Being forced to buy insurance is not "help." It's being forced to buy insurance. It may be a good idea for some, but calling it "help" is misleading. Most people with this insurance will see more of their money spent on premiums than they would receive in payments even when they do get sick and need medical care. The medical care savings accounts would have been much more helpful for most people in reducing their medical costs and in forcing them into long-term responsible behavior. But we couldn't do that. That would be too Republican an idea.
if you buy insurance in the exchanges, you can choose a high deductible policy, and if you choose a high deductible policy, then you can start a health care savings account with whichever one you choose.
By far the biggest impact from Obamacare has been the expansion of Medicaid. That could've been accomplished without messing with my private insurance.
If your insurance is through your employer, then it's not really messed with. If your insurance was through individual plans or a small group employer, then it really needed to be messed with. Insuring small groups or individuals is a disaster area, and insurers behaved accordingly; by having a lot of people end up on Medicaid, fror example. If you happened to come out ahead of the game by accident, that doesn't make it a wonderful feature of American life
It is not the role of government to force people to buy things.
Furthermore, Obamacare has done NOTHING to make health care more affordable. It does not address health care at all. It's a gift to the health INSURANCE industry.
You are laboring under the bogus notion that "health insurance" == "health care"
Insurance rates have not gone down and insurance plans haven't gotten better. If anything, people's attempts to be responsible and self-reliant are being actively sabotaged.
AVOIDING insurance still remains the cheapest option in many cases.
Absolutely, for the young and healthy, not getting insurance is always financially best.
Of course, this just means they will pay more later, when they are old and sick.
Which means they will not get insurance longer and longer.
Which means the costs will be even higher when they do get it, when they are older and sicker.
Which means they will not get insurance even longer.
You see where this goes?
Any competent engineer will tell you that if you want to eliminate an undesirable positive feedback, you need to damp it out. Like by requiring people to buy insurance. Or charging them a penalty if they don't. If people are responsible and self-reliant, they will buy insurance anyway, and they won't face either of those and won't be sabotaged, will they?
Are republicans so stupid that they can not see it's a Republican system?
Their memories are simply that short. That's how they forget that none of their interests have been served by their elected politicians, and proceed to re-elect them.
Here in California, however, we re-relected Jerry Brown. That's very like re-electing Marion Berry. Heh heh heh.
Being a republican means having no long term memory. Most of them don't even remember voting for Bush, and those that do vaguely remember how great things were when Bush was president and how much worse they are now.
That you have to pay "cash" to get medical attention strucks me as hard as if you'd had to pay to have the police assiting you, or that if you had to pay to get your children into the school. All of those are basic rights that any development country considers "essential". Of course you pay for them, but you do so in your taxes... and if you want a premium service, then yes: you can use your cash as much as you want, and have hot blonde nurses for all I care.
American republicans are fucked up around private healthcare. Why don't they ask for only-private police? that only serves and protects those that can afford it? or only-private education?
Things you'll never see conservatives demanding: privately funded military replacing out of control government spending. Even though they're all stocked up on their Second Amendment supplies just in case.
That's like saying that rich people have to pay taxes shown in the tables that the IRS provides to everyone with their tax forms. There are so many accounting tricks and loop-holes in the laws that that 15-20% limit is NEVER going to be achieved. The real solution to the problem is universal healthcare funded directly by tax payers. The republican complaint against it is that you'll have to hire an army of people to administer it- BIG GOVERNMENT! What we have now is insurance companies with armies of administrators and lawyers working to prevent spending on health care because it is more profiable to collect premiums and not pay money out. With a single-payer system you have an army of people working to ensure spending is going to health care and not fraud. I know which I would rather fund.
As far as I know, unlike the tax code, there are no "accounting tricks and loop-holes" in the "Medical Loss Ratio". If you know of any, clue me in, please.
You don't understand. Your visit to the doctor costs what it does because of the complexities of the insurance system, including both health insurance and malpractice insurance. Doctors have a lot of overhead to pay, and in hospitals, they are just employees with no control over their schedules. If the administrators put 40 people per day into their schedule, they see 40 people per day. People without insurance use the emergency room to fix problems after they occur, a very expensive way to deal with health problems - something which Obamacare was feebly attempting to address. Everyone else who uses the place has to pay more to cover those costs. Every time a doctor makes an error the patient calls a lawyer. Doctors order test after test to cover their asses against malpractice suits- they are told to do so in "risk management" seminars put on by insurance companies that they must attend every year to maintain their malpractice insurance. The system is full of waste at every level. Doctors are not the cause of the problem. They have been made to look that way by insurers and hospital administrators who want to deflect attention away from themselves.
When you look at Las Vegas, what do you see? You see huge luxury hotels, bright lights, excitement, partying, etc. Where does that money come from? From losers. Yet it's the winners who get the attention. Yeah, great, Vegas baby! Now look at insurance companies. Huge luxury office buildings, executives who make millions- it's a lot like Vegas. Where does the money come from? Losers like you and me who have to pay ridiculous premiums for minimal coverage. Yeah, Insurance baby!
My son has expressed an interest in studying medicine when he graduates from high school. My wife is a physician and I am a dentist. We have suggested that he get a degree in business and become a hospital administrator. Those people make $ millions with no special skill set and without the arduous training imposed on healthcare providers.
