OT: The next President of the United States: ★★★ Donald Trump ★★★

[cocktailswith_2short]

So here's a good example of politifact's awesome work:




I'm really glad that this was deemed "mostly false." Can you imagine the horror if health insurance premiums increased? Oh, what's that you say, the magical subsidies will make it all better?

The affordable care act has cost me over $1,200 each of the past 2 years (still do not agree that this new tax is constitutional, but that's probably too far in the weeds for this forum). This is still cheaper than insurance would've cost, but for those of you getting free health-care....you're welcome. And no, I will not vote for more of this no matter how naughty the other candidate is.

you're confused. THE GROWTH RATE OF COST OF MEDICAL CARE/PREMIUMS HAS NOT INCREASED UNDER OBAMACARE. in fact, up until this year, the growth rate had slowed (which isn't saying much). when people suggested that obamacare was helping to slow down premium increases in past years, i noted that there was very little in the way of cost control in it. same goes for the big increase scheduled for next year - has little to do with obamacare. obamacare is primarily a health insurance subsidy along with some long overdue changes to guarantee very basic protections for those covered - ability to get healthcare with preexisting conditions, which has saved countless lives, elimination of scam low cost plans that provided next to nothing, etc.

i had multiple 50% or more increases in my insurance premiums before obamacare. i had one after obamacare as well. the medical device companies and the pharmaceutical industry are taking you for a ride. THEY are gouging you. and the rest of us as well. it's been ramping up for decades now. because our congress is bought off. nothing has changed. until we get single payer health insurance (which every progressive would love and every conservative would hate) like every other goddamn civilized nation on earth, the american middle class will continue to shrink. it's been going on for far too long and there's no end in sight. huge profits being made from people being sick

medicare for all. it's the only humane solution. our health results as a nation will greatly increase, the cost of health care will greatly decrease. it's a no brainer

peoples LIVES have been literally saved by obamacare. and the number of medical bankruptcies is plummeting. people complaining that it doesn't address cost as well are way out of line. it's not designed for that. a public option would have done it. republicans and "blue dog" democrats made sure that didn't get into the bill. blame them. they wanted to maintain status quo for their financial backers. to the detriment of almost all americans. mission accomplished

The ACA was passed when Dems had majorities in the House, the Senate, and the Presidency. You cannot pretend that they had to compromise on this bill - exactly zero republicans voted in favor. So they were able to go all in with their strategy to improve healthcare. Now, of course it would be unfair to expect perfection, but as leaders, they are accountable for the state of healthcare. We've had years to judge their ideas to fix the healthcare mess, and the results have not been so wonderful.

It's also telling that even while trying to defend ACA, you pitch a better solution (single payer). So which is it, ACA is great, or it needs to be replaced? You can try to believe both, but it's disingenuous. If we move towards single payer, can we as a nation at least have an honest debate about it?

From my personal perspective, the ACA penalty has cost me almost 2,500 over the last 2 years and will cost another 1,200 or 1,300 in April. Nobody from my family has been to any doctor in that time (besides well-being visits). Good luck winning over people that would rather have the freedom to choose.

That's right . Truth bomb to the dome . But hey dice and duck ....You keep on cucking in the free world !

[League Circles]

until we get single payer health insurance (which every progressive would love and every conservative would hate) like every other goddamn civilized nation on earth

I wish people would stop using this offensive language.

I've noticed that a lot of people dismiss any countries that don't have certain policies as being uncivilized or not advanced.

Most countries don't have single payer health care. Are they all uncivilized?

FWIW I'd support a single payer plan, but I don't like the dismissal of people and countries who don't jump on board.

[johnnyvann840]

Wow. Premiums for Obamacare in AZ to go up an average of 116%.

[coldfish]

So here's a good example of politifact's awesome work:




I'm really glad that this was deemed "mostly false." Can you imagine the horror if health insurance premiums increased? Oh, what's that you say, the magical subsidies will make it all better?

