Rationing Medicare

[Quantum Windbag]

That video does nothing for your argument. He never said he was going to force insurance companies to keep offering products they don't want to offer.

You really are an idiot.

Quite a few plans that used to be available are illegal under Obamacare, why do you think they have been issuing waivers to keep people insured?

The "plans" you're referring to weren't insurance plans in the first place. However, this portion of the discussion began with you complaining that your current policy can no longer be offered because of the Affordable Care Act. As Greenbeard already noted, if your insurance company told you that, they lied to you, because self-insured plans are exempted from the requirements.

As I said before, I have to chose between some anonymous shill on the internet and people I can talk to face to face about who is lying, guess who wins.

 

[Quantum Windbag]

It's not like the issue is unexamined.

New regulations include rate bands that limit premium price variation, risk-adjustment policies that will transfer funds from low-actuarial-risk to high-actuarial-risk plans, and requirements that plans include “essential health benefits.” While the new regulations will be applied to all non-grandfathered fully insured policies purchased by businesses with 100 or fewer workers, self-insured plans are exempt from these regulations.

http://aspe.hhs.gov/health/reports/2011/LGHPstudy/EmployerSIDACA.pdf

Wow.

http://imsagencies.wordpress.com/2010/03/24/recent-health-care-reform-law-and-self-insured-plans/

Maybe if you read the whole thing instead of just the talking points that prove your point you will see the problem. Essentially it comes down to the fact that I buy a new policy every year, so the policy I would normally buy no longer exists, nor does any other policy exist that I can afford because they are required to cover things I neither want, nor need.

Not to worry, I still go to the doctor for routine stuff, and still pay out of pocket for routine tests. But, thanks to Obamacare, if I ever really get sick, someone else gets to pay my bills.

And you get to live in a delusional world where unicorns shit doctors.

 

[Gadawg73]

All medical care is and always has been rationed. That's the idea behind triage and many insurance practices.

So long as resources are finite and less than we'd need to treat everyone, there are more doctors than patients, and we operate in the real world, there will always be the need to decide how best to use those resources (financial, human, physical, and time) to achieve the most good for the most people. This is simply the reality of how the world works. I'm not saying it's good or right- that's just how it always has been and is likely to remain to the foreseeable future.

We've never had a bureau of unelected appointees deciding the criteria for who will get what treatment and what the cost will be. I can sue an insurance company, can't do shit against the US Gov't.

You can not sue an insurance company unless you are already a policy holder. They can deny you coverage.
Not the way Medicare was set up or has always worked.
Medicare has to be cut. Blank check health care must end.

 

[Greenbeard]

The company no longer offers the policy, and tells me, and everyone else, that is because of the PPACA.

I could go ahead and assume you're a ridiculously gullible dunce. But I'll give you a little more credit and just assume you've been lying to us with your fish stories (though you probably should've checked to see which plans the various provisions of the law apply to when you were crafting them).

It currently costs around $6,000 per person for an employer to offer the basic coverage they already do. That cost, as we have seen, will go up under the new mandated plans in Obamacare.

More of this? To reiterate, large group plans (i.e. for employers with >100 employees, though states have the option of defining employers with more than 50 employees as large if they wish), self-insured or not, don't have to offer "qualified health plans" that cover the essential benefits outlined in the law; self-insured plans of any size also aren't subject to those requirements, just as they're not subject to existing state benefit mandates right now. So presumably you're speaking here only of non-self-insured employers with 50-100 employees, given that there is no possibility of penalties for employers with less than 50 employees; if for some reason there's a serious problem with them in your state, I'd suggest asking your state legislature to exercise its option to regard them as large groups.

 

[dblack]

Of course they oppose it, because it represents a long-term threat to their business model.

???

The whole point of the ACA is to preserve their business model. To do it by force, actually. I'm not sure how you could possibly imagine it differently.

It preserves their form, but firms don't care about that. They care about the profit structure.

It locks their profit structure in, making it no longer dependent on satisfying customers, but a matter of negotiated politics. Based on their success in 'steering' health care reform, I'm sure the insurance companies are confident that's a game they will win.

 

[dblack]

They don't really cover critical problems though, at least to the same extent a standard policy does. They're a fig leaf.

That's simply not the case. Obviously different plans will have different coverage, but with the catastrophic plans the trade off isn't on the high end. That's where their essentially the same, or even better, than the traditional plans. What you lose with catastrophic coverage is coverage of the day-to-day expenses, which, in terms of downward price-pressure, is the whole point.

 

[dblack]

Since I'm going to bed, I'll cut to the final point about insurers and the ACA. The law is only good for insurers if increasing the number of consumers make up for the implementation of the medical loss ratio. That may be true for now, but it won't be true if the ratio is increased in the future. The structure created by the Affordable Care Act could very likely result in a system where people have the choice of several different private insurers which are so tightly regulated that they're functionally public provisions.

If the ACA survives (and works as advertised), it will essentially turn health insurance into a public/private utility. Their profits will be guaranteed by the same kind of political process that governs all other public utilities. Whether you see this as a good thing or a bad thing depends on your view of the accelerating trend converting our nation from capitalism to corporatism.

