Obama's State of the Union Address

[Skeptic Ginger]

I've desperately tried to buy a car for 9 years and could not. Why don't we make a law that makes it mandatory for everyone to get a car?

Or the DMV "won't accept" my insurance (actually they just haven't bothered to call my insurance company) so I'm technically driving my car illegally. I already sent them 2 letters and presented proof of insurance in person, yet I'm still driving my car illegally. The other day I got a parking ticket because my registration is suspended....

... The state of California wouldn't recognize my driver's license so I managed to accrue $3400 dollars in fines, which I couldn't pay at the time. Eventually they withdrew the money from my bank account without warning me because they had made up an address. That money could have easily paid 6 months of health insurance. I could have bought a more expensive car than the one I currently own with that money.

So which is it Richard, you can't buy a car or you have one and you've been driving on a suspended license? "Oh what a tangled web we weave...."

 

[Skeptic Ginger]

The problem with that stat runs a hell of a lot deeper than that. The very definition of medical bankruptcy that they use guarantees that they will include cases which most people would never consider to be medical bankruptcies. The study was designed from the start to provide an inflated number. The facts are all there^*, if you actually read the study. Which I have done (link above), but damned few other people seem to bother doing before throwing out statistics that they don't understand.

Actually, there's reason to believe someone screwed up with at least one reported number in the study too. Bonus points if you can find that problem.

Definition of medical bankruptcy in the study and study methodology:

METHODS: We surveyed a random national sample of 2314 bankruptcy filers in 2007, abstracted their court records, and interviewed 1032 of them. We designated bankruptcies as “medical” based on debtors’ stated reasons for filing, income loss due to illness, and the magnitude of their medical debts.

Without getting too far OT, could you be more specific?

 

[Ziggurat]

Definition of medical bankruptcy in the study and study methodology:

Without getting too far OT, could you be more specific?

Dig past the abstract and read the article, and you'll find this:

For this analysis, we replicated the most conservative definition employed in the 2001 study, which designated as “medically bankrupt” debtors citing illness or medical bills as a specific reason for bankruptcy; OR reporting uncovered medical bills >$1000 in the past 2 years; OR who lost at least 2 weeks of work-related income due to illness/injury; OR who mortgaged a home to pay medical bills.

Several problems jump out here. One is that people who lost two weeks of work for medical reasons might not have any unpaid or even uncovered medical expenses. For the current purpose, that means that even if their bankruptcy is medical (they lost an arm and can no longer work as a machinist, for example), that isn't what we want to know about if we're considering what this means for changes in our health care system. But it's even worse than that. Maybe they were off of work because they broke their leg on a ski trip, but that might have nothing to do with a bankruptcy due to a gambling addiction.

But there's an even more glaring problem: that $1000 threshold. Note that the actual text of the article makes it clear that this is a medical expense, not (as the abstract claims) a medical debt. If you start including the things that people have to pay for which cost more than $1000 over the course of two years, and then claim that any bankruptcies are "related" to that, well, you're going to get bankruptcies related to a hell of a lot of stuff. Like taxes, for example. Under their definition, food contributes to probably close to 100% of bankruptcies. But that's not very useful, is it?

 

[JoeTheJuggler]

I've desperately tried to buy a car for 9 years and could not. Why don't we make a law that makes it mandatory for everyone to get a car?

What problem would such a law address? Is there a problem of people who can afford cars but don't buy them somehow adding costs to car buyers? (I assume your question is related to the individual mandate for minimum essential healthcare coverage.)

 

[Skeptic Ginger]

Dig past the abstract and read the article, and you'll find this:



Several problems jump out here. One is that people who lost two weeks of work for medical reasons might not have any unpaid or even uncovered medical expenses. For the current purpose, that means that even if their bankruptcy is medical (they lost an arm and can no longer work as a machinist, for example), that isn't what we want to know about if we're considering what this means for changes in our health care system. But it's even worse than that. Maybe they were off of work because they broke their leg on a ski trip, but that might have nothing to do with a bankruptcy due to a gambling addiction.

But there's an even more glaring problem: that $1000 threshold. Note that the actual text of the article makes it clear that this is a medical expense, not (as the abstract claims) a medical debt. If you start including the things that people have to pay for which cost more than $1000 over the course of two years, and then claim that any bankruptcies are "related" to that, well, you're going to get bankruptcies related to a hell of a lot of stuff. Like taxes, for example. Under their definition, food contributes to probably close to 100% of bankruptcies. But that's not very useful, is it?

If you look at table 2, 57% of the bankruptcies are from either the bankrupt person said medical bills was the problem, medical bills were over $5,000 or >10% annual income, and/or a home mortgage was taken out to pay medical bills.