Again, no. Insurers are restricted by law to paying at least 80% of their premium income out again as actual medical costs. That leaves maximum 25% overhead, which ends up as maybe 3% profit in a good year. What they do have going for the is volume, which works two ways; they use those massive numbers of patients to negotiate much lower prices from doctors and hospitals, and on the actuarial side, having a huge number of insured people makes that 3% profit very predictable with no risk, which is good when you run a big company. The risk comes in whenever conditions change, like currently, and the past doesn't predict the future very well.
In general, the insurance industry isn't a "luxury" industry; there are a handful of well paid CEOs and VPs, supported by a huge army of overworked underpaid peons in little cubicles worried about the next layoff. Ironically, the healthcare plans insurance companies sell to their big clients are better than what they give to their own employees; they just don't make enough profit to offer anything better.
It must be nice to have the State-run Media on you side
Oh, Fox News and the WSJ aren't state-run, but it's an easy mistake to make, the way they wrap themselves in the flag and scream socialist traitor and everybody who disagrees.
Right after the Supreme Court's decision to lift limits on campaign contributions, Democrats and their left-wing supporters assaulted the decision as a boon to Republicans, "the party of the rich."
This of course is part of a far-wider narrative — slavishly repeated by largely unquestioning liberal media — that the GOP outspends Democrats on campaigns thanks to big-buck donors like the billionaire Koch brothers.
But, as it turns out, that's a lie — as big a lie, in fact, as "you can keep your insurance," "you can keep your doctor" and "ObamaCare will bend the cost curve down."
By almost every measure, in fact, it's the Democrats, not the Republicans, who are the party of the rich.
Start with Congress itself. Who are the wealthiest members? Well, there are 269 millionaires among Congress' 535 members. And most of them are Democrats.
And contrary to the hand-wringing on the left about the Supreme Court's 5-4 McCutcheon v. Federal Election Commission ruling Wednesday, Democrats far outspend Republicans on elections. It isn't even close.
According to OpenSecrets.org, from 1989 to 2014 rich donors gave Democrats $1.15 billion — $416 million more than the $736 million given to the GOP. Among the top 10 donors to both parties, Democrat supporters outspent Republican supporters 2-to-1.
But what about the villainous Koch brothers, those conservative plutocrats supposedly seeking to control American politics? They rank 59th on the list of big givers — behind 18 unions and No. 1 Act Blue, the massive left-wing fund raiser that gives only to Democrats.
Indeed, a recent book, "The New Leviathan," says donations to Democrats outstrip those to Republicans 7-to-1. How can this be? Democrat support soars when you include unions, universities, superPACs, nonprofits, left-wing interest groups, and — ready for this? — Wall Street (which overwhelmingly favors Democrats).
So Democrats don't really want to restrain money in politics. Just the money that goes to Republicans.
Yes, if you ignore all the 'dark money', there is more open donation to Democrats than to Republicans. Of course, if you look at the nondisclosing groups, such as Americans for Prosperity, which hapens to be run by the Koch Bros. by coincidence, they account for 80% of Republican funding, but only 30% of Democrats.
No wonder the Republicans think it's a Constitutional crisis when the IRS asks groups with the name "Tea Party", etc to further document their request to be considered anonymous nonpartisan campaign funding organizations.
Question: Not a single Republican voted for Obamacare, so exactly how does it make it their "wet dream"?
Answer: Because Obama adopted the Republican plan in an attempt to unify the parties in implementing healthcare reform. The Democratic plan was Single Payer, which was cheaper, simpler, and more effective. Obama agreed to the more expensive, complex and ineffective Republican plan in an attempt to get Republicans to engage in the reform.
Unfortunately, Republicans immediately turned against their own plan, because they cared more about preventing reform than in their own reform plans.
The shame is that the Democrats didn't then go back to their own plan and push that through. Unfortunately there were enough Democrats tied to the insurance industry (Lieberman....) that, combined with 100% Republican obstruction, they were able to force the country to waste $trillions on insurance company waste. Because what's waste to us is record profits for insurance companies.
The Clinton administration tried that. Didn't work out well. Considering how hard it's been to get this watered down former Republican dream past the 'fear of a Kenyan socialism Muslim' idiots, going back to a rational single payer plan wasn't going to work any better how than it did for the Clintons.
but now we're stuck with a golden goose for the insurance companies (aka a Republican wet dream).
Not a single Republican voted for Obamacare, so exactly how does it make it their "wet dream"? The Democrats are bought and paid for by the banking industry and Wallstreet. The insurance industry is just a sublet of the banking. The Republicans are bought and paid for by farming, energy, and military industries. At least try to get the group you want to blame right or you come off sounding like a moron.
Yeah. I'll believe "the insurance industry is just a subset of the banking", the first time an insurance company sells policies for less than cost and then packages them and sells them off as investments to people who sell them to other people, and so on, until the sucker holding the hot potato when the music stops goes broke. (Hint: they can't. Government regulation and al that).
The second were the $150/month genuine catastrophic plans. Insured pays $150/month, and in exchange the obligation of paying the first $10K of the bill, the insurance company might actually cover the remaining $90K. (Also, the insurance company might be able to bargain the hospital down from $100K to $20K, so even if they refuse to cover it, the insured isn't bankrupt.) These are gone, and that kinda sucks.
Are these plans outlawed by the ACA, like the first set of plans you describe? Or have insurers merely stopped offering them of their own volition? I'm genuinely asking, as I don't know. I haven't heard of any limitations on deductibles imposed by the ACA.
What ACA proponents don't get is that YES, premiums *DO* have to rise, markedly, and that as long as insurance companies remain middlemen, everyone is going to pay $10K. Because that's your actual actuarial risk including the middlemen's 50% cut.
