The glaring evidence that Obamacare is a catastrophic FAILURE continues to mount

[The Derp]

Major Obamacare Insurer Blue Cross Blue Shield Won’t Turn a Profit in 2017

All Obamacare does is show that for-profit private health insurance makes no sense whatsoever. What does a private insurance company actually do? They administer reimbursement to providers from the pool of premiums you pay into. For this administration, insurance companies can take as much as 20 cents of every dollar you pay for themselves. 20% of your premium goes straight into the black hole that is for-profit insurance and is not used for your care. So why are we paying a 20% admin fee to have a private company do the exact same thing (and using the same standards) Medicare does but for a fraction of the cost? Further, because there are multiple payors in the market, the bargaining power lies with providers and drug companies who can play insurers off one another for higher fees. That's why you see stupid things like exorbitant costs for prescription drugs whereas single-payer nations do not. There is nothing an insurance company does that improves your care or outcomes , and that is evidenced by the fact that the US health care system ranks below all other single-payer nations in nearly every single measurable health metric (i.e. life expectancy, infant mortality, cost per patient).

Furthermore, the average cost to insure a worker in an employer-provided plan (according to the Kaiser Family Foundation) is about $17,000/worker. The worker usually pays an average of $5,000 to that, and the employer pays an average of $12,000. So a business of 50 employees that provides coverage to its workers is spending about $600,000 a year to provide its workers with coverage. Contrast that with the single-payer proposal Sanders put forward during the Democratic Primary; do away with Medicare payroll tax, do away with Obamacare, do away with Medicaid, do away with S-Chip, and do away with private insurance and put in its place a single payer that is funded by a 6.2% payroll tax on workers and a 6.2% payroll tax on business profits. The average income in this country is about $53,000, which means the average worker would pay $3,286 a year for universal, single-payer health care (vs. $5,000 a year + deductibles, co-insurance, rx drugs, etc. for an employer-provided plan). For a small business of 50 employees to pay $600,000 a year for coverage would mean that small business would have to make close to $10M in profit. Which is virtually unheard of for any small business unless it's a hedge fund in which case, screw those gamblers anyway.

There is no benefit to having private health insurance. It does nothing to improve or enhance your care, is not outcome-focused, nor is it justifiable from a moral standpoint.

 

[The Derp]

I called it 4 years ago. The Dumbocrats are still too stupid to figure it out...
"Health insurers know the end of Obamacare is near"
Aetna CEO Says Obamacare in a 'Death Spiral'

So please help me understand...if Conservatives knew Obamacare was going to be a big, hot mess 7 years ago, why did they not have a viable replacement plan ready to go?

 

[dblack]

Major Obamacare Insurer Blue Cross Blue Shield Won’t Turn a Profit in 2017

All Obamacare does is show that for-profit private health insurance makes no sense whatsoever.

ACA highlights the folly of trying to use private insurance as a social safety net.

 

[The Derp]

Obamacare was the most catastrophic, idiotic, and embarrassing legislation in U.S. history...
If Government Fails to Fund Subsidies, Obamacare Premiums Will Rise by 19%

No surprise that private health insurance costs a lot of money. It's not a really sustainable business model, particularly as millions of Boomers move into Medicare. When it comes down to it, the role an insurance company plays in your health care is minimal at best, parasitic at worst. To understand that, you only need look at the sole function of an insurance company; mitigating risk. Which is just another phrase for administration of reimbursements. Which is just another phrase for paper-pushing. All an insurance company does is administer payment to your provider from the pool of premiums you paid into already. So they are basically taking as much as a 20% fee to move money from your insurance pool to your doctor. Medicare does the exact same administration (and private insurers use Medicare as the standard), but does it for a fraction of the cost, for the most sick among us; elderly folks, disabled persons, children. I happen to think paying a 20% fee to move money is a rip-off and have not heard a clear, coherent argument as to why it's better to have BCBS reimburse your providers vs. having Medicare do it?

I think the fundamental problem with health insurance reform (and that's all Obamacare was, BTW) is that most people don't even know what health insurance actually is, or what health insurance companies actually do. They do not employ your doctor (unless it's Kaiser). They are not taking your temperature. They are not performing your surgery. They are not sticking a finger up your butt to check your prostate. They have nothing to do with your actual health care, other than restrict access.

 

[The Derp]

ACA highlights the folly of trying to use insurance as a social safety net.

Yup. That's why there's no Public Option; if there was, people would gravitate to it because they'll realize it serves the same function, but costs a fraction of what private insurance does. And the health insurance lobby can't have that, right???

 

[dblack]

ACA highlights the folly of trying to use insurance as a social safety net.

