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You'll still have to get health insurance no matter what Republicans do in Washington

The State House News Service reports the individual mandate - basically a requirement for people to get or buy health insurance - will remain in Massachusetts thanks to the 2006 Romneycare law.

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Turned out to be a massive transfer of money from the young and poor to the old and rich, enforced with the threat of liquidation.

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Are you talking about? Medicare, Medicaid, Social Security, Welfare, Housing, Food Stamps?

Im confused, but equally upset about the absurd amount of taxes i pay.

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Do you understand how insurance works?

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Get a law passed that citizens have to buy your product. Collect premiums, don't pay claims.

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So then are you on board with joining the rest of the free world and instituting a universal healthcare system where staying alive is no longer a product?

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Have whatever system. Just come down off the high horse.

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Bullshit for breakfast, lunch, and dinner.

How's the money laundering biz going there?

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Especially not physicians, nurses, medical technicians, and everyone else who provides healthcare services, medical devices, and everything else that makes up about 1/5th of our GDP.

"Universal healthcare" would either have to pay them the same or pay them less.

If government were to pay less (the way it does with medicaid and medicare reimbursement) the quality of service would suffer because those cost cuts would be passed on as salary cuts, disincentivizing people who now go through nearly a decade of very rigorous, time consuming, and low-paid training. Hospitals that have a majority of patients on medicaid tend to do less well than hospitals that don't. That's an empirical observation, not a political opinion.

If government were to pay them the same, then that's an enormous tax hike, an enormous growth in a centralized bureaucracy, and a lots of opportunity for corruption and cronyism in lucrative government contracts for centralized health care. Think Pentagon procurement scandals times five. Literally times five, because medicaid/medicare budgets are about the same size as the defense budget right now and putting everyone on it would be a roughly five-fold expansion.

We actually have an example of entirely government-run healthcare: the VA. VA staff make market rates (they have to, since the VA isn't the only game in town), but the quality of care is on average awful compared to private sector because everyone's a government employee and it's harder to fire bad actors.

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I always hear the argument that quality of care would suffer under a universal healthcare system, but is there any evidence of that? According to the WHO, the US currently ranks 37th in healthcare. All 36 countries ahead of us have some sort of national healthcare.
http://thepatientfactor.com/canadian-health-care-information/world-healt...

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No facts allowed! Reality is chanted talking points and memes repeated over and over and over!

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You're also being told again that you can't compare apples to oranges. America is not Europe, Japan, or Canada. We have a wider diversity of people, cultures, income levels, and environmental factors than many of the other countries on that list. We have more people that bring up our average and more people that bring it down.

Thing two is that quality of care does, in fact suffer. As in VA system.

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To be fair, the VA is also not an apples to apples comparison though for many reasons. One of which being that veterans are not a representative sample of the US population as a whole, which is similar to the argument you're making against comparing the US to other countries.

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But I would guess that things like wait times don't really depend on the socioeconomic class of the person doing the waiting and are more of a reflection of management practices of the organization and the competence with which it allocates resources to its patient population.

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Phoenix aside, VA wait times are pretty good. My roomate's girlfriend gets care at the JP VA and got processed into primary care with an appointment in about a month. I, a consumer of the vastly superior private system, switched my PCP recently and was offered an appointment in.... next July.

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Did you pull that right off a white supremacist website? The "we can't compare ourselves to Europe because we have more brown people" is an oldie.

OF COURSE we are going to compare ourselves to other countries. Living in an America only bubble is not going to help you understand anything.

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How about in the back of the vegetable drawer in your refrigerator? That dark corner of the closet where you can never really know what's there?

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We have you right here.

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What were you doing under there?

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VA care isn't awful at all

Overall, the available literature suggests that the care provided in the VA compares favorably to non-VA care systems, albeit with some caveats. Studies that used accepted process of care measures and intermediate outcome measures, such as control of blood pressure or
hemoglobin A1c, for quality measurements almost always found VA performed better than
non-VA comparison groups. Studies looking at risk-adjusted outcomes generally have found no
differences between VA and non-VA care, with some reports of better outcomes in VA and a few
reports of worse outcomes in VA, compared to non-VA care. The studies of processes of care are mostly those about medical conditions, while the studies of outcomes are mostly about surgical conditions.

Source:https://www.hsrd.research.va.gov/publications/esp/quality.pdf

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before.

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You are so superficial. If you read the link you would see that this wasn't the VA doing the rating or ranking.

Too hard for you.

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"Universal healthcare" would either have to pay them the same or pay them less.

Alternatively, you could largely cut out what we currently pay for:

  • Large billing staffs at medical practices and hospitals, to deal with coding procedures and pushing papers to a morass of different payers with different rules
  • Large processing staffs at multiple payers, to receive the paper pushed to them by medical practices and hospitals, and to verify that the rules have been complied with
  • Large executive ad managerial staffs at multiple payors.
  • Large marketing expenses paid by payors to attract customers
  • Large portions of HR departments at employers, whose sole job is to deal with health isurance
  • An entire ecosystem of companies that run a cat-and-mouse game: teach hospitals and doctors how to code for maximum reimbursement; teach insurers how to detect gaming the system; teach everyone how to rewrite the rules for their respective benefit.

A lot of what we pay for 'health care' doesn't actually go to health care at all. You could deliver a lot better health care for a lot less.

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I don't doubt any of this. Just don't tell me Massachusetts is smarter or better or morally superior because of this law. We just had the money and the people who would win by the law crushed the people who would lose by it. The system as it is perpetuates because it pays off to lots of rich people (finance, insurance, medical) who kick back to the politicians.