If premiums do have to rise (because of the ACA), why? What are the increasing costs? Most arguments I've heard boil down to "my premiums went up, my coverage went down", but something's not adding up. The ACA has capped insurers' profits (to what extent this is effective remains to be seen), so I'm comfortable assuming that the alleged difference in cost isn't simply being pocketed. So where is it going? I can't answer that. The conclusion this brings me to is that either premiums are not going up, or coverage is not going down.
Exactly; more members are not a windfall for insurers like they are for cell phone companies or such, because insurers are legally required to have their total premiums be 125% or less of their total medical costs.
If your costs went up that significantly, then your coverage has changed dramatically. It's overwhelmingly likely that your previous policy had terrible coverage, coverage which doesn't meet requirements set forth in the ACA. Your costs have increased, but so has your coverage, comparably. If the increases you claim are accurate, then your previous policy was total shit and wouldn't have helped you much were you to actually need it for anything serious.
There are two kinds of low-end insurance plans.
The first are the $50/month bullshit scams that you're talking about. Sucker pays $50/month, and gets the *first* $2000 of his $100K medical bill paid for, but is on the hook for the remaining $98K. (i.e. "You get $2000 off your first bill!") These are gone, and good riddance.
The second were the $150/month genuine catastrophic plans. Insured pays $150/month, and in exchange the obligation of paying the first $10K of the bill, the insurance company might actually cover the remaining $90K. (Also, the insurance company might be able to bargain the hospital down from $100K to $20K, so even if they refuse to cover it, the insured isn't bankrupt.) These are gone, and that kinda sucks.
It only *kinda* sucks because the replacement (the bronze plans) are issued at around $300/month with $6300 deductibles, but, and this is where ACA detractors miss the point, they're issued to everybody, even to people with cancer and known expenses of at least $100K/year chemotherapy. You pay $300/month for a $6000 deductible, or $800/month for a $0 deductible. If you go Bronze, you pay ($300*12 + 6000 deductible) = $9600/year. If you go Gold/Platinum, you pay ($800*12 + 0 deductible) = 9600/year. It's still, to within an order of magnitude, the same amount of money at risk.
What ACA proponents don't get is that YES, premiums *DO* have to rise, markedly, and that as long as insurance companies remain middlemen, everyone is going to pay $10K. Because that's your actual actuarial risk including the middlemen's 50% cut.
Please (this isn't directed at you, parent poster), can we stop talking about Republicans and Democrats and which party wants to protect/harm you, and concentrate on actual policy?
If you read the documents for the now obsolete low-end plans, they basically come out and tell the purchaser that they aren't going to pay for anything much, but were just in effect a giant group purchase plan, so that you could get the discounts providers give insurance plans (typically way more than 50%) and not get stuck paying the "list price" the providers charge to the uninsured, who don't have the clout of 2000000 paying customers to bargain with.
Which brings me to the quibble: the middleman doesn't take a 50% cut. The insurer is legally required to spend 80% of premiums on actual medical expenses; and that 80% is the insurers' low negotiated cost, as I described above, not the list price. So that, from actual example, if you have no insurance and get a minor outpatient operation, you would pay $4,000; if you have insurance, your immediate cost would be $200 with the insurer paying out another $600 because their contracted cost is $800; averaged out over the entire membership, you would of course pay this amount in your premiums, plus an additional $200 max in overhead, for a grand total of $1000. There isn't any 50% cut in there no matter how you arrange the numbers.
It is, only in that it redistributes money from the healthy to the insurance companies. Saying that "these people are better off because they now have insurance" is misleading. They now have to pay for that insurance, and the cost of insurance has skyrocketed since the law was passed. Furthermore, they can only be said to have benefited from having insurance if they get sick, or if they were already sick and would have been denied coverage.
"the cost of insurance has skyrocketed"? really? for whom? you? not me. Or most people, apparently. The cost of insurance has to track the insurance companies' payouts to the actual medical care delivered; 80% of the premium has to go to actual payouts to medical providers. So the cost of insurance can't skyrocket unless the utilization of medical care by the members of the plan skyrockets.
In any event, Obamacare only affects the individual and small group insurance markets, which are a small fraction of US health insurance which is dominated by big employer coverage and Medicare.
The highest increase in annual healthcare cost was in 2002, over 8%; it dropped steadily from there to about 3% in 2009, where it's been stable ever since, and shows every indication of staying this year.
Do you in fact have insurance? If so, why? you believe you won't benefit if you don't get sick, why is that worth it to you, but not too people who got insurance for the first time this year?
Yes, but the article is NOT about health care. It is about health insurance. They are not the same thing. Having health insurance is not a benefit if there is no one to provide you with health care, which is what is happening with this law. Most of those who now have health insurance that did not have it before are those who have been added to the Medicaid rolls. Yet the number of health care providers who accept Medicaid patients has fallen.
8 million people have individual insurance through exchanges in March 2014. This is 30% more than people with individual insurance policies in Dec. 2013. Surveys of these people have 60% saying they were uninsured before getting the exchange policies.
Meanwhile, Medicaid enrollment rose by 10 million people between 2006 and 2013, before Obamacare, mostly children, indicating that the big driver here is the collapsing economy.
One of the biggest effects of Obamacare is children under 26 without insurance signing onto their parents' policies, which counteracts this long term rising enrollment of children into Medicaid.
Isn't Medicaid run by the individual states, who set the rates, in any event?
