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Author: nigelwhalmsley Big gold star, 5000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 1976159  
Subject: State by State? Date: 10/4/2012 10:27 AM
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Is implementing Romneycare state by state a good idea? Given the issues we have to consider when looking at healthcare, like moving across state lines, pre-existing conditions, etc., it seems like having 50 different sets of health care laws would be wildly inefficient.

It seems that Romney is saying that Romneycare is good because it is only on a state basis. Does this make any sense?
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Author: HMALETTER Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821017 of 1976159
Subject: Re: State by State? Date: 10/4/2012 10:54 AM
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Is implementing Romneycare state by state a good idea? Given the issues we have to consider when looking at healthcare, like moving across state lines, pre-existing conditions, etc., it seems like having 50 different sets of health care laws would be wildly inefficient.

It seems that Romney is saying that Romneycare is good because it is only on a state basis. Does this make any sense?
________________________

I've long believed that states should not be in charge of health care nor insurance. Possibly for the same reasons you do.

However, there are plans working in 3-4 states now. Not to say they wouldn't be better if residents were free to chose other plans not in state.

But Obamacare ends up being the responsibility of the states in a very large way. States know that, which is why they dread it.

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Author: AngelMay Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821023 of 1976159
Subject: Re: State by State? Date: 10/4/2012 11:03 AM
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It seems that Romney is saying that Romneycare is good because it is only on a state basis. Does this make any sense?



Not only does it not make any sense, it is actually frightening.
What happens when you spend half the year in one state and half in another state? Many people do this. We are not all rich like Romney so whether or not we are covered state-to-state is important to us. Sickness doesn't pay much attention to state lines.

AM

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Author: cjb44 Big funky green star, 20000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821026 of 1976159
Subject: Re: State by State? Date: 10/4/2012 11:16 AM
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Let's assume you're right and it's wildly inefficient.

three questions come to mind.

1 - Why do you think the Federal Government's plan would be more efficient? The Federal Government isn't exactly the model of efficiency.

2 - What if a State has a "better" plan? Should they be allowed to get a waiver? Why is the Federal Government holding back the States?

3 - Why do you think one size fits all is a good thing? The best plan for a State like Delaware might not work in Idaho.

Just because 50 plans would be inefficent, doesn't mean one Federal one wouldn't be a disaster either.

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Author: MetroChick Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821028 of 1976159
Subject: Re: State by State? Date: 10/4/2012 11:18 AM
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Is implementing Romneycare state by state a good idea? Given the issues we have to consider when looking at healthcare, like moving across state lines, pre-existing conditions, etc., it seems like having 50 different sets of health care laws would be wildly inefficient.

I say "yes" because then you have more choices. Maryland had a state insurance plan for residents with pre-existing conditions before ACA, and I was on it for about 1 year. It was run by BC/BS - so when I worked in DC it wasn't an issue to see a doctor in DC as long as they accepted BC/BS. Rates were by age-range and income and there were lower premiums if your income was X amount below median for the state - and it was doing well enough that it expanded to allow enrolls to enroll depedants - so if I'd had a spouse I could've had them covered, even if they didn't have pre-existing conditions.

Pre-existing conditions don't become an issue if (like Maryland's plan was) the insurance is specifically for people with pre-existing conditions, or if you can't deny people with pre-existing conditions (like ACA now) or if via HIPP laws you don't have a break in coverage.

I got off it once I had a full-time job where insurance premium was subsidized more by the employer than what I was paying in premium for Maryland's state plan.

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Author: lowstudent Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821030 of 1976159
Subject: Re: State by State? Date: 10/4/2012 11:21 AM
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It seems that Romney is saying that Romneycare is good because it is only on a state basis. Does this make any sense?


__________________________________

OK, this is going to be somewhat logical, so it will go way over your head, but you can try to understand.

In the simplest scenario.

Assume a state puts up a poor plan. Not that any government function could ever do that of course, this is sheer fantasy speculation of course.

