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Post by zenwalk on Nov 7, 2013 22:24:03 GMT -5
Sharing the risk is code for the healthy paying your bills. Insurance is about creating a pool of money from which to draw the revenue to pay off bills. Hopefully you have more in the pot at the end of the month than not. Gov does medicare exceptionally well. Gov has insured we have the finest fighting force on the planet. You got to start somewhere. If the repubs don't like what they see they should have contributed more to the process than obstruction. Medicare is rife with problems. Hospitals and clinics have shut down due to slowness of payments (Gundry Glass was killed this way, last psych hospital focusing on pediatrics, sore loss for Maryland). Doctors and hospitals are underpaid, and make it up by refusing Medicare patients, or overcharging others. Government does Medicare-- even moderately well would be stretching it- barely adequate only because it's not a monopoly would be a better descriptor. You haven't been close up and personal with Medicare (or any insurance company) when there's a secondary insurance involved with a large bill. The inevitable, "I'm not paying for this" comes at you from all directions. Bills can be tied up indefinitely in legal disputes. That's not Medicare's fault so much as the insurance biz being an ugly tank of sharks determined not to pay a dime for anything.
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Post by kemmer on Nov 7, 2013 22:29:02 GMT -5
So, the same people (young & healthy) being swept into buying faux insurance will ALSO have to pony up to pay the debt. Man, what a sweet deal they're getting! At the risk of stating the obvious, the healthy keep insurance companies afloat. You can cast stones at the ACA from a number of directions but you either accept the premise of insurance or you don't. As for the young they will sort out the messes we make today as they always have. But given the obstructions the repubs placed in writing the ACA it's something of miracle that anything at all was settled on. I'm agnostic on the ACA but I'm willing to give it a chance because our existing medical/insurance practices and billing policies are a tangled mess. I do accept the concept of insurance. I carry homeowner's insurance. I do understand that every year my house does not burn down, my premiums are used to reimburse people whose houses DID burn down. I carry liability car insurance. When we had small children and a mortgage, we carried life insurance--very happy that policy never had to be used! I sympathize with people who have to make insurance claims. The ACA is not insurance. One does not insure against 100% probabilities, nor does one insure against small losses. Why? Because the cost of the policy exceeds the cost/loss. I do not carry collision insurance on my 14-year-old car--over time, the cost of the insurance would exceed the cost of replacing the vehicle. The ACA requires insurers to pay for small expenses-- like pediatric dentistry. Remember, traditional health insurance has always covered oral surgery, so we're talking about routine, 100% probability here. Same goes for birth control pills and a routine gynecological exam-- again, a 100% probability. The extra paperwork involved in insuring for routine, low-cost, health-related activities must add to the base price for the service. Insurance is for protection against devastating losses. (Remember, it was invented by ship-owners who could be bankrupted by a singe storm or pirate attack. It wasn't used to pay for loading and unloading cargo, or to replace a rope chewed by a ship's rat.) What people need is "major medical" and "hospitalization." (I'm old enough to remember when in the vernacular, it was called "hospitalization", not "health insurance".) Anything else just raises the cost, for both the provider and the patient. It, also, encourages higher prices because "insurance will cover it." The ACA is all about "insurance will cover it." Therefore, insurance premiums must rise, and care costs must rise to cover the expense of processing claims. In that respect, it is more like those "appliance service contracts" smart people never purchase than genuine insurance.