The affordable care act has cost me over $1,200 each of the past 2 years (still do not agree that this new tax is constitutional, but that's probably too far in the weeds for this forum). This is still cheaper than insurance would've cost, but for those of you getting free health-care....you're welcome. And no, I will not vote for more of this no matter how naughty the other candidate is.

you're confused. THE GROWTH RATE OF COST OF MEDICAL CARE/PREMIUMS HAS NOT INCREASED UNDER OBAMACARE. in fact, up until this year, the growth rate had slowed (which isn't saying much). when people suggested that obamacare was helping to slow down premium increases in past years, i noted that there was very little in the way of cost control in it. same goes for the big increase scheduled for next year - has little to do with obamacare. obamacare is primarily a health insurance subsidy along with some long overdue changes to guarantee very basic protections for those covered - ability to get healthcare with preexisting conditions, which has saved countless lives, elimination of scam low cost plans that provided next to nothing, etc.

i had multiple 50% or more increases in my insurance premiums before obamacare. i had one after obamacare as well. the medical device companies and the pharmaceutical industry are taking you for a ride. THEY are gouging you. and the rest of us as well. it's been ramping up for decades now. because our congress is bought off. nothing has changed. until we get single payer health insurance (which every progressive would love and every conservative would hate) like every other goddamn civilized nation on earth, the american middle class will continue to shrink. it's been going on for far too long and there's no end in sight. huge profits being made from people being sick

medicare for all. it's the only humane solution. our health results as a nation will greatly increase, the cost of health care will greatly decrease. it's a no brainer

peoples LIVES have been literally saved by obamacare. and the number of medical bankruptcies is plummeting. people complaining that it doesn't address cost as well are way out of line. it's not designed for that. a public option would have done it. republicans and "blue dog" democrats made sure that didn't get into the bill. blame them. they wanted to maintain status quo for their financial backers. to the detriment of almost all americans. mission accomplished

IMO its a lot more complicated than that:
- Personally, I'm glad that some people have been helped. I really don't want a system where people suffer and die if it can be avoided.
- With that said, you can do stupid ass things like banning vehicles and say that it saved lives while ignoring the negatives
- Medical equipment companies, doctors and pharmaceutical companies don't make that much money as a net profit margin. This is important to remember for other points here. The US spends $3T a year on health care. The total profits of all insurance companies, medical instrument makers, big pharma, etc. only adds up to 10's of billions and that's for the entire globe. If you remove all profit you barely scratch costs.
- Universal health care in other western countries is subsidized by the US. We pay for drug development. We pay for the democratic world's defense. Guys like Trump and Sanders are right that our trade treaties suck and countries like Canada and western europe are among the beneficiaries. All of that frees up money for other first world nations to pay for entitlements. If we take on universal health care, who will subsidize us?
- The reality of any single payer system is subject to how it goes through congress. Given that our political system is broken, I have little hope that the reality would match any theoretical. Special interests would kill the effort on page 12,785 of the bill.
- The biggest issue with our system is cost. As I noted above, big pharma and other corporations aren't taking that big of a slice. There are two factors in this. Bureaucracy costs (which are huge) and end of life costs. Any effort to fix our health care system has to remove the legion of people involved with the documentation and billing of our system. Single payer only does that if it is extremely simple and straightforward.
- The VA sucks. Really sucks. Its a special case but its a scary reminder of what government run health care would look like.

Personally, I wish that "government option" was on the table. Make an entirely self funded system that is a subset of medicare. Then get rid of all of the regulations that create our massive health care bureaucracy and let the government option compete with the private system.

Single payer is a bridge too far, IMHO. I don't see any way that the reality of it would match the theory. Too much politics, special interests and global economic issues to work through.

Oh, and the AMA sucks. Any effort to fix health care should involve executing the SOB's in charge of our MD programs. Doctors shouldn't be hundreds of thousands of dollars in debt after working for years as a near unpaid intern.

[the ultimates]

So here's a good example of politifact's awesome work:




I'm really glad that this was deemed "mostly false." Can you imagine the horror if health insurance premiums increased? Oh, what's that you say, the magical subsidies will make it all better?

