[RD] Romneycare (aka Affordable Care Act, ACA, Obamacare) Failed Because It Didn’t Have Enough Taxes

[BvBPL]

It’s the types of ailments people suffer from when older than 55 versus when they are younger.

When a younger party has a medical issue, it is generally a non-chronic issue that is bounded in its recovery. Eventually, that broken bone heals.

However, older parties are more likely to face chronic, on-going conditions that continue indefinitely. It is that increase in consisted repeated care that raises the healthcare costs.

Specific to the United States, most of those chronic age-related conditions are treated by drugs. Drugs are a highly effective means to treat these conditions, after all. The United States is (nearly?) unique in Western nations that it does not regulate the price of drugs to patients. As such, drug companies can charge whatever they damn well please for drugs. Because the actual cost of the drugs are generally hidden from the consumer by pharmacy deductibles, the general public is unaware how much those drugs cost. However, the cost gets paid by the public anyway as the cost is spread across the insured population (or is paid for the by the public if on medicare or another public insurance).

 

[Lexicus]

Doctors. Doctors are the ones in position to examine a patient, look at the condition, and tell families that sorry, Grandma's days are numbered and treatment will be intrusive and expensive and at best will extend her life a few weeks, so here's the number of a really good palliative care and hospice company so her last weeks will be comfortable and she can die peacefully at home. We'll treat her if you really want, but you have to pay the entire cost up front and out-of-pocket.

My idea of 'palliative care' is a 24/7 morphine drip.

 

[warpus]

From the limited amount of reading I've done, most of it is due to the fact that drugs here are often several times more expensive here as opposed to elsewhere, and they are over-prescribed. It's practically cliche at this point that getting old in America means taking a large variety of pills each and every day. My own personal opinion is that doctors shouldn't prescribe pills for things that people can treat on their own with diet and exercise, and the fact that our life expectancy is middling is testament to the fact that our approach is not the best.

But those under 55 take pills as well both in the U.S. and in other western countries, I mean it's not like up until 55 Americans are drug free and then suddenly start popping pills every day.

If the high cost of drugs was the main variable here you'd expect healthcare in the U.S. to be more expensive across the board - but for those under 55 it is pretty much the same as in other western countries. So what happens after 55? In Europe and other western countries life continues as usual, and in the U.S. anyone over 55 is put on a regiment of pills?

 

[Farm Boy]

High blood pressure. Diabetes. Low testosterone. The meds that ameliorate the side effects of the medications that treat high blood pressure, diabetes, low testosterone. The pills that ameliorate the side effects of those. Anti-depressants filling in the gap left by the chief carcinogenic anti-depressant of (increasingly) yesteryear. Being obese for your entire adult life has immediate impacts, but it really starts killing untreated individuals in earnest in their 50s.

Or am I wrong about that? I could be, wouldn't mind being corrected.

 

[BvBPL]

People under 55 take fewer pills that are less expensive relative to the 55 plus demographic.

I said the US doesn’t regulate the price of drugs. Actually, that’s only half right. Patent law means drugs that are newer have great protections against competition. The regulation actually encourages higher prices for newer drugs. Recognizing the value of the 55 plus demographic, most newer drugs are made for that demographic. In contrast, many of the drugs taken by young people are generic and without patent protection and therefore more open to competition.

 

[warpus]

That just makes me then curious why these drug companies in the U.S. don't go more after people under 55. Surely there's a goldmine of extra profits to be made there, considering that right now healthcare for those under 55 is as cost effective as for people in other western countries. Seniors are paying 10x the amount of healthcare costs in other countries, surely the drug companies are looking at those under 55 thinking "They're not getting ripped off yet, we need to go after them next"

 

[Farm Boy]

They are thinking that. Think Epipens, AIDs medication, ADHD slow-release meth, kratom(possibly to be pill'd), beer, marijuana. There's lots of irons in the fire. But, "start taking this or you might not see your kid finish college or meet your grandchildren" and "you need this to get a proper stiffy" applying to significant portions of the population is really really the cash.

 

[metalhead]

But those under 55 take pills as well both in the U.S. and in other western countries, I mean it's not like up until 55 Americans are drug free and then suddenly start popping pills every day.

If the high cost of drugs was the main variable here you'd expect healthcare in the U.S. to be more expensive across the board - but for those under 55 it is pretty much the same as in other western countries. So what happens after 55? In Europe and other western countries life continues as usual, and in the U.S. anyone over 55 is put on a regiment of pills?

Not drug-free, necessarily, but much less likely to be taking an assortment of pills the way is extraordinarily common among people 55 and older.