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Post by kemmer on Nov 7, 2013 22:48:05 GMT -5
Medicare is rife with problems. Hospitals and clinics have shut down due to slowness of payments (Gundry Glass was killed this way, last psych hospital focusing on pediatrics, sore loss for Maryland). Doctors and hospitals are underpaid, and make it up by refusing Medicare patients, or overcharging others. Government does Medicare-- even moderately well would be stretching it- barely adequate only because it's not a monopoly would be a better descriptor. You haven't been close up and personal with Medicare (or any insurance company) when there's a secondary insurance involved with a large bill. The inevitable, "I'm not paying for this" comes at you from all directions. Bills can be tied up indefinitely in legal disputes. That's not Medicare's fault so much as the insurance biz being an ugly tank of sharks determined not to pay a dime for anything. Really? On the rare occasions I've made an insurance claim, I've found they pay in a timely manner according to the policy. Maybe I've just been lucky. (Blue Cross used to send 3 pages of boilerplate "appeal info" with every "This Is Not A Bill" statement, which I thought was wasteful, but that was mandated by the state insurance commission.) Medicare worked beautifully so long as the huge, Boomer population was paying in and not taking out. In spite of that (or, maybe because of it?) Medicare has far exceeded projected costs (even after adjusting for inflation.) The planned cost cuts have never been made, because of the "doc-fix" Congress always puts in place. [NB: I doubt the Medicare cuts that are supposed to fund the ACA will be made, either.] Plus, it's hard to tell how efficient Medicare is, given that overhead-- like capital expenses for office buildings, employee pensions, et al-- is placed in other budgets, and they don't have to worry about tiny things like real estate taxes, business taxes, a legal department to stay on top of new regulations, and such.
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Post by Deleted on Nov 7, 2013 23:20:57 GMT -5
Medicare is rife with problems. Hospitals and clinics have shut down due to slowness of payments (Gundry Glass was killed this way, last psych hospital focusing on pediatrics, sore loss for Maryland). Doctors and hospitals are underpaid, and make it up by refusing Medicare patients, or overcharging others. Government does Medicare-- even moderately well would be stretching it- barely adequate only because it's not a monopoly would be a better descriptor. You haven't been close up and personal with Medicare (or any insurance company) when there's a secondary insurance involved with a large bill. The inevitable, "I'm not paying for this" comes at you from all directions. Bills can be tied up indefinitely in legal disputes. That's not Medicare's fault so much as the insurance biz being an ugly tank of sharks determined not to pay a dime for anything. That only applies to those with dual insurance- and, yeah, that can be a nasty mess. Sadly, Medicare, and Medicaid, on their own can be a mess of buearcracy and delays on their own. Not too say private insurance is perfect- far from it. But at least there are options- if we go single payer, there will be none.
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Post by drjohnnyfever on Nov 7, 2013 23:23:05 GMT -5
Medicare is rife with problems. Hospitals and clinics have shut down due to slowness of payments (Gundry Glass was killed this way, last psych hospital focusing on pediatrics, sore loss for Maryland). Doctors and hospitals are underpaid, and make it up by refusing Medicare patients, or overcharging others. Government does Medicare-- even moderately well would be stretching it- barely adequate only because it's not a monopoly would be a better descriptor. You haven't been close up and personal with Medicare (or any insurance company) when there's a secondary insurance involved with a large bill. The inevitable, "I'm not paying for this" comes at you from all directions. Bills can be tied up indefinitely in legal disputes. That's not Medicare's fault so much as the insurance biz being an ugly tank of sharks determined not to pay a dime for anything. I have...many times (admittedly not recently)....what's the point?
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Post by Deleted on Nov 7, 2013 23:23:36 GMT -5
At the risk of stating the obvious, the healthy keep insurance companies afloat. You can cast stones at the ACA from a number of directions but you either accept the premise of insurance or you don't. As for the young they will sort out the messes we make today as they always have. But given the obstructions the repubs placed in writing the ACA it's something of miracle that anything at all was settled on. I'm agnostic on the ACA but I'm willing to give it a chance because our existing medical/insurance practices and billing policies are a tangled mess. I do accept the concept of insurance. I carry homeowner's insurance. I do understand that every year my house does not burn down, my premiums are used to reimburse people whose houses DID burn down. I carry liability car insurance. When we had small children and a mortgage, we carried life insurance--very happy that policy never had to be used! I sympathize with people who have to make insurance claims. The ACA is not insurance. One does not insure against 100% probabilities, nor does one insure against small losses. Why? Because the cost of the policy exceeds the cost/loss. I do not carry collision insurance on my 14-year-old car--over time, the cost of the insurance would exceed the cost of replacing the vehicle. The ACA requires insurers to pay for small expenses-- like pediatric dentistry. Remember, traditional health insurance has always covered oral surgery, so we're talking about routine, 100% probability here. Same goes for birth control pills and a routine gynecological exam-- again, a 100% probability. The extra paperwork involved in insuring for routine, low-cost, health-related activities must add to the base price for the service. Insurance is for protection against devastating losses. (Remember, it was invented by ship-owners who could be bankrupted by a singe storm or pirate attack. It wasn't used to pay for loading and unloading cargo, or to replace a rope chewed by a ship's rat.) What people need is "major medical" and "hospitalization." (I'm old enough to remember when in the vernacular, it was called "hospitalization", not "health insurance".) Anything else just raises the cost, for both the provider and the patient. It, also, encourages higher prices because "insurance will cover it." The ACA is all about "insurance will cover it." Therefore, insurance premiums must rise, and care costs must rise to cover the expense of processing claims. In that respect, it is more like those "appliance service contracts" smart people never purchase than genuine insurance. Well said!! When insurance covers every minor expense, they all become major ones. Have a third party paying aids in hiding pricing, and reduces the consumers desire to shop around for the best prices and services.