The affordable care act has cost me over $1,200 each of the past 2 years (still do not agree that this new tax is constitutional, but that's probably too far in the weeds for this forum). This is still cheaper than insurance would've cost, but for those of you getting free health-care....you're welcome. And no, I will not vote for more of this no matter how naughty the other candidate is.

you're confused. THE GROWTH RATE OF COST OF MEDICAL CARE/PREMIUMS HAS NOT INCREASED UNDER OBAMACARE. in fact, up until this year, the growth rate had slowed (which isn't saying much). when people suggested that obamacare was helping to slow down premium increases in past years, i noted that there was very little in the way of cost control in it. same goes for the big increase scheduled for next year - has little to do with obamacare. obamacare is primarily a health insurance subsidy along with some long overdue changes to guarantee very basic protections for those covered - ability to get healthcare with preexisting conditions, which has saved countless lives, elimination of scam low cost plans that provided next to nothing, etc.

i had multiple 50% or more increases in my insurance premiums before obamacare. i had one after obamacare as well. the medical device companies and the pharmaceutical industry are taking you for a ride. THEY are gouging you. and the rest of us as well. it's been ramping up for decades now. because our congress is bought off. nothing has changed. until we get single payer health insurance (which every progressive would love and every conservative would hate) like every other goddamn civilized nation on earth, the american middle class will continue to shrink. it's been going on for far too long and there's no end in sight. huge profits being made from people being sick

medicare for all. it's the only humane solution. our health results as a nation will greatly increase, the cost of health care will greatly decrease. it's a no brainer

peoples LIVES have been literally saved by obamacare. and the number of medical bankruptcies is plummeting. people complaining that it doesn't address cost as well are way out of line. it's not designed for that. a public option would have done it. republicans and "blue dog" democrats made sure that didn't get into the bill. blame them. they wanted to maintain status quo for their financial backers. to the detriment of almost all americans. mission accomplished

IMO its a lot more complicated than that:
- Personally, I'm glad that some people have been helped. I really don't want a system where people suffer and die if it can be avoided.
- With that said, you can do stupid ass things like banning vehicles and say that it saved lives while ignoring the negatives
- Medical equipment companies, doctors and pharmaceutical companies don't make that much money as a net profit margin. This is important to remember for other points here. The US spends $3T a year on health care. The total profits of all insurance companies, medical instrument makers, big pharma, etc. only adds up to 10's of billions and that's for the entire globe. If you remove all profit you barely scratch costs.
- Universal health care in other western countries is subsidized by the US. We pay for drug development. We pay for the democratic world's defense. Guys like Trump and Sanders are right that our trade treaties suck and countries like Canada and western europe are among the beneficiaries. All of that frees up money for other first world nations to pay for entitlements. If we take on universal health care, who will subsidize us?
- The reality of any single payer system is subject to how it goes through congress. Given that our political system is broken, I have little hope that the reality would match any theoretical. Special interests would kill the effort on page 12,785 of the bill.
- The biggest issue with our system is cost. As I noted above, big pharma and other corporations aren't taking that big of a slice. There are two factors in this. Bureaucracy costs (which are huge) and end of life costs. Any effort to fix our health care system has to remove the legion of people involved with the documentation and billing of our system. Single payer only does that if it is extremely simple and straightforward.
- The VA sucks. Really sucks. Its a special case but its a scary reminder of what government run health care would look like.

Personally, I wish that "government option" was on the table. Make an entirely self funded system that is a subset of medicare. Then get rid of all of the regulations that create our massive health care bureaucracy and let the government option compete with the private system.

Single payer is a bridge too far, IMHO. I don't see any way that the reality of it would match the theory. Too much politics, special interests and global economic issues to work through.

Oh, and the AMA sucks. Any effort to fix health care should involve executing the SOB's in charge of our MD programs. Doctors shouldn't be hundreds of thousands of dollars in debt after working for years as a near unpaid intern.

Drug companies are some of the most profitable in the world. The United States is certainly getting price gouged but i'ts not because of trade deals and treaties. When other countries went to a single payer or heavily subsidized healthcare they didn't give up the negotiating power on things such as drug pricing. It one of the biggest holes in the AMA and in Medicare. Changing treaties or trade deals isn't going to stop Shrekli or the company Mylan from raising prices.

[League Circles]

Just a thought but perhaps the discrepancy over whether drug companies make big profits or not is obscured by stock prices vs dividends paid. Operating revenue vs expenditures is not necessarily a good way to measure profitability if that's what's being done.

Because of the insanity of our tax system, it is common for profits to be hidden by stock price. See Apple for example.

[Mech Engineer]

What we feel as normal people is this...

