SeaWorld Parks doesn't pay any corporate income taxes after record year

Aamilj said:

When the conglomerate of pseudo-private government-mandated insurance companies FAIL under Obamacare...and they will... The next step is Captain Government and Single-Payer-Boy to save the day.

See, that's exactly what I'd like to see happen. Even if you fix everything else that's wrong with the system, leaving healthcare decisions up to for-profit entities can and will never be a good thing for anyone needing healthcare. Things like profit and shareholder value should never, ever be a factor in deciding whether people live or die.

CP Chris said:

Things like profit and shareholder value should never, ever be a factor in deciding whether people live or die.

I'm much more terrified by the thought of the government making those decisions. I mean, they have budgets to meet too.

And if you truly take it out of the government's hands and leave it to hospitals and doctors receiving lump-sum payments...well, surely you still see the need to profit being at least some of the decision making process.

I keep going back to my two core ideas - insurance (or big business) shouldn't be synonymous health care and the government should stay the hell out of it.

Not sure what's so hard about "I need. I pay."

It's a private transaction between me and a health care provider who can offer the service or care I need. It really doesn't have to be any more complicated than that...

...although I fully expect someone to explain to me why it is does. :)

There is no power in it for bureaucrats if it works that way.

Lord Gonchar, while I won't attempt to tell you it needs to be more complicated than "I need. I pay.", I'm wondering how you account for health-related situations that are in the best interest of the public?

For example, what do you do about vaccinations? What if someone was content with not paying for treatment of meningitis? Do you want to let the free market try to eradicate epidemics on its own? It's when someone's health and personal decisions about his/her health start to affect other people that I have a problem. And I admittedly don't know what the correct answer is.

My other issue with "I need. I pay." is that, for many, it's "I need. I can't pay." or "I need. I'm not conscious to say I'll pay." I just don't know how you address the situation of someone coming in to an emergency room requiring expensive life-saving procedures and saying "sorry". What if they're not conscious to sign on the dotted line saying they'll be responsible for payment?

Perhaps this is where the line between health insurance and health care becomes blurred, because a patient with insurance is the only patient that the health care provider knows will pay (generally speaking).

Health care is just such a unique market. This is an interesting conversation, though.

I agree that it's an interesting discussion.

I believe health insurance is a necessary entity. I would never be able to maintain a savings reserve big enough to handle my health care expenses out of pocket should I (or my family) ever really need significant care.

Health care doesn't have to be a unique market, though. It's just designed to be at the moment. There's way too much power for the providers and the insurance companies in the current system.

That's why I don't understand why the primary focus seems to be solely on providing coverage for everyone, when that issue is only part of the very larger problem.

I am guessing that Aamilj was trying to quote me when he said:

Is there a call for a downward market force on costs in those minor tweaks? I'd say that ANY health care system that does not include a market mechanism to exert downward pressure on spiraling costs could never fit under the definition of sane.

My point is that by changing the tax structure, you change the incentives on who buys insurance and how it gets paid for. I'm thinking that if you begin by re-establishing actual market conditions, at which point the market can then begin to do what it does. That would establish a competitive insurance market. That's the first step, and it could be done in a way that is initially at near-zero cost to anybody. Start by re-establishing a market. Then figure out how to optimize it.

--Dave Althoff, Jr.

I’m loving the discussion now too.

I start with the premise that there is no perfect system to deliver health care. Knowing this, I form my opinions based upon empirical observations.

Since Johnson signed Medicare into law in 1965, at a CBO estimated cost that has proven to be 100’s of times underestimated, the market relationship between patient and doctor has disappeared. Nobody shops for price and quality for their antibiotics, X-rays, etc. Massive governmental intervention has proven abhorrent in controlling costs. What semblance of private insurance remains to treat the “under 65” market (term used loosely) gets their marching orders from Medicare. Very simply, privates cannot compete with a government capable and willing to print money to stay afloat.

We have almost 50 years of observation to see what this massive 3-party payment system creates. While I can’t question the quality of our care…the COST is certainly out of line with inflation.

Knowing that 3-party payers that have bastardized our health care costs for almost 50 years. I can’t wrap my mind around it.

