Obamacare Only Looks Worse Upon Further Review

[Spoonman]

Obamacare Only Looks Worse Upon Further Review​

By Kevin Hassett - Aug 1, 2010 8:00 PM CDT

One of the more illuminating remarks during the health-care debate in Congress came when House Speaker Nancy Pelosi told an audience that Democrats would “pass the bill so you can find out what’s in it, away from the fog of controversy.”

That remark captured the truth that, while many Americans have a vague sense that something bad is happening to their health care, few if any understand exactly what the law does.

To fill this vacuum, Representative Kevin Brady of Texas, the top House Republican on the Joint Economic Committee, asked his staff to prepare a study of the law, including a flow chart that illustrates how the major provisions will work.

The result, made public July 28, provides citizens with a preview of the impact the health-care overhaul will have on their lives. It’s a terrifying road map that shows Democrats have launched America on the most reckless policy experiment in its history, the economic equivalent of the Bay of Pigs invasion.

Story continues here...

Congressman Kevin Brady (TX08) :: Press Release :: AMERICA'S NEW HEALTH CARE SYSTEM REVEALED

Love my country, hate my government.

 

[Greenbeard]

I think you're trying to argue extremes.

We're talking about the optimal number of abstract boxes on an organizational chart. What else is there to do but argue extremes? It's a pointless exercise unless you talk about the specific things those boxes represent.

It isn't useless at all. I would think answering questions like; Is our reform going to add more beauracracy going to make for a better system? Is it going to make things easier or harder on the user? Would be important questons to ask. You wanting to focus on this table suggests you are picking a minor battle to avoid having to defend the undefendable.

Again, without discussing specifics those questions are meaningless. The chart has "Internet portal" next to big exchanges bubble. HHS was directed to develop a website that compiles cost and quality data on every single health plan available to anyone in any state (as you can see, it'll also have things like quality data on hospitals). Is that "more bureaucracy"? Maybe. Is it going to make the system better and make shopping for insurance easier on the user? Definitely. That "bureaucracy" is making the individual health insurance market significantly more transparent and accessible than it's ever been.

"Is it going to make for a better system" is a good question to ask. What perplexes me is that you're not asking it of anything. "Will X improve the system" is not an abstract question. It's a concrete question about a concrete entity. You insist on discussing things in the abstract, so you're not asking questions like that.

... the more we hear about obama care, it gets worse, even recently, people's health insurance premiums are SKY ROCKETING! But, but, but... obama care was supposed to make things CHEAPER.... pfft... yeah, right, dream on.

Yeah, that thing that hasn't been implemented yet totally isn't accomplishing the things we hoped it would!

And the need to read the whole thing. It's not enough to listen to the politicians, you and certainly not those that 'needed change the most' will be getting what was 'promised.':

Your brief is about the high-risk pools that are being set up now to insure the uninsurable. These are a temporary stopgap measure to help some of these people out until the exchanges are up and running in 2014 (at which point these high-risk pools terminate and these high-risk people will be able to get the same insurance as everyone else in the regular market).

It's no secret that $5 billion isn't enough to insure every uninsurable person in the country through the end of 2013 (the legislation itself pretty much admits this). The pools will serve some and they'll do it as long as their funding will allow. In the original legislation, these things didn't even exist. There was nothing for them until the exchanges were set up (in 2013 in the House bill, and 2014 in the Senate, which is what ultimately became law).

 

[Charles_Main]

I heard 3% of total healthcare costs are due to malpractice suits, etc.

If we blocked that 3% you think they would reduce our rates by 3%?

LOL

It is the uncounted cost that is the Big one. The Doctors who all do more test than they would normally to cover their Ass and avoid a law suit in the first place. That is where the real cost of it is.

 

[Annie]

Your brief is about the high-risk pools that are being set up now to insure the uninsurable. These are a temporary stopgap measure to help some of these people out until the exchanges are up and running in 2014 (at which point these high-risk pools terminate and these high-risk people will be able to get the same insurance as everyone else in the regular market).