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Post by Deleted on Nov 8, 2013 1:59:35 GMT -5
Medicare is rife with problems. Hospitals and clinics have shut down due to slowness of payments (Gundry Glass was killed this way, last psych hospital focusing on pediatrics, sore loss for Maryland). Doctors and hospitals are underpaid, and make it up by refusing Medicare patients, or overcharging others. Government does Medicare-- even moderately well would be stretching it- barely adequate only because it's not a monopoly would be a better descriptor. You haven't been close up and personal with Medicare (or any insurance company) when there's a secondary insurance involved with a large bill. The inevitable, "I'm not paying for this" comes at you from all directions. Bills can be tied up indefinitely in legal disputes. That's not Medicare's fault so much as the insurance biz being an ugly tank of sharks determined not to pay a dime for anything. Wouldn't want to bet on that would you? Daughter had knee surgery 6 months ago, BC & Tricare. BC paid their amount and Tricare paid the difference.... my expense probably less than 100 dollars. Similar experience with me further back, 2 heart caths and both shoulders reworked and I didn't get bankrupted. Right now Tricare is up in the air as one of those "substandard" policies, why not.... it's for retired military. Will the bastard phuck with it?... who knows at this point but if he does there will be about 20 MILLION pissed off vets that will fight again.
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Post by Deleted on Nov 8, 2013 8:18:52 GMT -5
It's not the millions that will get free insurance that really bother me-- the plan was designed to do that, something I already knew. Best for fiscal health of nation? Unlikely- but very little seems to be these days. The health care issue that has me more concerned- the millions that are losing insurance due to their membership in the working and middle classes. As premiums rise, and they qualify for little or no help, they are being priced out. Obamacare - turning potential care for all to care for the destitute at the expense of those that work and earn decent incomes.
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Post by leon on Nov 8, 2013 9:20:57 GMT -5
It's not the millions that will get free insurance that really bother me-- the plan was designed to do that, something I already knew. Best for fiscal health of nation? Unlikely- but very little seems to be these days. The health care issue that has me more concerned- the millions that are losing insurance due to their membership in the working and middle classes. As premiums rise, and they qualify for little or no help, they are being priced out. Obamacare - turning potential care for all to care for the destitute at the expense of those that work and earn decent incomes. Bingo! Pricing out the working folks...seems like a theme these days...
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Post by redleg on Nov 8, 2013 9:25:26 GMT -5
So, the same people (young & healthy) being swept into buying faux insurance will ALSO have to pony up to pay the debt. Man, what a sweet deal they're getting! At the risk of stating the obvious, the healthy keep insurance companies afloat. You can cast stones at the ACA from a number of directions but you either accept the premise of insurance or you don't. As for the young they will sort out the messes we make today as they always have. But given the obstructions the repubs placed in writing the ACA it's something of miracle that anything at all was settled on. I'm agnostic on the ACA but I'm willing to give it a chance because our existing medical/insurance practices and billing policies are a tangled mess. They were a tangled mess because the government was so deeply involved in them. Government told insurance companies what they would cover, what they could charge, and how much they had to have in reserve. And now you think that the Feds taking over all health insurance is going to fix any of that?