1. Doctors make way too much money in this country. Some of the elite deserve it but an average doctor makes too much money for treating common medical problems even covering for their mal-practice insurance.

2. Insurance/Pharmaceutical companies are too much in the politicians pockets. They are unable to balance the service aspect with profits. They cannot be run like Amazon or Walmart. We honestly are struggling to find a balance where most can agree.

3. There is no simple solution and no wonder there is no solution. Obamacare is a start but it is unfortunate that didn't think of all these obvious problems/solutions.

[League Circles]

What we feel as normal people is this...

1. Doctors make way too much money in this country. Some of the elite deserve it but an average doctor makes too much money for treating common medical problems even covering for their mal-practice insurance.

Personally, I disagree with this. I'm not sure what the popular sentiment is. Being a doctor basically requires being on your true A game for about 12 years until you can get paid. Remove the high reward and you simply won't see enough people become doctors, especially non specialists.

2. Insurance/Pharmaceutical companies are too much in the politicians pockets. They are unable to balance the service aspect with profits. They cannot be run like Amazon or Walmart. We honestly are struggling to find a balance where most can agree.

Yeah this is truly an ethical dilemma. It's hard to ask private companies to serve the public and their shareholders simultaneously. IMO we should either buy all the pharmaceutical companies and make drug creation and production a public utility, or we should just accept that what we are offered for drugs will be based first and foremost on what is most profitable to pharma companies.

[coldfish]

Drug companies are some of the most profitable in the world. The United States is certainly getting price gouged but i'ts not because of trade deals and treaties. When other countries went to a single payer or heavily subsidized healthcare they didn't give up the negotiating power on things such as drug pricing. It one of the biggest holes in the AMA and in Medicare. Changing treaties or trade deals isn't going to stop Shrekli or the company Mylan from raising prices.

Pfizer $7B profit on $49B sales
https://finance.yahoo.com/quote/pfe/financials?ltr=1

Merck $4.5B in profit on $40B sales
https://finance.yahoo.com/quote/MRK/financials?p=MRK

10-15% net profit margins are nice but really aren't breaking our healthcare system.

Apple making $53B on $233B in sales is pretty good. ~20%
https://finance.yahoo.com/quote/AAPL/financials?p=AAPL

Microsoft $16B profit on $85B in sales ~20%
https://finance.yahoo.com/quote/MSFT/financials?p=MSFT

and the hot one, Mylan
https://finance.yahoo.com/quote/MYL/financials?p=MYL

0.85B profit on 9.5B in sales. They actually have the lowest profit margin on this list but the media never tells you that. Yes, the big, bad epi pen manufacturer everyone hates has a 9% net profit margin.

......

Drug companies have incredible gross profit margins. That's what everyone pays attention to. However, they have a government mandated legion of people they have to pay with that money.

The US pays significantly more than the rest of the world for drugs. Why this is and where the money is going is econ 101 type stuff. Drug companies have high fixed costs, due to the government. Since their variable costs are super low, every extra pill they can sell goes right to the bottom line. However, if they don't get enough revenue to cover their fixed costs, they go out of business. The US covers those fixed costs with our absurd pharma bills.

If you want to bring down US drug costs but continue to get drug development, you have to get other nations to pay more. When you do, countries like Canada's health care system aren't going to look quite as good. Drug companies just don't make enough money to be able to afford significant US revenue reductions without getting more revenue from somewhere else.

[burlydee]

So here's a good example of politifact's awesome work:




I'm really glad that this was deemed "mostly false." Can you imagine the horror if health insurance premiums increased? Oh, what's that you say, the magical subsidies will make it all better?

The affordable care act has cost me over $1,200 each of the past 2 years (still do not agree that this new tax is constitutional, but that's probably too far in the weeds for this forum). This is still cheaper than insurance would've cost, but for those of you getting free health-care....you're welcome. And no, I will not vote for more of this no matter how naughty the other candidate is.

you're confused. THE GROWTH RATE OF COST OF MEDICAL CARE/PREMIUMS HAS NOT INCREASED UNDER OBAMACARE. in fact, up until this year, the growth rate had slowed (which isn't saying much). when people suggested that obamacare was helping to slow down premium increases in past years, i noted that there was very little in the way of cost control in it. same goes for the big increase scheduled for next year - has little to do with obamacare. obamacare is primarily a health insurance subsidy along with some long overdue changes to guarantee very basic protections for those covered - ability to get healthcare with preexisting conditions, which has saved countless lives, elimination of scam low cost plans that provided next to nothing, etc.