If the cost of healthcare is too high, as everybody seems to worry about, you can't possibly provide it to more people and not raise costs without keeping payments low. The money has to come from somewhere. Right now, the money to cover the few services uninsured get in emergency rooms, etc. comes from the hospitals adding it to the bills of patients with insurance, which automatically makes healthcare more expensive. Pay for those costs with insurance subsidized by the government, and the cost of insurance to those not subsidized will drop accordingly.
Bingo! I would not have been able to do multiple start-ups and freelance in banking and writing if tied to a job by health insurance given that I have had imperfect health.
Score one for the UK NHS, even though also imperfect, for giving me mobility.
Rgds
Damon
Bingo! I would not have been able to do multiple start-ups and freelance in banking and writing if tied to a job by health insurance given that I have had imperfect health.
Score one for the UK NHS, even though also imperfect, for giving me mobility.
Rgds
Damon
So, the need to arrange for a new health provider if you leave your job and move to another state is more restrictive than not being able to get health insurance at all if you leave your job?
I'll have to think about that for a looooooong time.
It has pushed back against inequality, essentially redistributing income...
So it is an income redistribution plan. What we really need is a prosperity plan and other than getting out of the way, that is not something government can do.
Depends who you mean as "we", doesn't it? Some of "us" are getting quite prosperous.
The fact that cash price for surgery is $65,000 while insurance paid only $6200 is criminal.
That, and adding middlemen always increases prices. Insurance is middleman.
The fact that the insurance companies have enough individuals that they can bargain with the hospitals and doctors to take $6200 for the surgery but individuals don't have that bargaining power so the hospitals and doctors charge them $65,000 suggests that your analysis is overly simplistic.
Do you mean the same Doctors who have filed fraudulent claims to the tune of Billions ? While I can not stand medical insurance companies, someone needs to monitor the system.
Indeed. Individuals don't have the knowledge or the power to monitor the doctors and hospitals, insurance companies do. The government could too, as in Medicare; but for now we've decided to have the government monitor the insurance companies and have the insurance companies monitor the doctors and hospitals. Just eliminating that step in the hopes that unregulated medicine will do a better job than unregulated finance seems a bit dubious.
Doctors, hospitals, insurance companies, patients and employers have only had unneeded and unwanted intrusion, regulation and control into all their interrelationships. None of them benefit. The Government (i.e., "the people of the government" or the ruling class) are the only winners. Everyone else pays and loses at their expense.
Seriously? Insurance companies are part of the problem in health care, interfering with doctors, patients, and hospitals in providing/receiving care. They need to be regulated to doing their job (providing averaged risk assessment policies) and stay out of the hospitals and doctors business.
The insurance companies are the only ones who don't make money from unnecessary medical procedures and excessive medical costs. Doctors who prescribe antibiotics and schedule a couple of visits when you have the sniffles make money from that. Hospitals who give you infections then have you stay another two weeks make money from that. Insurance companies who tell doctors and hospitals they won't pay for that nonsense save themselves money, and the patient money as well, not to mention a lot of discomfort, suffering, and death.
To date, the Department of Health and Human Services (HHS) has approved 1,372 Obamacare waivers, covering 3.1 million Americans. Yesterday, The Daily Caller reported that among HHS’s most recent round of 204 Obamacare waivers, “38 are for fancy eateries, hip nightclubs and decadent hotels in House Minority Leader Nancy Pelosi’s Northern California district.” That’s right: Nearly 20 percent of exemptions from Pelosi’s crowning health care achievement were doled out in her backyard.
If that’s not enough irony for you, try this waiver on for size: On Monday, the Las Vegas Sun reported that Nevada—Senate Majority Leader Harry Reid’s home state—received a partial statewide Obamacare waiver, too. If you’re keeping score, Reid was Pelosi’s counterpart in the Senate fighting to get Obamacare passed into law. Now his state will be one of three to get a waiver from the law’s requirements, while the rest of America suffers.
Of course, it's just a coincidence that all these waivers are going out to coverage which meets or surpasses the general basic requirements of Obamacare, just as it is a total coincidence that leftish institutions offered health care plans which were generous.
Secret in the sense that it was only reported by the Associated Press, Bloomberg News, The New York Times, Los Angeles Times, The Washington Post, Reuters, McClatchy Newspapers, USA Today, ABC News, NBC News, CBS News, and, obviously, WSJ; but not reason.com or askheritage.org. Actually, I'm just guessing that it wasn't reported on the last two, maybe it was.
Quite right. Obamacare won't be "fully in place" until all of those "temporary wavers" go away, and we are past the front loaded funding to see what it really costs.
There is still a lot of smoke and mirrors being used to obscure the real cost and ultimate impact of Obamacare. Why do you think that is?
Because we don't know what the real cost and ultimate impact of obamacare is, so it can't be "obscured", but after 1 year it might still be interesting to see what is happening, despite the rightwing's devotion to coming to conclusions based entirely on fantasies of evil Democrats lying to them to hide their foul agenda, and allergy to any sort of data because it might potentially puncture their bubble?
Because every day we're getting older, and we have stuff we want to do before we die.
The minutes of your life lost by following the speed limit vs the decades potentially lost from a head-on collision with an 18-wheeler? Not necessarily a hard choice.
why is the 18 wheeler going the wrong way on the interstate, and how am i going to avoid him with a closing speed of only 110 mph rather than 115? (assuming he isn't speeding)
No car company is going to equip a car with a security system that will make it impossible for the dealers to repossess the car when the payments stop coming in.
