Alpha Centauri 2

Community => Recreation Commons => Topic started by: Geo on March 25, 2017, 09:27:39 AM

Title: Health care in the USA
Post by: Geo on March 25, 2017, 09:27:39 AM
With president [Sleezebag]'s latest struggle with legislative power in mind, I started wondering.

How many of the forum's members here (people living in the US of course) have been benefiting of Obama's Affordable Care Act installed a couple years ago?
And would you've been likely to lose this ACC entitlement if [Sleezebag]'s proposal would have been voted in last night?
Title: Re: Health care in the USA
Post by: Rusty Edge on March 25, 2017, 07:57:18 PM
Yeah, I think so, on both questions, but it's complicated, and my situation is atypical.

I think I have benefited from the standpoint of saving money, overall, and not just due to forced lapses in coverage.

I think I would have had to find a new insurance provider had their been a change, simply because our experience with ACA has been a procession of insurance company changes and lapses, and the implementation of ACA abolished the type of high deductible catastrophic care policy we'd been happily using before that. So repealing ACA wouldn't instantly re-create the policy choices we had before.

My medical history includes spontaneously collapsed lungs, cough syncope, Meniere's disease, and parathyroid gland problems, and kidney stones. I'm not 60 yet. A combination of bad luck and bad genes.  I'm one of those "interesting" patients. While my wife's issues are more pedestrian, she'd not a patient companies are eager to insure, either. We've been in and out of high risk pools, state and federally sponsored insurance since ACA took effect. No, I didn't get to keep my insurance or my doctor as Obama promised, even though I was pleased with them.

I think there are a number of better approaches to healthcare than the ACA. I think the one just voted down was only better for high income people and insurance companies, and even more poorly devised, and presumably would have been worse on implementation than ACA. A worse idea.

I'm probably the wrong guy to ask. In short, I paid insurance all of my life even when I didn't need it, and was short on cash and had to chose between insurance and utillities, was happy with my healthcare before ACA, and didn't need anybody to "fix it".

Title: Re: Health care in the USA
Post by: gwillybj on March 26, 2017, 12:05:12 AM
I don't think the ACA affected my household's coverage, since it was all in place before.
I don't mind sharing how it works for us:

I receive SSD (Social Security Disability) due to physical and psychiatric issues. This allows me to use Medicare, the federally-run program.

My girlfriend receives SSI (Supplemental Security Income), also due to physical and psychiatric issues. This allows her and her two sons to use Medicaid, the state-run program.

Since the Republican plan was supposed to not touch Medicare and Medcaid (I don't know if this is how is was actually written), we should have been okay.
Title: Re: Health care in the USA
Post by: Geo on March 26, 2017, 01:10:13 PM
If I understand correctly, quite a number of medical insurance programs are at large in your country.
Must be quite a hassle to determine which one suits your needs best (at least, if you have a choice. You didn't seem to have that, Rusty).

Are so many people in the US diagnosed with some condition or the other? Both of you have issues, and for another one I know the same counts.
Title: Re: Health care in the USA
Post by: Unorthodox on March 26, 2017, 08:50:04 PM
Hard to tell how much was caused by "Obamacare" and how much from market influences but we've seen generally declining coverage over the last few years.  Don't think the new bill would have impacted us at all.
Title: Re: Health care in the USA
Post by: Unorthodox on March 26, 2017, 08:52:04 PM
If I understand correctly, quite a number of medical insurance programs are at large in your country.
Must be quite a hassle to determine which one suits your needs best (at least, if you have a choice. You didn't seem to have that, Rusty).

Are so many people in the US diagnosed with some condition or the other? Both of you have issues, and for another one I know the same counts.

Generally. Full time employed people have 2-3 options their work helps pay for.  Retired, disabled, and some welfare folks get Medicare/Medicaid.   It's when you move outside of that bubble it gets interesting.

Dor instance, my brothers are both self employed. One with a small business. They have issues with the health care system.
Title: Re: Health care in the USA
Post by: Rusty Edge on March 27, 2017, 04:27:10 AM
Yes, it's true that I don't have a lot of insurance choices, and none of them seem to be long term choices due to companies getting out of health insurance, and changing government eligibility criteria.

I think Uno is right about the health insurance situation in general.

There's a further wrinkle. Here in Wisconsin, the state didn't implement the Medicaid expansion and insurance exchanges the way Obama envisioned. Obama blames my governor for political posturing because he had presidential ambitions. Gov. Walker said the Affordable Care Act  was a bait and switch scheme. Actually, I think they were both right. Gov Walker did run for president. While the average health insurance premium increase in Wisconsin is 16% this year, in our  sister state of Minnesota ( who did embrace the ACA insurance exchanges and Medicaid expansion, and accepted all of the federal subsidies ) the average premium increases were between FIFTY and SIXTYSEVEN %!  The state of Minnesota had to come up with over 300 million dollars in subsidies this year alone , to prevent a collapse. Large numbers of people were preparing to drop their insurance and pay penalties for not having it.

