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Texas ranks dead last in % of adults with health insurance


Shmitty

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Underinsured rates ahould also be included. There’s a huge percentage of people who can’t afford the cash outlay to meet their extremely high deductibles on their crappy plans. Unless there is something catastrophic or you are sick as crap, cash pay with the discounts is now becoming much cheaper.

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10 hours ago, Sbbruin said:

And y'all have a high percentage of fatties.  Bad combo.

Not really since health care isn't needed when you go from living and breathing one moment to falling over dead....   The dead don't need healthcare.....

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2 hours ago, Newdoc said:

Underinsured rates ahould also be included. There’s a huge percentage of people who can’t afford the cash outlay to meet their extremely high deductibles on their crappy plans. Unless there is something catastrophic or you are sick as crap, cash pay with the discounts is now becoming much cheaper.

Single payer, we welcome thee.

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8 hours ago, David Dennison said:

Single payer, we welcome thee.

Unfortunately it costs money to get healthcare.  I’m like everyone else in that I want my specialist visit to cost $5 and a monthly premium of $20 but the math doesn’t add up.   Many people have options to go with a lower premium but that comes with a high deductible. Or go with the higher premium, lower deductible.  

Healthcare is expensive.  People need to put money aside for when they need healthcare. 

 

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1 hour ago, Nice Guy Eddie said:

Unfortunately it costs money to get healthcare.  I’m like everyone else in that I want my specialist visit to cost $5 and a monthly premium of $20 but the math doesn’t add up.   Many people have options to go with a lower premium but that comes with a high deductible. Or go with the higher premium, lower deductible.  

Healthcare is expensive.  People need to put money aside for when they need healthcare. 

 

That's assuming that they even have the money to put aside.  With the cost of everything going up and wages not keeping pace, it's no wonder why many simply aren't.  

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25 minutes ago, Shmitty said:

That's assuming that they even have the money to put aside.  With the cost of everything going up and wages not keeping pace with that, it's no wonder why many simply aren't.  

I completely agree most people don’t have the money to put aside.  Many families need to make decisions on what is important to them.  You may want that $5K Disney trip but you don’t need it.  

Many professional workers live paycheck to paycheck because they live beyond their means or right up to that line.   Which is cool but don’t whine when an emergency occurs (and it will) and you have $100 in the bank.  

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20 minutes ago, Nice Guy Eddie said:

I completely agree most people don’t have the money to put aside.  Many families need to make decisions on what is important to them.  You may want that $5K Disney trip but you don’t need it.  

Many professional workers live paycheck to paycheck because they live beyond their means or right up to that line.   Which is cool but don’t whine when an emergency occurs (and it will) and you have $100 in the bank.  

I'm talking about how they don't have money to put aside because it all goes towards basic living expenses and bills, not luxuries and trips.  

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21 minutes ago, Shmitty said:

I'm talking about how they don't have money to put aside because it all goes towards basic living expenses and bills, not luxuries and trips.  

Seconded.  People don't have the money to put aside, so they skip medical treatement altogether in increasing numbers.

https://www.beckershospitalreview.com/finance/64-of-americans-avoid-treatment-due-to-cost-of-medical-care-5-survey-insights.html

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19 minutes ago, Shmitty said:

I'm talking about how they don't have money to put aside because it all goes towards basic living expenses and bills, not luxuries and trips.  

I feel for the person/family that truly have that scenario but I don’t think it’s always the case.  I know many people that don’t have much left over at the end of each month but they’re eating out several times per week, dropping 200+ on cable tv and have $100 mobile plans with the new iPhone.   I’m referring to white collar or professional workers.  

But back on the overall topic, I work in healthcare and there is a definite trend that even those with commercial insurance are behaving in the same manner as people without insurance.   We are getting to a point where something has to break.   The ACA has some good points and as much as so many hate the mandate; the only way to make insurance affordable for all is to force the healthy to buy it.  Take them out of the equations, and the sick cannot pay for themselves.  It’s not that much more complicated than that. 

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20 minutes ago, Nice Guy Eddie said:

I feel for the person/family that truly have that scenario but I don’t think it’s always the case.  I know many people that don’t have much left over at the end of each month but they’re eating out several times per week, dropping 200+ on cable tv and have $100 mobile plans with the new iPhone.   I’m referring to white collar or professional workers.  

