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Does healthcare hurt or help freedom? (1 Viewer)
- Thread starter IC FBGCav
- Start date
glvsav37
Footballguy
I don’t know if this is the answer you were looking for, but from an Entrepreneurial standpoint, rising HC to employment make it very hard for a young company to grow or even keeps a person who wants to start their own company tied to their job bc they cannot afford to leave the provided benefits.
Being able to striven our on your own and form your own business is “freedom” we have in this country, but the HC barrier is often too much for someone to attempt it
I know there is no way I could work for myself w/o my wife having a great job and holding the family HC.
Edit it to add: I don’t think Obama care is the answer, and our govt can’t get out of their own way or stop fighting each other long enough to put any type if successful universal care plan together. I think we have a long way to go before we can ever really break employer funded HC and make it effective for the whole country.
Being able to striven our on your own and form your own business is “freedom” we have in this country, but the HC barrier is often too much for someone to attempt it
I know there is no way I could work for myself w/o my wife having a great job and holding the family HC.
Edit it to add: I don’t think Obama care is the answer, and our govt can’t get out of their own way or stop fighting each other long enough to put any type if successful universal care plan together. I think we have a long way to go before we can ever really break employer funded HC and make it effective for the whole country.
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Mario Kart
Footballguy
Most major countries have provided health care for many decades yet we can't?
The majority of arguments against providing it are bogus. Whether they play up fear, cost, whatever, those arguments are not valid. If we were paving the way and the first country to do it, it'd be something out of the ordinary but countries like Algeria, Egypt, Bhutan, most of Europe, and many more, have had it for many years. And, the United States can't? Bull####! What have those countries suffered health wise?
The majority of arguments against providing it are bogus. Whether they play up fear, cost, whatever, those arguments are not valid. If we were paving the way and the first country to do it, it'd be something out of the ordinary but countries like Algeria, Egypt, Bhutan, most of Europe, and many more, have had it for many years. And, the United States can't? Bull####! What have those countries suffered health wise?
wikkidpissah
Footballguy
Gonna drown us either way if we dont address cost (which is why we cant convert like all the other countries - too many utensils forkin' up the pie)
Leroy Hoard
Footballguy
Healthcare hurts freedom. Without healthcare you are free to get as sick as you want.
Terminalxylem
Footballguy
Linking healthcare to employers adds substantially to the cost to do business, and effectively shackles employees to their job if they develop chronic illness. So it limits the freedom of both employer and employee.
Agree with others that our inability to provide universal healthcare is appalling, and the excuses for our inertia to change are rooted in fear-mongering + special interests with no desire to end the gravy train.
Agree with others that our inability to provide universal healthcare is appalling, and the excuses for our inertia to change are rooted in fear-mongering + special interests with no desire to end the gravy train.
The Commish
Footballguy
I've said this probably a billion times on these boards....the source of the payment isn't nearly as important as the costs. Until costs are addressed, little will change. And there is NO guarantee that the government will reign in costs if they are paying. They go out of their way to avoid dealing with costs now. They put that responsibility on insurance companies. I see little evidence they'd magically start doing it if they were writing the checks. They don't typically bite the hand feeding them. That's politician 101.
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djmich
Footballguy
Linking salary to employers does the same thing. Why does healthcare being paid for by an employer limit freedom any more or less than salary coming from the employer? Why differentiate.
Long Ball Larry
Footballguy
I have only ever briefly thought about this, but I think that the bolded May be why. I would have to go re-read about this to remember exactly, but I think that Taleb’s latest book talks about how current employer-employee relationships in a way fully tether employees to being reliant on their employer, yet the only benefit is the paycheck (and no other type of safety or security). Healthcare would fit in to that model of keeping employees as indentured servants.
(I probably shouldn’t even post this because I am just throwing out wild speculation based on disparate thoughts)
Long Ball Larry
Footballguy
so below is a partial transcript of the podcast where I heard Taleb talking about this. This is still not a fully fleshed out thought, but seems related.
Russ Roberts: Let's talk a little bit about employment. We may have talked about this in the last episode, but it's so interesting I just love it. Talk about the example of flying to Germany for Oktoberfest--I've contracted out my private plane and I've got a pilot coming and he informs me the day before that he's gotten a better offer and he's going to do something else.