So me and my wife being high risk and in the early retirement category, and in one of the few states that did things it's own way,( within limits )  my anecdotal experience probably distorts the big picture.
Title: Re: Health care in the USA
Post by: Geo on March 27, 2017, 09:26:59 AM
Rusty, wait one. People need to pay penalties for not signing in a health insurance contract?

And about that price increase in Minnesota, were  those for people enrolling in ACA, or for those who stayed outside of it?


What you write UnO sounds more or less like it is in my country. Working in the private sector you're covered through your employer with your wage being paid for a time if something happens, at least on the workfloor and during commuting from and to work. Working self-employed, you don't have an income at all during your sick leave.
Title: Re: Health care in the USA
Post by: Rusty Edge on March 28, 2017, 01:18:06 AM
Rusty, wait one. People need to pay penalties for not signing in a health insurance contract?

And about that price increase in Minnesota, were  those for people enrolling in ACA, or for those who stayed outside of it?

1) Yes. A feature of ACA was that health insurance was mandatory for all. Rather than jail time, the penalties are financial.

2) Enrolling in. Buying insurance on the state exchange.

So now you know why there were a lot of people who wanted changes made to the existing law. Broad participation was supposed to drive costs down, but it hasn't.

Title: Re: Health care in the USA
Post by: Geo on March 28, 2017, 10:42:41 AM
In conclusion, it is thus another system next to the already existing ones, but pointed towards those the traditional providers weren't willing to cover.

Seen from that perspective, one universal 'base' system does seem better.
Title: Re: Health care in the USA
Post by: Lorizael on March 28, 2017, 02:17:35 PM
When I quit my cushy government job in 2015, I lost insurance and had to sign up for the ACA. Since then, I've had 0, 1, and 2 jobs at any given time, none of which have provided insurance because they're part-time, and none of which pay me all that much. The result is that I qualify for Medicaid, which means my healthcare is overseen by a Managed Care Organization of my choice and doesn't cost me anything (as long as I get care from a provider in the MCO). I hadn't bothered to make use of this at all until recently, when I tried to get an eye exam and then 3 weeks ago when I had my trip to the ER. So far it's been a bit of a hassle to use, but I have low tolerance for bureaucratic headaches. Oh, also, Maryland's healthcare website is terrible.

Since I think I only qualify for Medicaid because of the ACA Medicaid expansion, I'm assuming I would have lost coverage had ACA been repealed. That would have been bad.
Title: Re: Health care in the USA
Post by: Rusty Edge on March 29, 2017, 09:03:41 PM
In conclusion, it is thus another system next to the already existing ones, but pointed towards those the traditional providers weren't willing to cover.

Seen from that perspective, one universal 'base' system does seem better.

Yes it's sort of like our tax code, cobbled together and layered over time, with no consistent philosophy. I would agree that a universal system like Medicare for all, or Canada's system would be an overall improvement. Coverage for more people for a lower % of the national Gross Domestic Product, with lower infant mortality and greater longevity.  I don't know if its the best way, but its better than what we've got.

*****

There are other factors. Many drugs and vaccines are invented, tested and developed here. The regulations are strict and the costs are high, to prove that new drugs and vaccines are safe and effective. When those things are sold here, the pricing has all of those costs built in. The companies negotiate lower prices with other countries, even Canada.

Then there is the matter of lawsuits and malpractice insurance, which seems to be more of an issue here than anywhere else in the world.

Another issue is population distribution. Rural people are less cost effective to serve. You may think, 'well, what about Canada?', but 90 % of Canadians live within 90 miles of the USA. Likewise, I think most of the Aussies live close to the coasts. Those concentrations make people easier to provide with healthcare and internet than America's farmers.

****

There are other ways of doing things. Food is an example. We have all kinds of meats, fruits, produce, and processed foods. A better selection and quality than I've seen in the countries I've been to. Plenty of competition , too, so that if you don't like the quality, price, or purity, you have alternatives.  The poor people get a monthly allowance from the government on a special debit card which is only good for unprepared food and drink. They can spend it where and how they see fit. It seems to work well.

Before we had ACA I looked into various healthcare solutions. I was impressed by the approach taken by Oregon and some other states I don't remember. Their philosophy was that while healthcare was not a right, it was an essential service, and they treated it like water, gas, electricity and telephone. It was regulated by their Public Utility Commission, which could veto unnecessary or excessive price increases.

Two reforms I'd dearly like to see in American heath care are published pricing and 30 day or free billing. It shouldn't be that hard to do in the computer era, but nobody knows what anything costs until after the fact. Sometimes 5 months after! By then who can remember well enough to dispute erroneous charges?
Title: Re: Health care in the USA
Post by: gwillybj on March 29, 2017, 09:56:01 PM
Two reforms I'd dearly like to see in American heath care are published pricing and 30 day or free billing. It shouldn't be that hard to do in the computer era, but nobody knows what anything costs until after the fact. Sometimes 5 months after! By then who can remember well enough to dispute erroneous charges?
;b;
Title: Re: Health care in the USA
Post by: Yitzi on March 30, 2017, 04:30:07 AM
I benefitted from the ACA for about a year, I think...then I became eligible for Medicaid, and hence ineligible for the ACA (even though the doctor I was using the ACA-provided insurance for doesn't take Medicaid).
Title: Re: Health care in the USA
Post by: Buster's Uncle on April 07, 2017, 08:23:27 PM
I just got back from an SSI hearing, and boy are my arms humiliated.
Title: Re: Health care in the USA
Post by: Geo on April 07, 2017, 08:59:18 PM
Arm wrestling with the board?
Title: Re: Health care in the USA
Post by: Buster's Uncle on April 07, 2017, 09:04:26 PM
It's a play on the old hacky joke "I just flew in from New York - and boy, are my arms tired".

