FDA bans preventative medicine to hide the cost of Obamacare?
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11-12-2013, 10:37 PM
RE: FDA bans preventative medicine to hide the cost of Obamacare?
(11-12-2013 09:04 PM)frankksj Wrote:  ... the only reason the FDA shutdown 23andme is because they have hundreds of thousands of clients...

Yeah. That's not true.

(11-12-2013 09:04 PM)frankksj Wrote:  In my OP I claimed that if people got diagnostic tests now (like mammograms) it would increase short-term health-care costs in 2014 (ie the cost of the mammograms), even though it would reduce long term costs in the future.

If that corresponds to a greater per-person cost in coverage.

Which if framed as a hypothetical might get a better response.

Framing it as "OBAMACARE IS A CONSPIRACY" makes you look insane.

(11-12-2013 09:04 PM)frankksj Wrote:  _IF_ cjlr, et al were arguing that politicians would never be so evil as to sacrifice our long-term health (like denying women mammograms) in order to get re-elected now in 2014 (by being able to show that the ACA didn't raise health care spending), well I could understand that argument, and there's no way to prove otherwise.

You can't argue to conclusions drawn from a premise without substantiating that premise.

Well, you can, but it's not very compelling.

(11-12-2013 09:04 PM)frankksj Wrote:  But what baffles me is that their argument seems really bizarre. Cjlr's counter is that "it cannot possibly follow, as you contest, that costs will increase" in the short term if people get tests, and the whole crux of his argument rests on the assumption that insurance will NOT cover diagnostic tests, like mammograms, insulin tests, etc., if the impetus was a 23andme test.

Costs will probably not increase long-term.

Insurance premiums aren't generally adjusted based on periods less than a year long, which is what would be required in order to influence the 2014 US elections as you keep suggesting.

(11-12-2013 09:04 PM)frankksj Wrote:  If cjlr is right, then to me this makes the ACA even worse, because I think everybody should get DNA tests, all women should mammograms, and take every preventative measure. So if cjlr is right, and everybody now has to hand their monthly health care budget over to insurance companies which will not cover such diagnostic tests, this means women will no longer be able to mammograms, I would be spending all this money now on Blue Cross and get nothing out of it--I _STILL_ would be on my own to pay for preventative/diagnostic procedures. See, when I formulated my argument, I had assumed that insurance WOULD cover those tests.

"I have to go from paying for stuff myself to paying for stuff myself!"

Apparently this really rustles your jimmies.

I didn't think I had to explain health insurance to you. You don't "get nothing out of it", you get what the terms of the plan say you'll get.

The general assumption being that most people aren't able to cover unexpected catastrophic costs out of hand, and outside health insurance participation nobody's particularly keen on the "just fuck 'em" plan.

Some people pay their insurance premium regularly and never come close to drawing that amount of coverage. An inevitability of statistics. Still better than the alternative.

(11-12-2013 09:04 PM)frankksj Wrote:  Since you've mentioned you have comprehensive insurance, can you weight in? If your wife got a 23andme test and it was revealed she had the 'breast cancer' gene and asked her doctor for a mammogram, would she be denied coverage and have to pay for the doctor's visit and mammogram herself out of pocket? What if you got a 23andme tests and it revealed you the 'diabetes' gene, would your insurance cover blood tests to see if you're pre-diabetic?

I trust that you'll give an honest answer... Thank you.

Look, my old friend, I know you hate these words, but:
it depends.

If you are asking, specifically, after GirlyMan's situation, then you ought to know that the answer is not applicable to anyone not in GirlyMan's situation.

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11-12-2013, 11:10 PM (This post was last modified: 11-12-2013 11:23 PM by GirlyMan.)
RE: FDA bans preventative medicine to hide the cost of Obamacare?
(11-12-2013 10:37 PM)cjlr Wrote:  
(11-12-2013 09:04 PM)frankksj Wrote:  Since you've mentioned you have comprehensive insurance, can you weight in? If your wife got a 23andme test and it was revealed she had the 'breast cancer' gene and asked her doctor for a mammogram, would she be denied coverage and have to pay for the doctor's visit and mammogram herself out of pocket?

Look, my old friend, I know you hate these words, but:
it depends.

If you are asking, specifically, after GirlyMan's situation, then you ought to know that the answer is not applicable to anyone not in GirlyMan's situation.