But back on the overall topic, I work in healthcare and there is a definite trend that even those with commercial insurance are behaving in the same manner as people without insurance.   We are getting to a point where something has to break.   The ACA has some good points and as much as so many hate the mandate; the only way to make insurance affordable for all is to force the healthy to buy it.  Take them out of the equations, and the sick cannot pay for themselves.  It’s not that much more complicated than that. 

The solution is quite simple:  single-payer.  

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21 minutes ago, Shmitty said:

The solution is quite simple:  single-payer.  

When you say that, do you basically just mean to switch the cost to future taxpayers by funding it via debt today?    If we went this route the responsible way would be a new Payroll tax that is solely for single payer and it has to balance each year.

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23 minutes ago, Nice Guy Eddie said:

When you say that, do you basically just mean to switch the cost to future taxpayers by funding it via debt today?   

To start, absolutely.

Quote

If we went this route the responsible way would be a new Payroll tax that is solely for single payer and it has to balance each year.

lol "the responsible way" is something conservatives only think about with paying for policies that actually help people

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1 hour ago, Nice Guy Eddie said:

When you say that, do you basically just mean to switch the cost to future taxpayers by funding it via debt today?    If we went this route the responsible way would be a new Payroll tax that is solely for single payer and it has to balance each year.

This is true.  I actually have no problem with single payer.  But you better tax everyone to pay for it.  

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1 hour ago, Nice Guy Eddie said:

I feel for the person/family that truly have that scenario but I don’t think it’s always the case.  I know many people that don’t have much left over at the end of each month but they’re eating out several times per week, dropping 200+ on cable tv and have $100 mobile plans with the new iPhone.   I’m referring to white collar or professional workers.  

But back on the overall topic, I work in healthcare and there is a definite trend that even those with commercial insurance are behaving in the same manner as people without insurance.   We are getting to a point where something has to break.   The ACA has some good points and as much as so many hate the mandate; the only way to make insurance affordable for all is to force the healthy to buy it.  Take them out of the equations, and the sick cannot pay for themselves.  It’s not that much more complicated than that. 

This is a problem our society has through many layers.   We have been programmed by marketing to eat things bad for us, and more of it at that.   10 to 12 ounces of soda was a large back in the 60s, now it's 44 oz?  64 oz?   Same for chips, bags have trebled in size.  And they are loaded with more and more additives for flavor.   You can't go into a fast food place without asking if you want it jumbo sized (mom joke opening).  So there is a lot of bloat going on out there.  And as the Dollar General thread mentioned, rural areas are going away from fresh veggies and foods to more processed twinkie type shit.

But there is a huge amount of bloat on the provider side in admin, big Pharma etc.  Everybody wants a piece of the pie.  I broke my arm, my local GP x-rayed it. set and casted it for $100 back in 1972.  Did it all in his office.  Flash forward to 2005, my son broke his arm, it cost $3,400 after ER visit, ER doctor, some ortho guy looking long distance at the X rays and who knows what else.    Calculating for inflation, that 100 in 72 was worth $463 in 2005.   That is nearly $3,000 difference in payment for the same procedure.   That is bloat.

 

The problem is solvable, but both sides have to be willing to work from each end to reach a workable solution in the middle.  That's something we seem to have lost the knack for.  Or maybe those who stand to profit from the status quo are blocking such negotiations.    Other countries make this work, you would think  we could.   While the ACA isn't perfect, it has been an important first step in the right direction.

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1 hour ago, JohnnyRage said:

‘Cash’ for routine care otherwise there is profit, greed, and fraud at each of the additional levels of bureaucracy. Require every citizen to obtain a catastrophic policy.

That's the dream but fat, lazy people in this country would flip their shit.  TuneUp for their car?  No problem...paying cash to keep their ticker going?  Riots in the street. 

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On 8/17/2018 at 4:24 PM, Huckleberry said:


You gotta admit that would make having the lowest percentage extremely likely.

It would indeed.  But I think that the fact that Texas is the 2nd most populated state means that something else is far more likely. 

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9 hours ago, Nice Guy Eddie said:

When you say that, do you basically just mean to switch the cost to future taxpayers by funding it via debt today?    If we went this route the responsible way would be a new Payroll tax that is solely for single payer and it has to balance each year.

However it happens, it's coming and it's going to be where this country ends up. It's inevitable.

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10 hours ago, Nice Guy Eddie said:

Unfortunately it costs money to get healthcare.  I’m like everyone else in that I want my specialist visit to cost $5 and a monthly premium of $20 but the math doesn’t add up.   Many people have options to go with a lower premium but that comes with a high deductible. Or go with the higher premium, lower deductible.  