What would be the first government response? Well history tells us, defend expand and claim it will work eventually.

What if there is a similar state, right next door, and that state has this awesome plan that works!

Very different than federal

Now let's take a different scenario.

Assume both states have good plans, because government after all, is infallible. Now there is this new feature, actually there are two ways of implementing it. One state tries one, the other uses the other way. One of those two ways works better! Less good state sees results and voila -- changes. If federal ? Hey that worked, cool -- no improvement.

The entire concept is about competition and why competition yields the best results and is key to the whole concept of 'best practices'

That anyone does not get this, is just really silly.

But then again, I have read about the right wing media being the reason that Obama only slightly won the debate, after all this is PA

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Author: nigelwhalmsley Big gold star, 5000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821036 of 1976159
Subject: Re: State by State? Date: 10/4/2012 11:29 AM
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"OK, this is going to be somewhat logical, so it will go way over your head, but you can try to understand."

I stopped reading there, but thanks for your input.

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Author: nigelwhalmsley Big gold star, 5000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821039 of 1976159
Subject: Re: State by State? Date: 10/4/2012 11:36 AM
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"three questions come to mind.

1 - Why do you think the Federal Government's plan would be more efficient? The Federal Government isn't exactly the model of efficiency."

Having 50 different plans, 50 different sets of rules, overhead, management, analysts, etc. does not strike you as being most likely inefficient?



"2 - What if a State has a "better" plan? Should they be allowed to get a waiver? Why is the Federal Government holding back the States?"

Not sure about that one. Who determines it is 'better' and how? I would think that a waiver system would work, as long as the states plan met the criteria.



"3 - Why do you think one size fits all is a good thing? The best plan for a State like Delaware might not work in Idaho."

I'm not sure how health care is that much different from state to state. How would a plan 'not work' in some places and 'work' in others?



"Just because 50 plans would be inefficent, doesn't mean one Federal one wouldn't be a disaster either."

No question, I agree. The worst case, of course, is that you could have 50 disasters, using your same logic.

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Author: nigelwhalmsley Big gold star, 5000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821040 of 1976159
Subject: Re: State by State? Date: 10/4/2012 11:38 AM
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"I say "yes" because then you have more choices."

No, you wouldn't. Whatever state you live in, that is your plan. Are you saying you'd move to another state to get a better plan?

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Author: SGIZ1 Big gold star, 5000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821042 of 1976159
Subject: Re: State by State? Date: 10/4/2012 11:42 AM
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"Just because 50 plans would be inefficent, doesn't mean one Federal one wouldn't be a disaster either."

No question, I agree. The worst case, of course, is that you could have 50 disasters, using your same logic. "


Actually a one size fits all centralized Federal government (Obamacare) is 50 disasters coming as it effect all 50 states.

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Author: SGIZ1 Big gold star, 5000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821044 of 1976159
Subject: Re: State by State? Date: 10/4/2012 11:43 AM
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"No, you wouldn't. Whatever state you live in, that is your plan. Are you saying you'd move to another state to get a better plan? "

???

In each state you will have many options (competitors) to choose from.

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Author: TheDope1 Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821045 of 1976159
Subject: Re: State by State? Date: 10/4/2012 11:44 AM
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Is implementing Romneycare state by state a good idea? Given the issues we have to consider when looking at healthcare, like moving across state lines, pre-existing conditions, etc., it seems like having 50 different sets of health care laws would be wildly inefficient.

It seems that Romney is saying that Romneycare is good because it is only on a state basis. Does this make any sense?


It makes sense if you understand that the US is comprised of...wait for it...50 individual states, so yes, it does.

BTW. States ALREADY have rules and laws in place.

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Author: AngelMay Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821046 of 1976159
Subject: Re: State by State? Date: 10/4/2012 11:46 AM
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It is VERY expensive to move these days.
I know...
We are packing our things right now.

