US Health Care Plan

Anybody have the scoop on this.. as in...
1) We (US citizens) will be forced to buy private health insurance? We can not opt out of this unconstitutional legislation?
2) If 1) is true than will a policy in another country (eg Thailand) satisfy this requirement? Since Cigna and UNH etc will not be benefiting the US Corp government may not accept your BUPA policy

My tax dollars go to the military industrial complex, bankers, corp farmers, etc etc, instead of free health care, and now they want to force me to pay more to an insurance company that's primary goal is to pay out as little as possible by whatever means possible. I am getting closer and closer to renouncing

Where did you get your information that has you so up tight?

There are currently two versions. There is a Senate version and a House version. The bills need to be merged together in committee. Both the House and Senate will have to vote again. The House, first, and then the Senate. If the bill's language changes in either vote with amendments, etc. It will have to go through that same process again, so this is far from done.

As of now, there is a mandate that all Americans be covered with health insurance. If you currently have insurance provided by your employer, you will be taxed on it. If that policy does not meet the government's standards, whatever those are, you will have to increase your coverage or be fined. If you refuse the fine, you will be jailed. You must prove your insurance coverage every year in your income tax return. The IRS will be charged with enforcing the health insurance mandate.

If you fall within a certain income level, the government will give you someone else's money to pay for your insurance.

There is also a tax on medical and health-related devices like wheel chairs, pace makers, prosthetic limbs, etc. These taxes, of course will be passed on to the citizens.

If the health insurance mandate passes in the final bill, I'm sure that there is a line of lawyers already assembled to challenge the constitutionality of forcing Americans to purchase a product (health care insurance). There is nothing currently in the US Constitution that allows for this. Some members of Congress claim that it is the same as being forced to buy auto insurance, but driving a car is a privilege, not a right.

It is unclear as to whether or not expats will have to purchase insurance, but I would bet that in order to escape it that you not have a US address and provide proof of residency in another country. That should be simple enough, but the Congress may want to extract another pound of flesh out of you in another way.

Most members of Congress do not even know what's in the bill. They didn't write it, and they didn't read it before voting on it. This was a good old fashioned cram down while one party still has the voting majority.

Thanks for enlightening me WBU ALUM... so my "up tight"-edness is not totally unfounded it seems.

rjj04 wrote:Thanks for enlightening me WBU ALUM... so my "up tight"-edness is not totally unfounded it seems.

No, you are correct to be concerned. I am very concerned about how it limits our freedoms and liberty.

Yes, The USA Health Care system is a disaster that continues to get more expensive with every passing day & bill. It has nothing to do with Health or Care & everything to do with cash.
Until a President & the Houses have the guts & honor to think more about the Health of its citizens & less about campaign contributions this travesty will continue.
I find much to be admired in the USA, sadly Health Care is excluded from that list.
As an European I find it totally puzzling that the citizens of a third world neighbour like Cuba have a greater life expectancy than the USA and yet many Americans refuse to believe that there is not something fundamentally flawed with the current system.

We're all so self absorbed that we can't see the forest for the trees.

From my experience Americans receive much, and actually believe, of their news from CNN, FOX, and the like. These media outlets are controlled by a very few corporations. So, Americans are really ignorant of the health care systems in other developed nations, and believe what the "tele" tells them. Most of what they are told through the mainstream media is skewed information (biased data) and thus they believe that their system is the best in the world. Ignorance is no excuse but at least it is not evil. Another way to look at it is not flattering in my opinion, and that is that some Americans may feel that one persons life is really more valuable than another persons life. Nobody will admit that, but in practice, that is is part of what is happening now.

If the US were to carbon copy the Canadian (or whichever system elsewhere that seems to provide the best service and contain costs best), and pay for it with current tax receipts (and similar direct payments from citizens into the system as in Canada), rather than other things the government pays for now, I would not be particularly opposed to it. But as it stands now (from what seems to be coming down the line) I will pay total taxes (Fed, state, local/prop) at a similar rate as somebody in Canada and then on top of it I will be FORCED by a government to pay for PRIVATE health insurance. What a joke this will be.