One of the ACA's effects is that everyone (well everyone with a social security number who don't live in a State that rejected Medicaid expansion) has access to the same degree of exceptional health care coverage as Girly has had for some 30 years now. Hell those Platinum plans the exchanges and healthcare.gov offer provide better coverage than is available to Girly on the FEHB exchange.

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Or your shadow at evening rising to meet you;
I will show you fear in a handful of dust.
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11-12-2013, 11:29 PM
RE: FDA bans preventative medicine to hide the cost of Obamacare?
(11-12-2013 11:10 PM)GirlyMan Wrote:  One of the ACA's effects is that everyone (well everyone with a social security number who don't live in a State that rejected Medicaid expansion) has access to the same degree of exceptional health care coverage as Girly has had for some 30 years now. Hell those Platinum plans the exchanges and healthcare.gov offer provide better coverage than is available to Girly on the FEHB exchange.

I dunno, Girly. That sounds an awful like some kind of Commie Fascist Liberal Conspiracy to me.

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11-12-2013, 11:40 PM
RE: FDA bans preventative medicine to hide the cost of Obamacare?
(11-12-2013 11:29 PM)cjlr Wrote:  
(11-12-2013 11:10 PM)GirlyMan Wrote:  One of the ACA's effects is that ...

I dunno, Girly. That sounds an awful like some kind of Commie Fascist Liberal Conspiracy to me.

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can't ... seem .. to ... parse ... that ...





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As it was in the beginning is now and ever shall be, world without end. Amen.
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12-12-2013, 10:48 AM
RE: FDA bans preventative medicine to hide the cost of Obamacare?
@Cjlr,

You must have a lot of free time on your hands to keep arguing with your imaginary friends. Now you're busy arguing why the claim that "OBAMACARE IS A CONSPIRACY" is false. Are you unaware that claim originated with the voice in your head, your imaginary friend, Mr. Strawman?

Here, on tta forum, all I said was my OP “asks a question, rather than making a claim. I was never claiming I knew that Obamacare was the straw that broke the camel's back and tipped the FDA to the 'shut it down' side. I only claimed it added some incentive.” No mention of any conspiracy on my side. So I won't get in the middle of the debate between you and your imaginary friends.

All I stated was the VERY obvious and accurate claim that if, today, in 2014, people run out and get mammograms and other diagnostic tests in response to a 23andme report, while it will likely reduce long-term health care costs, it will increases the short-term costs now in 2014, as people get those tests. This logic is simple enough for the average 10 year old, but somehow went entirely over your head.

Here was my claim:

“this genetic testing... saves … dollars in the long run … But, naturally, there is a modest cost NOW... So, by banning … it will likely reduce health care expenditures now, in 2014”

Your rebuttal was:

“Therefore it cannot possibly follow, as you contest, that costs will increase”.

You don't explicitly say you're referring to short-term costs or long-term costs. So we have 2 possibilities: That voice in your head made a claim that long-term costs would increase and you're off arguing with your friendly neighborhood strawman again. OR, the fact that these diagnostic costs increase short-term costs and the cost savings come later is too complex for you to get your head around.

Lastly, I gave you only 2 examples: 1) a woman learns she has the breast-cancer gene and gets a mammogram, or 2) someone learns he has the diabetes gene and gets an insulin test.

Your rebuttal was: “Hypochondriasis is not covered by insurance... Unnecessary procedures aren't covered by insurance”.

Again this means either your imaginary friends are hypochondriacs and you were addressing their procedures, OR you were here in the real world addressing my examples and claiming that people who get mammograms or insulin tests in response to learning of a genetic predisposition are hypochondriacs.

Regardless, GirlyMan responded that his wife gets mammograms and he gets insulin tests. Never in a million years did I imagine I would one day be on the side of a Federal Government employee and arguing with a physicist that he can't understand even the most basic concepts.
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12-12-2013, 11:08 AM
RE: FDA bans preventative medicine to hide the cost of Obamacare?
Girly,

Thank you for a fact-filled and productive debate. I was unaware of the ISO cert issues for 23andme. I disagree that my “insinuation that their sales volume has anything to do with the FDA's action reeks of paranoia”. The government always goes after the big fish. If the FDA learns I snuck back some antibiotics from Mexico for my mother, they probably won't do anything. If, however, I'm bringing in containers full of drugs, well that raises my profile. With millions of pages of laws on the books, legal scholars have said it's a given that all of us are breaking some laws on a daily basis. Since the government can't incarcerate everybody, they focus on the big fish. Regardless, that's a minor point.