-Actually, all of me is humiliated.
Title: Re: Health care in the USA
Post by: Geo on April 07, 2017, 09:14:22 PM
Do you have to pass every year or so?
Title: Re: Health care in the USA
Post by: Buster's Uncle on April 07, 2017, 09:16:49 PM
My understanding is, I either win the case or not, and won't have to do this again.
Title: Re: Health care in the USA
Post by: Geo on April 07, 2017, 09:26:51 PM
I was under the impression you already received some kind of benefits. Appearantly not so thus.

Good luck with the case then. :)
Title: Re: Health care in the USA
Post by: Buster's Uncle on April 07, 2017, 09:32:36 PM
The security guard in the lobby seemed to think he was protecting an airport in New York, too.  Never want to do that again.
Title: Re: Health care in the USA
Post by: Geo on April 08, 2017, 11:13:50 AM
Why not? You have all the fun tourists entering the USA do. ;relish
Title: Re: Health care in the USA
Post by: Buster's Uncle on April 08, 2017, 01:31:31 PM
;goofy;
Title: Re: Health care in the USA
Post by: Rusty Edge on April 08, 2017, 10:51:49 PM
It's a play on the old hacky joke "I just flew in from New York - and boy, are my arms tired".

-Actually, all of me is humiliated.

I can relate somewhat. My wife insisted I apply for disability, because I was more impaired than others she knew that had disability certification. I think I spent weeks on those freaking forms, enumerating the ways in which I was no longer useful or productive. Like the tinnitus in my ears, I find that the best way to deal with it is to not to think about it... which is impossible with the forms forcing you to focus on it.

At this point I would use language that would only be deleted.

Humiliated. In any event, I was turned down. They said I was still capable of working to support myself, although they wouldn't say how or what work I should seek. Gee, Thanks! Others with my condition say they always deny the first time. As it happens, there's an expired  time limitation, and to reset that I would need to be employed again for however long. 

More stuff that would be deleted.

Once upon a time when I was young and healthy I was appointed to a government board, and we watched a film of a speaker talking about sensitivity to disability. Terms have changed over the years. In president Truman's day, we used the word "Cripples". Then, it was handicapped, then there were a bunch of competing terms like "physically or mentally challenged" and "disabled". Well, the guy in this film said "It's not a disability, it's a pain in the ass!" That has stuck with me. Things aren't impossible, but his life requires planning, preparation, assistance, equipment, accommodations, and determination. But mostly an understanding lots of stuff is a pain in the ass.

Actually, the word handicapped sort of sums that up, it has taken on a different meaning in this context.

So, yeah. Humiliating when you're forced to face it and write about it and talk about it.
Title: Re: Health care in the USA
Post by: Buster's Uncle on April 08, 2017, 11:39:28 PM
-To have your private business entered into, not just public information, but legal proceedings.  To be forced by bean counters to fill out forms when your life doesn't FIT on their little forms - and one of your fundamental issues in the first place is with bean counters and their stupid little forms.

Bean counters can go to hell and they can die.
Title: Re: Health care in the USA
Post by: Buster's Uncle on April 08, 2017, 11:40:35 PM
 :mad: :-[ :mad:  :-[ :mad: :-[ :mad:
Title: Re: Health care in the USA
Post by: Geo on April 09, 2017, 06:30:56 PM
A trifle more mad then embarrassed?

In any case, I'm lucky I only have two minor "problems", which most of the time don't stand in the way of a normal productive life.


Nice (20+ °C) weather here, so took the opportunity to make a walk 3 quarter hour walk in the area.
Has Spring arrived on your side of the Atlantic?
Title: Re: Health care in the USA
Post by: Buster's Uncle on April 09, 2017, 07:47:33 PM
Hard to say.