Healthcare is expensive.  People need to put money aside for when they need healthcare. 

 

Yes, they do. They are going to be forced to through the tax code. Just like Medicare.

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8 hours ago, ChiTownDoc said:

This is true.  I actually have no problem with single payer.  But you better tax everyone to pay for it.  

If you read Bernie's proposal it certainly seems achievable. For employers with few high dollar employees they can even save money after giving employees a raise to cover the deductions. A raise in the minimun wage will ensure low wage workers are covered.

You also have to keep in mind that the Federal government already supplies healthcare to 123 milliin people between medicare, medicaid, Chips, and the VA. Health insurers mainly cover healthy people who are employed and their families since that is where they can make the most profit.

Bernie's proposal primarily includes a 6.2% payroll deduction, a 2.2% income tax increase, and taxing capital gains and dividends as normal income.

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1 hour ago, RayDog said:

You also have to keep in mind that the Federal government already supplies healthcare to 123 milliin people between medicare, medicaid, Chips, and the VA. Health insurers mainly cover healthy people who are employed and their families since that is where they can make the most profit.

 

This is a completely inaccurate representation. 

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57 minutes ago, Anastasis said:

 

This is a completely inaccurate representation. 

Which part?

44 million are on Medicare, 70 million on Medicare and Chips, and 9 million on VA.

About half of the US public has their primary health insurance through their work, or business, including those that are self employed.

Medicare would benefit greatly if they could tax and cover the healthy working majority.

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21 minutes ago, RayDog said:

Which part?

44 million are on Medicare, 70 million on Medicare and Chips, and 9 million on VA.

About half of the US public has their primary health insurance through their work, or business, including those that are self employed.

 Medicare would benefit greatly if they could tax and cover the healthy working majority.


Over 1/3 of medicare beneficiaries elect to use a private health insurance plan, i.e. MAPD. A significant number have supplemental plans.  A substantial amount of Medicaid coverage is through managed medicaid plans. Large and small group makes up about one half overall, correct. Medicare FFS is on a down trend and that trend will continue. 

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12 hours ago, phdhorn said:

SIngle payer would forever bury the health care industry without any hope of recovering, ever

First of all, every other western democracy does it, and they spend WAY LESS and get the same outcomes.   I don’t know about you, but that seems like a pretty good deal to me.   I would think conservatives would be interested in getting the same outcomes for 30 or 40% less cost.  

Second, your statement implies that our insane health care system has an expectation of “recovery” in its current form, which is laughable.

Finally, let’s all be really honest with ourselves and acknowledge that our broken system has zero to do with capitalism.    It just kills me how Republicans think the current (broken) system = capitalism, and single payer = socialism.   Neither is true.   You can have a single payer system that has enormous power to reward cost-effective innovation.  

tl,dr:   you’re scared of the wrong thing.

 

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32 minutes ago, Anastasis said:


Over 1/3 of medicare beneficiaries elect to use a private health insurance plan, i.e. MAPD. A significant number have supplemental plans.  A substantial amount of Medicaid coverage is through managed medicaid plans. Large and small group makes up about one half overall, correct. Medicare FFS is on a down trend and that trend will continue. 

Raydog I like you.  And I have made an amazing living kicking off value based medicine in 24 states.  But Anastasis is right.  It’s WAY more complicated. 

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20 minutes ago, Paul Wesley said:

First of all, every other western democracy does it, and they spend WAY LESS and get the same outcomes.   I don’t know about you, but that seems like a pretty good deal to me.   I would think conservatives would be interested in getting the same outcomes for 30 or 40% less cost.  

Second, your statement implies that our insane health care system has an expectation of “recovery” in its current form, which is laughable.

Finally, let’s all be really honest with ourselves and acknowledge that our broken system has zero to do with capitalism.    It just kills me how Republicans think the current (broken) system = capitalism, and single payer = socialism.   Neither is true.   You can have a single payer system that has enormous power to reward cost-effective innovation.  

tl,dr:   you’re scared of the wrong thing.

 

Let me tell you something.  ‘Every other blah blah blah....’.  My wife’s uncle died in Europe waiting for an operable brain cancer to be put under the knife.  Also you fuck something up in Europe you don’t get sued for 7 figures.  A LOT different here

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30 minutes ago, ChiTownDoc said:

Let me tell you something.  ‘Every other blah blah blah....’.  My wife’s uncle died in Europe waiting for an operable brain cancer to be put under the knife.  Also you fuck something up in Europe you don’t get sued for 7 figures.  A LOT different here

You think no one dies here from lack of care?