 

[Quantum Windbag]

The company no longer offers the policy, and tells me, and everyone else, that is because of the PPACA.

I could go ahead and assume you're a ridiculously gullible dunce. But I'll give you a little more credit and just assume you've been lying to us with your fish stories (though you probably should've checked to see which plans the various provisions of the law apply to when you were crafting them).

It currently costs around $6,000 per person for an employer to offer the basic coverage they already do. That cost, as we have seen, will go up under the new mandated plans in Obamacare.

More of this? To reiterate, large group plans (i.e. for employers with >100 employees, though states have the option of defining employers with more than 50 employees as large if they wish), self-insured or not, don't have to offer "qualified health plans" that cover the essential benefits outlined in the law; self-insured plans of any size also aren't subject to those requirements, just as they're not subject to existing state benefit mandates right now. So presumably you're speaking here only of non-self-insured employers with 50-100 employees, given that there is no possibility of penalties for employers with less than 50 employees; if for some reason there's a serious problem with them in your state, I'd suggest asking your state legislature to exercise its option to regard them as large groups.

What the fuck are you talking about?

In one of those posts I was talking about personal experience. In the other I was responding to a question about what incentives exist under Obamacare for insurers to drop coverage. Why the fuck should I ask my state to do anything when the federal government is supplying the incentive?

 

[signelect]

I will soon be 69, I am working full time and paying w/h and SS and medicare tax. I pay my own insurance so my wife can be covered because she is not old enough. It makes me sick to have people talk about SS and medicare like I am milking the system. I have been paying in SS for over 50 years under penalty of law I might add and was promised certain things and I want them. Our congressmen who passed those laws are too good for what I am getting so they have a better plan and that is a problem. Congress should not be able to pass laws that they don't have to follow. I believe that most of your agree, we are getting screwed by our own government.

 

[Polk]

Since I'm going to bed, I'll cut to the final point about insurers and the ACA. The law is only good for insurers if increasing the number of consumers make up for the implementation of the medical loss ratio. That may be true for now, but it won't be true if the ratio is increased in the future. The structure created by the Affordable Care Act could very likely result in a system where people have the choice of several different private insurers which are so tightly regulated that they're functionally public provisions.

If the ACA survives (and works as advertised), it will essentially turn health insurance into a public/private utility. Their profits will be guaranteed by the same kind of political process that governs all other public utilities. Whether you see this as a good thing or a bad thing depends on your view of the accelerating trend converting our nation from capitalism to corporatism.

And that, ultimately, is a bad deal for health insurers.

 

[dblack]

And that, ultimately, is a bad deal for health insurers.

Really? When's the last time a public/private utility company went broke? Getting in bed with government guarantees that won't happen. Their profit margins might not be as high (then again, they might be higher), but they can pretty much quit worrying about satisfying customers. The insurance industry is essentially setting up a government approved cartel.

And the bitch of it is, if ACA survives, we can't even say 'no' to their shitty product.

 

[Polk]

And that, ultimately, is a bad deal for health insurers.

Really? When's the last time a public/private utility company went broke? Getting in bed with government guarantees they won't go broke. There profit margin might not be as high (then again, it might be higher), but they can pretty much quit worrying about satisfying customers. The insurance company is essentially creating a government approved cartel.

And the bitch of it is, if ACA survives, we can't even say 'no' to their shitty product.

No might to it. It will result in much lower profit margins.

 

[dblack]

No might to it. It will result in much lower profit margins.

Why do you say that?

Here's why I say they'll be better off. The gig is up on their game. For many decades they were able to sustain profits even in while their pyramid scheme was driving up health care prices at double digit rates. The reason it worked is because they had a constantly expanding customer base. They could continue to pay the rapidly inflating health care prices without radical premium hikes, as long as they were able to sign up new customers faster than they were paying out claims to existing customers.

But that expansion slowed. What began as a basic fact of reduced population growth tipped the scales and then they had to start jacking up premiums. As they started doing that, more and more people couldn't afford health insurance or chose to forgo it because it was no longer as good a deal. Customers began dropping full coverage insurance and going to the catastrophic polices as a sane response to the rising premiums.

All this spelled the start of a viscous cycle that would surely lead to the death of the modern insurance industry in five (maybe ten?) years. There was simply no way people (or the businesses that employ them) would be able to pay the rates that would be required to make the modern insurance scheme viable. Faced with that, the insurance industry relied on good ole American ingenuity and concocted the plan to "join forces" with government, ensuring that they could continue to fleece Americans - at the point of a gun if necessary.

Look again at how the insurance companies are 'fighting' reform. They're not. They're arguing for better terms, doing whatever the can to create the best situation they can for themselves, but the last thing they want is to face the harsh reality of the free market. They want corporatism, and Obama is giving it to them.

 

[MikeK]

That sounds great, but that's not how the numbers break down in the real world.

The biggest problem with this entire argument is it assumes people want to "health care consumers". People don't shop for bargains because they lack incentives to do so. They don't shop for bargains because they don't want second-rate care.

Are you saying I got second-rate health care when I was in the Marines?

 

[dblack]

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