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  1. #191
    Senior Member cafe's Avatar
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    Quote Originally Posted by DiscoBiscuit View Post
    We agree here.



    I'm not sure that's true (and suspect its not), on what grounds do you say so?

    So far, the ACA has done a pretty excellent job of tripping over its own shoelaces.
    The jury is still out in terms of concrete outcomes. But I say this based on values that you probably do not share: I consider healthcare a basic human right that everyone should have access to regardless of their income and physical condition.

    Requiring insurance companies to insure people with pre-existing conditions is a good thing, as far as I'm concerned. Allowing people to stay on their parents' insurance until they are twenty-six is a good thing, too. Requiring a certain percentage of premiums to go to patient care is a good thing. Removing the cap for how much care insurance companies will cover is a good thing. Making preventative care free is a good thing. I consider those things improvements over how things were before ACA. I also think encouraging providers to use electronic medical records is a good thing.

    Edit: If you are in favor of a Singapore style system (which isn't my first choice, but is better than pre-ACA and probably better than ACA), campaign finance reform and closing the public/private sector revolving door would be really good places to apply your effort, IMO.
    “There are two novels that can change a bookish fourteen-year old’s life: The Lord of the Rings and Atlas Shrugged. One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs.”
    ~ John Rogers

  2. #192
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    Quote Originally Posted by cafe View Post
    The jury is still out in terms of concrete outcomes. But I say this based on values that you probably do not share: I consider healthcare a basic human right that everyone should have access to regardless of their income and physical condition.

    Requiring insurance companies to insure people with pre-existing conditions is a good thing, as far as I'm concerned. Allowing people to stay on their parents' insurance until they are twenty-six is a good thing, too. Requiring a certain percentage of premiums to go to patient care is a good thing. Removing the cap for how much care insurance companies will cover is a good thing. Making preventative care free is a good thing. I consider those things improvements over how things were before ACA. I also think encouraging providers to use electronic medical records is a good thing.

    Edit: If you are in favor of a Singapore style system (which isn't my first choice, but is better than pre-ACA and probably better than ACA), campaign finance reform and closing the public/private sector revolving door would be really good places to apply your effort, IMO.
    Politics is the art of the possible. Too many people (on both sides) are making too much with the system we have now. It would take some serious groundswell effort to either of the issues you bring up in your last sentence.

    More to the point addressing either (or both) of those issues is not a necessary (or possibly even sufficient) condition for implementing a Singapore style system.

    I would rather deal with disability fraud, double dipping, and reinstating work requirements to entitlements first.

    The reason I like the Singapore system is that it gets the universal coverage you guys want, but functions through market system cost controls that we want.

    EDIT - to respond to your quip about not sharing the same values, my solutions are based on an understanding of finance, the economy, politics, and national governance that you probably don't share.

  3. #193
    Senior Member cafe's Avatar
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    Quote Originally Posted by DiscoBiscuit View Post
    Politics is the art of the possible. Too many people (on both sides) are making too much with the system we have now. It would take some serious groundswell effort to either of the issues you bring up in your last sentence.

    More to the point addressing either (or both) of those issues is not a necessary (or possibly even sufficient) condition for implementing a Singapore style system.

    I would rather deal with disability fraud, double dipping, and reinstating work requirements to entitlements first.

    The reason I like the Singapore system is that it gets the universal coverage you guys want, but functions through market system cost controls that we want.
    Disability fraud? What, like people getting $700-1000/month? Yeah, that's a huge problem.

    I don't even know what double dipping means in this context.

    And as I've said before, I'm totally fine with able-bodied people being required to work (making allowances for transportation and childcare) as long as jobs are provided by the government if private sector work cannot be found (because we do have an unemployment problem right now) and/or volunteer work is accepted as work.

    Most able-bodied people of working age do work. However, a lot of times they aren't provided benefits and are not paid enough to meet their basic living expenses. We could address that and it might solve some problems.

    Edit: I understand that we are the only developed nation that somehow can't manage to provide healthcare for its citizens, despite being the richest country in the world.
    “There are two novels that can change a bookish fourteen-year old’s life: The Lord of the Rings and Atlas Shrugged. One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs.”
    ~ John Rogers

  4. #194
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    Quote Originally Posted by cafe View Post
    Disability fraud? What, like people getting $700-1000/month? Yeah, that's a huge problem.

    I don't even know what double dipping means in this context.

    And as I've said before, I'm totally fine with able-bodied people being required to work (making allowances for transportation and childcare) as long as jobs are provided by the government if private sector work cannot be found (because we do have an unemployment problem right now) and/or volunteer work is accepted as work.

    Most able-bodied people of working age do work. However, a lot of times they aren't provided benefits and are not paid enough to meet their basic living expenses. We could address that and it might solve some problems.

    Edit: I understand that we are the only developed nation that somehow can't manage to provide healthcare for its citizens, despite being the richest country in the world.
    From RealClearMarkets: America's Growing Social Security Disability Problem

    This long running disability epidemic, which hit its pandemic stage in the aftermath of the 2007 recession, has almost nothing to do with a decline in the overall health of working age Americans or in the severity of their health-based impairments. Rather, it is primarily the consequence of fundamental flaws in the SSDI program and its administration which have increasingly made it a long term unemployment program rather than the last resort transfer program for those unable to work due to their health-based impairments that Congress intended it to be. These flaws become most evident during severe during economic downturns but will remain long after we recover from the Great Recession.
    ....