i had multiple 50% or more increases in my insurance premiums before obamacare. i had one after obamacare as well. the medical device companies and the pharmaceutical industry are taking you for a ride. THEY are gouging you. and the rest of us as well. it's been ramping up for decades now. because our congress is bought off. nothing has changed. until we get single payer health insurance (which every progressive would love and every conservative would hate) like every other goddamn civilized nation on earth, the american middle class will continue to shrink. it's been going on for far too long and there's no end in sight. huge profits being made from people being sick

medicare for all. it's the only humane solution. our health results as a nation will greatly increase, the cost of health care will greatly decrease. it's a no brainer

peoples LIVES have been literally saved by obamacare. and the number of medical bankruptcies is plummeting. people complaining that it doesn't address cost as well are way out of line. it's not designed for that. a public option would have done it. republicans and "blue dog" democrats made sure that didn't get into the bill. blame them. they wanted to maintain status quo for their financial backers. to the detriment of almost all americans. mission accomplished

The ACA was passed when Dems had majorities in the House, the Senate, and the Presidency. You cannot pretend that they had to compromise on this bill - exactly zero republicans voted in favor. So they were able to go all in with their strategy to improve healthcare. Now, of course it would be unfair to expect perfection, but as leaders, they are accountable for the state of healthcare. We've had years to judge their ideas to fix the healthcare mess, and the results have not been so wonderful.

It's also telling that even while trying to defend ACA, you pitch a better solution (single payer). So which is it, ACA is great, or it needs to be replaced? You can try to believe both, but it's disingenuous. If we move towards single payer, can we as a nation at least have an honest debate about it?

From my personal perspective, the ACA penalty has cost me almost 2,500 over the last 2 years and will cost another 1,200 or 1,300 in April. Nobody from my family has been to any doctor in that time (besides well-being visits). Good luck winning over people that would rather have the freedom to choose.

If you have health insurance, why are you paying a penalty?

[Axl Rose]

You're right. But the issue I have is it presupposes that there is Trump support based solely on him being anti-establishment. That's not what it is. It's because these people absolutely LOVE what he says. He has given their hatred a mainstream voice after years of being told their prejudices are no longer publicly acceptable. And he is loved for it.

Almost no one who votes Trump will do so as a protest.

stereotyping a group of people are we?

[League Circles]

I think the political climate is ripe for an anti-establishment candidate, and that could be a positive. I think that's where a lot of the push back arises from the more reasonable anti-Clinton people in this thread.

However, Donald Trump is the worst vessel I can imagine for such a movement. I would argue that anyone who genuinely wants to dislodge the establishment/elite interest should support Clinton because 4 years of her is preferable to Donald Trump being your champion.

You're right. But the issue I have is it presupposes that there is Trump support based solely on him being anti-establishment. That's not what it is. It's because these people absolutely LOVE what he says. He has given their hatred a mainstream voice after years of being told their prejudices are no longer publicly acceptable. And he is loved for it.

Almost no one who votes Trump will do so as a protest.

To what extent you're correct I don't know. There are of course plenty of people who, for whatever reason, are more focused on issues like taxes, trade deals, etc, as opposed to finding an acceptable outlet for their own alleged hatred.

I do know this, though. You think it's important to identify such people and dismiss them with your various stereotypes. You've been doing it very consistently in this thread.

FWIW, I would argue very strongly that such attitudes as yours entrench people in whatever beliefs they may have. If they hated before, they really hate once they are called haters.

I just think we could make so much more progress without that type of dismissal, warranted or not. It's just not pragmatic to frame people that way IMO.

I'm voting for Clinton, but just consider that it may be more helpful to the world to be more agreeable than to be more correct. Just a thought.

[coldfish]

Just a thought but perhaps the discrepancy over whether drug companies make big profits or not is obscured by stock prices vs dividends paid. Operating revenue vs expenditures is not necessarily a good way to measure profitability if that's what's being done.

Because of the insanity of our tax system, it is common for profits to be hidden by stock price. See Apple for example.