Slashdot Mirror
Being forced to buy insurance is not "help." It's being forced to buy insurance. It may be a good idea for some, but calling it "help" is misleading. Most people with this insurance will see more of their money spent on premiums than they would receive in payments even when they do get sick and need medical care. The medical care savings accounts would have been much more helpful for most people in reducing their medical costs and in forcing them into long-term responsible behavior. But we couldn't do that. That would be too Republican an idea.
if you buy insurance in the exchanges, you can choose a high deductible policy, and if you choose a high deductible policy, then you can start a health care savings account with whichever one you choose.
By far the biggest impact from Obamacare has been the expansion of Medicaid. That could've been accomplished without messing with my private insurance.
If your insurance is through your employer, then it's not really messed with. If your insurance was through individual plans or a small group employer, then it really needed to be messed with. Insuring small groups or individuals is a disaster area, and insurers behaved accordingly; by having a lot of people end up on Medicaid, fror example. If you happened to come out ahead of the game by accident, that doesn't make it a wonderful feature of American life
We are free citizens of a democracy?
It is not the role of government to force people to buy things.
Furthermore, Obamacare has done NOTHING to make health care more affordable. It does not address health care at all. It's a gift to the health INSURANCE industry.
You are laboring under the bogus notion that "health insurance" == "health care"
Insurance rates have not gone down and insurance plans haven't gotten better. If anything, people's attempts to be responsible and self-reliant are being actively sabotaged.
AVOIDING insurance still remains the cheapest option in many cases.
Absolutely, for the young and healthy, not getting insurance is always financially best. Of course, this just means they will pay more later, when they are old and sick. Which means they will not get insurance longer and longer. Which means the costs will be even higher when they do get it, when they are older and sicker. Which means they will not get insurance even longer. You see where this goes? Any competent engineer will tell you that if you want to eliminate an undesirable positive feedback, you need to damp it out. Like by requiring people to buy insurance. Or charging them a penalty if they don't. If people are responsible and self-reliant, they will buy insurance anyway, and they won't face either of those and won't be sabotaged, will they?
Are republicans so stupid that they can not see it's a Republican system?
Their memories are simply that short. That's how they forget that none of their interests have been served by their elected politicians, and proceed to re-elect them.
Here in California, however, we re-relected Jerry Brown. That's very like re-electing Marion Berry. Heh heh heh.
Being a republican means having no long term memory. Most of them don't even remember voting for Bush, and those that do vaguely remember how great things were when Bush was president and how much worse they are now.
to be fair, none of them know any details about it no matter what you call it.
To be fair, half the electorate knows approximately nothing about anything; of what they do know, half is false and cancels out the other half.
That you have to pay "cash" to get medical attention strucks me as hard as if you'd had to pay to have the police assiting you, or that if you had to pay to get your children into the school. All of those are basic rights that any development country considers "essential". Of course you pay for them, but you do so in your taxes... and if you want a premium service, then yes: you can use your cash as much as you want, and have hot blonde nurses for all I care. American republicans are fucked up around private healthcare. Why don't they ask for only-private police? that only serves and protects those that can afford it? or only-private education?
Things you'll never see conservatives demanding: privately funded military replacing out of control government spending. Even though they're all stocked up on their Second Amendment supplies just in case.
That's like saying that rich people have to pay taxes shown in the tables that the IRS provides to everyone with their tax forms. There are so many accounting tricks and loop-holes in the laws that that 15-20% limit is NEVER going to be achieved. The real solution to the problem is universal healthcare funded directly by tax payers. The republican complaint against it is that you'll have to hire an army of people to administer it- BIG GOVERNMENT! What we have now is insurance companies with armies of administrators and lawyers working to prevent spending on health care because it is more profiable to collect premiums and not pay money out. With a single-payer system you have an army of people working to ensure spending is going to health care and not fraud. I know which I would rather fund.
As far as I know, unlike the tax code, there are no "accounting tricks and loop-holes" in the "Medical Loss Ratio". If you know of any, clue me in, please.
You don't understand. Your visit to the doctor costs what it does because of the complexities of the insurance system, including both health insurance and malpractice insurance. Doctors have a lot of overhead to pay, and in hospitals, they are just employees with no control over their schedules. If the administrators put 40 people per day into their schedule, they see 40 people per day. People without insurance use the emergency room to fix problems after they occur, a very expensive way to deal with health problems - something which Obamacare was feebly attempting to address. Everyone else who uses the place has to pay more to cover those costs. Every time a doctor makes an error the patient calls a lawyer. Doctors order test after test to cover their asses against malpractice suits- they are told to do so in "risk management" seminars put on by insurance companies that they must attend every year to maintain their malpractice insurance. The system is full of waste at every level. Doctors are not the cause of the problem. They have been made to look that way by insurers and hospital administrators who want to deflect attention away from themselves.
When you look at Las Vegas, what do you see? You see huge luxury hotels, bright lights, excitement, partying, etc. Where does that money come from? From losers. Yet it's the winners who get the attention. Yeah, great, Vegas baby! Now look at insurance companies. Huge luxury office buildings, executives who make millions- it's a lot like Vegas. Where does the money come from? Losers like you and me who have to pay ridiculous premiums for minimal coverage. Yeah, Insurance baby!
My son has expressed an interest in studying medicine when he graduates from high school. My wife is a physician and I am a dentist. We have suggested that he get a degree in business and become a hospital administrator. Those people make $ millions with no special skill set and without the arduous training imposed on healthcare providers.
