TrumpCare: gameing the system.

Discussion in 'Politics, Religion, Social Issues' started by PracticalMac, Mar 13, 2017.

  1. PracticalMac macrumors 68030

    PracticalMac

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    #1
    It sounds like it would be easy to game the system as proposed.

    Plan details here and here.

    One key aspect is 63 continuous days of coverage to avoid the 30% fine/fee (that what it is, really).
    It does not seem that hard to not have insurance for 60 days, be on, then off again. Sure there may be only 1 open enrollment period, but someone always finds a way around, like not pay for the last 2 months of insurance (but in emergency jump back on?)

    Then the 30% for 1 year, that is basically the price of 4 months of coverage. That is not that great a fine, and younger people would very likely not have insurance, even if it will cost them 1/5 a retired person ("Would let insurers charge older customers five times as much. That’s intended to draw more younger — and healthier — people into the individual insurance market.").

    No preexisting conditions will easily allow people to go in and out of coverage, and there is little the insurance could do to keep people in.

    There is no requirement for any business to offer insurance for employees, and if insurance can charge 5x more for older people then there is every incentive to kick older employees people out.
    PLUS financial support seem with the employee, not company, so companies would do better giving the employee a little extra money and no health care.

    This bill looks like it has too many loopholes.


    Obamacare was modeled after RomneyCare that had 2 years of operation and was producing results.
    TRyanCare is un-tested ideas.
     
  2. A.Goldberg macrumors 68000

    A.Goldberg

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    #2
    I don't see this plan working out well.

    The fundamental basis of health insurance (or any insurance) is that the healthy individuals pay for the sick individuals. I presume a large part of that is younger, healthier individuals paying in. If everyone avoids buying insurance until they are sick it undermines the entire system.

    The main premise behind Obamacare was to give uninsured people access to preventative healthcare, thus decreasing catastrophic care expenditures. While that didn't exactly turn out to be the case, I think that can probably be attributed to other factors such as the opportunity cost of treating the previously untreated and the exponentially rising costs of fundamental healthcare goods and services.
     
  3. juanm macrumors 65816

    juanm

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    #3
    Well, duh. Trump himself recently admitted -literally- that he had no idea healthcare was so complicated, and he has filled his cabinet with conflicts of interest.
     
  4. PracticalMac thread starter macrumors 68030

    PracticalMac

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    #4
    Not quite correct:
    Insurance is a safety deposit that if, if someone has major loss or injury there is money "in the bank" to cover the loss.
    The Mandate is much like Social Security, paying in now in anticipation of retiring in future.

    In the short term for the new law, yes, the healthy pay for for sick, but over years the healthy will have deposited for their own health care (if the premium is accurately charged)
     
  5. poloponies macrumors 68030

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    #5
    That's accurate for social security but not for health insurance. In health insurance it's 100% about maintaining a balance of customers across all demographics every year so that there are enough young, healthy people paying premiums in to support the group that uses healthcare services. There's no "paying in for the future" component to medical insurance (in fact, it's unlikely that most people will maintain coverage with the same company with any consistency).
     
  6. oneMadRssn macrumors 68040

    oneMadRssn

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    #6
    The thing about insurance is that it's a gamble.

    You are saying, I bet you $500 the this thing won't happen to me. The insurance company responds, I'll take that bet, and if you win, I'll pay the cost of this thing up to $1,000,000. That's basically how home-owners or car-insurance works. You're betting you won't have a house fire or a car accident, and the insurance company is betting that you will. It works because the events we're betting on are relatively rare. Most houses don't burn down, and most cars aren't ever in an accident.

    The whole thing sort of falls apart when the thing being bet on is nearly a 100% certainty. A house is most likely not going to burn down and a car is most likely not going to be in an accident, but every person will one day experience poor health or injury. Only in super rare cases of instantaneous death are there no medical services rendered.

    So health insurance is a misnomer, it's not really insurance but more of a spreading around of the cost and risk among the population. If it is treated like this, it really isn't such a stretch to say yes it should be mandatory.
     
  7. A.Goldberg, Mar 15, 2017
    Last edited: Mar 15, 2017

    A.Goldberg macrumors 68000

    A.Goldberg

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    #7
    Well, in reality it's a combination of the two concepts considering how expensive just a week in the hospital costs or even a chronic health condition. Working in a hospital I know people in their young twenties who utilized over $200,000 within a year, that's certainly more than they paid in and when they're dead at 24 they won't be repaying that. Obviously the goal is to get the person well so they can continue to pay into the system and not utilize significant resources. Your comment assumes the person pays into the same insurance for an extended period of time. I think dental and vision insurance are a better example of forced savings accounts.

    Whichever way you cut it, if you fail to pay into the system, there is no money to adequately treat yourself or others.

    If someone in their twenties only requires a couple doctors visits and a prescription or two year (call it $500 out of pocket), if they get cancer at 35 and buy insurance I'm not sure a 30% surcharge will make up the difference.
     
  8. jkcerda Suspended

    jkcerda

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    #8
    thank thor Trump won, people have a choice thanks to him :D
     
  9. HEK macrumors 68030

    HEK

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    #9
    What is so f.....ing hard. Everyone pays, everyone gets health care. Screw the insurance companies. This is not rocket science. Every other civilized nation has universal health care. Do we really have to cater to the few billionare insurance company executives.