Nassim Nicholas Taleb: Exactly. The reason we have employees--and that, again I credit conversation with you--is, the reason is not because an employee has, you know, is cheaper, delivers things better. It's because an employee has a lot more to lot. He has skin in the game. In other words, he has something to lose more than that specific job. So, if--and they also have signaled to us, employees, by being employees, someone who was an employee for 35 years, or for 25 years in a large corporation, they signal to us that they are not free. And it's great. So, you have an employee; it's inefficient; but, it's a good risk-management pool because you know that they are not going to let you down when you need them the most. They are always going to be there when you need them in an emergency. And that, you can get in a market system that is entirely built on subcontractors and [?] contracts. And that is sort of like, to me it's sort of a footnote to Coase. The reason we have corporations is to avoid having legal contracts. But that version, that the person, the employee, is not someone who escapes that notion of contract is to me quite central. And to me, why we have employees? Because you want to own some people. And just like we have, a lot of people have country houses that they don't use, is much more efficient to stay in a nice hotel, because they want to know that that place, they can go to it whenever they want to. If they woke up at midnight and decide to drive to a country house, they can do that. They won't do it, but they would like to know they can do it. So they don't want to share. And that's quite central this idea of skin in the game. And that was also a risk management tool, that the Romans--the Romans practically have discovered so many things--practically--I would say, almost everything, in one way or another. So the Romans figured it out because they never let a free person be a steward in a big state. They wanted a slave. What's the reason? Because you can punish a slave. If you own a slave--punish a slave. So, the person is caught cheating, the punishment is much harsher for a slave. So the steward[?] most typically a slave.
Russ Roberts: Yeah, that was very deep. I thought about Joseph in the Book of Genesis, when, he is the steward of Potiphar's house. And you are thinking: Why is this lowly person given this control? He's really smart, was one answer; but it's not enough. It's that ability to punish down-side. And of course, as a result of it Joseph ends up in prison, really, in what appears to be a life sentence, but manages to get out. But the point about having a slave versus an employee is a really interesting one. And it highlights something--and we talked about this in another one of our conversations. And it's so trivial, but it's so deep, because it's so easily misunderstood. And the way you phrased it is: Probabilities aren't the same as expectation. The odds of something being remote is not enough to mean you don't have to worry about it. Because it depends on the consequences of that remote thing happening, not just the probability. So, being wiped out by your slave, or being able to punish your slave is really very powerful because it's the magnitude, not just the probability that matters. And I think that's just an incredibly--it's incredibly obvious--but it's very deep because people forget it all the time. They say, 'That's just a low-probability event.' Well, but if you die when it happens, it's more important than if you don't die.
Nassim Nicholas Taleb: Exactly. And here--if you look at it--it's, you need a slave because you need someone who can be punished by a mistake. And an employee is going to, never going to be able to come back, if he develops a reputation, better reputation. Nobody would hire him or her. But a free person can always manage, because--
Russ Roberts: Well, you can only fire an employee, but you can torture a slave. I mean, it's not a very attractive thought, but that's the point.
Nassim Nicholas Taleb: Yeah, yeah, it's true, but an employee, by firing an employee, you actually have more to lose than just the job.
Russ Roberts: Oh, for sure. But--
Nassim Nicholas Taleb: A contractor, you fire a contractor, he finds another client. An employee has more downside.
Russ Roberts: Oh, agreed--
Nassim Nicholas Taleb: And typically these are people who want to stay in the job for the long run. They trade their freedom for real liability.
Russ Roberts: No, it's the same argument I make--the hierarchy you are suggesting is contractor:employee:slave. And as you--employee is getting close to slave because they have more at stake than contractor. But not as much as a slave. But, it reminds me of this argument I sometimes make about football coaches or general managers in sports. They are very risk averse. And yet they are in this highly competitive business. And it's hard to understand why they are so risk averse. But the answer is: There's a decent chance that if they mess up, they'll never get that job again. There are only 30 of them, say, or 32, depending on the sport. And as a result, they act very cautiously. You could say, 'Well, what's the worst thing that could happen, that doesn't work out? The strategy or the trade or the draft pick?' But it matters because the outcome isn't just unlikely. It's unlikely with effectively a death sentence: in employment, you may not be able to get that job ever again.
