ACA - Single-Payer \/ Multi-Player /\/ \/\ Hybrid ?

[Monk-Eye]

" ACA - Single-Payer \/ Multi-Player /\/ \/\ Hybrid ? "

* Free Enterprise Money Multipliers Compelled To Spend *

Is the Affordable Care Act A single-payer or a multi-payer system Or single-multi-payer hybrid ?

" Equal Endowment Challenging Positive Liberties "

* CBO Assessing Affordability Groups "

A technical element within the ACA that may be unconstitutional is whether the government is capable of fining individuals for not having health insurance when their net earnings are greater than 400% of the poverty line .

It is certainly clear that those between 100% and 400% are being taxed under the ACA because only a portion of total costs to purchase private health care insurance is being remitted back to those taxpayers .

For those with earnings between 100-400% who optioned to purchase a plan compliant with the ACA , did the portion of uncompensated costs for monthly premiums make individual health affordable and effective for the group , as would be expected for just compensation from property being taken by government in the form of a forced financial transaction ?

Consider if the ACA were to compensate individuals with earnings above 400% of the poverty line ; would remitting all but some portion of health care costs be consistent with a constitutional requirement for receiving just compensation ?

How does the portion of uncompensated costs for monthly premiums paid by individuals in the 100-400% translate into a congruent proportion of respective health care costs to government ?

How does the portion of uncompensated costs for monthly premiums paid by individuals over 400% translate into a congruent proportion of respective health care costs to government ?

When government chose to subsidize health insurance premiums for the earnings range of 100-400% , was that group chosen as those most representative of costs to government health care ?

If those above 400% also represent a significant portion of those most representative of costs to government health care , why were proportional incentives as tax credits not extended to those with earnings greater than 400% of the poverty line ?

* Open Questions *

Within the 100% to 400% poverty line , which percentage of those individuals have adopted the health insurance program and what are its satisfaction ratings ?

 

[Hossfly]

 

[Monk-Eye]

" Post Informative For Thread Poll "

* Focus Swing Two Equations *

tse1.mm.bing.net/th?id=OIP._XSmkUwsXvWlkzKkYLCiJQHaFj&pid=Api&P=0&w=216&h=163

Thank you Hossfly for voting the OP as informative .

The following post precedes the OP in order and elaborates on distinctions between single-payer , multi-payer and hybrid payer systems .

" Way Off Base "

* Reaching Out *

The ACA changed the statistic of government expense for citizen health care from one similar with a single-payer system to one similar with a multi-payer system .

Before the ACA , the statistic of government expense for citizen health care was measured as the total of direct payments from government to private health care providers for medical services rendered to the uninsured , that is similar with a single-payer system .

After the ACA , the statistic of government expense for citizen health care is measured as the total of direct payments from government to private insurance agencies to administer patient records and to administer compensation of costs for patient treatment , that is similar with a multi-payer system .

The ACA represents government negotiating health insurance policy preferences on behalf of citizens , as private entities would negotiate insurance policy preferences on behalf of themselves or their employees , again , as occurs in multi-payer systems .

The ACA includes a tax on individuals whose annual earnings are between 100% and 400% of the poverty line , where the tax is money not compensated to those individuals and the tax varies by factors ; see references , below .

en.wikipedia.org/wiki/Single-payer_healthcare

Single-payer healthcare is a healthcare system financed by taxes that covers the costs of essential healthcare for all residents, with costs covered by a single public system (hence 'single-payer').[1][2] Alternatively, a multi-payer healthcare system is one in which private, qualified individuals or their employers pay for health insurance with various limits on healthcare coverage via multiple private or public sources.[3][4]

Single-payer systems may contract for healthcare services from private organizations (as is the case in Canada) or may own and employ healthcare resources and personnel (as is the case in the United Kingdom). "Single-payer" describes the mechanism by which healthcare is paid for by a single public authority, not the type of delivery or for whom physicians work, which may be public, private, or a mix of both.[5][6]

en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act

To help households between 100–400% of the Federal Poverty Line afford these compulsory policies, the law provides insurance premium subsidies. Other individual market changes include health marketplaces and risk adjustment programs.

en.wikipedia.org/wiki/Premium_tax_credit

The premium tax credit (PTC) is a refundable tax credit in the United States. It is payable by the Internal Revenue Service (IRS) to eligible households that have obtained healthcare insurance by a healthcare exchange (marketplace) in the tax year. It can be paid in advance directly to a healthcare insurance company to offset the cost of monthly health insurance premiums.