But I still fear a state-by-state healthcare "system" (which, when broken into 50 separate parts really isn't a system at all). What would we do when we spend half the year in one state and half the year in another state? How would that be handled?

Of course Romney doesn't have to worry about such things, does he?
It's probably never even crossed his mind.
He's pretty good at running his mouth.
Too bad he's not as good at using his brain.

He should take a couple of years off from his rich cocoon and live on minimum wage like many people have to do. He might get a better appreciation for what real people go through just getting by from day to day.

Aristocrats. Bah!
France knew what to do with them.


AM

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Author: SGIZ1 Big gold star, 5000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821049 of 1976159
Subject: Re: State by State? Date: 10/4/2012 11:47 AM
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"It makes sense if you understand that the US is comprised of...wait for it...50 individual states, so yes, it does."

That's Chinees to the left, they see us as one state controlled by one centralized government.

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Author: lowstudent Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821050 of 1976159
Subject: Re: State by State? Date: 10/4/2012 11:50 AM
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In each state you will have many options (competitors) to choose from.
_______________________

And any state that chose badly will have a huge incentive as well as a lot of pressure to change quickly, not to try to throw money at failure.

You have to remind liberals regularly, that just because something fails, does not mean you can't 'CHANGE!!!!!!!!'

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Author: cjb44 Big funky green star, 20000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821058 of 1976159
Subject: Re: State by State? Date: 10/4/2012 12:01 PM
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Having 50 different plans, 50 different sets of rules, overhead, management, analysts, etc. does not strike you as being most likely inefficient?

__________________

Not really, I can see 50 States being more efficient that 1 Federal Government...and in all honesty, you wouldn't have 50 plans. Maybe 5 or 6 as most States would do the same thing.

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Author: cjb44 Big funky green star, 20000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821060 of 1976159
Subject: Re: State by State? Date: 10/4/2012 12:03 PM
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I'm not sure how health care is that much different from state to state. How would a plan 'not work' in some places and 'work' in others?

____________

Depends on the population, tax base and community needs. Florida and Arizona are more elderly so programs would be aimed at a higher retirement population for example. What's the tax based to pay for these things?

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Author: SGIZ1 Big gold star, 5000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821061 of 1976159
Subject: Re: State by State? Date: 10/4/2012 12:05 PM
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"Not really, I can see 50 States being more efficient that 1 Federal Government...and in all honesty, you wouldn't have 50 plans. Maybe 5 or 6 as most States would do the same thing."

This goes to Romney's point of states being the experimental laboratories, as you said above, states will learn from mistakes other states make and will adopt what works, the failures get weeded out and what's left is the successful ideas.

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Author: notehound Big gold star, 5000 posts Top Recommended Fools Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821063 of 1976159
Subject: Re: State by State? Date: 10/4/2012 12:09 PM
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Why do you think one size fits all is a good thing? The best plan for a State like Delaware might not work in Idaho."

I'm not sure how health care is that much different from state to state. How would a plan 'not work' in some places and 'work' in others?


Allowing the states to do what Massachusetts did and craft their own plans would follow the Constitution, allow states to gauge their own citizens' needs and allow voters to vote with their feet.

All the young people could move to certain states, which would result in those states having low insurance premiums. The rich old people in Florida would have to pay higher premiums or else move to a state with better demographics and premium rates.

The "right to work" Red States would continue to gain residents of working age, resulting in lower premiums and even more migration out of the Blue States.

Competition across state lines might allow insurance companies to configure their premiums to balance out the Red & Blue states or else quit doing business in Blue States.

Whether it would be more efficient, who knows - but it would certainly give people more options.

On the other hand, the only way that the federal government could really reduce medical costs and be more efficient would be to do what Obamacare should have done:

Make everyone eligible for Medicare (national single payer) and let citizens buy their own Medicare Advantage or supplemental plans like Germany and other Europeans countries do.