Again, no. Insurers are restricted by law to paying at least 80% of their premium income out again as actual medical costs. That leaves maximum 25% overhead, which ends up as maybe 3% profit in a good year. What they do have going for the is volume, which works two ways; they use those massive numbers of patients to negotiate much lower prices from doctors and hospitals, and on the actuarial side, having a huge number of insured people makes that 3% profit very predictable with no risk, which is good when you run a big company. The risk comes in whenever conditions change, like currently, and the past doesn't predict the future very well. In general, the insurance industry isn't a "luxury" industry; there are a handful of well paid CEOs and VPs, supported by a huge army of overworked underpaid peons in little cubicles worried about the next layoff. Ironically, the healthcare plans insurance companies sell to their big clients are better than what they give to their own employees; they just don't make enough profit to offer anything better.
It must be nice to have the State-run Media on you side
Oh, Fox News and the WSJ aren't state-run, but it's an easy mistake to make, the way they wrap themselves in the flag and scream socialist traitor and everybody who disagrees.
From investors.com
Right after the Supreme Court's decision to lift limits on campaign contributions, Democrats and their left-wing supporters assaulted the decision as a boon to Republicans, "the party of the rich."
This of course is part of a far-wider narrative — slavishly repeated by largely unquestioning liberal media — that the GOP outspends Democrats on campaigns thanks to big-buck donors like the billionaire Koch brothers.
But, as it turns out, that's a lie — as big a lie, in fact, as "you can keep your insurance," "you can keep your doctor" and "ObamaCare will bend the cost curve down."
By almost every measure, in fact, it's the Democrats, not the Republicans, who are the party of the rich.
Start with Congress itself. Who are the wealthiest members? Well, there are 269 millionaires among Congress' 535 members. And most of them are Democrats.
And contrary to the hand-wringing on the left about the Supreme Court's 5-4 McCutcheon v. Federal Election Commission ruling Wednesday, Democrats far outspend Republicans on elections. It isn't even close.
According to OpenSecrets.org, from 1989 to 2014 rich donors gave Democrats $1.15 billion — $416 million more than the $736 million given to the GOP. Among the top 10 donors to both parties, Democrat supporters outspent Republican supporters 2-to-1.
But what about the villainous Koch brothers, those conservative plutocrats supposedly seeking to control American politics? They rank 59th on the list of big givers — behind 18 unions and No. 1 Act Blue, the massive left-wing fund raiser that gives only to Democrats.
Indeed, a recent book, "The New Leviathan," says donations to Democrats outstrip those to Republicans 7-to-1. How can this be? Democrat support soars when you include unions, universities, superPACs, nonprofits, left-wing interest groups, and — ready for this? — Wall Street (which overwhelmingly favors Democrats).
So Democrats don't really want to restrain money in politics. Just the money that goes to Republicans.
Yes, if you ignore all the 'dark money', there is more open donation to Democrats than to Republicans. Of course, if you look at the nondisclosing groups, such as Americans for Prosperity, which hapens to be run by the Koch Bros. by coincidence, they account for 80% of Republican funding, but only 30% of Democrats. No wonder the Republicans think it's a Constitutional crisis when the IRS asks groups with the name "Tea Party", etc to further document their request to be considered anonymous nonpartisan campaign funding organizations.
Question: Not a single Republican voted for Obamacare, so exactly how does it make it their "wet dream"?
Answer: Because Obama adopted the Republican plan in an attempt to unify the parties in implementing healthcare reform. The Democratic plan was Single Payer, which was cheaper, simpler, and more effective. Obama agreed to the more expensive, complex and ineffective Republican plan in an attempt to get Republicans to engage in the reform.
Unfortunately, Republicans immediately turned against their own plan, because they cared more about preventing reform than in their own reform plans.
The shame is that the Democrats didn't then go back to their own plan and push that through. Unfortunately there were enough Democrats tied to the insurance industry (Lieberman....) that, combined with 100% Republican obstruction, they were able to force the country to waste $trillions on insurance company waste. Because what's waste to us is record profits for insurance companies.
The Clinton administration tried that. Didn't work out well. Considering how hard it's been to get this watered down former Republican dream past the 'fear of a Kenyan socialism Muslim' idiots, going back to a rational single payer plan wasn't going to work any better how than it did for the Clintons.
but now we're stuck with a golden goose for the insurance companies (aka a Republican wet dream).
Not a single Republican voted for Obamacare, so exactly how does it make it their "wet dream"? The Democrats are bought and paid for by the banking industry and Wallstreet. The insurance industry is just a sublet of the banking. The Republicans are bought and paid for by farming, energy, and military industries. At least try to get the group you want to blame right or you come off sounding like a moron.
Yeah. I'll believe "the insurance industry is just a subset of the banking", the first time an insurance company sells policies for less than cost and then packages them and sells them off as investments to people who sell them to other people, and so on, until the sucker holding the hot potato when the music stops goes broke. (Hint: they can't. Government regulation and al that).
The second were the $150/month genuine catastrophic plans. Insured pays $150/month, and in exchange the obligation of paying the first $10K of the bill, the insurance company might actually cover the remaining $90K. (Also, the insurance company might be able to bargain the hospital down from $100K to $20K, so even if they refuse to cover it, the insured isn't bankrupt.) These are gone, and that kinda sucks.
Are these plans outlawed by the ACA, like the first set of plans you describe? Or have insurers merely stopped offering them of their own volition? I'm genuinely asking, as I don't know. I haven't heard of any limitations on deductibles imposed by the ACA.