Yup. That's why there's no Public Option; if there was, people would gravitate to it because they'll realize it serves the same function, but costs a fraction of what private insurance does. And the health insurance lobby can't have that, right???

A 'public option' is still insurance, with most of the same pitfalls.

This is really a struggle between those who want to fix the health care market and those who don't want it to be a market at all

 

[The Derp]

A 'public option' is still insurance, with most of the same pitfalls.
This is really a struggle between those who want to fix the health care market and those who don't want it to be a market at all

What pitfalls are those? Because a single payer doesn't have to worry about profit margins, nor does a single payer allow a fragmented insurance market where providers and drug companies can play payors (insurers) off one another to get higher margins. Single-payer systems are also outcome-based, meaning that the incentive for the providers to treat you correctly is there because otherwise, they have to pay the costs out of their own pockets...which is precisely how Obama reformed Medicare when COnservatives accused him of stealing from it. That wasn't what he did. What he did was reform Medicare to where it no longer reimbursed doctors for treatment for conditions that derived from the initial treatment. For example, say grandpa goes to the hospital to get a kidney removed. While recovering from surgery, the patient gets a staph infection. Previously, Medicare would reimburse the provider for the initial kidney removal and the staph infection that resulted from post-surgery due to any number of factors (cleanliness of the hospital, misdiagnosis, neglect, etc.). The ACA reformed Medicare so that providers no longer get reimbursed for the conditions that arise from the care they provided. That is an outcome-based model, and one that private insurers do not do. So private insurers (largely) reimburse the provider regardless of the quality of care they performed. That's done in the service of profits, and why insurance premiums increase.

Fact is, everyone needs health care at some point in their lives. The profit motive tied to the administration of payments to your provider for that health care is not something that improves or enhances the care your provider gives you. It only restricts access. That's why it's a scam and why a single-payer system makes more sense.

 

[dblack]

A 'public option' is still insurance, with most of the same pitfalls.
This is really a struggle between those who want to fix the health care market and those who don't want it to be a market at all

What pitfalls are those?

Insurance, especially group plans that don't charge premiums based on the individual, drives inflation because people no longer have incentives to make value decisions. No one cares what health care costs because they're not paying for their health care costs.

The biggest problem with the health care market is that we are over-insured. Insurance works as a hedge against risk, but as a means of financing normal expenses it's a terrible way to go. Most consumers don't even understand insurance - they think it's a club you join to get free health care.

 

[The Derp]

Insurance, especially group plans that don't charge premiums based on the individual, drives inflation because people no longer have incentives to make value decisions. No one cares what health care costs because they're not paying for their health care costs.

OK, but you're looking at that through the prism of for-profit, are you not? In a single payer system there is only a single payer. So there are no such things as group plans. And since there is a single payer, that means the bargaining power shifts from providers and drug companies to patients who can use their leverage as the single payer to negotiate for cheaper prices for everything. And everyone pays for health care in a single-payer plan. A fixed percentage of the income. Sanders proposed 6.2% and he got to that figure by doing the math of eliminating the costs for private insurance (premiums, deductibles, co-insurance, drug costs, etc.), eliminating Medicaid, S-Chip, even Obamacare and replacing it all with Medicare-for-All that covers everything, doesn't require any out-of-pocket costs to patients, and gives the bargaining power to the single payer while taking it away from providers and drug companies, who are profit-driven. The reason health care costs go up is simply because of for-profit insurance. It's possible to have government-run single-payer and still have private, for-profit providers. In fact, a single payer would improve outcomes because you would have doctors competing for patients instead of insurance companies competing for customers. That's why we trail every first-world nation in every measurable health metric there is including cost.

Insurance works as a hedge against risk, but as a means of financing normal expenses it's a terrible way to go. Most consumers don't even understand insurance - they think it's a club you join to get free health care.

I don't know if they think that. But I do know that most people don't understand the function of an insurance company. When you say a hedge against risk, who's risk? Not the patients, because they pay premium dollars regardless. Not the providers, because they have to take every patient. So it's really the risk to the profits of the insurer, isn't it? What I don't understand is why the privatization of administering reimbursements is necessary or better than just having Medicare do it? Insurance companies have so little to do with health care, they don't even employ doctors! None of the people who work at insurance companies have any medical training. Yet we give them unimaginable power to profit off our sickness while doing nothing to treat it? There's something morally reprehensible about that.

 

[dblack]

since there is a single payer, that means the bargaining power shifts from providers and drug companies to patients who can use their leverage as the single payer to negotiate for cheaper prices for everything.

Bargaining power? If there's only one source of payment, there's really no need to bargain.

Insurance works as a hedge against risk, but as a means of financing normal expenses it's a terrible way to go. Most consumers don't even understand insurance - they think it's a club you join to get free health care.

