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U.S. Health Care Ranked Worst in the Developed World

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On 5/14/2019 at 2:59 AM, Just Win Baby said:

A couple of things to consider:

  1. The US public sector spending is comparable to other OECD countries. The significant gap is in private sector spending. See How does health spending in the U.S. compare to other countries?
  2. The US has the highest gross adjusted household disposable income among OECD countries.

How do these facts support the notion that US healthcare spending is a huge problem?

Also, here is an economic point of view, from The Value of Life and the Rise in Health Spending:

 

This is also very interesting. If all that private spending resulted in better outcomes, the economists might have a point. Unfortunately, as far as I can tell, it doesn't. 

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On 5/14/2019 at 9:07 AM, Henry Ford said:

If you and your employer pay a total of $500 per month for 30 years for your insurance you’re talking about $180,000 in premiums. Can you afford to pay $75,000 out of pocket for a procedure?

That would put a bit of a dent into the hooker and blow budget...

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On 5/14/2019 at 9:07 AM, Henry Ford said:

If you and your employer pay a total of $500 per month for 30 years for your insurance you’re talking about $180,000 in premiums. Can you afford to pay $75,000 out of pocket for a procedure?

tim is just saying you end up with a giant bill you couldn’t pay out of pocket, not that you aren’t profitable ultimately.  

I guess I'm missing your point here, but wouldn't the answer be "yes"?  As you didn't pay 180k into the system, you could pay that large bill out of pocket, and still have $100k left over.  You'd have a whole lot more, in fact, if you attach any "time value of money" into it, say even 3% over that 30 years. 

Or you you saying that you just blew that $180k that you and your employer didn't spend on insurance?

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5 minutes ago, matttyl said:

I guess I'm missing your point here, but wouldn't the answer be "yes"?  As you didn't pay 180k into the system, you could pay that large bill out of pocket, and still have $100k left over.  You'd have a whole lot more, in fact, if you attach any "time value of money" into it, say even 3% over that 30 years. 

Or you you saying that you just blew that $180k that you and your employer didn't spend on insurance?

Do you believe that people who don’t buy insurance put $500 aside every month?

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1 hour ago, Henry Ford said:

Do you believe that people who don’t buy insurance put $500 aside every month?

No, but in your example they wouldn't need to.  $129 a month in an account growing at 3% compounded for your 30 year example would be the $75k needed.  I understand that these are all just made up numbers - but all the time I end up not selling a health insurance policy to someone due to cost, and they're doing something with the money they aren't spending on the coverage.  Mainly they are putting it into their retirement, or education savings for kids.  Sure, some are blowing it on any number of things.  I get it much more in life insurance sales, honestly.  Why put $10k a year away into a whole life policy for a $500k death benefit (made up numbers) when I can put $1k into a term policy and invest the other $9k?  In some cases, sure they would be better off (especially with a longer timeline) and other times they are not.  Just like with your example, if that large claims comes in the early years, you don't yet have enough put away.   

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5 hours ago, matttyl said:

No, but in your example they wouldn't need to.  $129 a month in an account growing at 3% compounded for your 30 year example would be the $75k needed.  I understand that these are all just made up numbers - but all the time I end up not selling a health insurance policy to someone due to cost, and they're doing something with the money they aren't spending on the coverage.  Mainly they are putting it into their retirement, or education savings for kids.  Sure, some are blowing it on any number of things.  I get it much more in life insurance sales, honestly.  Why put $10k a year away into a whole life policy for a $500k death benefit (made up numbers) when I can put $1k into a term policy and invest the other $9k?  In some cases, sure they would be better off (especially with a longer timeline) and other times they are not.  Just like with your example, if that large claims comes in the early years, you don't yet have enough put away.   

Most people use it for rent. Or food.  Or kids. 

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10 hours ago, Henry Ford said:

Most people use it for rent. Or food.  Or kids. 

You mean most would use it for those things.  In your example, I think, people are having their health insurance taken away - but then also given ~$500 a month "instead".  I have to assume that right now, they already have monies allocated to rent or food or kids - you're talking about giving them an extra ~$500 a month.  You might actually be talking about giving them an extra $1.66k or more a month if we're talking kids (average premiums for family employer coverage was just a shade under $20k last year).  I guess I'm just hoping more people would be responsible with that money, if put in the situation of having their health insurance taken from them, but given $1.66k in place of it each month.  In the end, you're likely correct that many if not most would find something else to spend that money on.  Which is why I think it's crazy for people to suggest unlinking health insurance from employment.  If we did that, the uninsured rate would spike immediately. 