It's 74 degrees F here ATM.
Title: Re: Health care in the USA
Post by: Geo on April 09, 2017, 08:13:18 PM
A bit warmer then we had here today then.
Title: Re: Health care in the USA
Post by: Buster's Uncle on April 09, 2017, 09:31:45 PM
Just sat in the sun outside for over an hour with Maw and the cats.
Title: Re: Health care in the USA
Post by: Rusty Edge on April 09, 2017, 11:05:35 PM
I'd say it's Spring. The motorcycles are everywhere today.
Title: Re: Health care in the USA
Post by: Geo on April 10, 2017, 10:01:57 AM
Over here, in Flanders Fields, its the "terror"cyclists.
Imagine them with groups up to 30 driving on the road, avoiding the bycicle lane at all costs.
Don't even dare to blare your horn as to give room, or they're on you before you realize it.
Title: Re: Health care in the USA
Post by: Bearu on April 16, 2017, 04:38:45 AM
The singular solution for the healthcare system in the United States of America involves the creation of a nationalized socialist healthcare system like the system in Cuba. The CIA world fact book indicates the number of doctors and nurses per capita exceeds the number in the United States of America and the people need to recognize the need for a dramatic paradigm shift in the suppression of the bourgeoisie. The people need to respect the health and the welfare of the people as a foundation for the fundamental liberty of the people from the brutal oppressive exploitation of the bourgeois class across the world. The Cuban healthcare system, for example, represents the single country in the world to eradicate the HIV virus from the mother to infant transmission from the population. The potential applications from the creation of a nationalized healthcare industry demonstrates the ability of the people to place the health of the entire population above the petty concern for the profits of a few lumpen humans.
Title: Re: Health care in the USA
Post by: Elok on April 16, 2017, 08:41:21 PM
My semi-insider's opinion (I work at a pharmacy) is that the ACA fundamentally failed to address the real problems of American healthcare.  It's kind of like if you had a patient with a three foot long leech attached to his neck, and you couldn't figure out how to get it off, but you didn't want the patient to die either, so after a lot of hemming and hawing you decided to just pay for an indefinite series of blood transfusions.  It's not the worst choice you could have made, and it certainly beats inaction from the patient's perspective, but trumpeting it as a major success is rather laughable.  The leech is only going to get bigger.

Hospitals, drug manufacturers, device makers, pharmacy benefits managers, and others have all grown so big and musclebound that they can all but dictate their price, and our healthcare system is so complicated that it's almost impossible for the average person even to figure out who to begin to hold accountable.  Market forces simply can't work in such an environment.  Eventually the sheer amount of freeloading, rent-seeking, profiteering, and miscellaneous skullduggery will overload even America's ability to pay, and there will be some sort of crash.  I don't know what that will look like, except "ugly."
Title: Re: Health care in the USA
Post by: Buster's Uncle on April 17, 2017, 12:48:34 AM
Shoot; I knew ObamaCare was a terrible deal in 1993 when it was HilaryCare.  The insurance industry is the problem, not the solution.  Duh.

There hasn't been a real Democrat in the White House since Jimmy Carter; and I'm not that sure about him.
Title: Re: Health care in the USA
Post by: Elok on April 17, 2017, 12:53:12 AM
I'd say it's only the problem insofar as it acts as a shield for providers' exploitative behaviors.  People hear "your insurance won't cover this $500 drug" and fuss about the stinginess of their insurance rather than ask just why the drug is so expensive in the first place.
Title: Re: Health care in the USA
Post by: Buster's Uncle on April 17, 2017, 01:50:34 AM
The drug is so expensive because supporting bureaucrats runs the cost of everything up to infinity.  I remember the late 60s, when our family practitioner had two ladies working for him, one mostly nursing with him in back.  -After he retired, the same practice had --- I'd estimate six people working the front.  Five of them were just doing the insurance paperwork.

It's been nearly 40 years since any medical insurance bean-counters directed that my balls be fondled against my will, but I'll hear no defense of those scum.
Title: Re: Health care in the USA
Post by: Elok on April 17, 2017, 02:12:02 AM
Honestly, the profit margins on insurance aren't that big, and the reason they involve so much paperwork and defensive medicine all ties into various other issues--PBMs, our country's overload of lawyers, and a general desperate attempt to counteract profiteering.  Which, yes, does drive up costs, but not as much as, say, paying for the latest and hottest wonderdrug that's functionally identical to the last three released in its general class.  Doctors just love prescribing Nasonex, since the drug reps talk it up and give out samples (and possibly sexual favors, God knows).  Never mind that common fluticasone and budesonide work just as well for most people.  And that's a trivial example, compared to some others.  Once you get even a little way inside the industry, you quickly learn that there are thousands and thousands of little tricks to jack up prices, acquire monopolistic leverage, and dispense kickbacks to all cooperative parties.

Insurance gets the hate because they're everybody's common point of access, the apparent gatekeepers, and everyone figures that they have far more power than they actually do.  Also we associate the actual provision of medical care with doctors and nurses, whom we trust, and we have no direct contact with hospital administrators or drug company CEOs.  In reality, insurance companies are the only non-consumer party with a functioning incentive to keep the cost of service down.  Them, and pharmacy discount cards.
Title: Re: Health care in the USA
Post by: Geo on April 17, 2017, 07:24:54 PM
At some political decision level here on the old continent (beats me if its Belgian federal or European legislation), there's been a sort of law to prescribe generic medicines over the latest/hottest medicine in the sector, which should bring down the cost when purchasing at the pharmacy.

About insurances. About a year ago I had a labour accident when on cleaning duty in the old warehouse (some tool hit me on the elbow while manipulating it). I was home 2 or 3 (working) days for that. Afterwards, during reconstruction interview of the event with the safety advisor at work, a second-tier manager came in during the interview and had to tell me the cost of this whole event for the company: €900.
Mind you, at least half of that cost was the bill of the insurance provider for the company. The medical care itself and my salary being paid for those days on sick leave was somewhere between onethird and twofifth of the bill (that's my own estimate, based on my wage).
Title: Re: Health care in the USA
Post by: Yitzi on April 27, 2017, 11:00:44 PM
At some political decision level here on the old continent (beats me if its Belgian federal or European legislation), there's been a sort of law to prescribe generic medicines over the latest/hottest medicine in the sector, which should bring down the cost when purchasing at the pharmacy.

