I would be concerned about moral hazard leading to people not taking care of their own health. And yet, America has a disproportionately bad problem with weight and cardiovascular health. I get a discount for not smoking, sure, but I don't get a discount for going to the gym multiple times a week and adjusting my diet to keep my weight goals. I seem to be sharing a risk pool with a lot of very willingly unhealthy people.
I would be concerned about a DMV-like experience when trying to take care of my health care, except, that's what we have now. Bad incentives are created for providers, for insurers, and really it's all of them against me. And it's hardly a free market when there's still effectively a complete lack of transparency over pricing, and I can't very well shop around for where the ambulance should take me.
I'm very pro-immigration as long as we have some security / documentation process that people follow that we actually enforce, because I don't want a social healthcare system that just gets abused by people who have no intention of ever being a formal part of the system that funds it. Except we already have a drain on hospitals in many states where they have to provide life-saving care but will never get reimbursed for it. And that's exactly what Romney's major argument was in defense of his state's healthcare law, but Republicans ripped him to shreds over it.
I just don't understand what Republicans are arguing for here because the current system is not remotely giving any of the benefits of a free market and that doesn't seem to be changing any time soon. If the current system is privately-run healthcare, why is everyone so convinced that the vaccine is a government conspiracy? It seems to me we don't have either ideal, so we're stuck with a half-measure that isn't really working for anyone but insurers.
Government prevents that, the very people that push for government run healthcare, pushed to ensure all persons pay the same rates. The only discounts allowed by law are for Smoking. Your employer can not legally discount your health plan for anything other than smoking.
There are some loops holes for "health incentives" billed as bonus'
>>If the current system is privately-run healthcare,
No and that's really my point - we have this heavily regulated mix of public and private that I don't think anyone fully understands, makes it a nightmare for consumers, gives a heavy advantage to existing players, has massive amounts of overhead, etc. People who say things about wanting a free market don't seem to be pushing us in that direction, only pushing against reform.
I recently switched to an HDHP / HSA and I feel like it's much better. One of the problems is that insurance has stopped being about risk management because (almost) everyone has it and wants it to cover everything, so it's just a game of group negotiating on a group tab. I had the plan because my company negotiated it with the insurance company who had rates and networks negotiated and I was just supposed to go to the doctor and now pay whatever else was left but who knows what that was. But now my doctor's not even in-network. With an HSA, I can just pay her directly and forget the rest of it.
I agree, but I think the reason why is "it won't happen to me" syndrome. Sure, other companies or people might get regulated out of existence, but in the short term maximizing profits and hoping or expecting to see the boulder rolling downhill in time to get out of the way is seen as the better plan. Because if you're right, you get to keep a lot of money. And if you're wrong, well, you don't think you'll be wrong.
This seems to be the thinking of our entire economic system in the United States. Grab as much money as humanly possible, regardless of any future consequences, even if the very act of the grabbing increases the odds of a much worse outcome.
The private health care industry is not in such a situation. There is no guarantee that socialized healthcare is the future for America. But the more and more they attempt to extract from consumers per year, the more likely they make it that socialized medicine will happen here.
The private health insurance industry in the US is doomed. Whether or not the outcome is "socialized medicine" or some other form of universal healthcare coverage is beside the point.
Furthermore, I don’t think anything political like this is pre-ordained.
I want a private health system, one with actual market economics not with the hand of government poking and prodding at every turn making things worse. Sadly the free market shipped sailed away decades ago.
What we have today is terrible system of heavy government regulation, poor subsidies, "insurance" that is not really insurance, combined with the US health system bearing most of the RnD costs for the world.
Those that are opposing complete government take over already lost they just do not know it yet and are just prolonging the pain. Personally I say let it happen, and watch as it collapses because a US Federal run health system will be atrocious, the US Federal government is incompetent and corrupt, but it seems many citizens want a health system run by corrupt incompetence. So lets to it. then we can get way back to a free market once the people learn the lesson the hard way.
When you say free market do you mean with insurance? or without?
The problem with health care and free market is the incentive don't line up. Most of health care costs are accumulated at the end. so you can't really do loans. your left with some kind of upfront payment plan(aka insurance) and their incentive to maximize premium and minimize expenses(aka paying for your healthcare)
Then you run into the problem that you need private watchdogs to keep an eye on the insurance companies and rate them. Problem is the smaller they are the more easily corruptible they are.
Either I would like to so innovation in that space where today the government is stiffing that. For example there was a Doctor in Kansas I believe that attempted to open a Medical Coop where families would pay a monthly fee and then get access to the facility for their general medical needs.This was deemed to violate medical billing regulations so he was forced to shut it down. Then there is walmart, even a massive company like that could not navigate the regulatory burden to offer small clinics where a person could see an RN for minor medical conditions. They could not figure out how to comply with the regulations and make is profitable.
There is a reason ALOT of the medical services (Doctors offices, Networks, and Hospitals) are actually NON-profits. People believe that the "profit motive" is the reason for high costs, when in reality the delivery of medical services outside of Pharmaceuticals and devices, is already non-profit
As to insurance would also like to see a return of actual insurance. We we call "health insurance" is not really insurance. Insurance is about risk pooling to absorb known but unlikely events. Insurance that covers all medical expenses (i.e comprehensive coverage) is not insurance. My Auto Insurance does not cover oil changes, and my Home owners insurance does not cover replacing my HVAC system so why does my health insurance cover my annual checkup, and when I have a cold????