What ACA proponents don't get is that YES, premiums *DO* have to rise, markedly, and that as long as insurance companies remain middlemen, everyone is going to pay $10K. Because that's your actual actuarial risk including the middlemen's 50% cut.
If premiums do have to rise (because of the ACA), why? What are the increasing costs? Most arguments I've heard boil down to "my premiums went up, my coverage went down", but something's not adding up. The ACA has capped insurers' profits (to what extent this is effective remains to be seen), so I'm comfortable assuming that the alleged difference in cost isn't simply being pocketed. So where is it going? I can't answer that. The conclusion this brings me to is that either premiums are not going up, or coverage is not going down.
Exactly; more members are not a windfall for insurers like they are for cell phone companies or such, because insurers are legally required to have their total premiums be 125% or less of their total medical costs.
There are two kinds of low-end insurance plans.
The first are the $50/month bullshit scams that you're talking about. Sucker pays $50/month, and gets the *first* $2000 of his $100K medical bill paid for, but is on the hook for the remaining $98K. (i.e. "You get $2000 off your first bill!") These are gone, and good riddance.
The second were the $150/month genuine catastrophic plans. Insured pays $150/month, and in exchange the obligation of paying the first $10K of the bill, the insurance company might actually cover the remaining $90K. (Also, the insurance company might be able to bargain the hospital down from $100K to $20K, so even if they refuse to cover it, the insured isn't bankrupt.) These are gone, and that kinda sucks.
It only *kinda* sucks because the replacement (the bronze plans) are issued at around $300/month with $6300 deductibles, but, and this is where ACA detractors miss the point, they're issued to everybody, even to people with cancer and known expenses of at least $100K/year chemotherapy. You pay $300/month for a $6000 deductible, or $800/month for a $0 deductible. If you go Bronze, you pay ($300*12 + 6000 deductible) = $9600/year. If you go Gold/Platinum, you pay ($800*12 + 0 deductible) = 9600/year. It's still, to within an order of magnitude, the same amount of money at risk.
What ACA proponents don't get is that YES, premiums *DO* have to rise, markedly, and that as long as insurance companies remain middlemen, everyone is going to pay $10K. Because that's your actual actuarial risk including the middlemen's 50% cut.
Please (this isn't directed at you, parent poster), can we stop talking about Republicans and Democrats and which party wants to protect/harm you, and concentrate on actual policy?
If you read the documents for the now obsolete low-end plans, they basically come out and tell the purchaser that they aren't going to pay for anything much, but were just in effect a giant group purchase plan, so that you could get the discounts providers give insurance plans (typically way more than 50%) and not get stuck paying the "list price" the providers charge to the uninsured, who don't have the clout of 2000000 paying customers to bargain with. Which brings me to the quibble: the middleman doesn't take a 50% cut. The insurer is legally required to spend 80% of premiums on actual medical expenses; and that 80% is the insurers' low negotiated cost, as I described above, not the list price. So that, from actual example, if you have no insurance and get a minor outpatient operation, you would pay $4,000; if you have insurance, your immediate cost would be $200 with the insurer paying out another $600 because their contracted cost is $800; averaged out over the entire membership, you would of course pay this amount in your premiums, plus an additional $200 max in overhead, for a grand total of $1000. There isn't any 50% cut in there no matter how you arrange the numbers.
It is, only in that it redistributes money from the healthy to the insurance companies. Saying that "these people are better off because they now have insurance" is misleading. They now have to pay for that insurance, and the cost of insurance has skyrocketed since the law was passed. Furthermore, they can only be said to have benefited from having insurance if they get sick, or if they were already sick and would have been denied coverage.
"the cost of insurance has skyrocketed"? really? for whom? you? not me. Or most people, apparently. The cost of insurance has to track the insurance companies' payouts to the actual medical care delivered; 80% of the premium has to go to actual payouts to medical providers. So the cost of insurance can't skyrocket unless the utilization of medical care by the members of the plan skyrockets. In any event, Obamacare only affects the individual and small group insurance markets, which are a small fraction of US health insurance which is dominated by big employer coverage and Medicare. The highest increase in annual healthcare cost was in 2002, over 8%; it dropped steadily from there to about 3% in 2009, where it's been stable ever since, and shows every indication of staying this year. Do you in fact have insurance? If so, why? you believe you won't benefit if you don't get sick, why is that worth it to you, but not too people who got insurance for the first time this year?
Yes, but the article is NOT about health care. It is about health insurance. They are not the same thing. Having health insurance is not a benefit if there is no one to provide you with health care, which is what is happening with this law. Most of those who now have health insurance that did not have it before are those who have been added to the Medicaid rolls. Yet the number of health care providers who accept Medicaid patients has fallen.
8 million people have individual insurance through exchanges in March 2014. This is 30% more than people with individual insurance policies in Dec. 2013. Surveys of these people have 60% saying they were uninsured before getting the exchange policies. Meanwhile, Medicaid enrollment rose by 10 million people between 2006 and 2013, before Obamacare, mostly children, indicating that the big driver here is the collapsing economy. One of the biggest effects of Obamacare is children under 26 without insurance signing onto their parents' policies, which counteracts this long term rising enrollment of children into Medicaid. Isn't Medicaid run by the individual states, who set the rates, in any event? If the cost of healthcare is too high, as everybody seems to worry about, you can't possibly provide it to more people and not raise costs without keeping payments low. The money has to come from somewhere. Right now, the money to cover the few services uninsured get in emergency rooms, etc. comes from the hospitals adding it to the bills of patients with insurance, which automatically makes healthcare more expensive. Pay for those costs with insurance subsidized by the government, and the cost of insurance to those not subsidized will drop accordingly.