On the other side of the coin, you have uneducated media types citing things like "they charge $800 for an injection it costs them $50 to make!!!!"

While technically true, everyone has much better gross margins than net margins. While financials can certainly be manipulated, public companies have incentives to inflate their profit and margins so that it boosts their stock price and the CEO's get bonuses. These financials are a much better read on what is going on that the typical moronic gross profit margin analysis.

[the ultimates]

Drug companies are some of the most profitable in the world. The United States is certainly getting price gouged but i'ts not because of trade deals and treaties. When other countries went to a single payer or heavily subsidized healthcare they didn't give up the negotiating power on things such as drug pricing. It one of the biggest holes in the AMA and in Medicare. Changing treaties or trade deals isn't going to stop Shrekli or the company Mylan from raising prices.

Pfizer $7B profit on $49B sales
https://finance.yahoo.com/quote/pfe/financials?ltr=1

Merck $4.5B in profit on $40B sales
https://finance.yahoo.com/quote/MRK/financials?p=MRK

10-15% net profit margins are nice but really aren't breaking our healthcare system.

Apple making $53B on $233B in sales is pretty good. ~20%
https://finance.yahoo.com/quote/AAPL/financials?p=AAPL

Microsoft $16B profit on $85B in sales ~20%
https://finance.yahoo.com/quote/MSFT/financials?p=MSFT

and the hot one, Mylan
https://finance.yahoo.com/quote/MYL/financials?p=MYL

0.85B profit on 9.5B in sales. They actually have the lowest profit margin on this list but the media never tells you that. Yes, the big, bad epi pen manufacturer everyone hates has a 9% net profit margin.

......

Drug companies have incredible gross profit margins. That's what everyone pays attention to. However, they have a government mandated legion of people they have to pay with that money.

The US pays significantly more than the rest of the world for drugs. Why this is and where the money is going is econ 101 type stuff. Drug companies have high fixed costs, due to the government. Since their variable costs are super low, every extra pill they can sell goes right to the bottom line. However, if they don't get enough revenue to cover their fixed costs, they go out of business. The US covers those fixed costs with our absurd pharma bills.

If you want to bring down US drug costs but continue to get drug development, you have to get other nations to pay more. When you do, countries like Canada's health care system aren't going to look quite as good. Drug companies just don't make enough money to be able to afford significant US revenue reductions without getting more revenue from somewhere else.

Again those companies are still making money and very profitable. Those same companies go to the media and say they aren't making any money and they just have to raise prices. Then they use the same argument your making, because we have to charge less around the world we have to make it up by gouging you. Lets look at Mylan again by the way. The price of epinephrine hasn't skyrocketed its still cheap. Mylan has owned the company that makes the auto injector thus they own the ip for awhile. When the CEO went in front of Congress and then talked to the media nothing was said about the price going because of the drug itself or the manufacturing process for the injector becoming more expensive. They had a monopoly on the market and used it. A company doesn't have the right to price gouge and entire country or health system looking for Apple like margins.

[Bascitball]

you're confused. THE GROWTH RATE OF COST OF MEDICAL CARE/PREMIUMS HAS NOT INCREASED UNDER OBAMACARE. in fact, up until this year, the growth rate had slowed (which isn't saying much). when people suggested that obamacare was helping to slow down premium increases in past years, i noted that there was very little in the way of cost control in it. same goes for the big increase scheduled for next year - has little to do with obamacare. obamacare is primarily a health insurance subsidy along with some long overdue changes to guarantee very basic protections for those covered - ability to get healthcare with preexisting conditions, which has saved countless lives, elimination of scam low cost plans that provided next to nothing, etc.

i had multiple 50% or more increases in my insurance premiums before obamacare. i had one after obamacare as well. the medical device companies and the pharmaceutical industry are taking you for a ride. THEY are gouging you. and the rest of us as well. it's been ramping up for decades now. because our congress is bought off. nothing has changed. until we get single payer health insurance (which every progressive would love and every conservative would hate) like every other goddamn civilized nation on earth, the american middle class will continue to shrink. it's been going on for far too long and there's no end in sight. huge profits being made from people being sick

medicare for all. it's the only humane solution. our health results as a nation will greatly increase, the cost of health care will greatly decrease. it's a no brainer

peoples LIVES have been literally saved by obamacare. and the number of medical bankruptcies is plummeting. people complaining that it doesn't address cost as well are way out of line. it's not designed for that. a public option would have done it. republicans and "blue dog" democrats made sure that didn't get into the bill. blame them. they wanted to maintain status quo for their financial backers. to the detriment of almost all americans. mission accomplished