Although there are cases where someone has a reaction to all but one particular brand, and the law should probably have an exclusion for such cases.
Title: Re: Health care in the USA
Post by: Rusty Edge on December 15, 2017, 11:46:54 PM
It's Deadline Day for choosing an insurance plan.

I can't stay with my existing insurer, because they are leaving my state as of the end of the year. It seems like this every year, it's always something. It started with ACA outlawing the kind of high deductible plan we had and were happy with. Then we were in and out of high risk pools and state sponsored Medicaid equivalent. Then we were with our current provider as an only option. I can't say I've been happy with them. They insist that we only use CVS Pharmacy. I preferred Walgreens, but my legitimate complaint is that when the insurance declines a prescription for whatever reason or error, CVS never contacts me or my doctor. I have to call around to find out why I don't have what I needed two days ago. Oh well.

ACA was actually more affordable for us for years, but it was a lot of stress, paperwork and lapsed coverage. We were considering giving up health insurance next year. $1800/month minimum had us thinking about assuming our own risks and paying cash for services and the tax penalty. A higher tax rate doesn't mean much to people like me with more savings than income.

We're trying to go with Health Sharing,  sort of a loophole plan used by the Mennonites.
 https://www.calhealth.net/Aliera-care-health-sharing-plan-review-rates-plans.htm (https://www.calhealth.net/Aliera-care-health-sharing-plan-review-rates-plans.htm)  It sort of turns the clock back to the kind of high deductible plan we had before ACA came along.  There seems to be a glitch with the on-line enrollment.

O
Title: Re: Health care in the USA
Post by: Rusty Edge on January 03, 2018, 01:52:01 AM
To follow up, it did go through, I guess things were just a bit laggy from heavy usage at the time. As I recall, you can still sign up for it any time of year, not just during the December window. ( in case anybody is looking for insurance later this year )
Title: Re: Health care in the USA
Post by: Geo on January 20, 2018, 09:52:30 AM
So, it appearantly is 'shut down' time again in federal land.

Things that were mentioned in the morning news is how it affects National Park staff and in the midlong run payment of allowances for the people in need.

Since president [Sleezebag] last year renounced the Paris climate accords for his country, we on the old continent learned by the news here that some of the states continue or surpass the obligations stated in the climate accord, meaning they have in general alot of leeway in how they handle what is considered 'internal affairs' in the United States.

So I wondered if this shutdown also affected staff at State Parks (if such a separate branch exists in the USA) and perhaps allowances payed out on the state level, not the federal level.

Anyone in the knows?
Title: Re: Health care in the USA
Post by: Spacy on January 20, 2018, 02:25:21 PM
State parks do exist.  No impact to them.

The biggest impact is to the people who do things like answer the phones - as they are all told to not go in.  If it lasts a while, it will have other impacts, such as military who are working, but not getting a check (but will get a back pay check when things start back up) - but if it goes on long enough, their spouses and dependants, who need things like groceries & rely upon that money to purchase them, will start to suffer. 
Title: Re: Health care in the USA
Post by: Geo on January 20, 2018, 08:57:54 PM
A thought just struck me: during a government shutdown, is the presidential 'stipend' blocked as well? In short, is the office considered critical for the functioning of the country? ;cute
Title: Re: Health care in the USA
Post by: Rusty Edge on January 22, 2018, 02:05:20 AM
My understanding is that the Congress and President continue to be paid. My opinion is that they should be locked in together until they reach a resolution.

 This should have resolved last year before summer adjournment. But I can't say I blame those Senators refusing to approve the proposal which was on the table.  This is the 4th or 5th continuing resolution. There has been too much bait and switch. For some senators, they agreed to raise the debt ceiling in previous years only because spending caps were put in place, but those caps would be overridden with current proposals. For another, it was a vote for tax reform in exchange for getting this DACA Immigration passed this month. For another it was a vote on the tax bill in exchange for a health care provision getting done by the end of last year, which it wasn't.

It's hard to make a deal when you don't honor your recent ones.
Title: Re: Health care in the USA
Post by: Bearu on May 14, 2020, 05:53:12 PM
https://www.aarp.org/politics-society/advocacy/info-2020/supreme-court-aca-case.html

This new attempt from the American president continued the earlier attempts of the president for the repeal of the Affordable Health Care Act. The American president in Summer 2019 started a motion in the Judicial system for the Supreme Court's review of the legality of the Affordable Health Care Act. This process recently accelerated with the establishment of a review of the case. In addition, the American president has also been packing the Supreme Court with sycophants over the last three years similar to Franklin Roosevelt's skewing of the Supreme Court in 1937.

https://en.wikipedia.org/wiki/Judicial_Procedures_Reform_Bill_of_1937

This court packing process means the American Supreme Court possesses a favorable percentage of people working for the president's agenda, 5 Republican leaning to 4 Democratic leaning, and the court might rule in favor of the flimsy argument from Donald [Sleezebag]. If the Supreme Court rules the law unconstitutional, then many American members of this forum might suffer from the possible discrimination from insurance companies' denials in health coverage for preexisting conditions. Do you have health problems from cancer or cancer treatments? The private insurance companies can deny medical coverage of necessary treatments for health issues from cancer treatment. Do you suffer from arthritis? The private insurance company can refuse enrollment of a person despite the person's ability to pay the monthly fees, deductibles, and copay. Does the insurance company want to discriminate against overweight or underweight people with higher co-pays, deductibles, or outright refusal of renewed insurance for the next year? The insurance company possess the legal right to enact those policies.