It's no secret that $5 billion isn't enough to insure every uninsurable person in the country through the end of 2013 (the legislation itself pretty much admits this). The pools will serve some and they'll do it as long as their funding will allow. In the original legislation, these things didn't even exist. There was nothing for them until the exchanges were set up (in 2013 in the House bill, and 2014 in the Senate, which is what ultimately became law).

You are ignoring the not so subtle implication that the 'program' might well not survive 2011, much less more implications in 2014. Still not fully functional then.

It's a loser on a scale never before seen in US.

 

[Charles_Main]

Yeah, that thing that hasn't been implemented yet totally isn't accomplishing the things we hoped it would!

Could you be more disingenuous maybe? The Rates are going up in anticipation of the Law going into Effect. Even the CBO now says it will result in Higher costs, NOT LOWER.

 

[Oddball]

Yeah, that thing that hasn't been implemented yet totally isn't accomplishing the things we hoped it would!

Actually, it's working quite well in making premiums skyrocket, to the point that people will be dropping their coverage and businesses will no longer offer medical insurance as a benefit, subsquently forcing people onto the gubmint "insurance" pool.

But the Fabian socialist progressives never ever wanted a total socialistic gubmint takeover of the medical insurance and care industry!

 

[Charles_Main]

Yeah, that thing that hasn't been implemented yet totally isn't accomplishing the things we hoped it would!

Actually, it's working quite well in making premiums skyrocket, to the point that people will be dropping their coverage and businesses will no longer offer medical insurance as a benefit, subsquently forcing people onto the gubmint "insurance" pool.

But the Fabian socialist progressives never ever wanted a total socialistic gubmint takeover of the medical insurance and care industry!

Um actually he pretty much said he did want that. More than once, it was just ignored during the election.

 

[Oddball]

Right....But the lies "you'll be able to keep your doctor" and "you'll be able to keep your insurance" were re-re-re-re-rerepeated ad nauseum by the Boyking and his democrat toadies, in both congress and the lamestream media, while they were shoving it down or throats.

Well, you'll get to keep them as long as you can tolerate your premiums increasing at a geometric rate, anyways.

 

[Charles_Main]

Right....But the lies "you'll be able to keep your doctor" and "you'll be able to keep your insurance" were re-re-re-re-rerepeated ad nauseum by the Boyking and his democrat toadies, in both congress and the lamestream media, while they were shoving it down or throats.

Well, you'll get to keep them as long as you can tolerate your premiums increasing at a geometric rate, anyways.

yep, but then thinking people have always known this bill was just a means to an end. the End being some form of Government Option/universal Health care. They just know we would never actually vote for something like that, or want it, so they have to FUCK things up enough that it becomes a more attractive option.

 

[Bern80]

Lots of uneducated hysteria in this thread. So let me get this right, Obama doesn't want to make America better and provide better access to healthcare, what he wants is more power. More power from a bill that isn't even fully implemented until after his 4 years are up? Do I have that right?

No. I think liberals like Obama are well intentioned, just really poor problem solvers.

 

[Oddball]

Lots of uneducated hysteria in this thread. So let me get this right, Obama doesn't want to make America better and provide better access to healthcare, what he wants is more power. More power from a bill that isn't even fully implemented until after his 4 years are up? Do I have that right?

Right...He wants the credit for "getting something done", while being as insulated as possible from as many of the negative externalities as possible of his reckless power grab.

 

[Bern80]

.

"Is it going to make for a better system" is a good question to ask. What perplexes me is that you're not asking it of anything. "Will X improve the system" is not an abstract question. It's a concrete question about a concrete entity. You insist on discussing things in the abstract, so you're not asking questions like that.