The ACA was passed when Dems had majorities in the House, the Senate, and the Presidency. You cannot pretend that they had to compromise on this bill - exactly zero republicans voted in favor. So they were able to go all in with their strategy to improve healthcare. Now, of course it would be unfair to expect perfection, but as leaders, they are accountable for the state of healthcare. We've had years to judge their ideas to fix the healthcare mess, and the results have not been so wonderful.

It's also telling that even while trying to defend ACA, you pitch a better solution (single payer). So which is it, ACA is great, or it needs to be replaced? You can try to believe both, but it's disingenuous. If we move towards single payer, can we as a nation at least have an honest debate about it?

From my personal perspective, the ACA penalty has cost me almost 2,500 over the last 2 years and will cost another 1,200 or 1,300 in April. Nobody from my family has been to any doctor in that time (besides well-being visits). Good luck winning over people that would rather have the freedom to choose.

If you have health insurance, why are you paying a penalty?

TLDR version: I've decided to pay cash for my healthcare needs and save on premiums and deductibles. The details are below if you care to read.

I explained in a previous post - I choose not to have insurance. Let's look back at how this has worked out so far over 3 years.
With no insurance: Out of pocket total including ACA penalty and well-being visits was around $3,800.
Purchasing insurance: It would have cost at least $7,500 per year - so $22,500 over the same 3 years.

So I have invested the difference of $18,700 into savings that will grow (hopefully) and be useful later (for healthcare, emergencies, or retirement if I'm especially lucky). If this money was invested in a personal healthcare savings account that avoids all taxes (all pre-tax - so avoids FICA, Fed, and State tax), it would be all the better.

Saving this amount each year (difference between premium and actual out of pocket costs) would total $273,000 in 20 years (invested at 7% annual rate of return). So if a healthy person invested their premiums from age 26 to 46 - they'd have somewhere around a quarter million dollars saved to fund their own healthcare into their 50's and 60's. If you saved your premiums each year for 30 years - you'd have $630,000 saved by age 56. (note: obviously this is not a good strategy for those with known issues or high risks)

Keep in mind that something like the first $5,000 in medial expenses per year is out of pocket in the bronze plan (the plan covers $0). So a fairly healthy couple with under $5,000 per year in expenses will have a $630,000 nest egg advantage over a couple that chose to pay for insurance. And then they can purchase insurance at age 56 to cover the risk when it's likely to be needed. This strategy is completely legal right now. (Also note, if the government went to a plan like this, I would not have an ACA penalty and could save another 1,200 or so per year - so the nest egg would be even larger).

It's a calculated risk to be sure. It also illustrates some of the flaws in the system. There are many variables, but this is how the calculations look in my situation. I've studied this in a very detailed way - for my situation, not yours or the general public's.

[TheSuzerain]

That's all well and good until you have a moderately serious health issue and go bankrupt.

[League Circles]

That's all well and good until you have a moderately serious health issue and go bankrupt.

Perhaps the alternative is going broke from paying for the insurance?

[burlydee]

The ACA was passed when Dems had majorities in the House, the Senate, and the Presidency. You cannot pretend that they had to compromise on this bill - exactly zero republicans voted in favor. So they were able to go all in with their strategy to improve healthcare. Now, of course it would be unfair to expect perfection, but as leaders, they are accountable for the state of healthcare. We've had years to judge their ideas to fix the healthcare mess, and the results have not been so wonderful.

It's also telling that even while trying to defend ACA, you pitch a better solution (single payer). So which is it, ACA is great, or it needs to be replaced? You can try to believe both, but it's disingenuous. If we move towards single payer, can we as a nation at least have an honest debate about it?

From my personal perspective, the ACA penalty has cost me almost 2,500 over the last 2 years and will cost another 1,200 or 1,300 in April. Nobody from my family has been to any doctor in that time (besides well-being visits). Good luck winning over people that would rather have the freedom to choose.