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Romneycare isn't Universal SINGLE PAYER healthcare.

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You can't be telling me with a straight face that replacing many private bureaucracies with one massive government-run bureaucracy won't invite more bloat and nonsense. "Compliance" costs money.

A centralized government-run monopoly will also still need to rely on private vendors unless you want the federal or state government to get into the medical device, medical testing, laundry service, and all the other businesses that make up the medical industry. That's a very big and tempting target for political corruption.

Put succinctly, the government will go with the lowest bid, but if the lowest bid is on a bridge to nowhere in Alaska, the taxpayer does not save money.

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Compare the percentage of total health dollars spent on administration in Canada vs in the USA.

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Since a government run single payer system isn't run for profit, they don't need to charge more than it costs them for the service.

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Hospitals that have a majority of patients on medicaid tend to do less well than hospitals that don't.

And that's entirely due to the payment structure of medicaid, and not at all due to the comorbidities and habits of those suffering from poverty, AMIRITE???

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How dare those old people need medical attention! Why can't they just pull up their bootstraps and become young again?

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So make young people with less money pay for them?

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Then it will be MINE MINE ME ME MINE!

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My solution has been to make young people productive enough that their jobs support good health care. That's not what the mandate does. It attacks the young at precisely the point when they should be investing in their own training and education.

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... that his fictitious business can't pay minimum wage.

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Not long ago you were complaining about minimum wage going too high and how nobody deserved to be paid that much.

Just pick up your money laundering operation and go galt already.

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At the end of the day, "Old people" and "young people" aren't two distinct groups; every young person who doesn't die prematurely, becomes an old person. And so an insurance plan that charges young, healthy people more than their care actually costs, and uses the surplus to charge older, sicker people less than their care actually costs, is not actually a net transfer from anybody to anybody else. The only person who loses out here is the person who dies young; throw in a generous life insurance benefit and you've equalized that.

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Normally, I would absolutely agree with you, and state that as a younger person I'm happy to support the older and sicker now with the understanding that system will be there for me later. EXCEPT that we've been seeing a push by a lot of old, waning boomers to take these entitlements away from the young people currently paying in. Everyone my age has been warned for years our pension funds, social security, and medicaid are going bankrupt and won't be there for us later, that we need to save privately and plan on not retiring because the wealth and success of our parents and grandparents was an anomaly, not a trend. So it sucks to be paying into one more thing that inevitably isn't going to actually be there when we do need it, later.

But hey I guess I should stop eating so much avocado toast and stop complaining.

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a way of life.

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many older people are not rich, BTW.

It is not a money transfer, it is that we all pay into the system to help provide health insurance coverage for the greater good.

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.

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Remember Romneycare, it was a plan designed for THIS state , which worked, didn't have OUTRAGEOUS pricing and unrealistic deductibles.

But them Obama destroyed it. The worst part is that uber-liberal lap dog Deval didn't fight to keep our state plan intact, instead he blew $1 BILLION on a website my kid could have designed.

Good times!

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The federal Health Connector website template our state uses now actually works well now; and it has much more dynamic and useful live info than the original site, such as whether your doctor and their hospital are in network for the plan you're shopping for.

Your kid couldn't have designed the original site either, despite the database interface flaws at the beginning. It was designed by Optum, the consulting/solutions arm of UnitedHealthcare.

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We have a functioning website. Stop the presses!

How does that negate the fact we wasted a F'n BILLION dollar on something a high school kid could have built. YES A TEEN!

Also im very familiar with database architecture as im related to one of the leading women in the field.

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And I'm related to Albert Einstein, so hear what I have to say about special relativity :eyeroll:

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I wish I could see how your wife reacts when she finds out you think a teen would be just as good at her job as she is.

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So that's how Optum was able to afford to put up a shiny new building near Fenway!

(j/k - I don't know how they afforded it. Optum is a bad data-gathering joke in the employer-insurance mix. For those who don't know, employers use Optum to collect biometric and other data on employees; you provide the data or your employer doesn't help with health insurance costs as much as they could. Here comes GATTACA.).

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Is there some Howie Carr message board that crowdsources dumb comments like this, and has all ten members come over and upvote them?

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Its funny how republicans act like they are the experts on healthcare when the healthiest states are blue(MA is #1) and the least healthiest states are all red. Its like a morbidly obese person telling The Rock he doesn't know how to work out.

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Health has nothing to do with political view, but everything to do with income.

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The poor in MA are way healthier than the poor in Shitholian Redstatistan.

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Sources please on your groundbreaking “red states/ Blue states” metrics..and obliquely, the Rock is “juiced to the gills.” So, yay, he may know how to work out but he is a FAKE.

House of cards...

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I'm not him, but here you go:
https://assets.americashealthrankings.org/app/uplo...

Healthiest States:
1. Massachusetts
2. Hawaii
3. Vermont
4. Utah
5. Connecticut
6. Minnesota
7. Colorado
8. New Hampshire
9. Washington
10. New York

Least Healthy States:
41. Georgia
42. Kentucky
43. Oklahoma
44. South Carolina
45. Tennessee
46. West Virginia
47. Alabama
48. Arkansas
49. Louisiana
50. Mississippi

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Red state mortality.

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Why would you need that to be sourced? Are you seriously trying to tell us you thought Alabama and Arkansas were gonna top the list and Massachusetts would be way at the bottom? I call BS..

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Enroll by December 23 for January 1 coverage, or by January 23 for February 1 coverage.

(In most other states, open enrollment now ends this Friday, December 15.)

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