Single payer plus supplemental private coverage is the most efficient system.

It also would be Constitutional.

;-)

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Author: lowstudent Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821070 of 1976159
Subject: Re: State by State? Date: 10/4/2012 12:12 PM
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Not really, I can see 50 States being more efficient that 1 Federal Government...and in all honesty, you wouldn't have 50 plans. Maybe 5 or 6 as most States would do the same thing.
_________________________________

And in an iterative process there would likely be 2-3 general 'tracks' that states followed, piggybacking on the multiple states on the same track and copying the successful innovations.

Of course statists believe that no competition, no loss to overhead and no money being lost to profit is going to be the best solutions.

Isn't it obvious? Obama actually did say that BTW, no loss to profit so ObamaCare would work better. Yes it is what they believe in their frigid little souls. It is at the heart of all they want to do. It is more efficient. How could it not be?

If you have 1 perfect factory, with perfect innovation and perfect motives the economies of scale are awesome! If that factory does not need to make a profit... well, think how much less costly things are for the proletariat without profit!

These people are base evil, and they have no clue that they are.

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Author: BlueGrits Big gold star, 5000 posts Top Recommended Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821071 of 1976159
Subject: Re: State by State? Date: 10/4/2012 12:13 PM
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Allowing the states to do what Massachusetts did and craft their own plans would follow the Constitution, allow states to gauge their own citizens' needs and allow voters to vote with their feet.

And it seems like only yesterday that Republican'ts were telling us that there should be a uniform set of rules across all states and insurance companies should be allowed to seamlessly offer their products from state to state without regards to their individual laws....

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Author: lowstudent Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821072 of 1976159
Subject: Re: State by State? Date: 10/4/2012 12:15 PM
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And it seems like only yesterday that Republican'ts were telling us that there should be a uniform set of rules across all states and insurance companies should be allowed to seamlessly offer their products from state to state without regards to their individual laws....
_____________________________________________

And you thought that the Republicans believed there should be no rules?

The stuff you post is consistently mind numbingly valid.

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Author: Jeanwa Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821075 of 1976159
Subject: Re: State by State? Date: 10/4/2012 12:18 PM
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BTW. States ALREADY have rules and laws in place.

==============================

What happened to the "buy across state lines"?

I thought that was what the Republicians wanted.

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Author: SGIZ1 Big gold star, 5000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821076 of 1976159
Subject: Re: State by State? Date: 10/4/2012 12:18 PM
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"And it seems like only yesterday that Republican'ts were telling us that there should be a uniform set of rules across all states and insurance companies should be allowed to seamlessly offer their products from state to state without regards to their individual laws.... "

Lets stick with Romeny's plan vs. Obama's plan shall we?

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Author: cjb44 Big funky green star, 20000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821077 of 1976159
Subject: Re: State by State? Date: 10/4/2012 12:19 PM
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And it seems like only yesterday that Republican'ts were telling us that there should be a uniform set of rules across all states and insurance companies should be allowed to seamlessly offer their products from state to state without regards to their individual laws....

__________

No they didn't.

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Author: SGIZ1 Big gold star, 5000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821079 of 1976159
Subject: Re: State by State? Date: 10/4/2012 12:21 PM
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"And it seems like only yesterday that Republican'ts were telling us that there should be a uniform set of rules across all states and insurance companies should be allowed to seamlessly offer their products from state to state without regards to their individual laws....

__________

No they didn't. "


Funny how the left as fallen victim to their own trick, lie/distort/repeat/spin their talking point of what the other side really means/wants in hopes people will accept it as the truth, well it worked! They themselves no longer know reality vs. their spin of reality.

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Author: cjb44 Big funky green star, 20000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821080 of 1976159
Subject: Re: State by State? Date: 10/4/2012 12:22 PM
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What happened to the "buy across state lines"?

I thought that was what the Republicians wanted.