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Post by redleg on Nov 8, 2013 9:29:02 GMT -5
Well the premise of insurance is to share the "RISK", not the known costs, so what ACA does is take the risk out of the equation, it is now no longer insurance but a way to make those who are healthy pay for those who are not, but choice is not given but forced. Insurance should not cover things that we know will occur, regular doctors visits, dental cleanings, contraceptives.... or elective things like mammograms, and abortions regardless of if in the long run money is supposed to be saved. The young will figure out how not to pay as well. Then you go on to blame the pubs for how ACA was written, do you have a link? As far as I knew it appeared out of whole cloth immaculately, and was passed with no one reading it by dems only. Having the government do anything and expecting good results makes you not an agnostic, but a flaming optimist. Sharing the risk is code for the healthy paying your bills. Insurance is about creating a pool of money from which to draw the revenue to pay off bills. Hopefully you have more in the pot at the end of the month than not. Gov does medicare exceptionally well. Gov has insured we have the finest fighting force on the planet. You got to start somewhere. If the repubs don't like what they see they should have contributed more to the process than obstruction. In what universe does the Federal government do Medicare "exceptionally well"? They have cut payments to doctors and hospitals from 80% to 60% under Puppettax, they have doctors refusing Medicare patients more and more all the time, Medicare is still heading us ever faster towards bankruptcy.
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Post by redleg on Nov 8, 2013 9:32:44 GMT -5
Well the premise of insurance is to share the "RISK", not the known costs, so what ACA does is take the risk out of the equation, it is now no longer insurance but a way to make those who are healthy pay for those who are not, but choice is not given but forced. Insurance should not cover things that we know will occur, regular doctors visits, dental cleanings, contraceptives.... or elective things like mammograms, and abortions regardless of if in the long run money is supposed to be saved. The young will figure out how not to pay as well. Then you go on to blame the pubs for how ACA was written, do you have a link? As far as I knew it appeared out of whole cloth immaculately, and was passed with no one reading it by dems only. Having the government do anything and expecting good results makes you not an agnostic, but a flaming optimist. Sharing the risk is code for the healthy paying your bills. Insurance is about creating a pool of money from which to draw the revenue to pay off bills. Hopefully you have more in the pot at the end of the month than not. Gov does medicare exceptionally well. Gov has insured we have the finest fighting force on the planet. You got to start somewhere. If the repubs don't like what they see they should have contributed more to the process than obstruction. First, The Puppet is in the process of destroying the finest military the world has ever seen. He made sure that most of the sequester cuts hit the military, he's demanded that 80,000 be cut from the military, he's decided to put openly gay individuals in the military and women in combat MOS's, and he's purging the leadership of anyone that's not ideologically pure enough for his tastes. And the Repubs were told "either vote for what we give you, or shut up." They were locked out of all discussions, and the vote was held on Christmas Eve so no one would notice the abomination they were being saddled with.
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Post by Moses on Nov 8, 2013 10:11:05 GMT -5
Serfs and puppets! Oh my!
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Post by Ravenchamp on Nov 8, 2013 11:18:47 GMT -5
The whole plan is WRONG!