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6 minutes ago, matttyl said:

You mean most would use it for those things.  In your example, I think, people are having their health insurance taken away - but then also given ~$500 a month "instead".  I have to assume that right now, they already have monies allocated to rent or food or kids - you're talking about giving them an extra ~$500 a month.  You might actually be talking about giving them an extra $1.66k or more a month if we're talking kids (average premiums for family employer coverage was just a shade under $20k last year).  I guess I'm just hoping more people would be responsible with that money, if put in the situation of having their health insurance taken from them, but given $1.66k in place of it each month.  In the end, you're likely correct that many if not most would find something else to spend that money on.  Which is why I think it's crazy for people to suggest unlinking health insurance from employment.  If we did that, the uninsured rate would spike immediately. 

Well that kind of depends on the plan, doesn’t it?

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15 minutes ago, Henry Ford said:

Well that kind of depends on the plan, doesn’t it?

Which part?  The part about unlinking health insurance and employment?  Certainly.  But that part never gets talked about - they just want to unlink employment and coverage.  When brought up then ask if they are for universal coverage or single payer (not necessarily the same thing) - and generally they answer "no", they just want to pick their own coverage that has no connection to their employment and be able to keep it.

Now I've always found that odd for a few reasons.  First, as mentioned, it would cause the uninsured rate to spike immediately.  Secondly - for most people, they've always had that option

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1 hour ago, Maurile Tremblay said:

This twitter thread is worth reading:

https://twitter.com/MaryRobinette/status/1135684848465657857

It's about an American's experience with the health care system in Iceland.

Great story, and then to really get the point across is the other woman right below her. Awful. Good job America. Go USA.

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21 hours ago, Maurile Tremblay said:

This twitter thread is worth reading:

https://twitter.com/MaryRobinette/status/1135684848465657857

It's about an American's experience with the health care system in Iceland.

Good read.  Why would it take 3 office visits in the US (each, I assume, with it's own cost).  Maybe there's a huge issue for you, and why care here is so expensive. 

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19 hours ago, matttyl said:

Good read.  Why would it take 3 office visits in the US (each, I assume, with it's own cost).  Maybe there's a huge issue for you, and why care here is so expensive. 

I have had three office visits for knee/shoulder/elbow/etc. pain before I found treatment. I don't think that is uncommon at all :shrug:

Primary care to get a referral to an orthopedist. Orthopedist sent me to a sports medicine orthopedist. She sent me to physical therapist for care.

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 I liked the one tweet in the thread that went "I always think it’s weird when you see American pundits bang on about “western” values. Universal healthcare is a western value, that’s why everyone in the west has it... well nearly everyone."

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Posted (edited)
On 5/15/2019 at 3:34 PM, Terminalxylem said:

How do you reconcile the data showing international mortality across various disease states with your stance that our healthcare is top notch? 

https://www.healthsystemtracker.org/chart-collection/mortality-rates-u-s-compare-countries/#item-overall-age-adjusted-mortality-rate-decline-1980-2015

Quote

Among the major causes of death, the U.S. has lower than average mortality rates for cancers and higher than average rates in the other categories relative to comparable OECD countries. These categories accounted for nearly 74 percent of all deaths in the U.S. in 2015.

Aside from cancer care, US mortality is worse for all other conditions they studied. This includes diseases of the circulatory, respiratory, neurologic, and endocrine systems. We also do worse for mental and maternal health, and your favorite, trauma care.

Haven't had a chance to respond to this. I think it's hard to pinpoint a single factor that explains differences in mortality for various conditions. I suspect it is a combination of several things.

Cultural differences, such as obesity, poor diet, and lack of regular exercise is certainly a factor for some conditions and associated mortality rates.

There are significant differences in makeup of populations in different countries. For example, the US has a much larger population of Latinos and persons of African descent than the rest of the countries identified in the article you linked (the rest of those countries combined). Those segments of the population are subject to greater risks of certain conditions, and that can affect the national mortality rates.

Neither of those factors is necessarily reflective of lower quality of healthcare.

Another factor is obviously socio-economic differences, and that has already been discussed in the thread. There is no easy answer to that one.

It may be that the US does indeed provide lower quality healthcare in some cases, but I suspect the issues above are much greater contributing factors.

Edited by Just Win Baby

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3 hours ago, Just Win Baby said:

Haven't had a chance to respond to this. I think it's hard to pinpoint a single factor that explains differences in mortality for various conditions. I suspect it is a combination of several things.

Cultural differences, such as obesity, poor diet, and lack of regular exercise is certainly a factor for some conditions and associated mortality rates.

