Obama Care vs Republicans

[classicman]

Originally Posted by Lamplighter

Why "Shit" ?

The letter is clear that his policy continues thru the end of 2014
... and at that time an ACA-compatible policy will be available.

Incorrect - You cannot even read for comprehension. The plan will continue "UNTIL THE POLICY PERIOD ENDS" That would be in May.

Originally Posted by Lamplighter

Mr Whiner has returned...

Five or six years from now, Mr Whiner's son will turn 26, and no longer be on his parent's policy.
But even with "pre-existing condiotions" he can still have insurance due to ACA.
His son's income will be taken into account, and will probably
have very little, maybe zero, out-of-pocket premium payments.

Wrong son Mr. Asshole.
My son is 23. There is no The cost to "ADD" him to a parental policy is far more than for him to buy his own. Son does not qualify for any subsidies and there is no expanded Medicaid in PA.

So far you are nothing but wrong on all accounts.

[Happy Monkey]

You mentioned Medicare - if you would have been covered in extended Medicare, and your state refused it, you may be out of luck. The ACA was designed for Medicare to fill a particular hole that the exchanges and subsidies didn't cover.

You may have to wait until there are enough Democrats in Congress to fix any ACA problems. Republicans would rather have ACA problems to crow about than fix them.

[glatt]

How difficult would it be to move across the river to NJ? Do they have Medicare coverage? Or is it too far away?

[BigV]

it's helpful to keep in mind that our nation's for profit health insurance system has as its prime directive profit for the shareholders. that profit motive is *by law* the most important thing for these publicly held companies to take care of. the recent changes in the law like the ACA and earlier changes in the law like (forgetting the name at the moment) the instruction to treat insurance coverage for mental health like coverage for physical health are all done with a mind to regulate the industry, the health insurance industry. But they're all still in business to make money (not quite the same for the non profit/collectives out there).

regulating industries happens in numerous sectors of our economy from energy to automobile manufacturing to food production, etc, etc, etc, etc. these laws and regulations are done with a mind to the public good, usually. and usually, the industry finds a way to accommodate the rules. but they're still trying to make money. like the outfit above. they don't have a built in motivation to make the costs less, until they were compelled/cajoled into competing directly. competition has a long and well established track record of simultaneously allowing profits for effective companies and lowering prices for consumers where they have a choice.

And the converse proves the opposite--look at the cable television choices you have, as an example. Here we have ONE choice, and that monopoly (fuck you Comcast) provides ZERO incentive to lower prices. why the hell should they? and indeed they don't.

So, I'm not surprised that they're trying to lock in some profits like this. disgusted, yeah, suprised. Noper.

[xoxoxoBruce]

Originally Posted by BigV

they don't have a built in motivation to make the costs less, until they were compelled/cajoled into competing directly. competition has a long and well established track record of simultaneously allowing profits for effective companies and lowering prices for consumers where they have a choice.

Unless they collude to fix prices so the all get fat.
But they wouldn't do that, would they.

[BigV]

Originally Posted by xoxoxoBruce

Unless they collude to fix prices so the all get fat.
But they wouldn't do that, would they.

point well taken . however, what you describe is *not* competition anymore, it's collusion.

[Lamplighter]

The entire health insurance business, I think, started in Texas with Blue Cross/Blue Shield.
back in the 1930's as hospitalization and physician insurance, respectively, for teachers.

The plan coverages were, and still are, based on "usual and customary" fees;
but "reasonable" has been added now that BC/BS licensees process Medicare for the feds.

I don't think competition between physicians was a mechanism, and probably still is not.
It was/is insurance to assure payments to the benefit of hospitals and physicians.

Probably the only path to holding down health care costs is now thru Medicare/Medicaid limits,
and I hope the policies dictated within the Obamacare exchanges will eventually do that.

[Lamplighter]

Originally Posted by Lamplighter

<snip>Probably the only path to holding down health care costs is now thru Medicare/Medicaid limits,
and I hope the policies dictated within the Obamacare exchanges will eventually do that.

This is a very LONG posting, but it seems to be an authoritative summary of the cost-reducing effects of Obamacare.
It includes implications of the initial web-site problems. I have sniped out most of that.