Bingo! I would not have been able to do multiple start-ups and freelance in banking and writing if tied to a job by health insurance given that I have had imperfect health.
Score one for the UK NHS, even though also imperfect, for giving me mobility.
Rgds
Damon
Bingo! I would not have been able to do multiple start-ups and freelance in banking and writing if tied to a job by health insurance given that I have had imperfect health.
Score one for the UK NHS, even though also imperfect, for giving me mobility.
Rgds
Damon
So, the need to arrange for a new health provider if you leave your job and move to another state is more restrictive than not being able to get health insurance at all if you leave your job? I'll have to think about that for a looooooong time.
It has pushed back against inequality, essentially redistributing income ...
So it is an income redistribution plan. What we really need is a prosperity plan and other than getting out of the way, that is not something government can do.
Depends who you mean as "we", doesn't it? Some of "us" are getting quite prosperous.
The fact that cash price for surgery is $65,000 while insurance paid only $6200 is criminal.
That, and adding middlemen always increases prices. Insurance is middleman.
The fact that the insurance companies have enough individuals that they can bargain with the hospitals and doctors to take $6200 for the surgery but individuals don't have that bargaining power so the hospitals and doctors charge them $65,000 suggests that your analysis is overly simplistic.
Do you mean the same Doctors who have filed fraudulent claims to the tune of Billions ? While I can not stand medical insurance companies, someone needs to monitor the system.
Indeed. Individuals don't have the knowledge or the power to monitor the doctors and hospitals, insurance companies do. The government could too, as in Medicare; but for now we've decided to have the government monitor the insurance companies and have the insurance companies monitor the doctors and hospitals. Just eliminating that step in the hopes that unregulated medicine will do a better job than unregulated finance seems a bit dubious.
Doctors, hospitals, insurance companies, patients and employers have only had unneeded and unwanted intrusion, regulation and control into all their interrelationships. None of them benefit. The Government (i.e., "the people of the government" or the ruling class) are the only winners. Everyone else pays and loses at their expense.
Seriously? Insurance companies are part of the problem in health care, interfering with doctors, patients, and hospitals in providing/receiving care. They need to be regulated to doing their job (providing averaged risk assessment policies) and stay out of the hospitals and doctors business.
The insurance companies are the only ones who don't make money from unnecessary medical procedures and excessive medical costs. Doctors who prescribe antibiotics and schedule a couple of visits when you have the sniffles make money from that. Hospitals who give you infections then have you stay another two weeks make money from that. Insurance companies who tell doctors and hospitals they won't pay for that nonsense save themselves money, and the patient money as well, not to mention a lot of discomfort, suffering, and death.
Who Gets an Exemption From Obamacare?
How About a National Obamacare Waiver?
To date, the Department of Health and Human Services (HHS) has approved 1,372 Obamacare waivers, covering 3.1 million Americans. Yesterday, The Daily Caller reported that among HHS’s most recent round of 204 Obamacare waivers, “38 are for fancy eateries, hip nightclubs and decadent hotels in House Minority Leader Nancy Pelosi’s Northern California district.” That’s right: Nearly 20 percent of exemptions from Pelosi’s crowning health care achievement were doled out in her backyard.
If that’s not enough irony for you, try this waiver on for size: On Monday, the Las Vegas Sun reported that Nevada—Senate Majority Leader Harry Reid’s home state—received a partial statewide Obamacare waiver, too. If you’re keeping score, Reid was Pelosi’s counterpart in the Senate fighting to get Obamacare passed into law. Now his state will be one of three to get a waiver from the law’s requirements, while the rest of America suffers.
Of course, it's just a coincidence that all these waivers are going out to coverage which meets or surpasses the general basic requirements of Obamacare, just as it is a total coincidence that leftish institutions offered health care plans which were generous.
ObamaCare's Secret Mandate Exemption
Secret in the sense that it was only reported by the Associated Press, Bloomberg News, The New York Times, Los Angeles Times, The Washington Post, Reuters, McClatchy Newspapers, USA Today, ABC News, NBC News, CBS News, and, obviously, WSJ; but not reason.com or askheritage.org. Actually, I'm just guessing that it wasn't reported on the last two, maybe it was.
Quite right. Obamacare won't be "fully in place" until all of those "temporary wavers" go away, and we are past the front loaded funding to see what it really costs.
There is still a lot of smoke and mirrors being used to obscure the real cost and ultimate impact of Obamacare. Why do you think that is?
Because we don't know what the real cost and ultimate impact of obamacare is, so it can't be "obscured", but after 1 year it might still be interesting to see what is happening, despite the rightwing's devotion to coming to conclusions based entirely on fantasies of evil Democrats lying to them to hide their foul agenda, and allergy to any sort of data because it might potentially puncture their bubble?
Because every day we're getting older, and we have stuff we want to do before we die.
The minutes of your life lost by following the speed limit vs the decades potentially lost from a head-on collision with an 18-wheeler? Not necessarily a hard choice.
why is the 18 wheeler going the wrong way on the interstate, and how am i going to avoid him with a closing speed of only 110 mph rather than 115? (assuming he isn't speeding)
No car company is going to equip a car with a security system that will make it impossible for the dealers to repossess the car when the payments stop coming in.