Here's the main thing I want to dig into more:

(11-12-2013 09:53 PM)GirlyMan Wrote:  One of the ACA's effects is that everyone...has access to the same degree of exceptional health care coverage as Girly has had for some 30 years now.

Q: How do you know if your health care is “exceptional” if you haven't compared? I've been to US doctors as well as medical tourism facilities, and I'm convinced the latter are orders of magnitude better (not to mention 1/10 the price).

Q: Remember our debate where I showed you that, even if you have somewhat worse than average medical problems, if you start when you're young and healthy setting aside into a HSA the cost of that platinum plan, and pay for your healthcare yourself, then by the time you're old you'll have over $3 million saved up? So, while I concede that some people will be better off under the ACA, can you also concede that other people who have the self-discipline to save and manage their own healthcare and aren't cursed with serious medical problems will lose millions because the ACA forces them to give that money instead to an insurance company? So, will you concede that some people (like myself) are worse off under the ACA?

Q: Lastly, you mention that now people can get health care who couldn't before. True. But, who is paying for it? We know the doctors aren't—they don't work for free. The rich aren't—insurance premiums aren't progressive and there were no tax increases on the rich. Most states already had claims the ratio laws in the ACA anyway, so it's unlikely the insurance companies will pay. Do you think it's a 'free lunch' and these people get health care and NOBODY pays for it? If not, who do you think is paying for it?
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12-12-2013, 05:16 PM
RE: FDA bans preventative medicine to hide the cost of Obamacare?
(12-12-2013 11:08 AM)frankksj Wrote:  
(11-12-2013 09:53 PM)GirlyMan Wrote:  One of the ACA's effects is that everyone...has access to the same degree of exceptional health care coverage as Girly has had for some 30 years now.

Q: How do you know if your health care is “exceptional” if you haven't compared? I've been to US doctors as well as medical tourism facilities, and I'm convinced the latter are orders of magnitude better (not to mention 1/10 the price).

Sure. Let's take my 70 yo mother's aortic valve replacement. In the US it cost around $100K and in India it costs like $10K. But here's the thing. My mother doesn't have $10K. She paid nothing for the surgery and the chief heart surgeon at Christiana Hospital performed it. I don't live anywhere near a border and I can't go bopping off to another country every quarter, hell the air fare alone would be at least 20X my co-pay. So that's kinda a moot point for me or my mum.

(12-12-2013 11:08 AM)frankksj Wrote:  Q: Remember our debate where I showed you that, even if you have somewhat worse than average medical problems, if you start when you're young and healthy setting aside into a HSA the cost of that platinum plan, and pay for your healthcare yourself, then by the time you're old you'll have over $3 million saved up?

Yes Frank, I understand the concept of compound interest and I'm working it FOR MY RETIREMENT not my medical expenses. And again this is also a moot point for me since my employer pays 75% of my premium. I'd be a fool not to take that deal.

(12-12-2013 11:08 AM)frankksj Wrote:  Q: Lastly, you mention that now people can get health care who couldn't before. True. But, who is paying for it?

The rest of us. Or rather, since me and Manly are on the receiving side of the healthcare benefit, the rest of you and all the healthy young women signing up left and right 'cause they know they're going to use it (babies and other girly matters) long before they've saved up millions of dollars. That's kinda the way it's designed to work and why there's this whole Medicare tax thing coming outta my paycheck.

As it was in the beginning is now and ever shall be, world without end. Amen.
And I will show you something different from either
Your shadow at morning striding behind you
Or your shadow at evening rising to meet you;
I will show you fear in a handful of dust.
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12-12-2013, 05:55 PM
RE: FDA bans preventative medicine to hide the cost of Obamacare?
(12-12-2013 05:16 PM)GirlyMan Wrote:  Yes Frank, I understand the concept of compound interest and I'm working it FOR MY RETIREMENT not my medical expenses. And again this is also a moot point for me since my employer pays 75% of my premium. I'd be a fool not to take that deal.

No offense intended. We already agreed that in your case a HSA makes no sense since you cannot get your employer to give you the cash instead of the insurance. I was just reminding you that you agreed that some people, like myself who do have the choice of taking the cash or the insurance, lose out big time.