Washington Post
David Cutler
November 8, 2013
The health-care law’s success story: Slowing down medical costs

The anger over the botched rollout of the Affordable Care Act’s federal health insurance exchange
— and over the conflicting explanations about whether people can keep their coverage —
has been bipartisan and well-deserved.<snip>

The law has two overarching goals: Cover almost everyone, and slow the growth of medical care costs.
The goals are equally important. Too little coverage, and premiums in the exchanges will be unaffordable;
too rapid a cost increase, and the federal government will not be able to afford the subsidies.

Since 2010, the average rate of health-care cost increases has been less than half the average in the prior 40 years.
The first wave of the cost slowdown emerged just after the recession
and was attributed to the economic hangover. Three years later,
the economy is growing, and costs show no sign of rising. Something deeper is at work.

The Affordable Care Act is a key to the underlying change.
Starting in 2010, the ACA lowered the annual increases that Medicare
pays to hospitals, home health agencies and private insurance plans.
Together, these account for 5 percent of the post-2010 cost slowdown.
Medicare payment changes always provoke fears — in this case,
that private plans would flee the program and that the quality of care in hospitals would suffer.
Neither of these fears has materialized, however.
Enrollment in private plans is up since the ACA changes.

The law also emphasized that payments should be based on the value, not the volume, of medical care.
In a value-based system, compensation is made for the patient as a whole, not for specific services provided.
As a result, eliminating services that are not needed is financially rewarded.
The reaction to this change has been rapid:

Hospital readmissions, which used to bring in substantial dollars, are now penalized.
Unsurprisingly, the readmission rate in Medicare is down 10 percent since 2011.
Similarly, hospital-acquired infections used to bring in additional dollars, but now they do not.
One program to cut infections, encompassing only 333 hospitals, saved more than $9 billion.
Both of these changes improve patient health even as they reduce spending.

Cost savings induced by the ACA are particularly beneficial
because they could increase quality while they lower spending.
The reduction in technology development means lower costs
but also fewer ways to treat sick people.
People with high deductibles use fewer valuable services as well as fewer less-valuable ones.
Only by eliminating unnecessary care can we ensure that everyone benefits from saving money in health care.

Governors and legislators in red states are almost universally opposed to the ACA.
But these states are still seeing cost savings from the law — and they are participating in other ways.

For those who want to blame Obama for anything and everything that affects them personally,
they should put the blame where it belongs, on the GOP and the GOP Governors
who are fighting tooth and nail to defeat the A.C.A. law for their own political purposes.

So there, I said it

[classicman]

Originally Posted by Lamplighter

For some people, this is the Obamacare they see...

And for folks like you, this is all they see.

[Lamplighter]

[classicman]

Words matter

LIAR

[classicman]

they don't have a built in motivation to make the costs less

They still don't - they do have a motivation to keep them all about the same - more or less.

[Clodfobble]

To be fair, the same could be said of any industry. That's why price-fixing and collusion among competitors is illegal. That's not to say it doesn't happen, but at least now there is a *potential* element of competition in the healthcare marketplace.

[tw]

Originally Posted by Clodfobble

That's not to say it doesn't happen, but at least now there is a *potential* element of competition in the healthcare marketplace.

We went through similar problems with automobile insurance in the 1960 and 70s. The solution was to change how insurance was conducted - at state levels. That included requiring auto insurance. Also was not fair - according to naysayers. But it solved skyrocketing costs. Permitted the free market to work properly.

Health insurance is being restructured to solve a similar problem. But increasing costs are not limited to how health insurance was implemented. If our extremists want to advance America, then we are already moving on to other parts of the problem - ie hospital billing. That could not be solved without Obamacare. It is now possible to fix reasons for skyrocketing hospital bills.

Unfortunately naysayers want to maintain a bad system rather than address problems. Unfortunately a discussion of how to solve hospital billing is impossible - because many have been told and therefore believe we want America to fail. So many want a defective status quo; have and refuse to offer any solutions.

So many critics. So few want to address or even discuss reasons for radically increasing hospital costs.

[classicman]

Clod - I know and agree to a point.

Lamp - sorry to say that your post is nothing more than one team pointing the finger at the other. I think there is plenty of blame to go around. The R's are being asshats in some respects, but the law itself was written very poorly, none of them read it and when you only have one tool (writing laws) the old "when all you have is a hammer, everything looks like a nail" comes to mind. This law was nothing more than an attack on one industry while completely missing the other cost drivers which are Big Pharma, Medical equipment manufacturers, hospitals and providers.