Probably because I subscribe to K.I.S.S. method of problem solving. Keep It Simple, Stupid. Arguing the specifics of this graph assumes the premise that it's accurate and relevant. YOU are the one who first suggested it isn't (and you're probably right). This problem isn't so hard that it requires this new beauracracy here and that one there. The more government tries to 'fix' things the more it fucks them up. Here's an idea government; STAY THE FUCK OUT OF IT. De-regulate health care so that the insurance companies actually have to compete. Government doesn't need to fund and create some new database to help people shop for health care. People aren't so dumb that they don't know how to shop for a deal and what's best for them.

 

[code1211]

The point is, imagine you've repealed the law. Or gone back in time and prevented it from being written. How much does your graphic change? Not all that much. Most of the items remain: states, employers, private plans, Cabinet-level departments and their subdivisions (DHHS and subdivisions like CMS, AHRQ, etc).

But again: what are you finding to be bewilderingly complex or confusing?

What I find to be not at all bewildering or confusing is the following:

1. Most of the dim bulbs who were in favor of this are the folks who cannot afford insurance and think they will get insurance free. They are not aware that they will have to buy insurance and will have more of their meager incomes taken courtesy fot he shady, unscrupulous swindle which was the lies told by the dems supporting this.
2. Health care premiums have increased and will increase more.
3. In addition to the millions of people who will be taxed in forced premiums or penatlties for non compliance and the increased premiums paid by those who are already paying, there is more than 1 Trillion dollars being taxed additionally to support the shortfalls.
4. The number of entitlements that historically come in on or under budget can be counted on one finger with one finger left over.

An interesting suspension of disbelief occurs with the dual debates on Health Care insurance being the worst in the world and the average life expectancy rising so high so fast that it will bankrupt Social Security. What's wrong with this picture?

The usual Democrat arguing technique is to bury any issue in meaningless details. By doing this, in this case, they have hidden the facts that the costs are expanding faster under their plan to reduce the costs than they did without the plan.

The Stimulus.
The Healthcare Insurance Reform.
Cap and Trade.
Ethanol.
Plug the Hole.
Close Gitmo.
Get out of Iraq.
Win the "Good War".
Unemployment under 8%.
Save or Create Jobs.

Is there anything these jokers can't make worse?

By their own standards of success, these guys are failing and doing it big time. They picked the field. They defined success and now, when they have shown themselves to be utter failures, they Blame Bush.

Who could possibly have predicted that.

 

[007]

Lots of uneducated hysteria in this thread. So let me get this right, Obama doesn't want to make America better and provide better access to healthcare, what he wants is more power. More power from a bill that isn't even fully implemented until after his 4 years are up? Do I have that right?

"Uneducated hysteria"... wowwie... listen to your bad self... you're just above the whole damn country on this subject I guess... huh... yeah you da' man. Get over yourself chief.

Yes, it's about power, and don't forget it. When a bill is written behind looked doors excluding the opposing party, then bringing it vote before it's read, buying and bribing officials to vote for it, and then having it contain unconstitutional provisions, yeah, you fucking bet, IT'S ABOUT POWER.

 

[Oddball]

"Is it going to make for a better system" is a good question to ask. What perplexes me is that you're not asking it of anything. "Will X improve the system" is not an abstract question. It's a concrete question about a concrete entity. You insist on discussing things in the abstract, so you're not asking questions like that.

Because better questions are being asked...Like; "what huge bureaucratic endeavor has the federal gubmint involved itself in, which came in costing less than projected and delivered what it promised, let alone more"?

The answer to which is, of course; There ain't one.

 

[Oddball]

While we're at it pointing out elitist snobbery and all that, let's take a good gander at who's telling us that we're not asking the "right" questions about Obolshevikcare!

Just who died and left Pinkbeard in charge of what constitutes the "right" questions to ask, or not?

 

[Greenbeard]

It is the uncounted cost that is the Big one. The Doctors who all do more test than they would normally to cover their Ass and avoid a law suit in the first place. That is where the real cost of it is.

