something ignored about obamacare

Discussion in 'Healthcare/Insurance/Govt Healthcare' started by jtw4796, Nov 6, 2012.

  1. jtw4796
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    jtw4796 Rookie

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    I have a job making decent money but thanks to Obamacare my health insurance deductable will go up 300% and I am losing my prescription coverage. So in 2014 I will be better of to quit my job start drawing food stamps and let the government pay for my family's health insurance. I will not do that but they are the facts. So with obamacare the people who refuse to work and the ones who are just plain lazy will have better insurance than I am working and paying for.
     
  2. AquaAthena
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    AquaAthena INTJ/ INFJ

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    That last sentence may be true. But those people will have to look at themselves in a mirror everyday, and see a nothing....
     
  3. TNHarley
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    TNHarley Gold Member

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    It seems to me that is what obama is trying to do. Dependence on the gov't. I fucking hate this care BS. Only one it is helping is the lazy fucks who dont want to do anything with their life.

    But those people will have to look at themselves in a mirror everyday, and see a nothing....
    I'm sure they are satisfied with who they are, so that will not be a factor
     
  4. dblack
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    dblack Gold Member

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    Hmm... these are precisely the kinds of changes we need to get control of health care inflation, so I'm begrudged to admit this as a (very rare) positive outcome of Obamacare. Do you have any indication as to why your policy changed? Did they cite any specific part of PPACA that prompted the change?
     
    Last edited: Nov 6, 2012
  5. peach174
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    peach174 Gold Member Gold Supporting Member Supporting Member

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    Yep our's is going up too.
    All Cadillac plans will go up by 40%.
    Any drug that you have that can not be generic is rising also.
    One drug my husband uses, does not come in any type of generic drug. It has gone up three times now.
    First it cost 32.00 then 53.00 and in just one month it has gone up to 86.00. This is what we are paying after insurance has paid for it. Seniors can't afford this huge continual hikes.
    This is what the New Health Care Act bill does. punish the ones who cannot get generic drugs.
     
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  6. oldfart
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    oldfart Older than dirt

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    A couple of things are happening here. The biggest one has nothing to do with the ACA. Employers have been cutting back on health benefits and coverage for the last 20 years and the trend is accelerating. Employers who have been cutting back on health benefits now blame the ACA for what they had been doing and planned to continue to do anyway; shift more of the financial burden onto the employee.

    Until America gets the cost of health care under control, fewer and fewer people (employers or employees) will be able to afford good insurance. Americans pay more than double what any other economically advanced nation pays and gets results that are best mediocre. The most successful American health care systems are single-payer like the VA system, Medicare, and the military. The same is true in other countries. I don't see any clear advantage to single-provider (managed care, HMO, or "socialized medicine" or whatever else you want to call it) but I do see that a single payer system can control costs and deliver better care.

    The ACA will involve some increases in short term costs (2 or 3 years) for much of the health care and health care financing industries. Most of these effects will be offset by much larger cost savings in the future. For example, free cancer screenings and immunizations should reduce the cost of treating cancer by early detection reducing the number of cases detected at late stages which are more expensive to treat and reducing the pool of un-immunized people who could contract expensive to treat diseases. Similarly moving toward universal coverage, especially for people with pre-existing conditions, will result in more preventative care and earlier detection when diseases are less costly to treat.

    I think there are three areas where the ACA could be improved that would yield huge benefits in both outcomes and cost and move us toward the average of developed economies. First is to extend the benefits of negotiated rates to as much of the health care industry as possible. Single-payer could do this fairly easily. If Medicaid can negotiate drug prices, why shouldn't Medicare?

    Second, we should eliminate the bureaucracy that makes private health insurance incur 15--20% administrative overhead where the similar figure for Medicare is under 2%, USING THE SAME COMPANIES AS CLAIMS PROCESSORS. If insurance companies can no longer cherry-pick and have no incentive for denying claims on frivolous grounds, we end the game of ping pong with claims bouncing back and forth between providers and insurers and the savings could accrue to everybody in the system, insurers, providers, and patients.

    Third, we need to dismantle emergency facilities as the provider of first choice for any and all medical conditions. The best way to do this is a system adopted by many teaching hospitals. "Emergency services" is actually divided into four functions: triage, acute care, medical screening clinic, and surgical screening clinic. Triage evaluates patients and determines which of the other three areas is most appropriate. Acute care functions like what we see on the TV shows, dealing with life-threatening emergencies. The screening clinics have longer wait lines, often make appointments for non-immediate care at a later date, and frequently only provide sufficient care to hold people over until the later appointment. It's amazing how many people can be treated with acetaminophen, an antibiotic, and a mild sedative. In mass casualty situations, this model allows for all hands and resources to be assigned to triage and acute care.

