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View Diary: Obama administration issues rules for individual mandate, America continues to exist (94 comments)

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  •  that's how I see it. I'm 52, but I have not (2+ / 0-)
    Recommended by:
    Beastly Fool, Odysseus

    been to a doctor in over 20 years. So it makes zero sense for me to pay $200-300 a month or whatever (I get no subsidy) for a health policy I very likely won't use. It's much better for me to just pay the $95 next year at tax time.

    I'd be more inclined to just pay the money per month IF that money were going to provide care for somebody else or reducing someone else's cost (by, say, financing a tax-paid health care system). I'd have no gripe or problem with paying a $200/month tax if it goes to provide health care for others who need it. But it's not doing that---any money I pay for a policy is just a monthly welfare payment straight to the insurance company's profits, and I don't give a flying fuck about the insurance company's profits. So my plan is to not buy any policy until/unless I need it, and just pay the fine, or tax, or whatever we want to call it (and sadly they won't even use THAT to actually provide health care to anybody). I see no reason whatsoever to give free money to the insurance company for doing nothing, especially when it helps absolutely nobody except the CEOs bonus. (shrug)

    And if the insurance companies start bitching and moaning because people aren't giving them their free welfare payments, then I say let them go ahead and repeal the whole idiotic insurance mandate idea if that's what they wanna do--that way we can do what we should have done in the first place; install a tax-funded Medicare-style health care for everyone and tell the insurance companies to go fuck themselves.

    •  Exchange options (1+ / 0-)
      Recommended by:
      Beastly Fool

      I remember reading something last year (before the campaigns revved up into high gear) about one of the exchange options possibly being a non-profit insurance carrier. It wouldn't quite be a public option, but something pretty close to it. Perhaps someone remembers the details better than I can.
      Addressing your resistance to contributing to ins co profits, would you be willing to obtain insurance from an entity whose only purpose was promoting healthcare, and not lining the pockets of its CEOs?

      •  That's DOA now (4+ / 0-)

        The 2013 tax bill cut all funding for non-profit health exchanges.

        Some of the best provisions of PPACA, like Sanders' community health centers, have already been the victim of recent budget cuts. At least the Medicaid expansion survives intact--so far, and for those states adopting it.

      •  absolutely (2+ / 0-)
        Recommended by:
        jeopardydd, tofumagoo
        would you be willing to obtain insurance from an entity whose only purpose was promoting healthcare, and not lining the pockets of its CEOs?
        Though I would still prefer that my taxes or payments or whatever would actually go to providing actual care to actual people, which ACA does not do no matter who has the policy.  Catastrophic health insurance is great (at least for the minority of people in the US who actually HAVE homes and cars and 401k's and such to lose), but it doesn't provide doctor care to people who need it.

        My situation with regards to ACA is a bit unique, since my income has quadrupled in the past four years, so I have gone in one fell swoop from being poor and qualifying for full subsidies under ACA (which, I discovered quickly, would still not allow me to afford to see a doctor when I needed one, since the only policies available with the subsidy were high-deductible shit policies) to being NOT poor and not qualifying for any subsidy at all (making ACA for me a simple catastrophic health insurance policy, which I don't need since I have no house or car or 401k to protect). I've now seen ACA from both ends, and not been happy with either view.

    •  I strongly recommend you get annual check ups (3+ / 0-)
      Recommended by:
      MRobDC, davewill, mdmslle

      About 10 years ago one of my best friends, who also hadn't been to a doctor in over 20 years, very suddenly dropped dead, leaving a wife and three small children.

      "We have always known that heedless self-interest was bad morals, now we know that it is bad economics." Franklin Delano Roosevelt, Jan. 20, 1937

      by Navy Vet Terp on Wed Jan 30, 2013 at 04:15:41 PM PST

      [ Parent ]

    •  You say: "So it makes zero sense for me to pay (2+ / 0-)
      Recommended by:
      tofumagoo, Odysseus

      $200-$300 a month or whatever (I get no subsidy) for a health policy I very likely won't use."