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57 minutes ago, ChiTownDoc said:

I have made an amazing living kicking off value based medicine in 24 states.

This is where we need to and will be moving continually. FFS is a fucking shit show. Outcomes based reimbursement is the right type of alignment. 

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4 hours ago, Anastasis said:


Over 1/3 of medicare beneficiaries elect to use a private health insurance plan, i.e. MAPD. A significant number have supplemental plans.  A substantial amount of Medicaid coverage is through managed medicaid plans. Large and small group makes up about one half overall, correct. Medicare FFS is on a down trend and that trend will continue. 

I am aware of that, and it is entirely possible that a final m4a bill would retain some or many of those options.

I don't know about trends continuing as I think Bernie will win in 2020 and have a Democratic House and Senate, so I expect to see some sort of m4a bill passed in 2021.

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11 hours ago, Paul Wesley said:

Also, your anecdotes aren’t arguments against mountains of data.   Sorry.  

If you want to offer a factual argument for the American system’s costs and outcomes  vs those of other Western democracies, go right ahead.   

Please STFU.  What other country can you get sued for any significant amount of money for shit outcomes?  I'll standby.  CYA medicine drives up costs.  Fucking moron. 

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3 hours ago, ChiTownDoc said:

Please STFU.  What other country can you get sued for any significant amount of money for shit outcomes?  I'll standby.  CYA medicine drives up costs.  Fucking moron. 

Dude, you've offered nothing at all to this discussion except bragging about your "amazing living" and personal attacks.  I'm thoroughly unimpressed with you, even though feel the need to boast and to put "doc" in your user name.  FYI, there are a lot of experts on these boards that don't feel the same need to advertise themselves.  Draw your own conclusions.

Other countries get the same outcomes for significantly less money.  When I pointed that out, you started your replied with "Let me tell you something..." like you're THE fucking authority on this topic.  Then you tried to dismiss me by quoting "blah, blah, blah."  Which is pretty dickish.   Then you told a fucking anecdote of your in-law who didn't get timely surgery.... like that's how science works (it's not, doctor).

Now you're trying to change the argument to "But American doctors might get SUED!!!"  Which is true, but you're just pointing out one of a hundred reasons why our system is wasteful and inefficient.  It's hardly an argument FOR our system, is it?  

Again, if you want to argue for the merits of the American system, then step up and do so.   Alternatively, since the facts are overwhelmingly against you and you've dug yourself in on the losing side, you could pretend to be *the* authority, tell us all a little anecdotal story, and then resort to name calling.  

So far, that's all you've got.  

 

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On 8/18/2018 at 9:08 PM, Paul Wesley said:

First of all, every other western democracy does it, and they spend WAY LESS and get the same outcomes.   I don’t know about you, but that seems like a pretty good deal to me.   I would think conservatives would be interested in getting the same outcomes for 30 or 40% less cost.  

Second, your statement implies that our insane health care system has an expectation of “recovery” in its current form, which is laughable.

Finally, let’s all be really honest with ourselves and acknowledge that our broken system has zero to do with capitalism.    It just kills me how Republicans think the current (broken) system = capitalism, and single payer = socialism.   Neither is true.   You can have a single payer system that has enormous power to reward cost-effective innovation.  

tl,dr:   you’re scared of the wrong thing.

 

fourth, you assume that the Federal government can manage anything worth a half a shit.   Now that's  the part that's so hysterically laughable, it's potentially lethal from asphyxiation.  That's all, folks!


Well fifth, we had the healthcare thing discussed for 10+ years starting in 2008 on the now-shit site, and no need to rehash the mountains of data there which shows that single payer is self-throat slashing (though granted, it's not much worse than ObieCare to boot).  And, since ObieCare has proven to be exactly the piece of shit even a second-grader knew it would be, there's not much more to day except let's make it shittier and let the Guv run our entire payment process! Yeah, like that's worked so well.. lol I can even remember when some held the VA up as the "shining example"  OOPS!  Nevermind...Done having those old arguments, but carry on if you want.

The good thing is I won't be around if/when single payer completely fucks the health care system (which is "recoverable" , the opposite of which is "laughable".  I'll be resting with Jesus in heaven by then, dunking basketballs effortlessly.

Anyway carry on.

Edited by phdhorn
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