Nassim Nicholas Taleb: Yeah. That's--but in fact, I may observe somewhere that we have many more slaves today than we did in Roman times. Because in Roman times, slaves were actually sometimes freer.
Russ Roberts: And why are we so slave-burdened today?
Nassim Nicholas Taleb: Because we have a more complex system than need more [?]. An employee is practically a slave. I mean, you think about it in these terms. Right? He can't say what he thinks--he'd get fired. He can[?] go on Twitter and curse at someone else. There are a lot of things he can[?] do. But it's not there that they're a slave, because they have to show up and give you their time, 9-5, or 9-6, or sometimes 8-10, 10 at night. So, they have to give you so much, and they are scared. With a slave, in Roman times, of course they have downsides--they could be beaten, they could be crucified--
Russ Roberts: Those are two negative things--
Nassim Nicholas Taleb: But a slave at a time--if you damage a slave, you can't sell them, so you lose market value. And with an employee, it's not the same. So it's quite--I haven't written much about it in Skin In the Game, of course, there are so many other topics. But I'm certain that we have more people who are independent today than we did in Roman times.
Russ Roberts: It's an interesting argument. You do bear some costs if you fire your employees all the time. I mean, people are less excited to work for you.
Nassim Nicholas Taleb: That's true. But they are--an employee is--okay, someone who sold you his work unconditionally, saying, okay, you are going to report to him and come back, or sometimes there is nothing to do, they still have to show up. So--or, maybe you have employees who are freer. But that's a typical standard. Why is that so? Well, because you want people who are not free. And this is why we have the school system, to basically teach people to not be free, between 8 and 4 p.m.
Russ Roberts: It's practical.
Nassim Nicholas Taleb: This is how it works.
Russ Roberts: It's practice.
Nassim Nicholas Taleb: Yeah. So they are broken in young, and they learn. And so you have employees.
Nassim Nicholas Taleb: Exactly. The reason we have employees--and that, again I credit conversation with you--is, the reason is not because an employee has, you know, is cheaper, delivers things better. It's because an employee has a lot more to lot. He has skin in the game. In other words, he has something to lose more than that specific job. So, if--and they also have signaled to us, employees, by being employees, someone who was an employee for 35 years, or for 25 years in a large corporation, they signal to us that they are not free. And it's great. So, you have an employee; it's inefficient; but, it's a good risk-management pool because you know that they are not going to let you down when you need them the most. They are always going to be there when you need them in an emergency. And that, you can get in a market system that is entirely built on subcontractors and [?] contracts. And that is sort of like, to me it's sort of a footnote to Coase. The reason we have corporations is to avoid having legal contracts. But that version, that the person, the employee, is not someone who escapes that notion of contract is to me quite central. And to me, why we have employees? Because you want to own some people. And just like we have, a lot of people have country houses that they don't use, is much more efficient to stay in a nice hotel, because they want to know that that place, they can go to it whenever they want to. If they woke up at midnight and decide to drive to a country house, they can do that. They won't do it, but they would like to know they can do it. So they don't want to share. And that's quite central this idea of skin in the game. And that was also a risk management tool, that the Romans--the Romans practically have discovered so many things--practically--I would say, almost everything, in one way or another. So the Romans figured it out because they never let a free person be a steward in a big state. They wanted a slave. What's the reason? Because you can punish a slave. If you own a slave--punish a slave. So, the person is caught cheating, the punishment is much harsher for a slave. So the steward[?] most typically a slave.
Russ Roberts: Yeah, that was very deep. I thought about Joseph in the Book of Genesis, when, he is the steward of Potiphar's house. And you are thinking: Why is this lowly person given this control? He's really smart, was one answer; but it's not enough. It's that ability to punish down-side. And of course, as a result of it Joseph ends up in prison, really, in what appears to be a life sentence, but manages to get out. But the point about having a slave versus an employee is a really interesting one. And it highlights something--and we talked about this in another one of our conversations. And it's so trivial, but it's so deep, because it's so easily misunderstood. And the way you phrased it is: Probabilities aren't the same as expectation. The odds of something being remote is not enough to mean you don't have to worry about it. Because it depends on the consequences of that remote thing happening, not just the probability. So, being wiped out by your slave, or being able to punish your slave is really very powerful because it's the magnitude, not just the probability that matters. And I think that's just an incredibly--it's incredibly obvious--but it's very deep because people forget it all the time. They say, 'That's just a low-probability event.' Well, but if you die when it happens, it's more important than if you don't die.