      Well, in the first place, you probably wouldn't pay anywhere near that little at age 52.  

      Here's the link to the Mass Health Connector.  But it is closed until open enrollment period July 1-August 15, 2013.

      At any rate, not long after they established the Exchange, I went to the Connector to price it (don't live in Mass, but wondered what kind of deal the folks there were getting).

      At just ages 53 then, the premiums for mid-range (for coverage) catastrophic policies were priced from $700-1100 monthly (for that age group).

      And remember, the federal exchange will be "age-rated" also, at 3:1.

      So, Lenny, "only in your dreams" will you find a policy with that low of a premium today (true, that's only my guess, based on the Mass Health Exchange).  Although, I suppose if one were to shop for a 60/40 plan, one might make out fairly well, moneywise.

      Seriously, group health insurance premiums have literally skyrocketed since I looked into the Mass Exchange.

      Our group premium has tripled since Year 2001.

      So good luck!

      Mollie

      “If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

      by musiccitymollie on Wed Jan 30, 2013 at 04:23:29 PM PST

      [ Parent ]

      •  I looked just the other night (1+ / 0-)
        Recommended by:
        musiccitymollie

        There were many in that price range on Blue Cross/Blue Sheild's website here in Mn. That was for a 52 yr old smoker.

        Some people have short memories

        by lenzy1000 on Wed Jan 30, 2013 at 04:56:36 PM PST

        [ Parent ]

        •  Good for you! Mr. Mollie says we're moving to (1+ / 0-)
          Recommended by:
          lenzy1000

          Minnesota!  LOL!

          Mollie

          “If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

          by musiccitymollie on Wed Jan 30, 2013 at 06:11:05 PM PST

          [ Parent ]

          •  Minnesota has low rates (2+ / 0-)
            Recommended by:
            musiccitymollie, GayHillbilly

            due to low malpractice rates made possible by common sense tort reform. We require a second independent doctor to confirm damages before a lawsuit can proceed. We also have no tolerance for bad doctors. If they screw up we pull their license. Many have fled south to Texas where they can be free from those nasty lawsuits. Low income patients are covered by MnCare which is funded by a tax levied on insurance companies for every healthcare policy they issue. The consumer never sees it and many don't even know they are funding it.

            Some people have short memories

            by lenzy1000 on Wed Jan 30, 2013 at 06:39:16 PM PST

            [ Parent ]

            •  Yeah for Minnesota! My state (red) had exorbitant (2+ / 0-)
              Recommended by:
              Willa Rogers, lenzy1000

              prices for catastrophic policies listed on the Medicaid-lite website, at one time.  After I read your reply, got on the website, and found that they no longer even offer any for folks just over the Medicaid eligibility income.  (Maybe because the ACA will soon come online.)

              At any rate, 0ur Medicaid program is handled by a private insurer, United Healthcare, and is a managed-care program, not a PPO.  And it is very difficult to find a doctor who will accept anymore Medicaid patients (and increasingly, Medicare patients).

              Mollie

              “If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

              by musiccitymollie on Wed Jan 30, 2013 at 07:27:30 PM PST

              [ Parent ]

    •  But you SHOULD have gone to a doctor (2+ / 0-)
      Recommended by:
      AoT, MRobDC

      in the last 20 years. You could have any number of issues that would have been better dealt with sooner.

      "Nothing happens unless first a dream. " ~ Carl Sandburg

      by davewill on Wed Jan 30, 2013 at 04:24:43 PM PST

      [ Parent ]

      •  I'm always a little disgusted (1+ / 0-)
        Recommended by:
        Odysseus

        By people who say things like "i haven't been to the doctor in 20 years" with pride. My mother was the same way and had been living with uncontrolled diabetes (unknown to her) for god knows how long. She's not paying the price, with very expensive visits to multiple doctors a month that could have been to a large degree avoided if she had found out years ago that she was diabetic.