>>Most of health care costs are accumulated at the end.
That is not an example of the incentives not lining up, and we have a solution for that, a solution I would like see expanded but HSA are designed for that.
The real question is health care a right?
If it is who pays? If it is the taxpayers, then they should have some say in the behavior of others right? No more overeating, no more smoking, no more risky sex, no more drugs, then the question is who will enforce this? It is a spiral of government intervention. It is a tough problem, now compound this problem with citizenship. Should noncitizens be covered? If the answer is yes then one must think of the global implications. If a country is exporting people without any restrictions we could easily bankrupt our taxpayers. If we treat them and charge back to the host country, and they refuse to pay, what then?
I understand that it's a 1 paragraph story but there's some nuance there that's being implied and some that people pass along that's not supported by that paragraph.
In 2007, the housing market was down. That's where you'd get bankruptcies: because the house was worth less than the mortgage. So called "underwater mortgages". You get foreclosed upon, but still have to pay $100,000 after losing your house and becoming homeless.
So it all depends on the market price of homes.
In many states your personal residence is protected and exempted from bankruptcy so it would not be wise to use your equity or get to the point of foreclosure in lieu of filing bankruptcy.
If you have large amounts of unsecured debt (i.e personal loans, credit cards, etc) then I would absolutely explore bankruptcy before becoming homeless or losing my home
Only 4% of US bankruptcies are because of medical bills (<https://www.washingtonpost.com/blogs/post-partisan/wp/2018/0...>). A tipoff that [insert large percentage here] of bankruptcies aren't actually because of medical costs is that only 6% of bankruptcies by those without health insurance are because of that cause.
The biggest cause of bankruptcies is lack of income, which health insurance doesn't affect. In other words, people going bankrupt because health problems = lack of work = lack of income.
From the Post piece:
>So Carlos Dobkin, Amy Finkelstein, Raymond Kluender and Matthew J. Notowidigdo did what’s called an “event study.” Instead of looking at bankruptcies to see how many involved medical bills, they started with the illness, and asked how much more likely people were to declare bankruptcy after they got sick. That’s a much better way to tease out causation than asking whether someone who just went through a financially ruinous divorce also owed his or her dermatologist thousands of dollars.
In other words, it's not surprising that someone who declares bankruptcy owes medical bills among all the bills he is behind on. While "correlation is not causation" is used far too often by people who don't really understand its meaning, this is an example. Again, from the Post piece:
>That jibes with what we’ve seen in the bankruptcy data since Obamacare passed. If medical bills really were driving so many people into bankruptcy, then we would have expected filings to plummet after 2013, when millions of people gained health insurance coverage. Instead we see a smooth decline from the recession-era peak.
In any case (and contrary to what Reddit would have you believe), 91% of Americans have medical insurance (<https://www.census.gov/library/publications/2020/demo/p60-27...>), whether through their employers, or government programs like Medicare/Medicaid. That's compared to 95-97% in other developed countries because there are always some people who fall through cracks, like (say) a Canadian who doesn't get a new provincial health care card after moving, or a German who neglects to buy into a new sickness fund after changing careers.
Two thirds of Americans have private medical insurance. One third have public insurance of some type, including 20% from the aforementioned Medicaid.
Some large chunk of the 4-6% differential in the US versus other countries is illegal aliens who don't qualify for public insurance and are working cash jobs that don't provide private insurance. The only such national systems with actual 100% (or as close to it as possible) coverage is something like the UK NHS, which does not have a requirement to show a membership card (because, well, there isn't one) to receive treatment.
While in CA, you are only provided $250,000 in coverage.
Personally, I don't think anyone should be able to touch your first primary home for any reason.
(I thought all bankruptcy laws were federal. I just assumed they would all be the same in every state, but they don't appear to be? Everyone dumps on TX, but they do some thing right. I heard that if you are arrested for a DUI in Texas. A judge will take into account previous alcohol tolerance. So basically, if you are an alcoholic, and you pass a computer simulation provided by the state, you might be able to get out of that DUI. I think it logical, but I must have miss heard that?)
What do they do, make you get exactly as drunk as when you were pulled over to take the test? Where does the alcohol come from, the mini-bar under the judges desk, between the gun rack and stack of bribe envelopes?
There are some protections for primary residence in Chapter 7, but it is not complete protection. I believe it is around $25,000 in equity, Meaning if your home is worth $225,000 and you owe $200,000 then your home is safe
If however you have a $225,000 home, and only owe $80,000 on it under the Federal Exemption system you could be forced to sell to satisfy debtors
Many states, as you have discovered, have additional exemptions, one generally has to choose if they want to use State or Federal Exemptions at the time of filing.
(Nor, frankly, do I think that it's morally defensible. Laws are better when everyone can predict whether or not what they're doing is legal. A clear cut BAC limit is easier for everyone to comply with than some nebulous concept of "tolerance").
California upped their homestead exemption to $600k this year.
There are still a bunch of states that have sub $100k exemptions on the books, with Tennessee and Virginia at $5k.