    Finally, one of the problems with the current system is that there are not enough health care resources to provide quality health care to everyone, especially in certain areas of practice such as primary care, care for elderly, and long-term care. Health financing reform needs to be coupled with a reorganization of health care delivery and an investment in both facilities and training. The role of PA's and NP's should be expanded and perhaps a two-tier system of licensing and training for physicians instituted.

    We can't stay with a system that is sinking more each year and we can't go back to an ideal system that never really existed. We can either muddle along hoping to stabilize the system (which is all that the ACA really does) or we can use it to launch a health care delivery and financing system the American people deserve.
     
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  7. dblack
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    dblack Gold Member

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    And this is exactly what needs to happen to cure the health care market.

    It's rather obvious our health care market is deeply imbalanced. We're overinsured and under invested in our own health. Health care providers experience virtually no downward price pressure from health care consumers. People either have insurance and don't care much about costs because they're "covered", or they don't have insurance and don't care about costs because they can't afford the inflated prices.

    Everything I've studied and read about the dysfunctions of the health care market points to over-insurance as the principle driver of health care inflation. Yet the entire zeitgeist of PPACA is that it is imperative to maximize the role of corporate insurance, positioning the insurance industry as middlemen (largely unnecessary middlemen) in every single health care transaction.

    Because, especially if we get single-payer (but even if we don't), government agencies don't 'negotiate'. They dictate. What you're homing in on here is defacto government mandated price controls on health care.

    Speaking of cherry-picking, I'm taking this somewhat out of context to ask about the bolded part. I'm just curious what removes this incentive? I see no reason to believe insurance companies won't challenge claims as aggressively as ever. What provisions of PPACA would have this effect? Does it actually outlaw challenging claims?
     
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  8. OohPooPahDoo
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    OohPooPahDoo Gold Member

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    Obamacare has nothing to do with that. That's your employer screwing you over. Stop being an idiot.
     
  9. whitetrashmama
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    whitetrashmama freedom-is-sacred

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    When is anyone in gov't, or even the general public, going to notice the obvious fallacy of all employer-provided health insurance? SICK PEOPLE DON'T WORK!!! The ONLY ones who have ever benefited in most jobs are the families of breadwinners. Once the breadwinner gets too sick to work, within a few months he/she is highly likely to lose the insurance coverage for ongoing expenses.

    I don't know if Obama is consciously trying to force the American public onto a general everyone-pays system, but he is botching the job if he is because he is trying to turn it into a "no-one pays at all", not an "everyone pays a little" and the health providers know this. Somehow the drug companies will get paid just like the prostitutes in any society, but the providers? They are the abandoned lovers, already taking lower payments for medicare/medicaid patients.

    One of the other sneaky parts of Obama-care is a new loophole that will punitively refuse payment to any clinic/hospital that has a "complication" arise requiring re-treatment of a patient. You know how they will handle that? Of course: they'll just refuse treatment to any case that looks difficult or risky.

    It is all slow genocide or national collective suicide of the USA, whether intentional or not... really, it is just too weird to consider what Obamacare really will accomplish.....
     
    Last edited: Nov 6, 2012
  10. oldfart
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    oldfart Older than dirt

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    Most studies I have seen indicate that consumers do a petty good job of controlling their own over-utilization of medical services. While a nose job might be attractive with a face lift, few people are insisting on a triple bypass when they think an angioplasty will do.

    But if we wanted to encourage this kind of self-rationing, then we should equalize the "cost" of medical care by scaling the copays or deductibles to income. Everybody could probably pay a $5.00 copay for an office visit, but that's not enough for a person making $200,000 a year to worry about cost containment. Apart from the logistical problems, people would intensely dislike such a system.

    Couldn't agree more!

    I'm not sure I agree with about the causes of medical cost inflation, but I agree that feeding more money into the health care financing industry without reforms to reduce its monopoly and monopsony power is a bad idea.

    But if the problem is a concentration of market power, there really is no alternative. If someone has an idea how to make medical markets behave like competitive markets, I'd say give it a try. As things now stand care is often rendered before the patient ever sees a cost estimate or bill. How can a competitive market work when consumers don't even know what the prices are?

     

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