    This is absolutely rediculous. Give Bernie the mandate to fix it and in 30 days we will all have health care. Lot's of pissed off rich people, but so what. The rest of us outnumber them 100 to 1.

    We can reasonably assume the person in Tennessee dying of cancer that can't get stem cell bone marrow replacement and is going bankrupt won't mind if a few insurance companies go belly up.
     
  10. Zenithal macrumors 68040

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    #10
    Catestrophic accidents aside, most people won't experience health problems until they reach their wrinklies period. Currently, there is little work done on preventative care. Millions of people under 30 YOA are in poor health, even if they look fine on the outside. The young always pay in for the old. That's how a spread cost works. Insurance and taxes are essentially a pay it forward method.

    It'd be simple to have a hybrid system. Universal healthcare for those who want it, done through taxes, and the ability to purchase your own insurance and forgo the universal healthcare.

    That way people who don't trust the "gubbiment" so-called "death panels" and "multi year wait times (BS)" can purchase their own insurance.
     
  11. HEK macrumors 68030

    HEK

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    #11
    Makes sense. Everyone gets medicare from birth to death. Everyone pays taxes to support it. No hospital or doctor can exclude medicare. And anyone who wants it can pay out of pocket or buy insurance on top of medicare.

    See how simple this can be. Health care for every american, as a right. And we all chip in so none of us have to suffer bankrupcy to stay alive. Rich will scream bloody murder. But so what they murdering people now with let em die if they can't pay programs. I have far greater chance to die from health related problem and poor insurance coverage than i do from being attacked by foreign nation because we have one less carrier group.

    Let's put the dollars where the need is, not where it makes military industrial complex richer.
     
  12. Zenithal macrumors 68040

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    #12
    I've invested in defense companies so I can't quite agree with you, but it is a system that can be done. Question is whether or not politicians would take to it, or rather what their masters, the insurance companies, will say.
     
  13. Alrescha macrumors 68020

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    #13
    This cannot work, because some people are too poor to pay and rather than let people have something for nothing Republicans would rather they just die. Democrats on the other hand would happily pay.

    Desperate people will steal to feed and house their loved ones. Republicans would put these people in jail rather than feed and house them themselves - even though it would cost less to do that than sending them to jail. That is how these people think.

    The great irony is that many of these people call themselves Christians. If there is a god, these folks are going burn, burn, burn.

    A.
     
  14. Zenithal macrumors 68040

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    #14
    These are the same poor Rs that get money for other social reasons because they've fallen on hard times?
     
  15. HEK macrumors 68030

    HEK

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    #15
    God is another way to put off what people need to do. Punishment in some afterlife may give slight comfort, but doesn't solve anything.

    The country as a whole is the richest in the world. If other poorer countries can provide universal health care, so can the US. Sure poor will not be able to pay, that's why the rich need to chip in way more. They won't do it voluntarily. They will have to be forced by the much larger majority.

    At present the government is under the firm control of the richest one half of one percent. This could change but would require a real democracy of the people. Currently we have the democracy of the rich. And wholesale removal of current politicians is required.

    The propoganda will be fierce, as the rich will spend billions to retain control. We can have a revolution of the electorate. It is possible. The alternative as history repeatably shows is a more bloddy revolution. People will only take so much, at some point they break. Kings, Czars, Dictators, have found this out the hard way.

    The current ruling elite have been much smarter in providing just enough to keep the masses somewhat content and working like good little worker bees. Distraction, reduced education, inducing battles between each other have so far been successful. The fact that this effort id now globalized, makes it more difficult for the masses to overcome.

    Have no illusion that this battle will ever have a final victory, where we care for and about each other more equally. Greed is a strong motivating factor that no form of government has yet to overcome. The fathers of our government made a valiant and to date the most succesful attempt. However greed is once again winning out.

    We have the mechanism to alter this course. As elections have not yet been banned by the rich. A great many attempts have been successfully made to mitigate any populace effort at equity andfair distribution of what should be considered every person's right. Like clean air, clean water, health care, freedom from government survelance, etc

    So while i see the climb as steep, i am not resigned to as you put it "this cannot work".

    If i recall correctly, believe Seatle proved that by housing the homeless, helping them back on their feet, less money was spent. Than by locking them up or shipping them elswhere. Amazing how when we legislate some compassion, that things can actually improve. Social Security, Medicare, GI Bill, to name a few.
     
  16. oneMadRssn macrumors 68040

    oneMadRssn

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    #16
    Yes, I would love that system. Also, supplemental insurance can be an option in the hybrid system. Afraid of long wait times - get extra insurance to visit private clinics that guarantee no wait times ever for routine stuff, and fall back on the government healthcare for the really complicated and life-threatening stuff.
     
  17. PracticalMac thread starter macrumors 68030

    PracticalMac

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    #17
    Yes, but a 20-Y-O with $200,000 bill is rare, less than 0.01%? Then there is a chance he will recover enough to pay back most of not all.

    For sure with Preexist Cond, a 30% fee to join in when cancer is discovered is nothing, it will bankrupt the industry.
     
  18. ibookg409 Suspended

    ibookg409

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    #18
    I just called all the offices of my states senators and congressmen and told them to come to macrumors all the answers to the healthcare issue are right here. :rolleyes:
     

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