(12-12-2013 05:16 PM)GirlyMan Wrote:  
(12-12-2013 11:08 AM)frankksj Wrote:  Q: Lastly, you mention that now people can get health care who couldn't before. True. But, who is paying for it?

The rest of us. Or rather, since me and Manly are on the receiving side of the healthcare benefit, the rest of you and all the healthy young women signing up left and right 'cause they know they're going to use it (babies and other girly matters) long before they've saved up millions of dollars. That's kinda the way it's designed to work and why there's this whole Medicare tax thing coming outta my paycheck.

Agreed. The only point I was making is that since insurance rates aren't progressive, and neither is medicare, the cost is born by the poor and middle class. So, all you're doing is shifting money around so some poor/middle class are forced to pay for the healthcare of other poor/middle class. Some win. Some lose. But in the end, there's no free lunch. A better approach, imo, would have been to reduce the cost health care.

As far as your Mom. My Mom is in the same situation. To me it's tragic because my Mom (and presumably yours too) have sent in a ton of money to social security, medicare, insurance companies, etc. over their lives. And IF they had invested it themselves wisely, our Moms would right now have millions saved up, and your Mom could afford to hire a nurse to escort her to India or Mexico where she could get her aortic valve replaced for a very modest cost without having to dip too much into her retirement... And fly first class, and get a vacation out of it.

However, it's a tough call because, knowing my Mom, if the government had not FORCED her to send in money to ss/medicare/etc., she probably would have spent the money rather than investing and would be even worse off than she is today. That's why I think the better approach is to try to educate people about their options and let them make informed decisions based on their unique circumstances, and help them be self-sufficient.
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12-12-2013, 06:46 PM (This post was last modified: 12-12-2013 06:50 PM by GirlyMan.)
RE: FDA bans preventative medicine to hide the cost of Obamacare?
(12-12-2013 05:55 PM)frankksj Wrote:  
(12-12-2013 05:16 PM)GirlyMan Wrote:  Yes Frank, ...
I was just reminding you that you agreed that some people, like myself who do have the choice of taking the cash or the insurance, lose out big time.

Well not you specifically since you're planning on bailing on us and shit. And catastrophic coverage is still available to the youngsters under the ACA. Just that now after 30, you officially ain't a youngster no more. Tongue

(12-12-2013 05:55 PM)frankksj Wrote:  
(12-12-2013 05:16 PM)GirlyMan Wrote:  The rest of us. ...
However, it's a tough call because, knowing my Mom, if the government had not FORCED her to send in money to ss/medicare/etc., she probably would have spent the money rather than investing and would be even worse off than she is today.

Mine was a single mom raising 3 brats. There's no way that money wouldn't have gone straight back into the economy whether she understood compound interest or not and she'd be shit outta luck now. Or rather, I'd be shit outta luck 'cause she's my mom and all.

As it was in the beginning is now and ever shall be, world without end. Amen.
And I will show you something different from either
Your shadow at morning striding behind you
Or your shadow at evening rising to meet you;
I will show you fear in a handful of dust.
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12-12-2013, 07:31 PM
RE: FDA bans preventative medicine to hide the cost of Obamacare?
(12-12-2013 06:46 PM)GirlyMan Wrote:  Just that now after 30, you officially ain't a youngster no more. Tongue

I just need a few nips, tucks and lifts at my posh medical tourism facility and you'll never be able to tell. Big Grin

(12-12-2013 06:46 PM)GirlyMan Wrote:  Mine was a single mom raising 3 brats. There's no way that money wouldn't have gone straight back into the economy whether she understood compound interest or not and she'd be shit outta luck now. Or rather, I'd be shit outta luck 'cause she's my mom and all.

You and are both in the same boat and I never really questioned the wisdom of it all until I lived in Switzerland. Over there, nearly every old person has millions already stashed away in the bank after years of saving and investing. There's no government welfare program, no nanny state to tell you what to do. Instead, the government's "gift" is a good, solid education teaching you how to be self-sufficient. And it has worked out very well, and I imagine that if we did the same in the US, it would work out well for Americans too. But, in the US a culture of dependence has been fostered and people depend on the government for survival. So if the government pulled out suddenly, it would be a disaster for many Americans, like our Moms. This culture of dependence is something that would take many decades to solve.
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