I understand that the cost per citizen of health care in Canada is nearly half what it is in USA.
That is taking raw data. So amount spent in the country on all health care (both private & public) divided by the number of citizens. The Canadian system is universal (all citizens covered) where as the American system is not (some of which the current bill/s are suppose to address). From that my conclusion would be that the actual cost to someone who does pay in USA is considerably more than double that paid by by their Canadian counterpart.
I would be interested to hear Khun Tilo's views on the Canadian system, as I have no personal experience of it...

rjj04 wrote:Another way to look at it is not flattering in my opinion, and that is that some Americans may feel that one persons life is really more valuable than another persons life. Nobody will admit that, but in practice, that is is part of what is happening now.

I think many Americans don't want government to decide which American's lives are worth saving and which aren't. Much like the government has recently decided whose mortgages are paid by the government, who gets loans to go to college, which auto makers and banks get bailouts, etc. The government is not supposed to decide these things in free enterprise.

rather than other things the government pays for now, I would not be particularly opposed to it. But as it stands now (from what seems to be coming down the line) I will pay total taxes (Fed, state, local/prop) at a similar rate as somebody in Canada and then on top of it I will be FORCED by a government to pay for PRIVATE health insurance. What a joke this will be.

I don't want the government to carbon copy anything that goes on elsewhere because I hear complaints and praises from everywhere else. I want this government to take the time to come up with a plan for America that is based on free enterprise and democracy and that will benefit those without health care without burdening those who already have it, like what they have and pay into the system!

If they got rid of welfare and food stamps to pay for health care, I would not be opposed to it. I'm tired of paying for other people. I know people personally who lie on their govt forms, don't work, and live off of my money. People like them are everywhere in America. I'm tired of footing the bill due to fraud and abuse.

Health care, the economy and free enterprise all rolled up into one. Government involvement in free enterprise props up failing businesses and discourages the hard-working businesses because they are now competing with that failing business and the government. That's just part of what is discussed in this video.

A free market works when the government is not controlled by money interests. A free market health care system might work in the USA if say the AMA didn't lobby the Senate to actually prevent more medical schools from forming. I once knew a Doctor from China who had practiced there successfully for many years (in gynecology) but in the USA she could get into the system because of accreditation practices. Why is it that in most countries around the world an engineer makes more in salary then an MD, but in the USA, the opposite is true? Engineers do not have a lobby in DC but the AMA has one, and it is very powerful. Unfortunately the fact is that the government in the USA is controlled, primarily through the Senate, by money interests. Those interests get the government to set up barriers to competition or subsidization for themselves. So, most civilized countries, having decided that the life of individual citizens is not just a matter of competition, took control away from free markets (not entirely) when it comes to health care. It is called having compassion for others. In such a Christian country as the USA, you would think that compassion for others would be at the top of their priorities, but apparently abortion is far higher (oh that is another story) Free markets are not the solution to all the worlds problems. Disabled people for instance, or would we just let natural selection have its way? America needs to get a dose of compassion injected into it and learn from EVERY OTHER DEVELOPED country in the world!!! America is not always right, as has been shown time and time again as of late.

I have paid far far more than my share of taxes in my lifetime, and gotten almost nothing back from my government for doing so, I am not and never have been, one of those freeloaders you are referring to. When I was working 18 hour days, seven days a week, without holidays, I was wondering at the time, why am I bothering since more and more as a percentage of my money was going to the government for somebody else to take as food stamps and the like. What did I get from it? So, it is not like I am sympathetic to the government taking more of my money.

I went to a clinic last night and saw a Doctor in 30 seconds after my entrance. Total cost with medicine was 200 baht. Why in heavens name is medicine more available and affordable in Thailand and almost every country in the world than the USA? It is time to rethink the whole system I think. Almost all countries have a two tiered system where there is always some basic government backed medicine available to ANY citizen, but for a price you can get "better" care if you want it. There is no such option in the USA (for anyone under the Medicare age) and that is just Darwinism on steroids.

In practice anyone can get medical care in the US. They go to an emergency room at any hospital that receives federal money, which is almost all. These hospitals are required to provide care regardless of the ability to pay. If they are poor or don't have insurance they get treated and never pay the bill.

Most of the patients in emergency rooms are there because they have deferred medical care to the point that they are in need of urgent care. They have done this because they can not afford the care, but it has gotten so bad they have to do something.

Individual doctors and clinical practices are not required to provide care as hospitals are.

To recover the costs of treating these patients who can't pay, the hospitals raise the price of their services so that they can make enough money to stay in business. Consequently, the bills for patients with money and/or insurance are inflated to cover that upaid care. This inflates the cost of insurance coverage for the businesses and individuals who have it. As these costs continue to inflate fewer people have health insurance and more people are unable to pay their hospital bills and the cycle continues.