There are significant differences in makeup of populations in different countries. For example, the US has a much larger population of Latinos and persons of African descent than the rest of the countries identified in the article you linked (the rest of those countries combined). Those segments of the population are subject to greater risks of certain conditions, and that can affect the national mortality rates.

Neither of those factors is necessarily reflective of lower quality of healthcare.

Another factor is obviously socio-economic differences, and that has already been discussed in the thread. There is no easy answer to that one.

It may be that the US does indeed provide lower quality healthcare in some cases, but I suspect the issues above are much greater contributing factors.

Well, the rest of the world is adopting our dietary habits, with attendant increases in obesity. Australia and New Zealand are already comparable, and Canada ain't too far behind. Yet their healthcare consistently ranks better, and costs less. Hell, the whole world is getting fatter, but life expectancy isn't dropping like in the US.

The UK has a fairly substantial population of ethnic minorities, including blacks. Their healthcare is better (and cheaper) too.

Disparity and access to care are absolutely linked to healthcare quality. While we may lead the world in technological innovation, it isn't necessary for most sick people. They need readily available care they can afford. But the "business" of medicine encourages the overuse of high-tech and costly testing/treatment.

Our capitalist system promotes expensive healthcare, with an overly complex delivery system. This is compounded by "defensive medicine" and providers incentivized to see more patients in less time, with much of their effort dedicated to documentation rather than actual patient care. And it is only getting worse. 

What makes you think our care is top notch, and are you content with maintaining the status quo regarding its implementation/paymement?

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Don't have any skin in this issue per se, but I've lived various places in the world as a permanent resident and I now live in Denmark (where I am a citizen).

One of the reasons for that is that I know that should I get sick one day, medical bills won't bankrupt me.

The fact that my kids' education is free as well played a role as well, obviously.

I pay a higher percentage of my earnings in taxes here than I did in e.g. the US or Brazil, but I do get substantial benefits in return

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50 minutes ago, msommer said:

Don't have any skin in this issue per se, but I've lived various places in the world as a permanent resident and I now live in Denmark (where I am a citizen).

One of the reasons for that is that I know that should I get sick one day, medical bills won't bankrupt me.

The fact that my kids' education is free as well played a role as well, obviously.

I pay a higher percentage of my earnings in taxes here than I did in e.g. the US or Brazil, but I do get substantial benefits in return

Yep, there are studies which show medical bills are the #1 cause of personal bankruptcy. http://www.pnhp.org/new_bankruptcy_study/Bankruptcy-2009.pdf

Quote

BACKGROUND: Our 2001 study in 5 states found that medical problems contributed to at least 46.2% of all bankruptcies. Since then, health costs and the numbers of un- and underinsured have increased, and bankruptcy laws have tightened.


METHODS: We surveyed a random national sample of 2314 bankruptcy filers in 2007, abstracted their court records, and interviewed 1032 of them. We designated bankruptcies as “medical” based on debtors’ stated reasons for filing, income loss due to illness, and the magnitude of their medical debts.


RESULTS: Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income. The rest met criteria for medical bankruptcy because they had lost significant income due to illness or mortgaged a home to pay medical bills. Most medical debtors were well educated, owned homes, and had middle-class occupations. Three quarters had health insurance. Using identical definitions in 2001 and 2007, the share of bankruptcies attrib- utable to medical problems rose by 49.6%. In logistic regression analysis controlling for demographic factors, the odds that a bankruptcy had a medical cause was 2.38-fold higher in 2007 than in 2001.


CONCLUSIONS: Illness and medical bills contribute to a large and increasing share of US bankruptcies

 

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19 hours ago, msommer said:

Don't have any skin in this issue per se, but I've lived various places in the world as a permanent resident and I now live in Denmark (where I am a citizen).

One of the reasons for that is that I know that should I get sick one day, medical bills won't bankrupt me.

The fact that my kids' education is free as well played a role as well, obviously.

I pay a higher percentage of my earnings in taxes here than I did in e.g. the US or Brazil, but I do get substantial benefits in return

A) how many immigrants does Denmark support?

B) what is Denmark doing to support the rest of the world militarily?

 

No country can be compared to the US, it’s an apples to oranges comparison.

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On 5/5/2019 at 2:43 AM, Terminalxylem said:

I like 4 and 6, and to a lesser extent 1. Number 2 is pretty ridiculous, as the bulk of chronic illness is at least partially self-inflicted.

I’m tired of paying for other people’s mistakes.   And now Warren wants me to pay for bad student loan decision making.  

 

Eat healthy, exercise, don’t smoke and don’t drink alcohol excessively.

only then am I willing to consider subsidizing your healthcare

 

 

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40 minutes ago, TripItUp said:

A) how many immigrants does Denmark support?