Who looks at 50 years of Medicare data and concludes…”I gotta get me more of that?” It is not logical. This tells me costs are not part of the Obama agenda. He may try to sell it politically as a cost saver (i.e. lie)…but we have almost 50 years of observations to show the problems are inherent to the very same system he wants to expand.

Instead of 2000 plus pages of hand-slight for which the highest supporters begged to pass and THEN digest…I propose a different path. Not a perfect path. A different path that reintroduces market forces to health care while maintaining a safety net.

Why not just write a simple 1-page bill outlawing all government subsidized insurance for the first $15K (number for argument purposes) of annual health care expenditures per individual? Make it illegal for tax payer funds to subsidize the initial costs.

This would immediately reintroduce a market to health care. The first $15K for all health care expenditures in any given year is still a decent sample from which to save money, and more importantly collect data. We’ve seen what 3-party’s do. Why can’t we see what some good market forces do?

There will still be debates over premiums for the catastrophic insurance needs (over 15K) as well as premium assistance for the first 15K among the indigent, lazy, etc. We can still blame Obama, Bush, et al. Liberals can call conservatives asses. Conservatives can call liberals pussies. None of that fun stuff need change.

However, there would finally be a market we have not seen in 50 years. Something to exert downward pressure on health care COSTS… Furthermore, there would be a “different” way of attacking the problem from which to learn/tweak, etc. We have had plenty of time to learn the Obamacare way…and the people…informed and ill-informed…overwhelmingly do not want it. Why not try a more simple market approach?

Finally, and I consider this huge…my plan adheres to the wonderful confines of our founding documents.

I'm well aware it is not perfect...but it certainly is a bit more logical than expanding a flawed system at a time in our history we could LEAST afford to add expense. While doing nothing is preferable to Obamacare, there are legitimate means of attempting to bring costs in line. But if these attempts do not include a shopping place where the end consumer can go to compare quality and costs...I dare say we are all bending over and grabbing our ankles...no matter how sweet a tune the Piper is playing while we are "taking it."



Carrie J. said:

I believe health insurance is a necessary entity. I would never be able to maintain a savings reserve big enough to handle my health care expenses out of pocket should I (or my family) ever really need significant care.

I'd argue that that's the case because of insurance. The cost of health care is what it is because of the system that's been created where insurance is necessary to cover health care costs.

Secondly, if you really think about your statement for a moment it reveals a much larger problem.

You couldn't afford significant health care without insurance. I feel the same way. I imgine it's true for every single person reading this thread. So how is the insurance company affording it? How the hell does a pyramid scheme work when the people in the bottom put in less than the people at the top take out? Let's ask Bernie Madoff. ;)

Like others have said, I don't have the answers - and I know there are people replying that word things much better than I can. I just know what makes sense to me and what doesn't. I'll always maintain that the insurance industry is the problem with out health care system and forcing everyone into it is exactly the wrong course of action.

Gonch said: So how is the insurance company affording it? How the hell does a pyramid scheme work when the people in the bottom put in less than the people at the top take out? Let's ask Bernie Madoff. ;)

Isn't that the irony of this whole discussion? They do it by collecting from everyone and banking on the fact that only a percentage of those paying in will actually need the coverage... or at least need the coverage in large amounts.

The system is designed to make some pay for the care of others under the promise that they themselves will be covered should they need it someday. And now they just want to expand the program to enable those who can't afford to pay in to also be covered.

Gonch, you've had children. Did you see any of the bills as far as what insurance paid for? Even the natural process of child birth would be a catastrophic financial event for most people.

Insurance isn't a pyramid scheme, it's a system of spreading risk so no one person carries it all. I mean, I've never had an accident in my life, but when that woman destroyed my car on Christmas Eve, I was glad that I had insurance to take care of it, and that the moron did too. I would've been out $16k with nothing to show for it.

That's the issue, though, Jeff. You only ever see the bill. You never see the associated expenses that drive the bill. Sticker price alone shouldn't dictate the need for insurance. Though I agree significant care is still likely too much to handle out-of-pocket.

I don't understand. The bills I see are quite detailed.

