Gerry

The Tao or Taoism? I would say that the Tao that exists existed before consciousness existed in the universe. Perhaps it was from farting apes in Africa.

After sitting around I thought your question would work better for the other long post about Medicare/Public option. The bulleted points about parts A, B and D and secondary insurance were simple Google searches: "cost medicare part a/b/d premium" then coping what popped up in the "box". I know I went to this site for part b https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

Brian it is HC costs! There will always be a big red flag.

I think it is France where there are co-pay, upfront service costs, paid at the time of the medical service. However the nonprofit insurance Company has to pay back those fees in a narrow time window. [i think under 10 days] It would be easy enough have them returned on a sliding scale related to your gross income. My crazy ass brother that "earns" about $15k gets back $20 of the $25 co-pay for his doctor visit. I get back $1 from my co-pay. A child's visit has 100% return. Maybe you add a "you got to stop living in your doctor's office" fine and after my 8th visit in a month I get a co-pay bill for an additional $10/visit that month. "Everyone want to get HC for free. Somebody has to pay for it!" In France when they do not return the co-pays on time, the company gets fined.

Brian, I just killed a 1000 word RE to you explaining what was still missing from that post, and my pointer on my HYPER sensitive touch pad floated over a link to whothefuckknowswhat. POOFF! it was all gone. I'll do it again later. I will re-say what my wife likes to say, "Everyone thinks they should get HC for free. Well it has to be paid for some how!"

Those were my words, my daughter. I still need to read, then read again, the paper in Brian's post. When I wrote "I have not read in depth Brian's link just scanned it for now. From the article"" I was referring to the link Brian posted. It is an article on the rate of bankruptcy and the "real" effects of medical expenses on bankruptcy. I still need to read, then read again, the paper in Brian's post. Edit adjustment: In my original posting I did use the quote button to quote a single line from Brian's link. This is Brian's link

As an advocate for an American UHC system, I too am not a fan of the ACA. It was rat sausage made by rat politicians. The worst of those rats were the democratic rats that worked against making the ACA better. What is interesting is this "deductibles increasing dramatically and insurance increasing by %100 100% wasn't enough" argument is not generally true. There are segments of the insured population for which it is more true than not. Those segments of the insured population are the ones sold out by the rat [fuck] politicians. These concerns could have been avoided. These concerns can still be worked on. Insurance companies that make even one cent of federal money in the health care domain should be mandated to provide coverage in the exchanges in all states in which they do any business be that public or private. All health care insurance providers should be mandated by law to be converted into non-profits or be compelled to cease business. A public option should be established with Medicare as the design. Individual cost would not be uniform across this domain with the variable premiums determined by factors such as gross income. There should be no "in network" or "out of network" structures. Participation in this should be voluntary and premiums for these services should be progressive and based on a fixed maximum percentage of an individuals gross income. If you choose not to be part of the Public option, you could buy private HC insurance. You could opt to be uninsured, but more conversation would be needed about this choice. To be clear about Medicare as it exists today. MEDICARE IS NOT FREE HC! One needs to recognize that Medicare as structured now is not free HC. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $413. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $227. There are co-pays/deductibles too. The standard Part B premium amount in 2017 is $134 (or higher depending on your income). However, most people who get Social Security benefits pay less than this amount. This is because the Part B premium increased more than the cost-of-living increase for 2017 Social Security benefits. If you pay your Part B premium through your monthly Social Security benefit, you’ll pay less ($109 on average). Social Security will tell you the exact amount you'll pay for Part B in 2017. (My wife and I each pay $402.00 per quarter for part-B. Part B only pays 80% of the cost of services. Many participants in Part B also buy secondary insurance to cover this "hole". Often those secondary plans cover the Part D expences. Part D premiums range from $10-$100 per month (depending on the plans available in your area and on the partiular plan you choose). The maximum deductible—the amount you must pay out-of-pocket before Medicare will contribute to your prescription costs—in 2017 is $400. So what could be done? You could start by making these premiums higher or lower by an adjustable set of metrics. In so doing you create a public option with adjustable premiums. Those in the highest gross income categories would be "means tested" out of the public option at the point that an individual private policy became more cost effective. No one need be compelled to use the Public Option, but everyone would be be able to buy into it. I would eliminate Medicaid, VA, CHIP, Native American Affairs HC administrations. Just one administration for the one public option. Some of the former Medicaid clients could "buy in" but their cost might be near to zero. {However I would rather that every user pay some amount based on their gross income.} In addition to this public option, private policies sold by the non-profit insurance market should be roughly competitive. The coverage in both Private and Public plans should be uniform, cover the same basic fixed set of items, but the private insurers might offer coverage for things not on the basic list. These private non-profit HC insurers would of course be allowed to pair for profit product such and home, auto, and life insurance with their plans. [see France for limits on payment of services to providers.] Deductibles schedules would be standard with out-of-pocket limits set by one's Gross income. Like wise for co-pays for Dr. visits and Rx costs. This might be another area for the for profit policies to compete on. One company might reduce deductibles as an incentive. The public option would be managed by private insurance companies, mostly the same companies, and they too might offer incentives to enhance the list of standard coverage as an enticement to have you as a customer. Related though not actually part of a HC system is the absolute need to enhance the tax burden of the top 20% + of gross income households. Most of this, and why the 20% target mentioned, is the removing of the cap on taxable income for the SS fund. It is capped now at approximately $125,000. All gross income must be included. After that the minimum tax rates on the top 5% of gross income need to be enhanced. On the top 1% it needs to be significantly adjusted. And then on the top 0.5% of gross incomes it needs to be just plain painful.