40% lost income due to illness.

There is a lot of overlap in that data but I don't see your argument standing out as accounting for significantly inflating the total.


Then there is this additional matter:

The study data, published online Thursday in The American Journal of Medicine, likely understate the full scope of the problem because the data were collected before the current economic crisis. In 2007, medical problems contributed to 62.1 percent of all bankruptcies. Between 2001 and 2007, the proportion of all bankruptcies attributable to medical problems rose by about 50 percent.

Getting back to the thread topic, the point of the medical cause of bankruptcy study supports the case there is a crises in paying for health insurance or health coverage directly. Do you think the problem is fabricated like I believe the claim businesses are drowning in regulations is fabricated?

 

[Ziggurat]

If you look at table 2, 57% of the bankruptcies are from either the bankrupt person said medical bills was the problem, medical bills were over $5,000 or >10% annual income, and/or a home mortgage was taken out to pay medical bills.

But we don't know the breakdown. And even $5000 doesn't usually make a bankruptcy.

40% lost income due to illness.

But again, we don't know how much.

There is a lot of overlap in that data but I don't see your argument standing out as accounting for significantly inflating the total.

The article itself indicates otherwise. Using different definitions (though all of them problematic), their total percentage can vary from 69% to 49%. That's a pretty significant difference, don't you think?

I doubt that the number we really want is in the single digits, but we have every reason to believe it's less than their lowest number, possibly by quite a bit. If it dropped another 20% (which it might, since their own definition changes made that big a difference), then we're down to 29%. That's still a lot, but it's also a lot less than the figures commonly being bandied about.

Then there is this additional matter:

That's not an additional matter. That's a press report on the same paper. Oh, and that problematic number I mentioned pops up again in this report too. See if you can spot it. If you give up, I'll tell you.

Getting back to the thread topic, the point of the medical cause of bankruptcy study supports the case there is a crises in paying for health insurance or health coverage directly. Do you think the problem is fabricated like I believe the claim businesses are drowning in regulations is fabricated?

I don't think the problem is fabricated, nor have I suggested that it is. I do think the numbers commonly used to quantify it are bogus, though. And I can back that up with very specific evidence, which I did. But the existence of a real problem isn't license to use bad facts to promote your preferred solution. You can still argue for whatever you want to, just don't use numbers which are garbage.

 

[RandFan]

The numbers.

• American population = 300,000,000. X .5 = 150,000,000 X .28 = 42,000,000
• America spends more per capita for health care than other nations with UHC (see below, click on chart for source).

Assuming for a moment that the study overstates the percentage it would seem on it's face that there are many millions who are seriously hurt by medical costs and IMO for no good reason. And here is the kicker. The American model can't keep the costs from rising faster than other nations with UHC. We are biting our nose to spite our face.

 

[Skeptic Ginger]

But we don't know the breakdown. And even $5000 doesn't usually make a bankruptcy.

??? The breakdown was right there in front of you on table 2. You're simply ignoring the facts here.

That's not an additional matter. That's a press report on the same paper. Oh, and that problematic number I mentioned pops up again in this report too. See if you can spot it. If you give up, I'll tell you.

So far you've failed to impress me. So feel free to try again. As for yes, it is an additional matter, I'm referring to the comment that the study is pre-economic crisis and therefore likely understates the problem. Perhaps you missed that key comment.

I don't think the problem is fabricated, nor have I suggested that it is. I do think the numbers commonly used to quantify it are bogus, though. And I can back that up with very specific evidence, which I did. But the existence of a real problem isn't license to use bad facts to promote your preferred solution. You can still argue for whatever you want to, just don't use numbers which are garbage.

You failed to demonstrate your criticism of the study results are valid. However, if you don't like that study, it doesn't sound like you are prepared to provide evidence why a health insurance crisis does not exist nor need a solution. All the right wing whining about the supposedly awful Health Care Bill is no more than pre-election propaganda slogan just like the propaganda claim over-regulation is the reason the economy is slow to recover.

 

[Richard Masters]

A.) Demonstrate that not having a car is directly and statistically significant cause of bankruptcy. B.) There is a public option (public transportation).

I've been over this in another thread. It takes me 2 hours to get to work with public transportation and it's very unreliable. Takes me 30 minutes driving.

This doesn't argue for you. A system that systematicaly leaves so many unnecessarily destitute isn't much of a system. But the residual is still statistically significant. American population is 300,000,000. You are talking about making 42,000,000 bankrupt as a matter of course.
And I'm trying to point out that it is unconscionable not to. Allowing people to suffer because they have preexisting conditions seriously hurts society for no good reason.

No. Health insurance doesn't help 78% of people with medical problems avoid bankruptcy.