I don't know if they think that. But I do know that most people don't understand the function of an insurance company. When you say a hedge against risk, who's risk? Not the patients, because they pay premium dollars regardless. Not the providers, because they have to take every patient. So it's really the risk to the profits of the insurer, isn't it?

No. I don't know where to begin. You don't seem to understand insurance either. Should I bother explaining it?

Yet we give them unimaginable power to profit off our sickness while doing nothing to treat it? There's something morally reprehensible about that.

Morally reprehensible? Maybe. I just think it's stupid. That's why I buy as little insurance as I can possibly afford. Do you think being stupid should be illegal?

 

[debbiedowner]

Insurance, especially group plans that don't charge premiums based on the individual, drives inflation because people no longer have incentives to make value decisions. No one cares what health care costs because they're not paying for their health care costs.

OK, but you're looking at that through the prism of for-profit, are you not? In a single payer system there is only a single payer. So there are no such things as group plans. And since there is a single payer, that means the bargaining power shifts from providers and drug companies to patients who can use their leverage as the single payer to negotiate for cheaper prices for everything. And everyone pays for health care in a single-payer plan. A fixed percentage of the income. Sanders proposed 6.2% and he got to that figure by doing the math of eliminating the costs for private insurance (premiums, deductibles, co-insurance, drug costs, etc.), eliminating Medicaid, S-Chip, even Obamacare and replacing it all with Medicare-for-All that covers everything, doesn't require any out-of-pocket costs to patients, and gives the bargaining power to the single payer while taking it away from providers and drug companies, who are profit-driven. The reason health care costs go up is simply because of for-profit insurance. It's possible to have government-run single-payer and still have private, for-profit providers. In fact, a single payer would improve outcomes because you would have doctors competing for patients instead of insurance companies competing for customers. That's why we trail every first-world nation in every measurable health metric there is including cost.

Insurance works as a hedge against risk, but as a means of financing normal expenses it's a terrible way to go. Most consumers don't even understand insurance - they think it's a club you join to get free health care.

I don't know if they think that. But I do know that most people don't understand the function of an insurance company. When you say a hedge against risk, who's risk? Not the patients, because they pay premium dollars regardless. Not the providers, because they have to take every patient. So it's really the risk to the profits of the insurer, isn't it? What I don't understand is why the privatization of administering reimbursements is necessary or better than just having Medicare do it? Insurance companies have so little to do with health care, they don't even employ doctors! None of the people who work at insurance companies have any medical training. Yet we give them unimaginable power to profit off our sickness while doing nothing to treat it? There's something morally reprehensible about that.

In fact, a single payer would improve outcomes because you would have doctors competing for patients instead of insurance companies competing for customers.

THAT WHAT PROVIDER NETWORKS ARE "COMPETING FOR PATIENTS"

Insurance companies have so little to do with health care, they don't even employ doctors! None of the people who work at insurance companies have any medical training.

MOST HEALTH INSURERS HAVE DOCTORS ON STAFF AND PLENTY OF RN'S.

 

[The Derp]

THAT WHAT PROVIDER NETWORKS ARE "COMPETING FOR PATIENTS"

No, they don't. Provider Networks compete for insurers. Provider Networks do not negotiate rates with you, nor do you reimburse them for the care they provide. The insurer does that. Providers play insurers off one another to get higher reimbursements by increasing their fees. You have nothing to do with that. Providers aren't competing for patients in an open market. They're competing for patients among the insurance plans they accept. Patients are secondary.

MOST HEALTH INSURERS HAVE DOCTORS ON STAFF AND PLENTY OF RN'S.

No they don't. You are confusing Providers with Insurers. Insurers have nothing to do with your care. All they do is administer reimbursement to your provider for the care they provide. Unless it's Kaiser, no insurance company employs any medical staff at all. In fact, insurers don't even have physicians on staff that determine what is covered and what isn't. That is determined by accountants, not doctors.

 

[The Derp]

Bargaining power? If there's only one source of payment, there's really no need to bargain.

Right, the single payer can set the fees. Which is how you control health care costs. Why do you think Conservatives wanted to prevent Medicare from negotiating for cheaper prescription drug prices as a part of their Medicare Part-D? Because they knew allowing Medicare to do so would result in lower costs for drugs, and that runs in direct conflict with drug companies who want to increase profits and lobby heavily -with as much as 20% of your premium- to prevent that sort of thing from happening.

No. I don't know where to begin. You don't seem to understand insurance either. Should I bother explaining it?