Not true. https://www.usconstitution.net/consttop_slav.html

"god" help me... I'm still here. I have not read in depth Brian's link just scanned it for now. From the article" This does not say here that prior to medical indebtedness, that trouble paying bills was commonly a household issue and that was already placing these households at the edge of needing bankruptcy protections. Secondly the implication, as I read this, is some people who live on the margin, our working poor, struggle with finances. However these households while in debt are not households entering bankruptcy. What it is clearly saying, as I read this, is if you have an economically challenged household, medical debt will escalate [instantly?] your situation to the point of needing bankruptcy protections. What I also read is a pejorative suggestion that these households were already no better than dead beats by their nature. For a unskilled household to struggle with bills is not an indication of a fundamental character flaw. To personalize this... My daughter and her husband while working 80+ hours a week earn just above what 70% of households earn. The husband is employed through a temp agency which renders him vulnerable to intermittent layoffs. He does this because these temp jobs pay 150% to 200% of the pay for typical unskilled labor. These "typical unskilled" jobs are easy to get, but they also do not assure a 40 hour work week. His skill, an Art major, is an area that is hard to find full time employment. When he is between placements they struggle and might fit into the papers pejorative suggestions, that is their household is tending toward dead beat status. It is fortunate their health care is provided for by her employer. Their household is in the 70th percentile of American house holds. If my daughter lost her position, and depending on the insurance she might secure, their household's ability to pay their medical costs could force them into a very weakened situation. Going from the working poor to an impoverished household is a thin line. If in the worst of all circumstances medical bills pushed their total indebtedness to the point of needing bankruptcy protections, the cause of the bankruptcy would be medical costs even given the associated other economic stresses.

Again IMNHO, and I believe a demonstrative truth, in America you are more likely to die [or live] because of your access to medical services based on your economic status. That is, you find the personal cost of HC driving Americans away from HC services. The ACA moved us away from this truth. I do not see a transition back to a market place HC system as improving HC services for most American. I am convinced that the 60% plus of American households earning less that $50,000 per year will feel this pain the most.

Please do not say that the cause of medical bankruptcies is related to the increase in governments involvement in medical costs. However, this is an American issue that should shame us all into the most reasonable solution, UHC. Now this is my POV, and I am sure that you do not agree. But what difference does this make. We both know that there will never be anything like UHC in America. For the moment, that post with all the graph, and my inability to scale them, have left me a bit frustrated and I am worn down by the "he said.... She said" nature of the debate. So I am going to be on the side line for a while. I hope I can stick with this choice.

