our views. But, it is easy to see how certain concepts are an uncomfortable fit to either view.

  32. maha  •  Feb 12, 2013 @12:18 pm

    So far, I have not received any direct support from Social Security or Medicare. But, my parents did, and that made my life a lot easier.

    That’s something that doesn’t sink in with some people. Especially were it not for Medicare, most people would bequeath their children nothing but a pile of medical bills. And a majority of older folks in nursing homes get their bills paid through Medicaid, I found out.

  33. Swami  •  Feb 12, 2013 @2:02 pm

    Maha…Good job of giving that wingnut a smack down. I enjoyed your explanation about the differences between auto/home and health insurance. It’s easy to confuse proper health care and with having insurance, and then focusing on the inequities within the insurance industry while taking your eyes of the need for a proper health care system.

    My sister passed away last June from a heart condition that gave her every indication that it was coming had she gone to a doctor. Unfortunately, she didn’t understand the seriousness of her condition and was hoping to make it to medicare coverage because she couldn’t afford/allocate even the basic cost of an office visit. She was living on Social Security only in “New York”. So she didn’t have the luxury of running to a doctor for every unexplained slight pain or feeling of discomfort she experienced before it was too late.
    And from what I understand her condition was not the result of an unhealthy life style..It was a condition the effects women and runs in family genetics..My remaining three sisters were all advised by the coroner to get themselves checked out.

  34. uncledad  •  Feb 12, 2013 @2:03 pm

    “My wife, who also has had a pre-existing condition for decades”

    She should get a divorce!

    Whats’ wrong maha, twit filter broken?

  35. goatherd  •  Feb 13, 2013 @9:28 am

    “I would argue, in contrast to the Cochrane analysis, that the routine office visit may in fact be the most cost effective therapy in medicine today.”

    That was a great link, short (for those of us who tend to get, … distracted) and it nicely pointed out the practical value of regular care. The practice of medicine is both an art and a science. I personally find it disturbing that it has to be a business too, but, we’ve got to take the bitter with the sweet. That’s reality. Practices nearly all employ a business manager as part of the crew and a few people to deal with insurance companies. The fee for service system can be easily exploited and so can DRG billing. The “art” of medicine, seems to be where it comes back to the main point of saving lives and healing the sick.

    Warning anecdotes follow:

    My primary care doctor saved my life by discovering a cancer at a very early stage. She found it because she is thorough and very smart, but also because she truly engages her patients. I truly think many other doctors would have missed it and my life would have been much different, mostly, shorter. This would not have been possible with regular office visits. Fortunately we had been paying through the nose for additional insurance to cover cancer and such, so the insurance company couldn’t weasel out of paying.

    And then …

    France spends about half of what we do on healthcare as a percentage of GDP. Their system incorporates an entity most like a non-profit insurance provider, as difficult as that may be to conceive of for us in the USA. You can buy into it after four years of residency by the way. I may have related this before. One of us needed a surgical procedure that was health related, but wasn’t covered by our insurance. After comparing the cost for the procedure here and in France, we found that we could both travel to France, spend a week in Paris, a week in Lyon and a week in Provence and STILL spend less that we would for the procedure alone, in the USA. Which option would you choose?

  36. goatherd  •  Feb 13, 2013 @9:31 am

    The first anecdote, penultimate sentence, should “This would not have have been possible WITHOUT regular offices visits.”

    Sorry.

  37. JR  •  Feb 13, 2013 @8:22 pm

    If I have to choose between my grandmother paying more and me, I choose me.



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