According to the CBO in 2004:

Proponents of limiting malpractice liability have argued that much greater savings in health care costs would be possible through reductions in the practice of defensive medicine. However, some so-called defensive medicine may be motivated less by liability concerns than by the income it generates for physicians or by the positive (albeit small) benefits to patients. On the basis of existing studies and its own research, CBO believes that savings from reducing defensive medicine would be very small. [. . .]

However, when CBO applied the methods used in the study of Medicare patients hospitalized for two types of heart disease to a broader set of ailments, it found no evidence that restrictions on tort liability reduce medical spending. Moreover, using a different set of data, CBO found no statistically significant difference in per capita health care spending between states with and without limits on malpractice torts. Still, the question of whether such limits reduce spending remains open, and CBO continues to explore it using other research methods.​

An excellent article published last year drives the point home:

“It’s really just a distraction,” said Tom Baker, a professor at the University of Pennsylvania Law School and author of “The Medical Malpractice Myth.” “If you were to eliminate medical malpractice liability, even forgetting the negative consequences that would have for safety, accountability, and responsiveness, maybe we’d be talking about 1.5 percent of health care costs. So we’re not talking about real money. It’s small relative to the out-of-control cost of health care.”

Insurance costs about $50-$60 billion a year, Baker estimates. As for what’s often called “defensive medicine,” “there’s really no good study that’s been able to put a number on that,” said Baker.

Krauthammer cited a study by the Massachusetts Medical Society that found that five out of six doctors said they ordered additional tests, procedures and referrals to protect themselves from lawsuits. He also relies on a much-criticized study from the libertarian Pacific Research Institute on the civil justice system to conclude that “defensive medicine” wastes more than $200 billion a year.

Baker is skeptical, and makes the point that “defensive medicine” is not the same thing as wasteful medicine. “Like defensive driving, some defensive medicine is good,” he said. “To change behavior. When you drill down those studies, you see that what it means is, doctors are more careful with patient records. They spend more time with the patient. They’re more careful to say hello and goodbye to the patient. That’s good.”

Other health economists agree that “defensive medicine” is not the main driver of costs, and malpractice liability reform is not a panacea.

“If you were to list the top five or ten things that you could do to bring down health care costs that would not be on the list,” said Michele Mello, a professor of Law and Public Health at Harvard.​

Just to pile on one more story from last year:

A major new study released today by Americans for Insurance Reform finds that premiums and claims for doctors both have dropped significantly in recent years while the medical malpractice insurance industry is enjoying remarkable profits in light of the global economic collapse. It concludes that further limiting the liability of negligent doctors and unsafe hospitals is not only unjustified, but also would have almost no impact lowering this country's overall health care expenditures.

AIR's report, True Risk: Medical Liability, Malpractice Insurance and Health Care, is by Gillian Cassell-Stiga and Joanne Doroshow of the Center for Justice & Democracy, and actuary J. Robert Hunter, who is Director of Insurance for the Consumer Federation of America (CFA), former Commissioner of Insurance for the State of Texas, and former Federal Insurance Administrator under Presidents Carter and Ford.​

Do you have anything to back up what you're saying or are you just talking?

[...]It's no secret that $5 billion isn't enough to insure every uninsurable person in the country through the end of 2013...

You are ignoring the not so subtle implication that the 'program' might well not survive 2011, much less more implications in 2014. Still not fully functional then.

Explicitly noting that the high-risk pools are underfunded for a three-year run is ignoring it?

It sounds to me like you're confusing the high-risk pools with the exchanges. The high-risk pools aren't supposed to last (ideally they would make it through 2013 but then ideally they'd have three times the funding they do). There are no implications for them in 2014 because they won't exist in 2014.

Could you be more disingenuous maybe? The Rates are going up in anticipation of the Law going into Effect. Even the CBO now says it will result in Higher costs, NOT LOWER.