Nassim Nicholas Taleb: Exactly. And here--if you look at it--it's, you need a slave because you need someone who can be punished by a mistake. And an employee is going to, never going to be able to come back, if he develops a reputation, better reputation. Nobody would hire him or her. But a free person can always manage, because--
Russ Roberts: Well, you can only fire an employee, but you can torture a slave. I mean, it's not a very attractive thought, but that's the point.
Nassim Nicholas Taleb: Yeah, yeah, it's true, but an employee, by firing an employee, you actually have more to lose than just the job.
Russ Roberts: Oh, for sure. But--
Nassim Nicholas Taleb: A contractor, you fire a contractor, he finds another client. An employee has more downside.
Russ Roberts: Oh, agreed--
Nassim Nicholas Taleb: And typically these are people who want to stay in the job for the long run. They trade their freedom for real liability.
Russ Roberts: No, it's the same argument I make--the hierarchy you are suggesting is contractor:employee:slave. And as you--employee is getting close to slave because they have more at stake than contractor. But not as much as a slave. But, it reminds me of this argument I sometimes make about football coaches or general managers in sports. They are very risk averse. And yet they are in this highly competitive business. And it's hard to understand why they are so risk averse. But the answer is: There's a decent chance that if they mess up, they'll never get that job again. There are only 30 of them, say, or 32, depending on the sport. And as a result, they act very cautiously. You could say, 'Well, what's the worst thing that could happen, that doesn't work out? The strategy or the trade or the draft pick?' But it matters because the outcome isn't just unlikely. It's unlikely with effectively a death sentence: in employment, you may not be able to get that job ever again.
Nassim Nicholas Taleb: Yeah. That's--but in fact, I may observe somewhere that we have many more slaves today than we did in Roman times. Because in Roman times, slaves were actually sometimes freer.
Russ Roberts: And why are we so slave-burdened today?
Nassim Nicholas Taleb: Because we have a more complex system than need more [?]. An employee is practically a slave. I mean, you think about it in these terms. Right? He can't say what he thinks--he'd get fired. He can[?] go on Twitter and curse at someone else. There are a lot of things he can[?] do. But it's not there that they're a slave, because they have to show up and give you their time, 9-5, or 9-6, or sometimes 8-10, 10 at night. So, they have to give you so much, and they are scared. With a slave, in Roman times, of course they have downsides--they could be beaten, they could be crucified--
Russ Roberts: Those are two negative things--
Nassim Nicholas Taleb: But a slave at a time--if you damage a slave, you can't sell them, so you lose market value. And with an employee, it's not the same. So it's quite--I haven't written much about it in Skin In the Game, of course, there are so many other topics. But I'm certain that we have more people who are independent today than we did in Roman times.
Russ Roberts: It's an interesting argument. You do bear some costs if you fire your employees all the time. I mean, people are less excited to work for you.
Nassim Nicholas Taleb: That's true. But they are--an employee is--okay, someone who sold you his work unconditionally, saying, okay, you are going to report to him and come back, or sometimes there is nothing to do, they still have to show up. So--or, maybe you have employees who are freer. But that's a typical standard. Why is that so? Well, because you want people who are not free. And this is why we have the school system, to basically teach people to not be free, between 8 and 4 p.m.
Russ Roberts: It's practical.
Nassim Nicholas Taleb: This is how it works.
Russ Roberts: It's practice.
Nassim Nicholas Taleb: Yeah. So they are broken in young, and they learn. And so you have employees.
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Long Ball Larry
Footballguy
that's from Econtalk (http://www.econtalk.org/).