I refuse the return of the health care policies from the first quarter to the middle of the twentieth century. This bizarre American policy concoctions from the World War II era enabled employers' attachment of health insurance to employment as an enticement for the recruitment of factory workers. Americans need both nationalized health insurance like Canada, Cuba, the United Kingdom, and Russia to name a few and the abolition of private insurance in the United States of America.

P.S. I searched for a better thread. I did not see any mention of the topic. If you have another topic more appropriate for this health care discussion from the previous few years, then please delete my message.
Title: Re: Health care in the USA
Post by: Lorizael on May 15, 2020, 01:55:10 AM
[Sleezebag] is terrible and repealing the ACA would be bad, but he is not packing the Supreme Court in the way FDR wanted to or in any way. Court packing is adding additional justices to the court beyond the current number. [Sleezebag] has done nothing of the sort; he's just filled two vacancies. The snaky part was implemented by McConnell, who kept a vacancy during Obama's term open until [Sleezebag] was elected.
Title: Re: Health care in the USA
Post by: Bearu on May 15, 2020, 03:03:03 AM
[Sleezebag] is terrible and repealing the ACA would be bad, but he is not packing the Supreme Court in the way FDR wanted to or in any way. Court packing is adding additional justices to the court beyond the current number. [Sleezebag] has done nothing of the sort; he's just filled two vacancies. The snaky part was implemented by McConnell, who kept a vacancy during Obama's term open until [Sleezebag] was elected.
I will not dispute you on the absence of court packing from Donald [Sleezebag]. My comparison between Donald [Sleezebag] and Franklin Roosevelt illustrates both presidents' intention for the accumulation of influence on the Supreme Court through the installment of sympathetic of Supreme Court justices.
Title: Re: Health care in the USA
Post by: Lorizael on May 15, 2020, 03:44:57 PM
I don't think [Sleezebag]'s intentions wrt to the Supreme Court have been substantially different from past presidents. They've basically all sought to install ideologically friendly justices, which is why we can talk about "liberal" and "conservative" members of SCOTUS. Where [Sleezebag]'s probably done significant harm judicially speaking is in filling up Federal court vacancies with often egregiously unqualified judges. Again, we mostly have Mitch to thank for that, because getting judges confirmed is what he does instead of legislating. [Sleezebag] doesn't personally care about the judicial system except insofar as it gets in his way, in which case it is "unfair." [Sleezebag]'s only governing ideology is "me me me make it all about me." He doesn't care about abortion, or healthcare, or really anything else, but he knows his rabid base does and he wants them to pay attention to him.
Title: Re: Health care in the USA
Post by: E_T on May 15, 2020, 05:40:19 PM
[Sleezebag] is terrible and repealing the ACA would be bad, but he is not packing the Supreme Court in the way FDR wanted to or in any way. Court packing is adding additional justices to the court beyond the current number. [Sleezebag] has done nothing of the sort; he's just filled two vacancies. The snaky part was implemented by McConnell, who kept a vacancy during Obama's term open until [Sleezebag] was elected.

IIRC, it was one of his failures because he tried to get the Congress to amend the Con or pass a law (I really think it was the amendment, but not sure) that would allow him to add more justices.  The Congress refused and he had to wait to try to add more, but the things that were very socialist at the time (you would have liked them Bearu) were not implemented.

Although the overall effect was to increase the overall time of recovery from the Great Depression (and keep in mind, the thing that allowed the country to fully recover and get over it WAS The War...), it kept us from sliding into a more socialist state at the time.  And with some of the Fascist that were also prevalent at the time, it would have likely taken a Socialist/Fascistic slant (although, on a 1D chart, they are opposite, if you use the 2D one that Jerry Pournelle had come up with, they would have had a common ground between them that could have taken elements from both)...
https://images.app.goo.gl/8fTAWf1PTCUAoej17
(https://images.app.goo.gl/8fTAWf1PTCUAoej17)(http://[url=https://images.app.goo.gl/8fTAWf1PTCUAoej17]https://images.app.goo.gl/8fTAWf1PTCUAoej17[/url])
Title: Re: Health care in the USA
Post by: Bearu on May 16, 2020, 04:39:58 AM

IIRC, it was one of his failures because he tried to get the Congress to amend the Con or pass a law (I really think it was the amendment, but not sure) that would allow him to add more justices.  The Congress refused and he had to wait to try to add more, but the things that were very socialist at the time (you would have liked them Bearu) were not implemented.