Things naturally happen to all of us as we age, and many of those conditions happen to be treatable with pharmaceuticals. I have no idea if the same thing happens in Europe or not. Judging by the graph I posted, it looks like per capita care expenses do go up in other countries as well, but at modest rates, where ours skyrockets. Perhaps they use fewer pills, perhaps their health care regimes are much more comfortable using older, generic versions of medicines for treating the ills of aging, perhaps they benefit simply from the fact that they pay far less than we do for the same exact pills. I'm guessing it might be a combination of those things.

 

[BvBPL]

It is a combination. There are relatively few market price controls on drugs in the US. The consumer has no interest in having anything but the best drug on the market. Because the cost of the drugs is spread out across the insured population, the consumer doesn't even realize how expensive the best drug is. There is very little motivation for a US medical consumer to choose s anything but the best drug, which is often the most expensive.

In other counties, governmental systems have more controls over drug pricing so the consumer doesn't even have the option to choose the best drug.

 

[Gori the Grey]

I had a suspicion, so I did a little Googling on metalhead's chart.

The chart was compiled from a study that tracks government spending on healthcare. That skyrockets in the US at retirement age because that's when people are eligible for Medicare, so it's only then, in the US, that the government starts paying for healthcare.

Read the comment by Bruce at this site:

http://theincidentaleconomist.com/w...-day-health-care-spending-by-age-and-country/


For all that, I'm still preparing myself to die inexpensively if possible, when my time comes.

 

[Timsup2nothin]

My idea of 'palliative care' is a 24/7 morphine drip.

They have patches for that now. No needle required, just stick 'em on and you're good to go.

For all that, I'm still preparing myself to die inexpensively if possible, when my time comes.

If I don't win the sudden unexpected drop dead prize, I plan on hiking up into the local hills (leaning on sons if necessary) with my close friends and family members and partying my tail off, climaxing in a massive heroin overdose and collapsing into an available unmarked grave. This, of course, when infirmity makes my happy go lucky lifestyle no longer sustainable and not before.

 

[Gori the Grey]

My own fantasy is to go to a very remote place, dig my own grave, piling the soil on the windward side of the grave, expire with the effort, and have the wind slowly cover my corpse.

I eat poorly enough that I might win your drop-dead prize, in which case disposing of my corpse will lamentably be something I burden someone with. But not late-life health care, that I'm determined.

 

[Timsup2nothin]

My own fantasy is to go to a very remote place, dig my own grave, piling the soil on the windward side of the grave, expire with the effort, and have the wind slowly cover my corpse.

That is substantially less practical.

 

[Gori the Grey]

Well, it's a fantasy. Those don't have to be practical.

 

[Timsup2nothin]

Well, it's a fantasy. Those don't have to be practical.

True. Mine would be better classified as a plan. Plans do require a level of practicality.

 

[cardgame]

But that doesn't explain why this doesn't happen in other western countries though, that's what I'm after. What's so different about the American system that rates are almost identical up until people turn 55?

It's almost as if all variables are equal and then suddenly when people turn 55 something changes in America but doesn't in Europe or Canada (or Australia, etc.). What is it, though?

Medicare kicks in at 55 or approximately thereabouts, and then all the corporations start scamming the government. Gori nailed it.

I mean, have you seen the ludicrous adverts on TV for medical products? Tons of stuff and they all claim medicare pays every last cent, you get it for free. Which admittedly is what it's there for, but I guarantee they're gouging the hell out of those invoices to the government. Just like defense contractors.

 

[Cutlass]

But that doesn't explain why this doesn't happen in other western countries though, that's what I'm after. What's so different about the American system that rates are almost identical up until people turn 55?

It's almost as if all variables are equal and then suddenly when people turn 55 something changes in America but doesn't in Europe or Canada (or Australia, etc.). What is it, though?

People over 50ish simply use more medical care than younger people. Now in other countries, that's a cost to be controlled. In the US, that's an opportunity to be exploited.

 

[metalhead]

I have a feeling that if the Republicans succeed in privatizing Medicare, the gravy train will swiftly come to a screeching halt.

 

[Timsup2nothin]

I have a feeling that if the Republicans succeed in privatizing Medicare, the gravy train will swiftly come to a screeching halt.

Not at all. The privatized medicare will be "backed" by the government just like the FDIC backs banks, and the current inadequate fraud controls will be removed altogether since "a private for profit company will take care of that themselves" given enough deregulation. The people who own the privatized version will take over the gravy train and gouge it deeper than ever.

 

[cardgame]

It is possible that competition could lower prices, but as we've seen with internet and telecomms, that theory doesn't exactly work in real life.