If you have health insurance, why are you paying a penalty?

TLDR version: I've decided to pay cash for my healthcare needs and save on premiums and deductibles. The details are below if you care to read.

I explained in a previous post - I choose not to have insurance. Let's look back at how this has worked out so far over 3 years.
With no insurance: Out of pocket total including ACA penalty and well-being visits was around $3,800.
Purchasing insurance: It would have cost at least $7,500 per year - so $22,500 over the same 3 years.

So I have invested the difference of $18,700 into savings that will grow (hopefully) and be useful later (for healthcare, emergencies, or retirement if I'm especially lucky). If this money was invested in a personal healthcare savings account that avoids all taxes (all pre-tax - so avoids FICA, Fed, and State tax), it would be all the better.

Saving this amount each year (difference between premium and actual out of pocket costs) would total $273,000 in 20 years (invested at 7% annual rate of return). So if a healthy person invested their premiums from age 26 to 46 - they'd have somewhere around a quarter million dollars saved to fund their own healthcare into their 50's and 60's. If you saved your premiums each year for 30 years - you'd have $630,000 saved by age 56. (note: obviously this is not a good strategy for those with known issues or high risks)

Keep in mind that something like the first $5,000 in medial expenses per year is out of pocket in the bronze plan (the plan covers $0). So a fairly healthy couple with under $5,000 per year in expenses will have a $630,000 nest egg advantage over a couple that chose to pay for insurance. And then they can purchase insurance at age 56 to cover the risk when it's likely to be needed. This strategy is completely legal right now. (Also note, if the government went to a plan like this, I would not have an ACA penalty and could save another 1,200 or so per year - so the nest egg would be even larger).

It's a calculated risk to be sure. It also illustrates some of the flaws in the system. There are many variables, but this is how the calculations look in my situation. I've studied this in a very detailed way - for my situation, not yours or the general public's.

I appreciate your explanation. I think you reasoning does not make sense for multiple reasons. You're obviously not a woman who may give child birth. You don't sound like you have children, but god forbid they need braces, or they fall and break their arm. God forbid you get pneumonia. The cost of going to the emergency room and the subsequent doctor visits and medication would knock you on your ass. Your entire plan is 100% based on great health for 20 to 30 years, not just for you, but everyone in your family. Under this rationale, why buy any insurance? Godspeed my friend.

[Bascitball]

That's all well and good until you have a moderately serious health issue and go bankrupt.

Ding, Ding, Ding. We have a winner. That's another beautiful part of the plan. IF something serious comes up before age 56 , simply go bankrupt. Don't forget you have savings of $6,200 per year plus interest for all the years leading up to the health issue. It grows fast, so it would have to be pretty expensive to cause bankruptcy (which isn't all that bad anyway - you keep your house, cars, and most investments). Also, the odds of going bankrupt from job loss go up considerably when you don't have savings (which are hard to accumulate when you're paying $8,000 per year on premiums). Job loss is more likely than expensive medical - so I'm actually less likely to go bankrupt by saving money than buying bad health coverage.

Like I stated: It's a calculated risk. And I'll add that bankruptcy is the last resort backup plan. However, none of my grandparents or parents had any serious medical costs before age 56.

When all risks and options are calculated into the plan - it's almost impossible to come out worse than paying for these ridiculously bad healthcare plans. SO PAYING FOR THESE PLANS IS THE WORST OPTION ON THE TABLE.

[League Circles]

I appreciate your explanation. I think you reasoning does not make sense for multiple reasons. You're obviously not a woman who may give child birth. You don't sound like you have children, but god forbid they need braces, or they fall and break their arm. God forbid you get pneumonia. The cost of going to the emergency room and the subsequent doctor visits and medication would knock you on your ass. Your entire plan is 100% based on great health for 20 to 30 years, not just for you, but everyone in your family. Under this rationale, why buy any insurance? Godspeed my friend.

If he's not a woman, wouldn't that make it make sense? I mean, he clearly said it was reasoning for him, not for others or society at large.

His plan can be changed at any time (or any year at least). So far, he's coming out ahead. He won the calculated risk. It's as simple as that.

Is there any level of cost that would make avoiding it and taking a risk seem appropriate in your eyes?