B) what is Denmark doing to support the rest of the world militarily?

 

No country can be compared to the US, it’s an apples to oranges comparison.

Well, to take B first, Denmark joined the US in it's ill conceived wars in Iraq and Afganistan from the beginning.  We  were also part of the coalition that beat up on Saddam in Kuwait, as well as being part of multiple peacekeeping missions under UN and NATO auspices.

Re A. Have you heard of Syria? Migrants to the EU from Africa and the war torn Middle East? Do you actually believe that only the US is a destination for immigration?

Apart from that then nice deflection (are you seriously of the opinion that money spent on wars overseas are better spent than providing healthcare for your population?) 

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Posted (edited)
8 minutes ago, msommer said:

 

Apart from that then nice deflection (are you seriously of the opinion that money spent on wars overseas are better spent than providing healthcare for your population?) 

No, I am Pointing out that the US pays a disproportionate amount of its globally leading budget on defense.  

The US also pays a globally leading amount on healthcare.   

The US also has higher quality healthcare for those that receive it.

 

Denmark is an apples to oranges comparison.

 

 

Edited by TripItUp

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Posted (edited)
13 minutes ago, msommer said:

 

Re A. Have you heard of Syria? Migrants to the EU from Africa and the war torn Middle East? Do you actually believe that only the US is a destination for immigration?

 

Number of immigrants being supported by the US = 44.5 million as of 2017

Total population of Denmark = 5.7 million

 

lets start there before we compare Denmark to the US

Edited by TripItUp

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14 minutes ago, msommer said:

Well, to take B first, Denmark joined the US in it's ill conceived wars in Iraq and Afganistan from the beginning.  We  were also part of the coalition that beat up on Saddam in Kuwait, as well as being part of multiple peacekeeping missions under UN and NATO auspices.

 

US defense spending = 700 billion for 2018

Denmark defense spending = 4 billion 

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20 minutes ago, TripItUp said:

US defense spending = 700 billion for 2018

Denmark defense spending = 4 billion 

Apparently Denmark cares more about it's citizens than creating a war machine. I guess you're right, Denmark is a delicious apple, America is a disgusting orange. 

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2 hours ago, TripItUp said:

No, I am Pointing out that the US pays a disproportionate amount of its globally leading budget on defense.  

The US also pays a globally leading amount on healthcare.   

The US also has higher quality healthcare for those that receive it.

 

Denmark is an apples to oranges comparison.

 

 

Dude, you are the one comparing stuff. I only advised how it came to be that I live in Denmark and not the US.

PS No one rfom the outside is forcing the US to be the globally leading power in terms of spending on defense. The budget is made by Americans, for Americans for reasons perhaps only Americans understand.

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The good news is that President Trump promised to repeal and replace Obamacare with something terrific so we have that going for us, which is nice.

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5 hours ago, TripItUp said:

I’m tired of paying for other people’s mistakes.   And now Warren wants me to pay for bad student loan decision making.  

 

Eat healthy, exercise, don’t smoke and don’t drink alcohol excessively.

only then am I willing to consider subsidizing your healthcare

 

 

you understand you're already doing this right?

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4 hours ago, TripItUp said:

No, I am Pointing out that the US pays a disproportionate amount of its globally leading budget on defense.  

The US also pays a globally leading amount on healthcare.   

The US also has higher quality healthcare for those that receive it.

 

Denmark is an apples to oranges comparison.

 

 

In what ways is our healthcare higher quality than other top systems?

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2 hours ago, msommer said:

Dude, you are the one comparing stuff. I only advised how it came to be that I live in Denmark and not the US.

PS No one rfom the outside is forcing the US to be the globally leading power in terms of spending on defense. The budget is made by Americans, for Americans for reasons perhaps only Americans understand.

Yeah....even WE don't understand.  I'm trying to figure out why we keep buying all these F35 fighter jets when it's pretty clear the next world war is likely to be of the cyber/technology variety.

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1 minute ago, The Commish said:

you understand you're already doing this right?

Of course, I could have been more specific there

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Posted (edited)
2 minutes ago, Terminalxylem said:

In what ways is our healthcare higher quality than other top systems?

Google it

 

Im not interested in that debate 

Edited by TripItUp

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3 minutes ago, TripItUp said:

Of course, I could have been more specific there

Sure...go for it.  I'd like to understand what you mean.

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3 minutes ago, The Commish said:

Sure...go for it.  I'd like to understand what you mean.