 

[Richard Masters]

You are not convincing anyone of your position with this blatantly false analogy.

 

[Richard Masters]

My wall of text was in reply to your wall of text.

I'll summarize it for you.

You claim we are over-regulated.
I claim that is a myth.
We agree some regulations are needed.

You provided an example of how overregulation hurt you personally.
I pointed out it was not the regulations that caused your problem, it was the decision of a pharmacist not to accomodate you and a flub by your clinic and/or the pharmacy.

I didn't get a chance to talk to a real pharmacist.

You claim that mandating purchase of medical insurance infringes on the rights of the individual.
I pointed out that the individual who could afford but chose not to purchase medical insurance was a freeloader. People who do pay for medical care cover the costs of the people who get care and don't pay their bills.
You expressed ignorance that the unpaid bill cost other customers.
I hope you see your error there but I'm not sure you do.[/quote]

You are just legalizing the ability of freeloaders to be freeloaders. You are not solving any problem.

If I didn't intend to be constructive, I wouldn't have wasted my time replying to you.
If you support a candidate, generally that means you accept at least some of the candidate's platform. Ron Paul's platform is extreme.

I support the consequences of his platform. I thought that was clear from the beginning, but you decided to ignore the heart of my argument.

Trying to change the debate to the straw man that I've misrepresented your position and I am somehow arguing you "agree with Ron Paul at every level" might be satisfying to you. But anyone else reading this exchange as well as myself can see that is not what I've pointed out to you at all.

What I have tried to point out was your misconceptions about regulations being the source of the problems you believe they are.

It's not regulations I'm against. It's absurd and counterproductive regulations.

 

[Richard Masters]

... You must have quite a legal record.

Besides being the target of handcuff neuropathy by a deputy sheriff, I have no record.

Not worth comment. Drinking age is a very important law. More than a few of us would like to see pot decriminalized and you are welcome to your opinion on the legality of recreational drugs but it's not the clear cut issue you seem to think it is.

So you agree, but you choose not agree because you think Obama is God.

This is pure BS but requires a new thread and I'm out of energy to spend on you. In short, I heard a debate on this just yesterday. The right wing was claiming the cost of education went up because of tax support (in other words the money received was spent resulting in a rise in costs, rather than the costs incurred were reimbursed). But the college president in the debate pointed out the actual costs had not risen beyond the rate of inflation, rather the state funding shrank and the increased need for funding was shifted more and more to tuition.

The cost of education rose beyond the cost of inflation. You've been lied to.

In other words, it was a lie that tuition rate increases were due to increased spending, rather they were the result of cost shifting. I'm pretty sure there is data to support this version of reality.

Find it and we'll discuss it.

You cannot guarantee that you will not incur a bad debt for medical care you don't believe you might need in the future.

Never claimed otherwise.

If you change the law and allow EDs to refuse to treat people and let them die on the ED steps, you can eliminate mandatory health insurance.

How many people die on the ED steps? Sounds like an edge case.

It's the same with laws requiring drivers carry auto insurance. You simply cannot guarantee you'll pay if you incur costs without insurance or a bond of some kind.

But driver's insurance is optional. You can choose not to drive and then you don't have to buy insurance.

 

[Richard Masters]

So which is it Richard, you can't buy a car or you have one and you've been driving on a suspended license? "Oh what a tangled web we weave...."

Spare me your conspiracy theories. There is no contradiction. I've been wanting to get a car for 9 years and could finally afford it last year. So now I have a car.

 

[Richard Masters]

What problem would such a law address? Is there a problem of people who can afford cars but don't buy them somehow adding costs to car buyers? (I assume your question is related to the individual mandate for minimum essential healthcare coverage.)

It was a direct response to Travis who claimed that people have been wanting to buy insurance. So I noted that I'd been trying to buy a car for nine years, but that doesn't mean the government should make everyone buy one.

 

[RandFan]

I've been over this in another thread. It takes me 2 hours to get to work with public transportation and it's very unreliable. Takes me 30 minutes driving.

The point is that you don't have to go bankrupt because you have a public option. What public option exists to keep people without health insurance avoid bankruptcy.

No. Health insurance doesn't help 78% of people with medical problems avoid bankruptcy.

A.) Doesn't address my point. B.) Not something for you to brag about. Citizens who live in nations with UHC don't go bankrupt over health care. Our system is so FUBAR that even having insurance won't protect you. And you actually think that mitigates the fact that people without insurance also go bankrupt. Never mind the simple fact that many people who can't afford health care are already bankrupt.

So, lets address my point:

RandFan: 50% of bankruptcies are health care related.
Richard Masters: 72% of those did have health insurance.
RandFan: Then that means that 28% of the 50% DON'T have insurance, right?