What came first: prices getting out of control or most people having insurance which insulates them from the costs?

We need to find ways to create incentives to reduce medical costs. And shielding us consumers from more and more of the costs doesn't create that incentive.

But how many people actually look at the bills? And how many people who look at them actually care about anything other than the line that says what they owe (after insurance has been applied)?

Jeff said:

I don't understand. The bills I see are quite detailed.

Yes. So is the sticker price on a new vehicle. And yet, we all know the manufacturer's invoice tells a different story.

EDIT: And we also know that's really only the top layer of all of the price/cost inflation that goes on. Why do we believe the healthcare industry doesn't also have that kind of bloat?

I guess what I'm trying to understand is if some of you are suggesting that consumers are somehow responsible for the cost of the bill given after the fact. If every consumer read every detailed bill, what would be different?

I'm not saying that. I can't speak for anyone else.

The only point I'm making (or supporting as I don't think I've said it first) is that the current system avoids the natural cost-reducing flow that occurs in a free market. By establishing a middle man (insurance company) and then making that middle man a part of employment benefits or other group offerings, the natural containment of costs and therefore price has been compromised. (And I KNOW I am not saying this as intelligently as others can and have.)

I think that's where the start of reform should occur. Once that's been addressed, then it will be easier and less expensive to insure everyone, in my opinion.

Reading the bill after the fact won't help reduce costs (unless it scares you into changing your behavior such that your healthcare needs in the future are reduced). Knowing the cost of a given procedure/office visit in advance wouldn't do much either if your insurance will cover the cost of it. Though try asking your doctor next time how much a procedure will cost and see if he/she knows. The few times I have asked, they have had no clue (other than some round, totally make it up out of thin air guess). What incentives do you have to reduce costs?

When we look at reducing our healthcare costs, aren't we typically ignoring a very significant driver of the costs which is us, the consumer?

Carrie J. said:
Isn't that the irony of this whole discussion? They do it by collecting from everyone and banking on the fact that only a percentage of those paying in will actually need the coverage... or at least need the coverage in large amounts.

The system is designed to make some pay for the care of others under the promise that they themselves will be covered should they need it someday. And now they just want to expand the program to enable those who can't afford to pay in to also be covered.

Yeah I know how it works, I was being a bit facetious.

The point is, you say you couldn't afford health care. I agree. I think we all agree.

So if what we're paying in isn't enough to afford health care on our own, but the insurance company who we pay that money to can cover it, then how the hell does the system work? We all can't take more than we give. But we do - or at least feel like we do because health insurance isn't just for emergencies anymore. It's for maintenance and repairs and check-ups. It is synonymous with health care. To get any kind of care in this country you need coverage. How can I possibly NOT be paying more than needed because of the coverage that exists between me and my health care provider?

Which ties perfectly into:

Jeff said:
Insurance isn't a pyramid scheme, it's a system of spreading risk so no one person carries it all. I mean, I've never had an accident in my life, but when that woman destroyed my car on Christmas Eve, I was glad that I had insurance to take care of it, and that the moron did too. I would've been out $16k with nothing to show for it.

The difference is that you could go your whole life paying into your auto insurance and never take out of it. It's insurance in the truest sense of the word. It's there's for emergencies. You don't use it to get your oil changed or fill up with gas or get new wiper blades. You use it when, and only when, the crap hits the fan.

Health insurance doesn't even come close to operating the same way. 

Carrie J. said:
The only point I'm making (or supporting as I don't think I've said it first) is that the current system avoids the natural cost-reducing flow that occurs in a free market. By establishing a middle man (insurance company) and then making that middle man a part of employment benefits or other group offerings, the natural containment of costs and therefore price has been compromised. (And I KNOW I am not saying this as intelligently as others can and have.)

I think that's where the start of reform should occur.

This. This. This.

What some of you are alluding to, is a product that already exists--high deductible plan paired with a medical savings acount.

Here's an article that says they save money (warning: written by an R governor, and appearing in the WSJ.)

http://online.wsj.com/article/SB10001424052748704231304575091600470293066.html

I've heard conflicting information if Obamacare outlaws these. (Not yet, I've had one for years.)