Looking for a gotcha, no thanks

 

this message board can be ridiculous 

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2 minutes ago, TripItUp said:

Looking for a gotcha, no thanks

 

this message board can be ridiculous 

:confused:

 

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Just now, TripItUp said:

Google it

No, you made the general statement. I’m asking you for specifics to back up your assertion.

Aside from cancer care, and maybe a handful of procedures, I don’t think the US is demonstrably better than any of the top international healthcare systems.

People mistakenly think access to expensive testing/procedures (if you can afford it) results in better health outcomes. This often isn’t the case, as “VIP syndrome” can result.

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I like when opponents announce their reason as basically "other people in this country aren't worthy of my help." We can work against that a lot better than we can when insurance agents post hundreds of times telling us why it's so complicated to do.

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7 hours ago, TripItUp said:

 

Eat healthy, exercise, don’t smoke and don’t drink alcohol excessively

Your empathy shown in these threads is stunning.  

 

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7 hours ago, TripItUp said:

I’m tired of paying for other people’s mistakes.   And now Warren wants me to pay for bad student loan decision making.  

 

Eat healthy, exercise, don’t smoke and don’t drink alcohol excessively.

only then am I willing to consider subsidizing your healthcare

 

 

Yep healthy people never get cancer.  They also are never involved in accidents that exceed insurance limits.

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Posted (edited)
16 minutes ago, KarmaPolice said:

Your empathy shown in these threads is stunning.  

 

I really do have empathy, I just  don’t believe I should be paying for other people’s mistakes/bad decisions when I’ve busted my ### to get to where I’m at and have lead a relatively disciplined life that required making personal sacrifices.  I wouldn’t want others to pay for my poor judgement. 

 

Edited by TripItUp

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1 minute ago, TripItUp said:

I really do have empathy, I just  don’t believe I should be paying for other people’s mistakes/bad decisions when I’ve busted my ### to get to where I’m at.  I wouldn’t want others to pay for mine.  :shrug:

Could just be my interpretations of your posts, but they come off as "I was able to do this and generate wealth and stay healthy, you should be able to".  That's not empathy. 

Maybe I am a little more pessimistic.  I get your point up to a certain level.  Not sure I want to punish people too much for mistakes.  I guess as far as bad decisions, I would probably want to make sure there was a system in place for them to make good decisions.  Still, we aren't going to cure people of mistakes and bad choices, so I believe it's better to have a system in place that takes care of everyone.  

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3 minutes ago, KarmaPolice said:

Could just be my interpretations of your posts, but they come off as "I was able to do this and generate wealth and stay healthy, you should be able to".  That's not empathy. 

Maybe I am a little more pessimistic.  I get your point up to a certain level.  Not sure I want to punish people too much for mistakes.  I guess as far as bad decisions, I would probably want to make sure there was a system in place for them to make good decisions.  Still, we aren't going to cure people of mistakes and bad choices, so I believe it's better to have a system in place that takes care of everyone.  

I disagree with the free college.  If you decide to go on to school have a plan to pay for it.  It's a conscience decision to sign up for classes.  Getting sick or being in an accident isn't a choice, there is no reason someone should loose everything they worked for because they have a pile of medical bills.

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13 minutes ago, TripItUp said:

I really do have empathy, I just  don’t believe I should be paying for other people’s mistakes/bad decisions when I’ve busted my ### to get to where I’m at and have lead a relatively disciplined life that required making personal sacrifices.  I wouldn’t want others to pay for my poor judgement. 

 

Again....you're already doing this.  You said you should have said it differently before, but you just echo'd it again here framed the same way you did before.  Doesn't make sense :shrug: 

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29 minutes ago, yak651 said:

Yep healthy people never get cancer.  They also are never involved in accidents that exceed insurance limits.

Healthy people never change jobs. And are never presented with the choice of expensive COBRA or going without insurance and doctor visits for 1 to 6 months. Only in America.

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19 minutes ago, SoBeDad said:

Healthy people never change jobs. And are never presented with the choice of expensive COBRA or going without insurance and doctor visits for 1 to 6 months. Only in America.

Individual health insurance down?

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1 hour ago, roadkill1292 said:

I like when opponents announce their reason as basically "other people in this country aren't worthy of my help." We can work against that a lot better than we can when insurance agents post hundreds of times telling us why it's so complicated to do.

That directed at me?

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2 minutes ago, matttyl said:

Individual health insurance down?

Affordable option down?

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1 minute ago, yak651 said:

Affordable option down?

Since the ACA, yes.  Especially for health people, which was the example. 

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5 minutes ago, matttyl said:

That directed at me?

Yes, I think your voluminous posting on this subject is mostly self serving and not acting in the best interests of the country at large.

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