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Post by zenwalk on Nov 8, 2013 11:24:36 GMT -5
At the risk of stating the obvious, the healthy keep insurance companies afloat. You can cast stones at the ACA from a number of directions but you either accept the premise of insurance or you don't. As for the young they will sort out the messes we make today as they always have. But given the obstructions the repubs placed in writing the ACA it's something of miracle that anything at all was settled on. I'm agnostic on the ACA but I'm willing to give it a chance because our existing medical/insurance practices and billing policies are a tangled mess. I do accept the concept of insurance. I carry homeowner's insurance. I do understand that every year my house does not burn down, my premiums are used to reimburse people whose houses DID burn down. I carry liability car insurance. When we had small children and a mortgage, we carried life insurance--very happy that policy never had to be used! I sympathize with people who have to make insurance claims. The ACA is not insurance. One does not insure against 100% probabilities, nor does one insure against small losses. Why? Because the cost of the policy exceeds the cost/loss. I do not carry collision insurance on my 14-year-old car--over time, the cost of the insurance would exceed the cost of replacing the vehicle. The ACA requires insurers to pay for small expenses-- like pediatric dentistry. Remember, traditional health insurance has always covered oral surgery, so we're talking about routine, 100% probability here. Same goes for birth control pills and a routine gynecological exam-- again, a 100% probability. The extra paperwork involved in insuring for routine, low-cost, health-related activities must add to the base price for the service. Insurance is for protection against devastating losses. (Remember, it was invented by ship-owners who could be bankrupted by a singe storm or pirate attack. It wasn't used to pay for loading and unloading cargo, or to replace a rope chewed by a ship's rat.) What people need is "major medical" and "hospitalization." (I'm old enough to remember when in the vernacular, it was called "hospitalization", not "health insurance".) Anything else just raises the cost, for both the provider and the patient. It, also, encourages higher prices because "insurance will cover it." The ACA is all about "insurance will cover it." Therefore, insurance premiums must rise, and care costs must rise to cover the expense of processing claims. In that respect, it is more like those "appliance service contracts" smart people never purchase than genuine insurance. I think you are over examining my point. If you pay into the system every paycheck your expectations are that it covers your medical bills as they arise. 99 out of a 100 people would agree that's insurance. And if you are going in for something like open heart surgery the bill is likely a devastating loss if you are uninsured. It's off to file for medicaid for Grandma.
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Post by howarewegoingtopay on Nov 8, 2013 11:31:47 GMT -5
I do accept the concept of insurance. I carry homeowner's insurance. I do understand that every year my house does not burn down, my premiums are used to reimburse people whose houses DID burn down. I carry liability car insurance. When we had small children and a mortgage, we carried life insurance--very happy that policy never had to be used! I sympathize with people who have to make insurance claims. The ACA is not insurance. One does not insure against 100% probabilities, nor does one insure against small losses. Why? Because the cost of the policy exceeds the cost/loss. I do not carry collision insurance on my 14-year-old car--over time, the cost of the insurance would exceed the cost of replacing the vehicle. The ACA requires insurers to pay for small expenses-- like pediatric dentistry. Remember, traditional health insurance has always covered oral surgery, so we're talking about routine, 100% probability here. Same goes for birth control pills and a routine gynecological exam-- again, a 100% probability. The extra paperwork involved in insuring for routine, low-cost, health-related activities must add to the base price for the service. Insurance is for protection against devastating losses. (Remember, it was invented by ship-owners who could be bankrupted by a singe storm or pirate attack. It wasn't used to pay for loading and unloading cargo, or to replace a rope chewed by a ship's rat.) What people need is "major medical" and "hospitalization." (I'm old enough to remember when in the vernacular, it was called "hospitalization", not "health insurance".) Anything else just raises the cost, for both the provider and the patient. It, also, encourages higher prices because "insurance will cover it." The ACA is all about "insurance will cover it." Therefore, insurance premiums must rise, and care costs must rise to cover the expense of processing claims. In that respect, it is more like those "appliance service contracts" smart people never purchase than genuine insurance. I think you are over examining my point. If you pay into the system every paycheck your expectations are that it covers your medical bills as they arise. 99 out of a 100 people would agree that's insurance. And if you are going in for something like open heart surgery the bill is likely a devastating loss if you are uninsured. It's off to file for medicaid for Grandma. Just because you pay every month should not mean you are covered for optional, and personal choices, only major expenses, anything else isn't insurance but prepaid health care and that of course will cost a lot more than insurance by itself.
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Post by zenwalk on Nov 8, 2013 11:56:47 GMT -5
I'm not covered for everything now. Few are. This is just word games.
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Post by howarewegoingtopay on Nov 8, 2013 12:27:04 GMT -5
I'm not covered for everything now. Few are. This is just word games. Words have meaning, and when you distort the meaning of insurance then you are no longer talking about insurance.