It's actually kind of cute that you think insurance rates started skyrocketing now (instead of, say, at the beginning of the recession-you know, when they actually did) "in anticipation" of something. You may have missed it but rates have been going up quite a bit the past few years:

In Arizona and North Carolina:

The nonprofit Blue Cross Blue Shield of Arizona raised rates on individual-market policyholders every year between 2007 and 2009, while its surplus grew from $648 million to $717 million, the study shows. In North Carolina, Blue Cross Blue Shield raised rates by a total of 39 percent between 2008 and 2010, even though its surplus was $1.4 billion by 2009 — more than four times the regulatory minimum.​

In Maine in early 2009:

Maine's superintendent of insurance has rejected a set of rate increases proposed by Anthem Blue Cross and Blue Shield.

In a decision released Monday night, Superintendent Mila Kofman said the increases sought by Anthem would be excessive and unfairly discriminatory.

But Kofman said with some scaling back Anthem could win approval.

As a result of changes proposed by the superintendent, the total average rate increase proposed by Anthem of 18.5 percent would be reduced to 10.9 percent, according to Kofman.​

Others in 2009:

Anthem of Connecticut requested an increase of 24 percent last year, which was rejected by the state. [...]

In 2009, Blue Cross/Blue Shield of Michigan requested approval for premium increases of 56 percent for plans sold on the individual market. Regency Blue Cross Blue Shield of Oregon requested a 20-percent premium increase. UnitedHealth, Tufts, and Blue Cross requested 13- to 16-percent rate increases in Rhode Island. And rates for some individual health plans in Washington increased by up to 40 percent until Washington State imposed stiffer premium regulations.​

Yes, 2010 is truly the year of the health insurance premium increase. Well, until you remember that so was 2009. And 2008. And most of the years before that in fact.

In this economic climate, with people out of work and incomes taking a hit, insurance pools also take a hit. People who choose to remain in the individual market or continue their coverage through COBRA after losing their jobs are either 1) people who can afford to do so or 2) people who can't afford not to do so (i.e the sick). That latter part is adverse selection, since healthy people who can choose to skip out on paying for insurance until the economic dust settles will do so, leaving pools sicker and more expensive.

The legislation itself carries penalties for unjustified rate increases in anticipation of the exchanges opening: exclusion from the new exchanges (i.e. the market in which everyone receiving a subsidy will be shopping)

(b) Continuing Premium Review Process-

`(1) INFORMING SECRETARY OF PREMIUM INCREASE PATTERNS- As a condition of receiving a grant under subsection (c)(1), a State, through its Commissioner of Insurance, shall--

`(A) provide the Secretary with information about trends in premium increases in health insurance coverage in premium rating areas in the State; and
`(B) make recommendations, as appropriate, to the State Exchange about whether particular health insurance issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.​

[...]
`(c) Grants in Support of Process-

`(1) PREMIUM REVIEW GRANTS DURING 2010 THROUGH 2014- The Secretary shall carry out a program to award grants to States during the 5-year period beginning with fiscal year 2010 to assist such States in carrying out subsection (a), including--

`(A) in reviewing and, if appropriate under State law, approving premium increases for health insurance coverage; and
`(B) in providing information and recommendations to the Secretary under subsection (b)(1).​

Actually, it's working quite well in making premiums skyrocket, to the point that people will be dropping their coverage and businesses will no longer offer medical insurance as a benefit, subsquently forcing people onto the gubmint "insurance" pool.

What "government insurance pool" are you talking about? The health insurance exchanges containing only private health plans?

Probably because I subscribe to K.I.S.S. method of problem solving. Keep It Simple, Stupid. Arguing the specifics of this graph assumes the premise that it's accurate and relevant. YOU are the one who first suggested it isn't (and you're probably right). This problem isn't so hard that it requires this new beauracracy here and that one there. The more government tries to 'fix' things the more it fucks them up. Here's an idea government; STAY THE FUCK OUT OF IT. De-regulate health care so that the insurance companies actually have to compete. Government doesn't need to fund and create some new database to help people shop for health care. People aren't so dumb that they don't know how to shop for a deal and what's best for them.