    SSDI's most fundamental structural flaw is its reliance on a flat payroll tax for funding which does not rise for firms whose workers disproportionately come onto SSDI rolls or fall for firms who take measures to instead keep them on the job. Hence firms have less incentive to accommodate or rehabilitate their workers at the most effective point for such treatments-when workers first experience a health shock that affects their ability to work.

    Worse, an increasing share of workers coming onto the rolls are marginal cases. They might have been able to continue to work with an intervention at the very beginning. Instead, these workers make up the majority of new beneficiaries who are awarded benefits based on difficult-to-determine mental and musculoskeletal conditions or who have conditions that do not exceed the medical listing but are accepted based on vocational criteria (e.g. age, education, and work history).
    ....

    By experience rating the disability payroll tax to look more like Workers' Compensation (WC), firms would have greater incentives to hire private sector long-term disability insurers to better manage their workers when they first experience the onset of a health related work limitation. This would lead to greater accommodation and rehabilitation and a reduction in SSDI applications. This "work first" policy makes far better sense than current SSDI policies where workers must demonstrate that they cannot work before being offered incentives to work once they are on the program.

    Under a reformed system, like that of the Dutch, payments would be awarded only after workers try to return to work-and after their employers try to accommodate their work limitations. Because firms would more directly bear the costs of disability, directing their workers onto the SSDI rolls would become increasingly expensive and decreasingly desirable. This together with a tightening of the most highly subjective health condition criteria, especially mental and musculoskeletal conditions, would help SSDI administrators make decisions more consistently and reduce uncertainty about eligibility.

    Not all persons with disabilities can work, so it is important to maintain a last resort SSDI program that provides protection for these workers. But the reality is that SSDI has increasingly become the first, rather than the last resort for many new SSDI beneficiaries. The program's looming insolvency only increases the need for fundamental reform.

  5. #195
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    Quote Originally Posted by DiscoBiscuit View Post
    Did I mention we have an unemployment problem? Like, there aren't enough jobs now for the people who want to work?
    “There are two novels that can change a bookish fourteen-year old’s life: The Lord of the Rings and Atlas Shrugged. One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs.”
    ~ John Rogers

  6. #196
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    Quote Originally Posted by cafe View Post
    Did I mention we have an unemployment problem? Like, there aren't enough jobs now for the people who want to work?
    Your point being?

  7. #197
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    Quote Originally Posted by DiscoBiscuit View Post
    Your point being?
    We kick everyone who might have the capacity to work off of SSI/Disability tomorrow, the vast majority of them are not just going to go out and get a job. There aren't jobs for most of them. They aren't going to have any money at all. So, depending on the state, they will now be eligible for Medicaid (because in some states, like mine, an adult who is not pregnant probably makes too much money on disability to qualify for medicaid), at least temporarily, possibly TANF, and (depending on family size) more food stamps. They will probably be worse off, but taxpayers probably won't save any money. More often than not, people are on disability because they can't find work rather than not working because they are on disability.
    “There are two novels that can change a bookish fourteen-year old’s life: The Lord of the Rings and Atlas Shrugged. One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs.”
    ~ John Rogers

  8. #198
    Senior Member Mal12345's Avatar
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    Quote Originally Posted by cafe View Post
    We kick everyone who might have the capacity to work off of SSI/Disability tomorrow
    And how do you determine who MIGHT have the capacity to work?

    Does my 21 year old step-daughter who is on disability have the capacity to work?
    "Everyone has a plan till they get punched in the mouth." Mike Tyson
    “Culture?” says Paul McCartney. “This isn't culture. It's just a good laugh.”

  9. #199

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    The whole anxiety about free loaders is over done.

  10. #200
    Senior Member cafe's Avatar
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    Quote Originally Posted by Mal+ View Post
    And how do you determine who MIGHT have the capacity to work?

    Does my 21 year old step-daughter who is on disability have the capacity to work?
    Hey, I'm not the one wanting to kick people off. My son (15 y/o) is medically approved for disability due to autism (he doesn't get it because we make too much money - I thought it was worth a try to apply because DB said a bunch of middle class people were getting it and we're at 130-150% of the poverty line) and with enough support, I have no doubt he could work, but not a lot of employers are in a hurry to offer that kind of support (unless they are like Goodwill, who pays disabled people less than minimum wage) when there are college graduates willing to work low-wage jobs because there aren't enough jobs.

    But before labor unions, little kids worked in factories and mines and before the industrial revolution, people made lace and stuff at home, so it's conceivably possible a lot of people on disability now could do some kind of work. It's just really not practical or profitable. I don't think that's a reasonable standard, but who knows what people that are up in arms about somebody getting $700 a month might think is reasonable?
    “There are two novels that can change a bookish fourteen-year old’s life: The Lord of the Rings and Atlas Shrugged. One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs.”
    ~ John Rogers

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