Although the overall effect was to increase the overall time of recovery from the Great Depression (and keep in mind, the thing that allowed the country to fully recover and get over it WAS The War...), it kept us from sliding into a more socialist state at the time.  And with some of the Fascist that were also prevalent at the time, it would have likely taken a Socialist/Fascistic slant (although, on a 1D chart, they are opposite, if you use the 2D one that Jerry Pournelle had come up with, they would have had a common ground between them that could have taken elements from both)...
https://images.app.goo.gl/8fTAWf1PTCUAoej17
(https://images.app.goo.gl/8fTAWf1PTCUAoej17)(http://[url=https://images.app.goo.gl/8fTAWf1PTCUAoej17]https://images.app.goo.gl/8fTAWf1PTCUAoej17[/url])

Thank you E_T for the information. I looked at the chart you provided from Jerry Pournelle.
World War II produced strange bedfellows. Hitler and Stalin formed an alliance for almost two years in the Molotov Ribbentrop Pact between 1939 and 1941. Franklin Roosevelt's position in the pre-World War II period remained closer to a welfare liberal and Roosevelt maintained an ambivalent position on socialism until the United States of America's official entrance into World War II in 1941. The United States of America in the 1920s and 1930s suffered from strong isolationist tendencies as seen in the Neutrality Acts, so I think the United States of America would have maintained a free market leaning from the strong corporate interests in the American government without World War II. The Neutrality acts enabled the rise of Japan and Nazi Germany before World War II because of America's refusal for participation in a fight against fascist powers in Mussolini's Italy in the 1920s and Hitler's Nazi Germany in the early 1930s.

https://en.wikipedia.org/wiki/Neutrality_Acts_of_the_1930s
https://en.wikipedia.org/wiki/Molotov%E2%80%93Ribbentrop_Pact

Back to the healthcare topic, my major concern with modern American healthcare remains the foundation of healthcare in the relationship between employers and employees instead of a citizen and the state. In my European history course of the 19th century course, I traced part of the healthcare development in Europe versus the United States of America. The modern healthcare systems in the world originated from the middle of the 1800s and developed along either state controlled benefits like Prussia and Germany or along private enterprise as in the United States of America or the United Kingdom. The majority of countries with significant devastation from World War II either already possessed state controls on healthcare or quickly developed those structures like in the United Kingdom as a repatriation for the workers' suffering in World War II. The United States of America remained one of the countries without significant losses from World War II and never developed an integrated healthcare system.

Without the development of a modern healthcare system, gross abuses like the mid to late 1800s in American private healthcare persisted until the 2010 Affordable Healthcare Act, and the United States of America suffers from lower health outcomes for the majority of the population. The United States of America pays more money per capita than the European nations, suffers from higher rates of deaths from preventable diseases than Europe, and lower life expectancy than Cuba despite the massive disparity in spending on healthcare between Cuba and the United States of America. The United States of America can learn more from Cuba's healthcare system through the removal of archaic laws and sanctions on Cuba from the 1961 Cuban Missile Crisis.
Title: Re: Health care in the USA
Post by: Geo on May 16, 2020, 12:16:28 PM
The United States of America can learn more from Cuba's healthcare system through the removal of archaic laws and sanctions on Cuba from the 1961 Cuban Missile Crisis.

How can a country learn more about another one's healthcare system simply by removing laws and sanctions still in effect?

I think every US resident so inclined can read up to his/her heart's content about the Cuban Healthcare system.
Poor choice of words here, Bearu. :P
Title: Re: Health care in the USA
Post by: E_T on May 16, 2020, 06:13:02 PM
I have only seen clips of "Sicko", by Michael Moore, but it did show that the US is far behind many other countries in health Care
Title: Re: Health care in the USA
Post by: Bearu on May 16, 2020, 07:02:57 PM
The United States of America can learn more from Cuba's healthcare system through the removal of archaic laws and sanctions on Cuba from the 1961 Cuban Missile Crisis.

How can a country learn more about another one's healthcare system simply by removing laws and sanctions still in effect?

I think every US resident so inclined can read up to his/her heart's content about the Cuban Healthcare system.
Poor choice of words here, Bearu. :P

I agree with your analysis on my poor word choice. The archaic American sanctions from 1961 actually enacted a complete embargo on all non-specifically excluded economic transactions between the United States of America and Cuba. This means research teams require special permission from the United States of America's government for travel inside Cuba. This inhibition of travel limits research into the methods of the Cuban government and restricts transfers of personnel and research between the governments based on administrative whims.

The majority of research on Cuban and other foreign healthcare methods exist behind pay barriers of university level research, so the average American citizen possesses limited access to the research materials. The majority of my information on the actual functions of the Cuban healthcare system originated from subscriber only databases of research.

One example from a speech I made includes this article from 2012. This article describes the specific efficacy of the Cuban healthcare system despite the American embargo for the last 50 years:
Keck, William and Gail Reed. “The Curious Case of Cuba.” American Journal of Public Health, vol. 102, no 8, 2012, 13-22. Online, 10.2105/AJPH.2012.300822.