Here are some things for you to consider while you're keeping it simple:

1) What do you want insurers to compete on? Price? Risk (i.e. win by attracting the healthiest enrollees and rejecting everyone else)?
2) How does fragmenting the insurance market empower insurers to negotiate down reimbursements to providers, particularly in geographic regions where certain providers have attained substantial market clout (driving up prices)?
3) The five large health insurance companies are already national operations--how would removing state restrictions on out-of-state companies ("deregulation") dent their market shares? Just as Cleveland is a hub for Continental Airlines, why wouldn't Maine remain a "hub" for Anthem Blue Cross Blue Shield? In fact, given that insurers form relationships with networks of providers, why wouldn't the large, nationally present insurers (i.e. those who already have relationships with providers in most states, including lower reimbursements--and ultimately lower premiums--than potential competition) have an immediate and likely insurmountable advantage over any sort of upstart insurance company?
4) Why is market transparency now a bad thing? You don't think prices should be publicly available to shoppers?

An interesting suspension of disbelief occurs with the dual debates on Health Care insurance being the worst in the world and the average life expectancy rising so high so fast that it will bankrupt Social Security. What's wrong with this picture?

Just for sake of argument, who is it that you think is providing health insurance for the elderly in this country? Blue Cross?

While we're at it pointing out elitist snobbery and all that, let's take a good gander at who's telling us that we're not asking the "right" questions about Obolshevikcare!

Just who died and left Pinkbeard in charge of what constitutes the "right" questions to ask, or not?

Who said anything about the "right" question? I agreed with Bern that the questions he was raising were good ones. How elitist!

 

[RDD_1210]

Lots of uneducated hysteria in this thread. So let me get this right, Obama doesn't want to make America better and provide better access to healthcare, what he wants is more power. More power from a bill that isn't even fully implemented until after his 4 years are up? Do I have that right?

"Uneducated hysteria"... wowwie... listen to your bad self... you're just above the whole damn country on this subject I guess... huh... yeah you da' man. Get over yourself chief.

Yes, it's about power, and don't forget it. When a bill is written behind looked doors excluding the opposing party, then bringing it vote before it's read, buying and bribing officials to vote for it, and then having it contain unconstitutional provisions, yeah, you fucking bet, IT'S ABOUT POWER.

Lots of claims in here by you, yet no real facts. Lets list the scary buzz terms that don't actually mean anything or have valid supporting evidence -
1) bill written behind locked doors excluding the opposing party
2) voting on it before it's read
3) buying officials to vote
4) unconstitutional provisions
5) POWER (in big bold letters....well done)

Like I said...."Hysteria".

 

[Zoom-boing]

Greenbeard is right, insurance premiums have been steadily rising it's not just now, in 2010. Didn't an insurance company in CA raise their premiums something like 39% while the HC debate was going on and the DC crowd glommed on to that saying "see, rising premiums, we must pass Obamacare!". And premiums will continue to rise . . . likely, even faster and higher . . . . because no one really knows how this will all play out come 2014. Insurance companies are going to grab what they can while they can (and joe average, once again, gets the shaft). But at some point uncle will say "see, still rising premiums, not even Obamacare could stop it!, the only solution is single-payer, government controlled HC." That's the end-game, always was. They just couldn't get that through all in one fell swoop . . . . but step by step they are moving towards it.

 

[Charles_Main]

Greenbeard is right, insurance premiums have been steadily rising it's not just now, in 2010. Didn't an insurance company in CA raise their premiums something like 39% while the HC debate was going on and the DC crowd glommed on to that saying "see, rising premiums, we must pass Obamacare!". And premiums will continue to rise . . . likely, even faster and higher . . . . because no one really knows how this will all play out come 2014. Insurance companies are going to grab what they can while they can (and joe average, once again, gets the shaft). But at some point uncle will say "see, still rising premiums, not even Obamacare could stop it!, the only solution is single-payer, government controlled HC." That's the end-game, always was. They just couldn't get that through all in one fell swoop . . . . but step by step they are moving towards it.

There is nothing steady about a 45% rise in premiums since the passing of the law.