The tax credit is part of a host of Affordable Care Act tax provisions, introduced by the IRS in 2014,[1][2] and is meant to extend health insurance coverage to 18 million lower and middle-income Americans.[3]

There are three factors that determine if a household is eligible to receive the PTC:
Household income
Household size
State of residence
Individuals planning to use the filing status Married Filing Separately (MFS) are not eligible for the PTC.[7]

There are four factors that determine the amount of the PTC:
Household income
Size of household
Age of individuals making up the household
State county of residence

Households with incomes between 100% and 400% of the federal poverty level are eligible to receive federal subsidies for policies purchased via an exchange.[70][71] Subsidies are provided as an advanceable, refundable tax credits.[72][73] Additionally, small businesses are eligible for a tax credit provided that they enroll in the SHOP Marketplace.[74] Under the law, workers whose employers offer affordable coverage will not be eligible for subsidies via the exchanges. To be eligible the cost of employer-based health insurance must exceed 9.5% of the worker's household income.

 

[Mac1958]

It's obviously not single payer, and it's obviously not free market, so it's a weird Frankenstein's monster hybrid.

A far more efficient, functional, popular and LOGICAL hybrid is the current Medicare/Medicare Advantage/Medicare Supplement system, which has found an excellent balance of publicly-financed foundational, preventive, diagnostic and critical care with dynamic free market competition and innovation.

We don't want to expand that to everyone, of course, because that would make too much sense, and because we're too blinded by our competing narcissistic ideologies.
.

 

[Monk-Eye]

" Batch Payment Transactions Are Less Expensive and With Out Multiple Human Transactions "

* Open Source Communities *

It's obviously not single payer, and it's obviously not free market, so it's a weird Frankenstein's monster hybrid.

A far more efficient, functional, popular and LOGICAL hybrid is the current Medicare/Medicare Advantage/Medicare Supplement system, which has found an excellent balance of publicly-financed foundational, preventive, diagnostic and critical care with dynamic free market competition and innovation.

We don't want to expand that to everyone, of course, because that would make too much sense, and because we're too blinded by our competing narcissistic ideologies.
.

Text is available under the Creative Commons Attribution-ShareAlike License; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. - Wikipedia:Text of Creative Commons Attribution-ShareAlike 3.0 Unported License - Wikipedia

Medicare Advantage - Wikipedia

Medicare Advantage is a type of health insurance that provides coverage within Part C of Medicare in the United States. Medicare Advantage plans pay for managed health care based on a monthly fee per enrollee (capitation), rather than on the basis of billing for each medical service provided (fee-for-service, FFS) for unmanaged healthcare services. Most such plans are health maintenance organizations (HMOs) or preferred provider organizations (PPOs). Medicare Advantage plans finance at a minimum the same medical services as "Original Medicare" Parts A and B Medicare finance via fee-for-service. Part C plans, including Medicare Advantage plans, also typically finance additional services, including additional health services, and most importantly include an annual out of pocket (OOP) spend limit not included in Parts A and B. A Medicare Advantage beneficiary must first sign up for both Part A and Part B of Medicare.

All four Parts of Medicare—A, B and C, and D -- are administered by private companies under contract to the Centers for Medicare and Medicaid Services (CMS). Almost all these companies are insurance companies, except for those that administer Medicare Advantage and other Part C plans. Most Medicare Advantage and other Part C plans are administered (CMS uses the term "sponsored") by integrated health delivery systems and non-profit charities under state laws, and/or under union or religious management.

Medicare Part A provides payments for in-patient hospital, hospice, and skilled nursing services. Part B provides payments for most physician and surgical services, even some in hospitals and skilled nursing facilities, as well as for medically-necessary outpatient hospital services such as ER, surgical center, laboratory, X-rays and diagnostic tests, certain preventative medical services, and certain durable medical equipment and supplies. Part C health plans, including Medicare Advantage plans, not only cover the same medical services as Parts A and B but also typically include an annual physical exam and vision and/or dental coverage of some sort not covered under Original Medicare Parts A and B. Less often, hearing and wellness benefits not found in Original Medicare are included in a Medicare Advantage plan. The most important difference between a Part C health plan and FFS Original Medicare is that all Part C plans, including capitated-fee Medicare Advantage plans, include a limit on how much a beneficiary will have to spend annually out of pocket; that amount is unlimited in Original Medicare Parts A and B.

Most but not all Medicare Advantage plans (and many of the other public managed-care health plans within Medicare Part C) include integrated self-administered drug coverage similar to the standalone Part D prescription drug benefit plan. The federal government makes separate capitated-fee payments to Medicare Advantage plans for providing these Part-D-like benefits if applicable just as it does for anyone on Original Medicare using Part D.

Nearly all Medicare beneficiaries (99%) had access to at least one Medicare Advantage plan; the average beneficiary had access to 18 plans in 2015.[1]

 

[dblack]

" ACA - Single-Payer \/ Multi-Player /\/ \/\ Hybrid ? "

* Free Enterprise Money Multipliers Compelled To Spend *

Is the Affordable Care Act A single-payer or a multi-payer system Or single-multi-payer hybrid ?

NOTA. It's a corporatist sell-out.