This is not the only problem with our system, but it is a significant one. So in practice, those with health insurance are subsidizing the cost of hospital care for the indigent. The worst position to be in is to need medical care and have money, but no insurance. The largest single source of bankruptcies in the US is for medical care.

Medical care here, in a developing country, is vastly superior in price and convenience to the US for routine care. Emergency care has not been well developed here, yet.

Some, like myself, can not see the reasoning that we should give a huge percentage of the nation's economy over to the government to run. Their history and failure at running Social Security, Medicare, Medicaid, the Postal Service, AMTRAC, FreddieMac, FannieMae, or any other program boggles the mind. The recent "Nightmare on Wall Street" has proven they're totally unable to police and protect the public's money. And now we're supposed to trust them? We're talking about people that vote themselves raises in the middle of the night while people are losing homes, jobs, and living on the street. Oh Hell No!

I'm afraid some of you have rose-colored view of health care in Thailand,,,,, it's great if you're an expat and live so far above the average Thai's standard. Any treatment seems possible,, everything seems cheap.

There are also huge numbers of people in the US that are wealthy and don't want or need insurance, they're self-insured. They are part of the "millions" mentioned as "poor uninsured Americans". The new laws will penalise them for being successful and independent.

LoongLee wrote:Some, like myself, can not see the reasoning that we should give a huge percentage of the nation's economy over to the government to run. Their history and failure at running Social Security, Medicare, Medicaid, the Postal Service, AMTRAC, FreddieMac, FannieMae, or any other program boggles the mind. The recent "Nightmare on Wall Street" has proven they're totally unable to police and protect the public's money. And now we're supposed to trust them? We're talking about people that vote themselves raises in the middle of the night while people are losing homes, jobs, and living on the street. Oh Hell No!

I'm afraid some of you have rose-colored view of health care in Thailand,,,,, it's great if you're an expat and live so far above the average Thai's standard. Any treatment seems possible,, everything seems cheap.

There are also huge numbers of people in the US that are wealthy and don't want or need insurance, they're self-insured. They are part of the "millions" mentioned as "poor uninsured Americans". The new laws will penalise them for being successful and independent.

The Canadian system provides public coverage with private delivery. It doesn't actually operate the delivery of health care. The US government spends 50% more ALREADY on health care per capita than does Canada. I do share your doubt about the Federal governments ability to "run" anything more than a deficit. But actually "running" the operations is not really in the cards. I would hope that even with the Federal governments ineptitude it can't mess up too much if it just copied another system and did not actually run the important bits. If other countries can control costs and have universal coverage why can't the USA? I don't have an answer, for sure, but I think that from what seems to be coming in this health care plan, it will only get worse instead of better. We have a system that is much more "free market" now, and that seems to be far less efficient that the Canadian system. On another thread there has been criticism of the Canadian system (facilities that would seem to want no business rather than public insurance business), so it certainly is not perfect.

I can't believe that the utter mess that is coming down the line will make things better. No way! In fact I will hazard a guess that if the system is tweaked now, the efficiency will actually go DOWN ten years hence instead of going up. I'd put a bet on that if I could!!

It is also unconstitutional to force a citizen to pay an insurance company for health insurance. The states could do it, but the federal government can not. IMHO (certainly no constitutional lawyer here) But, it seems the Constitution is being subverted all the time nowadays anyway

For my jaunt to the clinic, on a relative basis, it still seems cheaper and more available here than in the US system. 200 baht = $6 US versus I will hazard a guess at $150 dollars in the US (I tried to look at online information for that guess... from personal experience I have never seen a bill less than $150 for a visit in the US). Per capita income in US is about 6x that of Thailand so 6 * 6 = $36. Even at 10x it would be $60, not $150. So from a simple back of envelope calc it seems that this trip to the clinic was still less expensive in Thailand than in USA. It was much much faster and more pleasant as well, for what that is worth. The matter of quality of care here in Thailand... well I think that issue may not have much to do with money at all. I do not see the Thai system through rose colored glasses, but other than QOS concerns, I do think it is better here, in non-emergency service (as per UdonExpat), but I don't know much about health care operations in general and stand to be corrected.

Conclusion... the US system is a mess... and seems likely to become a much bigger mess shortly!!! It will also further erode the Constitution which IMHO made America admired throughout the world!!!