I was just going to post the first couple of the below, but then in my search, a bunch of others came up seemed like they might interest you.
https://www.econtalk.org/kevin-kelly-on-the-inevitable/
https://www.econtalk.org/nassim-nicholas-taleb-on-rationality-risk-and-skin-in-the-game/
http://www.econtalk.org/mcafee-mcardle-and-ohanian-on-the-future-of-work/
http://www.econtalk.org/david-autor-on-the-future-of-work-and-polanyis-paradox/
https://www.econtalk.org/richard-jones-on-transhumanism/
https://www.econtalk.org/rodney-brooks-on-artificial-intelligence/
https://www.econtalk.org/james-bessen-on-learning-by-doing/
https://www.econtalk.org/brynjolfsson-on-the-second-machine-age/
https://www.econtalk.org/matt-ridley-on-the-evolution-of-everything/
https://www.econtalk.org/chuck-klosterman-on-but-what-if-were-wrong/
Long Ball Larry
Footballguy
yeah, should definitely be moved elsewhere. there are 2 threads started where it would fit:
https://forums.footballguys.com/forum/topic/751835-automation-jobs-pt-1-the-economy/?tab=comments#comment-19653164
https://forums.footballguys.com/forum/topic/775581-your-thoughts-automation-could-wipe-out-almost-half-of-all-jobs-in-20-years/?tab=comments#comment-21872294
mr. furley
Footballguy
the simplest way to think about this is "which way makes businesses the most money"? that way is the best way and thus of course helps freedom.
the more ways there are to grift off the proceeds of health care, the better. the more money there is to grift off health care, the more free we are.
duh
the more ways there are to grift off the proceeds of health care, the better. the more money there is to grift off health care, the more free we are.
duh
Jayrod
Footballguy
There are a lot of industries making boatloads on the US healthcare system. They will fight tooth and nail to avoid a universal or single-payer healthcare system. The for-profit model has benefits, but at this point, I believe we need to get out of this quagmire we've created and use some kind of social medical system.
This article explains some things and I this quote is my exact stance on the issue:
“So I, who do not believe in socialized health-care, would advocate a single-payment system...because it will get this monster that we’ve created out of the economy and allow the rest of capitalism to flourish without the awful things that healthcare is doing to us,” he said.
This article explains some things and I this quote is my exact stance on the issue:
“So I, who do not believe in socialized health-care, would advocate a single-payment system...because it will get this monster that we’ve created out of the economy and allow the rest of capitalism to flourish without the awful things that healthcare is doing to us,” he said.
matttyl
Footballguy
Explain. And I'm a health insurance agent. That may have been the case prior to the ACA, or possibly even before HIPAA, and I don't understand (unless very specific circumstances) why that would still be the case today.
Take my family for instance. I work, and I have my own personal coverage though my employer. My wife works, and she and our child's coverage is with her employer. She's currently possibly looking for alternate employment, but is in no rush. We don't have a chronic illness in the family (our child has some very serious stuff going on, but it's not chronic, and for all we know may already be solved), but I'm not sure how her search would be different if we did.
She can continue on the plan she has now with her current employer via HIPAA (for up to 18 months, so all the way till 2021) if she were to leave - and do so for just herself, for just our child, or for both. The two of them could enroll on my plan with my employer. The two of them could go to the guaranteed issue individual market and have the choice of anything available where we live (which, ain't much). If she were to go out on her own and be self employed, once she files a tax return as a self employed individual, which could be as early as January 2020, she actually could join the group/employer market as a "group of one" (this is the case at least in my state, and possibly others - I'm only a licensed agent here in Virginia). So, how would she be shackled to her current employment if she did have a chronic illness?
Terminalxylem
Footballguy
I think you mean COBRA, not HIPAA. After losing one’s employment coverage, COBRA coverage lasts only a finite period of time, and then you’re on your own. As an individual I have less bargaining power when applying for insurance, so my choices may be limited and more expensive than the insurance I received through my employer. Correct me if I’m wrong, but I don’t think all insurers participate in ACA marketplaces?
pollardsvision
Footballguy
If the FFA were to ever rank the best one-liner posters (maybe we have and I don't know), you, sir, would have to be #1 with bullet.
matttyl
Footballguy
Yes, in the last part I did mean COBRA for 18 months, not HIPAA - my bad.
So yes, in my example she (or our son) could have COBRA (meaning the exact same coverage they've always had) for up to 18 months. There are some circumstances which could extend that out to 36 months, but it's the exception, not the rule. But 18 months is 18 months - or a year and a half. If that happened today, you'd have continuing coverage until 2021. That's quite a long while. And that's assuming you couldn't just go onto your spouses plan from the start (as was an option in my example).