_____________

That's not what's being discussed. If you were to buy insurance across State lines, you'd have to buy the policy that follows that State's rules. Insurance companies in different States would have different policies based on different rules. You could but the policy that's best for you, but the rules governing the policies would be different.

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Author: notehound Big gold star, 5000 posts Top Recommended Fools Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821106 of 1976159
Subject: Re: State by State? Date: 10/4/2012 12:56 PM
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And it seems like only yesterday that Republican'ts were telling us that there should be a uniform set of rules...

Grits, I'm not a Republican - and you didn't read to the bottom of my post. I clearly stated that just because the Constitution protects states rights and competition between states doesn't mean I think it's most efficient.

Single payer Medicare for all is the most efficient - supplemented by private insurance or Medicare Advantage type plans paid for by those who want more than Medicare covers.

Obamacare should have been an expansion of Medicare and a de-regulation of competition across states lines for private supplemental plans.

Instead, it was a partisan imposed 2500 page mess requiring thousands more pages in unwritten regulations that ultimately will do nothing but enrich insurance companies and drive up everyone's premiums.

A lot of it was simply Obama's failure to understand the art of the deal - and abdicating his leadership role to Pelosi and Reid.

Obama himself could have gotten single-payer through because he was more persuasive and popular than Hilary was when she tried it.

Obama just didn't want to sully himself with dealmaking, hobnobbing with lowly Congressmembers and the late night phonecalls and horsetrading and cajoling that would have been required to get a modified single-payer system through. His party was in control of both houses, for goodness sake.

Obama always tries to go "over the head" of Congress directly to the voters as his means of getting Congress to do what he wants.

That method only makes enemies, not friends, in Congress - especially among the opponents whose votes and contributions to legislating are essential. And no president can ever be a real leader, dealmaker and successful bi-partisan policy promoter without offering your opponents the respect they demand (old coots are just part of what Congress is all about).

Political scientists surely will analyze Obama as being brilliant at campaigning and lousy at governing - primarily because he doesn't know how to do a deal with people he despises.

Obama is a Demagogue (and to some, a Demigod).

dem·a·gogue/'dem??gäg/
Noun:

A political leader who seeks support by appealing to popular desires and prejudices rather than by using rational argument. (in ancient Greece and Rome) A leader or orator who espoused the cause of the common people.

Synonyms: demagog

More info »Wikipedia - Dictionary.com - Answers.com - Merriam-Webster


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Author: MetroChick Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821120 of 1976159
Subject: Re: State by State? Date: 10/4/2012 1:28 PM
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No, you wouldn't. Whatever state you live in, that is your plan. Are you saying you'd move to another state to get a better plan?


In some areas - such as Metro DC or NY, yes, you could move states since both areas have 3 surrounding states workers typically move among.

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Author: richieds Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821281 of 1976159
Subject: Re: State by State? Date: 10/4/2012 10:21 PM
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"What if a State has a "better" plan? Should they be allowed to get a waiver?"

Part of the GOP plan is the ability to cross state borders to buy insurance, am I correct?

That said then, if one state has a "better" plan, then wouldn't that state be overwhelmed with citizens of other states crossing borders to buy insurance there?

If the state I live in passes a mandate (such as Mass. did because Romney knows it's a good idea) but I buy my insurance in a different state, do I have to pay the mandate in the state I live in but don't buy insurance there? After all, the mandate is only that I have insurance, correct? Need I go into the possible problems that would cause?

If Aetna or BCBS know that they get the best deal in one particular state, wouldn't they set up shop in that state and ONLY sell insurance in that state being that anyone could buy through them there anyway?

"The best plan for a State like Delaware might not work in Idaho."

Why not? Are the people more disease resistant in one or the other?

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Author: jakalant Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1821377 of 1976159
Subject: Re: State by State? Date: 10/5/2012 9:57 AM
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Obama himself could have gotten single-payer through because he was more persuasive and popular than Hilary was when she tried it.

That is BS.

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