      •  that's nice, but alas (3+ / 0-)
        Recommended by:
        tofumagoo, Odysseus, Willa Rogers

        until about three years ago, I was poor and couldn't afford a visit to the doctor even if I needed it (broken bone or something). I have a gap in my jawbone right now because about ten years ago one of my wisdom teeth got infected, cracked, and the pieces fell out one at a time. I couldn't afford the oral surgeon to treat it.

        So what I should have done and what I could actually afford to do, were two entirely different things. And alas, self-righteous tut-tutting on someone else's part won't alter that.

        If we'd had a decent health care system like every other civilized country does, of course, then I could have gone to the doctor for routine checkups as well as needed medical treatments.

        But we didn't. So I couldn't. (shrug)

    •  Yeah, but I'm pretty sure that you'd be hit with (0+ / 0-)

      huge costs if something happens.   Say you fall off your roof, or get shot on the street, or develop diabetes.....   sure, the insurance company can't deny coverage, but if you don't have insurance at the time of your accident, then the hospitals and doctors  ARE allowed to charge you for services that you need to keep you alive if you present to a hospital emergency room.   HUGE costs.  And then, if you need ongoing  care, they'll either charge you market rates for medical services, or offer to sell you a policy with a level of premiums to make up for the fact that you weren't sharing the risk with the rest of us while you had no coverage.

      •  oddly enough, that is precisely the same situation (0+ / 0-)

        I've been in for nearly all of my adult life.

        There will inevitably be changes in ACA, though, for the simple reason that ACA does not actually provide any access to a doctor for people who actually need it.  All ACA does is provide catastrophic coverage, mostly to people who don't need it because they don't have any assets to protect. As far as actual medical access, all ACA subsidies do is pay for high-deductible shit policies which guarantee that poor people still can't afford to see a doctor when they need to.

        That will have to be dealt with.

        Soon.

        •  Well, that's "half right," LOL! (0+ / 0-)

          Definitely can't argue with this statement:  As far as actual medical access, all ACA subsidies do is pay for high-deductible shit policies which guarantee that poor people still can't afford to see a doctor when they need to."

          But don't forget, it is beneficial to more affluent folks, small business owners, etc., for whom a "high deductible" policy (set up with a health savings account) is quite sufficient.  For many of them, the premiums may not be a steal, but they'll probably be lower than than could find in the private individual insurance market.

          I do know a little about this, since I come from a huge family of insurance and securities brokers, although I'm not personally 'in th biz.'  :-)

          Mollie

          “If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

          by musiccitymollie on Wed Jan 30, 2013 at 05:56:41 PM PST

          [ Parent ]

          •  regarding this: (2+ / 0-)
            Recommended by:
            musiccitymollie, BusyinCA
            But don't forget, it is beneficial to more affluent folks, small business owners, etc., for whom a "high deductible" policy (set up with a health savings account) is quite sufficient.  For many of them, the premiums may not be a steal, but they'll probably be lower than than could find in the private individual insurance market.
            that is indeed the viewpoint that many people here at DKos look at it through, since many of the people here are themselves upper-middle class, more affluent folks. Me, I've been dirt-poor for nearly my entire life (the highest wage I ever got was eight bucks an hour and I never had benefits of any sort, not even paid sick days), and even though I was fortunate enough to claw my way out of it, I still view the world through that lens. So it really really annoyed me when, back during the "kill the bill" pie fight, many people here were arguing that we needed ACA to protect people from losing their house or retirement savings because of a medical emergency.  Many Kossacks were (and many still are, probably) utterly oblivious to the fact that most people in the US don't even HAVE any retirement savings and don't own a home, so they have no assets to lose or to protect, and forced catastrophic insurance does absolutely nothing for them. It doesn't even let them see a doctor when they need to.

            So for the non-affluent, the ACA does nothing.  Nothing at all whatsoever.

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