Another aspect of the limitations on the transfer of research, regardless of the legal limitations, between the countries includes the historical and current persecution of any socialist methods for healthcare or other social programs.

The American government possesses a long history of anti-socialist and anti-communist sentiments. The rise of modern socialism in the middle of the 1800s, the persecution in the first Red Scare, the persecution of the second Red Scare, the persecution of socialism in the 1960s Civil Rights movement, Ronald Reagan's persecution of socialism and communism, Bush Junior's advocacy against socialism, and the current administration's persecution of Cuba and China under anti-communist hysteria all contain numerous examples of persecution against socialists and communists. You can even see fragments of anti-communist hysteria here on the forum from the management. The management labelled me with the derogatory label of "Commie" without any input from me.


Title: Re: Health care in the USA
Post by: Bearu on May 16, 2020, 07:17:24 PM
I have only seen clips of "Sicko", by Michael Moore, but it did show that the US is far behind many other countries in health Care

The case of American healthcare in 2020 remains worse than many people realize. Since 1998, the life expectancy of the United States of America's citizens decreased in relation to other nations and actually declined since 2014. The healthcare in the United States of America ignores the prevention of diseases in the name of profit. Cuban and other medical systems provide additional emphasis on the prevention of diseases instead of costly healthcare treatments. In short, socialist systems emphasize subsidized national healthcare for preventive and prophylactic care instead of reactive care for the treatment of diseases in the United States of America.

https://www.advisory.com/daily-briefing/2019/12/02/middle-age-death (https://www.advisory.com/daily-briefing/2019/12/02/middle-age-death)
Title: Re: Health care in the USA
Post by: E_T on May 16, 2020, 08:38:58 PM
I do know, that for a very long time (and may still be somewhat the case) that younger people in Cuba, so as to get some aspects of better overall care (food, housing, etc), intentionally had themselves infected with HIV.  To me, that does not speak well towards the overall system, if their only hope is to contract a potentially fatal illness.  I know these things as I've been POZ for over 25 years now... and that is one of the many things that I learned about this thing that I am forced to live with.
Title: Re: Health care in the USA
Post by: Bearu on May 18, 2020, 05:36:01 PM
I do know, that for a very long time (and may still be somewhat the case) that younger people in Cuba, so as to get some aspects of better overall care (food, housing, etc), intentionally had themselves infected with HIV.  To me, that does not speak well towards the overall system, if their only hope is to contract a potentially fatal illness.  I know these things as I've been POZ for over 25 years now... and that is one of the many things that I learned about this thing that I am forced to live with.

I cannot comment on the alleged cases of children and youth infecting themselves with HIV in Cuba. Do you have sources on this claim? I have heard similar cases in the United States of America of intentional self-injury for benefits, but I need facts on a topic before I form an opinion.
I can comment on the fact Cuba's healthcare system eliminated Mother to Child transmission of HIV and Syphilis according to the UN and World Health Organization in 2015.
https://www.who.int/mediacentre/news/releases/2015/mtct-hiv-cuba/en/ (https://www.who.int/mediacentre/news/releases/2015/mtct-hiv-cuba/en/)

Cuba's healthcare system produces more doctors and dentists per capita than the United States of America as of 2012. Gail Reed and William Keck reported Cuba's healthcare system generated approximately 1 team of doctors and assistants per 100 to 120 families and possessed an average life expectancy of around 79 years compared to the USA's life expectancy of around 78.[1] This information remained consistent with data from the World Bank despite Cuba's spending less on healthcare expenses and possessing far less GDP than the USA.

https://data.worldbank.org/indicator/SP.DYN.LE00.IN?locations=CU (https://data.worldbank.org/indicator/SP.DYN.LE00.IN?locations=CU)
[1] William Keck and Gail Reed, “The Curious Case of Cuba,” American Journal of Public Health, vol. 102, no 8, (2012): 15, 10.2105/AJPH.2012.300822.

E_T, that sucks on your status as person with an HIV positive status. I recognize the United States of America contained and contains a lot of stigma around the topic of HIV from fear and ignorance.
We could prevent major outbreaks of HIV and other similar diseases with universal preventive healthcare, but the solutions, even with government social programs under private insurance, suffered from the ubiquitous discrimination seen before 2010. We have seen the major problems with the inflated healthcare compromise agreements after 2010. The only logical solution I perceive remains the adoption of a nationalized healthcare system and abolition of private insurance and government regulation of other critical industries under the transformation into a socialist economy. This process should follow the best science and data based on the leaders of the healthcare successes of Northern Europe, Cuba, the older Soviet Model, and the Maoist China models.

Title: Re: Health care in the USA
Post by: Rusty Edge on July 09, 2020, 04:01:15 AM
I repeatedly see the similarity between US healthcare and US pandemic results. There are so many potential effective approaches that are more cost-effective regarding healthcare. There are so many countries that had better pandemic results with equal or less lead time- South Korea with it's testing and contact tracing, New Zealand with it's strict quarantine, Japan with it's compliance with face masks and hand washing. A few smaller countries which attempted to test everybody.

It seems like we have several advantages, but we haven't been able to realize them. So people die.
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