MarbleHead, For me this chapter is I believe culture and language, both current and ancient, gets between me and some translations. As to the "Shamanic beliefs", I must bracket them off too.

We are born. We live. We die.

Can anyone tell me if it is possible to scale graphs/images in this software. Since I need a url, and I cannot just upload size adjusted images, Even I could careless about my last post.

Search: indigent healthcare in Massachusetts What do I get is the medicaid requirements. This does not have anything to do with the uninsured. Ok: found this list Where do these facilities get their funding. Also found this I notice the geographic spread. I also found this This is why MA has such a low number of uninsured. My tax dollar at work. look at this And this This for me shows the problem most clearly [i could not post the chart. I do not know how to manage scale of posted graphs] Also consider

Not that this makes my argument, and not that it covers the full ACA period. Also not the best quality. Look at 200 - 2003; The percent arguments about Bush-2 probably reflect that. I have not stored the articles about this on my hard drive, and I might be willing to search for that later. What should be of interest is the data from 2009 - 2012 [source]

34% under ACA.

A different topic.... One thing that the founding fathers should have set into the original Constitution.. Automatic Con-cons every 50 years. Con-cons with no previously elected official participation. Then the resultant adjustment to the documents should be put to the people in a vote. Election with each change voted on like a referendum. A nation wide election and 50% of the national vote wins the day on any point. If you served as a representative to the con-con you could never be eligible for any elected post [national or local] for life.

Really? You expect that dog to be a winner? Pre-ACA under the free market efficiencies of the insurance companies rate of medical cost were rising 80% plus. Those fee market forces create hundreds of policies with loop holes the Ins. Co. could deny services, limit coverage, place life time limits on coverage. The only thing that improved under that system was the CEO compensation packages. Any one who thinks that is the way to go should be .....

Actually tht is not how this works. "A man without insurance walked into an ER..... Or was in a car crash ... or had a heart attack .... or had stage 4 cancer that had not been diagnosed....." Such people get, and got, billed in full What did they do? They defaulted on their obligations, and most likely ended up in bankruptcy. Their economic status is irrevocably destroyed. How did/do the hospitals deal with this? They pass the cost onto the insured patients by increasing the cost of services. It is the insured having to pay for the uninsured. You know, $5.000 asprins.... I would like to see any program where the "cost is adjusted according to one's ability to pay". That this was not true before the ACA, with insurance companies driving up the total costs of HC to both the society and the individual, is why the ACA made some sense. Under Bush 2 those increase were reaching into the 80% per year category.

Well, maybe. I think if you talk to Brits they love their HC system until they talk about it a bit. When they dig down into the weeds, I think they are not as happy. Ten years ago we sailed from England to Boston and made the acquaintance of a british couple who were in their late 60's. [That is my age now.] I heard "we love it but..." in different ways, but the big thing even then was how "the new comers", the immigrants were getting the same perks as true Brits.

Of course that is not going to work for them because the EU is not the strong central force DC is in America. It is the damnable Constitution we have. We need to be rid of it Brian and form an EU style of localized governance is regional authorities. Are you with me brother?

No that is not true, well I guess mostly not true. I'm sure about Germany and France, their system is as properly called private as it is governmental. The payments flow through government. I am certain if I would call that the management of the care services are implemented via private non-profit insurance companies. Medicare is more of a "run by the federal government" establishment than the UHC in those countries. There are however vast differences in many aspects of their HC implementations that would not work in America without a complete overhaul. They incomes of doctors is a whole different thing "over there" What I believe is wrong in what you said is how they implement their HC delivery system.

Can you look at the German and French system which is managed by private insurance companies in accordance with State laws? The "central government starts deciding who gets which treatment" is a straw dog. I am more fearful of insurance companies making HC choice for me as a means to the end, their profit margin.

Who thinks the British NHS is the model to be emulated?