Please to point out anything that is not true?

 

[Skeptic Ginger]

...
You claim that mandating purchase of medical insurance infringes on the rights of the individual.

No, I said the opposite. Not carrying health insurance infringes on my rights as a paying health care consumer because the un-paying person is gambling with my money. When the uninsured person loses the gamble, I pay the cost in my medical bills.

...I pointed out that the individual who could afford but chose not to purchase medical insurance was a freeloader. People who do pay for medical care cover the costs of the people who get care and don't pay their bills.
You expressed ignorance that the unpaid bill cost other customers.
I hope you see your error there but I'm not sure you do.

It would seem you are messing up your quotes. I assume you meant to show that as my comments?

...You are just legalizing the ability of freeloaders to be freeloaders. You are not solving any problem.

You make no sense.

...I support the consequences of his platform. I thought that was clear from the beginning, but you decided to ignore the heart of my argument.

It's not regulations I'm against. It's absurd and counterproductive regulations.

No one, least of all me, ignored your argument. Let me repeat myself, it is a myth that over-regulation is a problem.

 

[Richard Masters]

No, I said the opposite. Not carrying health insurance infringes on my rights as a paying health care consumer because the un-paying person is gambling with my money. When the uninsured person loses the gamble, I pay the cost in my medical bills.

It would seem you are messing up your quotes. I assume you meant to show that as my comments?

You make no sense.

Yeah, it looks you are arguing with yourself.

No one, least of all me, ignored your argument. Let me repeat myself, it is a myth that over-regulation is a problem.

Everyone else seems to agree it's a problem. Either way you haven't presented your case.

 

[Ziggurat]

??? The breakdown was right there in front of you on table 2. You're simply ignoring the facts here.

Since the definitions are overlapping, and most of those categories are overly broad, no, it doesn't really tell us the breakdown we want. But I will note that the percentage of people who said that medical bills were the reason for bankruptcy stands at 29%, which is indeed far below the 49% or 69% numbers they used, and is probably much closer to the figure we're interested in. Evidently you think there's a pandemic of people driven to bankruptcy by medical care costs who don't even know that this is why they're bankrupt.

So far you've failed to impress me.

So far you've failed to address the inadequacies of the paper. I really don't care about impressing you, since you seem so indifferent to the actual facts.

You failed to demonstrate your criticism of the study results are valid.

That's simply false. I told you why the study is crap. The definition it uses is nonsense. I explained why in plain language, and you have not addressed that inadequacy in any way.

However, if you don't like that study, it doesn't sound like you are prepared to provide evidence why a health insurance crisis does not exist nor need a solution.

Why would I do that, when I'm not trying to make either argument?

I'm pointing out that this paper is crap. Are you suggesting that we should just accept a crap paper because it supports your viewpoint? Ignore the problems for the sake of some higher truth?

Sorry, truth doesn't work that way. Feel free to make whatever argument you want to make about health care, but don't use this statistic to do it, because it's bogus.

 

[RandFan]

It was a direct response to Travis who claimed that people have been wanting to buy insurance. So I noted that I'd been trying to buy a car for nine years, but that doesn't mean the government should make everyone buy one.

The govt provides a social program to solve your problem. That public transportation is an inconvenience isn't a valid rebuttal. Many people who go bankrupt for lack of healthcare would be willing to make that sacrifice to save their home.

Now, if the govt mandated that everyone pay into a fund for that transportation, say, oh I don't know, through taxes maybe to lower the cost of a ticket then that's cool by me.

Your example fails because that is what we do it's just not direct. If you prefer a single payer system like public transportation then that's fine by me. And hey, I wouldn't even mind co pays (like purchasing a ticket for the bus) so long as it is affordable.

 

[Skeptic Ginger]

Besides being the target of handcuff neuropathy by a deputy sheriff, I have no record.

And yet you are driving on a suspended license.

The cost of education rose beyond the cost of inflation. You've been lied to.

I cited a debate between 2 college deans on CSPAN yesterday. Care to cite your own source of information?

How many people die on the ED steps? Sounds like an edge case.

No one currently. IT'S AGAINST THE LAW FOR THE HOSPITAL TO TURN ANY PATIENT AWAY. Are you really having that hard of a time following this discussion? Let me try again:

Take your pick:

Mandatory health insurance, or,
Allow hospitals to turn away non-paying patients even if that means they die on the steps, or,
Paying patients have to cover the costs of patients who don't pay.

But driver's insurance is optional. You can choose not to drive and then you don't have to buy insurance.

It's not optional for a hospital to turn away an uninsured patient and it is not optional if an uninsured individual has the bad luck to suffer a serious medical problem.