You're also at least partially correct on the individual stuff. Not all insurers participate in the marketplaces, and even if they do in your state, they may not (and likely don't) participate state wide. Take my home state of Virginia for instance. We have I think 8 carriers now - but geographically speaking about 80% of the state only has a single carrier available to them (which is the case in my county where only Anthem participates). Where you might not be correct is on cost, but that depends totally on your income. In your example, you're leaving your job, so the assumption is that your income either goes way down, or possibly away entirely. In that case, at absolute most, coverage will cost you no more than about 9.6% of your income for a silver tier plan (and since carriers got smart and really ramped up the prices of those silver plans over even gold tier plans, you could actually get a gold tier plan for even less than that). While your choices may be, and likely are, limited where you live - for many if not most people in your example, coverage could be very reasonably priced for them or even free (I have quite a few clients who are paying less than $100 a month for coverage, and maybe with subsidized deductibles as well).
Anyway, back to your point, I keep hearing over and over that linking healthcare to employment "shackles" that person to their job and I don't really see that being the case. I mean, no more than the income that job provided "shackles" them to the job to be able to afford food for themselves and their family. Isn't unemployment down to pretty much the lowest it's ever been? Why be stuck in one job (that provides health care) when apparently you can obtain another one in this economy you might like better (which likely provides health care)? And that's not counting on other options most individuals have (spouse's coverage, COBRA, individual market, self employed "group").
Terminalxylem
Footballguy
Pretty sure my statement was 100% accurate - losing one's job limits insurance choices, and may increase cost depending on the carrier and coverage. Low unemployment doesn't change that, as available jobs aren't guaranteed to be the same quality as one's current position, nor is their provided insurance. Same goes for safety nets like the health care exchanges - as you said, "carriers got smart and really ramped up the prices", placing their profit margins ahead of affordable insurance coverage.
Unlike salary, linking health insurance to one's employment is an artificial coupling. It creates extra middle people and cost within businesses, all with incentive to game the system in favor of the employer over employee. I prefer eliminating these considerations and non-clinical administrative staff in every facet of healthcare, which would be best accomplished with a universal single payor system.
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Terminalxylem
Footballguy
Soulfly3
Footballguy
my family and i are all alive and well, and not a dollar poorer despite more than a few past health issues, surgeries, meds, etc.
matttyl
Footballguy
Not 100% accurate at all. In fact, having one's insurance linked to their job is what likely limits choices. Take me for instance - I'm limited to the one plan that my employer has decided is the one they'll offer all employees nationwide. It's an HDHP with Cigna. It works fine for me personally, but may not be for everyone - and it's the one choice we all have. Losing my job would mean I could choose to keep that plan for up to another year and a half (via COBRA), go to my spouse's plan (different carrier, different style of plan which may suit me better), or go to the individual market and have whatever options might be available to me there (which to me personally aren't many as I live in a rural area, but in most urban areas there are generally 2-3+ carriers), which depending on my income may be heavily subsidized. I would not have the option of subsidized individual coverage so long as I have group coverage offered to me with my employer - once that ends, that door opens up.
You did quote my "carriers got smart and really ramped up the prices" but you didn't include in your quote that they only did that to silver tier plans. In the end, that generally is a HUGE benefit to individuals, as subsidies are based off of the premiums for those silver plans. If the prices of those silver plans go up, then so do the subsidies to the individuals. To the point that the subsidy for many is now large enough to completely pay the premiums for a bronze tier plan - effectively making them free to the individual. That's why I said "carries got smart" above.