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Post by zenwalk on Nov 8, 2013 13:17:43 GMT -5
Forking over your contribution out of every paycheck or directly out of your wallet is a distinction without a difference. One of us is missing something.
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Post by howarewegoingtopay on Nov 8, 2013 13:19:08 GMT -5
Forking over your contribution out of every paycheck or directly out of your wallet is a distinction without a difference. One of us is missing something. It does look like we aren't communicating doesn't it.
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Post by Deleted on Nov 8, 2013 13:56:28 GMT -5
I do accept the concept of insurance. I carry homeowner's insurance. I do understand that every year my house does not burn down, my premiums are used to reimburse people whose houses DID burn down. I carry liability car insurance. When we had small children and a mortgage, we carried life insurance--very happy that policy never had to be used! I sympathize with people who have to make insurance claims. The ACA is not insurance. One does not insure against 100% probabilities, nor does one insure against small losses. Why? Because the cost of the policy exceeds the cost/loss. I do not carry collision insurance on my 14-year-old car--over time, the cost of the insurance would exceed the cost of replacing the vehicle. The ACA requires insurers to pay for small expenses-- like pediatric dentistry. Remember, traditional health insurance has always covered oral surgery, so we're talking about routine, 100% probability here. Same goes for birth control pills and a routine gynecological exam-- again, a 100% probability. The extra paperwork involved in insuring for routine, low-cost, health-related activities must add to the base price for the service. Insurance is for protection against devastating losses. (Remember, it was invented by ship-owners who could be bankrupted by a singe storm or pirate attack. It wasn't used to pay for loading and unloading cargo, or to replace a rope chewed by a ship's rat.) What people need is "major medical" and "hospitalization." (I'm old enough to remember when in the vernacular, it was called "hospitalization", not "health insurance".) Anything else just raises the cost, for both the provider and the patient. It, also, encourages higher prices because "insurance will cover it." The ACA is all about "insurance will cover it." Therefore, insurance premiums must rise, and care costs must rise to cover the expense of processing claims. In that respect, it is more like those "appliance service contracts" smart people never purchase than genuine insurance. I think you are over examining my point. If you pay into the system every paycheck your expectations are that it covers your medical bills as they arise. 99 out of a 100 people would agree that's insurance. And if you are going in for something like open heart surgery the bill is likely a devastating loss if you are uninsured. It's off to file for medicaid for Grandma. . Doesn't work that way for any other type of insurance. Car, homeowners, life- it has to be major and catastrophic to be covered, no matter how much you pay.
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Post by redleg on Nov 9, 2013 13:15:05 GMT -5
So, the same people (young & healthy) being swept into buying faux insurance will ALSO have to pony up to pay the debt. Man, what a sweet deal they're getting! At the risk of stating the obvious, the healthy keep insurance companies afloat. You can cast stones at the ACA from a number of directions but you either accept the premise of insurance or you don't. As for the young they will sort out the messes we make today as they always have. But given the obstructions the repubs placed in writing the ACA it's something of miracle that anything at all was settled on. I'm agnostic on the ACA but I'm willing to give it a chance because our existing medical/insurance practices and billing policies are a tangled mess. The difference is, under real insurance, you had a choice. You could get a plan that covered you for what you needed. Now, there is no choice. You WILL pay for someone else's pregnancy coverage, mammograms, well baby checkups, drug addiction treatments, and anything else The Puppet or his Merry Marxists decide you should pay for. After all, if you have a job today, you are among the "fortunate", therefore you "owe" everyone else to support them.
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Post by Evil Yoda on Nov 9, 2013 16:20:37 GMT -5
At the risk of stating the obvious, the healthy keep insurance companies afloat. You can cast stones at the ACA from a number of directions but you either accept the premise of insurance or you don't. And the ACA... doesn't. Insurance is about shared risk. When you mandate that insurers cover existing conditions, regardless of previous insurance, that breaks the insurance model. Or, more precisely, replaces it with socialized medicine (defined here as "everyone pays, everyone's covered"). You might think that's a moral or social obligation, but what you can't call it is insurance.
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