Example of above - I don't know if you're a car guy or not, but lets take BMW for instance. They have a more basic 3 series (let's equate them to a bronze tier car), a more mid-range 5 series (let's call them silver tier), and the luxury 7 series (let's call them gold tier). Government comes out and say that to make them affordable, we'll subsidized the 5 series car to make it no more than $25k to the individual, and let's say that they cost $35k. So the subsidy would be $10k - which could be used on any of the cars - lets say the $20k 3 series, the $35k 5 series, or the $50k 7 series (again, totally made up numbers here). But what happens if BMW all of a sudden increased the price of the 5 series to $60k? Well, now the subsidy has to be $35k - enough to knock the now $60k sticker price down to $25k to the individual. Now the person can "buy" a 3 series with zero out of pocket, or even get a luxury 7 series for only $15k. That's what carriers have done - they're now the one's "cheating the system", and it's greatly benefiting the individuals. And again, that option doesn't exist for individuals so long as they have coverage with their employer. Losing that coverage increases their options, giving them the ability to take advantage of this situation. And I haven't even mentioned the possibility that within that 18 months (if accepting COBRA) the individual could obtain another job with just as good or better coverage.
Now I'm not saying the current system is perfect, or even great. It's no where near it. I just don't understand people saying that the system, in it's current form, shackles individuals to their jobs. I just don't see it.
IC FBGCav
Footballguy
IC FBGCav
Footballguy
The Commish
Footballguy
To an extent, and the medical community allows it because they know they can make up ther difference by gouging the private sector to make up the difference. Once that safety net goes away, all bets are off
IC FBGCav
Footballguy
IC FBGCav
Footballguy
You can cover everyone and have a supplemental market.
Why has technology made care more expensive in the US?
The Commish
Footballguy
Not sure I follow. The medical companies have made it more expensive because they can get away with charging the prices. Healthcare industry is probably one of the least capitalistic industries in this country the way they are set up right now.
The Commish
Footballguy
Because our government won't step in and cap the price gouging. This isn't complicated. At this point I am hoping these are rhetorical questions for your sake.
Terminalxylem
Footballguy
A big reason costs are out of control IS the source of payment. Insurers have made billing/reimbursement so opaque nobody really knows what they're paying for - health care providers and patients alike. If there was standardization and transparency in pricing, coupled with removal of unnecessary middle people, costs would go way down. Single payor should accomplish this much more effectively than our current system.
This site does a decent job explaining some of these concepts.
IC FBGCav
Footballguy
IC FBGCav
Footballguy
IC FBGCav
Footballguy
Terminalxylem
Footballguy
I think you understand it, but dismiss the significance people place on their employer-sponsored plans, and the ease with which they can obtain an equivalent replacement.
To ask a related question, why should health insurance be coupled to employment?
IC FBGCav
Footballguy
IC FBGCav
Footballguy
Terminalxylem
Footballguy
Why should healthcare be capitalistic? How would a purely capitalist system provide for indigent care?
IC FBGCav
Footballguy
A capitalistic system will never take care of anyone they can't knowingly profit off of. Hence it should be a right. Pretty basic stuff.
The Commish
Footballguy
The Commish
Footballguy
The Commish
Footballguy
This is only true IF our politicians do the right thing and stand up to the industry. As long as they continue to choose to line their pockets to the detriment of their constituents, it doesn't matter how many sources of payment there are. Our politicians have chosen the later thus far and gone a step further and put insurance companies in the role they are supposed to be in effectively making them the scapegoats in this whole thing. It's the perfect setup for those politicians who want to say one thing and do another.
I am not defending insurance companies because we all know they are in it to make money just like the rest of the industry, however, I think they get a bad rep a lot of the time. They are doing a job that shouldn't be theirs and could be making WAY more money than they are right now if they wanted to for the reasons you mention about payments.
matttyl
Footballguy
If it weren’t, and we didn’t replace it with a true universal system immediately, the uninsured rate would skyrocket instantly.
Said another way /m- there is a HUGE chunk of the population who only has coverage because it’s with their employer. If there employer didn’t offer it as part of employment, they wouldn’t go out and spend their money directly on a policy.
Terminalxylem
Footballguy
Terminalxylem
Footballguy
Of course. Hence, universal single payor, financed through taxes, at least for catastrophic medical care.
Transitioning from our current system will be a b!tch any way you cut it, as too many parties have financial interest in maintaining the status quo.
matttyl
Footballguy
Who’s getting taxed to pay for the few trillion annually that it will take? A few years ago I was self employed, doing pretty well, and between self employed tax, income tax both state and federal, and other various taxes I was at nearly 40% already. If taxed more than that as a self employed person, people will be even more tied to working for large companies as they won’t be able to afford going out on their own. I mean, the title of this thread is about freedom, right?Terminalxylem said:
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