Oh, I understand it fine. You seem to be ascribing more to insurance than what it actually does. Keep in mind, I am talking about private insurance, not the concept of insurance as a whole. Private insurance does nothing more than the administration of reimbursement to providers. Which is exactly what Medicare does, but Medicare doesn't carve out as much as 20% of the premium for itself like insurance companies do. As much as 20 cents of every dollar you pay in premiums goes into the pocket of the insurance company and is not used for your care. And what do we get for this 20%? Nothing. We get absolutely nothing for it. In fact, we aren't even a part of that transaction. That's done entirely between the insurer and provider. You have nothing to do with that. My question, that is still unanswered, is why is privatizing the function of administration of reimbursements even necessary at all? It does nothing to improve or enhance your care. All it does is restrict access.

Morally reprehensible? Maybe. I just think it's stupid. That's why I buy as little insurance as I can possibly afford. Do you think being stupid should be illegal?

No, I think Conservatism should be illegal until we can determine the extent of Russian influence in the GOP, Trump, and the right-wing media that promotes it.

 

[jillian]

As the Dumbocrats on USMB love to crow about - Obamacare was passed into law by Congress, signed into law by the president, and upheld by the Supreme Court. So why exactly does the federal government have to piss away billions to promote an existing law?!? Has this ever been done with any other law in U.S. history?

They begged the NBA to help promote it and the NBA said yes. They begged the NFL to help promote it, and the NFL told them to go fuck themselves (doh!). So why are they so desperate to reach people through Hollywood and sports? Because even the Dumbocrats know this is a miserable failure, and they know it is going to be repealed eventually unless they can do major damage control and brainwash the masses (especially the young and impressionable - hence the NBA, NFL, etc.) that this is a "good" thing.

Super Bowl champ Baltimore Ravens getting paid $130,000 to promote Obamacare | WashingtonExaminer.com

anything else you want to make up, nutter butter?

 

[dblack]

Bargaining power? If there's only one source of payment, there's really no need to bargain.

Right, the single payer can set the fees. Which is how you control health care costs.

Government would control health care altogether, which is the goal, near as i can tell.

No. I don't know where to begin. You don't seem to understand insurance either. Should I bother explaining it?

Oh, I understand it fine.

Are you sure? You seem confused about the concept of using insurance as a hedge against risk.

Morally reprehensible? Maybe. I just think it's stupid. That's why I buy as little insurance as I can possibly afford. Do you think being stupid should be illegal?

No, I think Conservatism should be illegal until we can determine the extent of Russian influence in the GOP, Trump, and the right-wing media that promotes it.

Cute. But I was referring to your claim that people who allow insurance companies to profit from their health care are "morally reprehensible". You want to make that illegal. I'm trying to understand why.

 

[The Derp]

Government would control health care altogether, which is the goal, near as i can tell.

How does government taking over the mechanism by which your doctor is reimbursed for your care translate to government control of health care? How health care is paid and how health care is delivered are two mutually exclusive things.

re you sure? You seem confused about the concept of using insurance as a hedge against risk.

Who's risk? The payors. Who is the payor? The insurance company. So it's not your risk, it's risk to the profits of the payor. I don't think you really understand what the risk is in this equation.

Cute. But I was referring to your claim that people who allow insurance companies to profit from their health care are "morally reprehensible". You want to make that illegal. I'm trying to understand why.

Yes, I do want to make it illegal because it is reprehensible and does nothing to improve or enhance your care. We are paying insurance companies as much as 20% of our premiums to do what? Administration. You wouldn't accept a 20% admin fee when buying a car, so why would you accept a 20% admin fee to have someone in Hartford, with no medical training, press a button to send payment to your provider? It makes no sense. It's like the "why are you hitting yourself" game.

 

[dblack]

Government would control health care altogether, which is the goal, near as i can tell.

How does government taking over the mechanism by which your doctor is reimbursed for your care translate to government control of health care? How health care is paid and how health care is delivered are two mutually exclusive things.

Heh... right. If you control the purse strings, you control everything - as you've proven. If government is supplying the cash, than can simply mandate which services they will pay for, which they won't, how much they will pay, who is eligible, who isn't, etc, etc....

Are you sure? You seem confused about the concept of using insurance as a hedge against risk.

Who's risk? The payors. Who is the payor? The insurance company. So it's not your risk, it's risk to the profits of the payor. I don't think you really understand what the risk is in this equation.

Wow.. you really don't get what a hedge is. Do some reading: Hedge (finance) - Wikipedia
Individuals live with the risk that they might get sick and not be able to afford an available cure. They pay insurance companies a monthly fee (a premium) to cover some or all of the costs if the risk is realized.

How did everyone in this country get so confused about health insurance?

 

[The Derp]

Heh... right. If you control the purse strings, you control everything - as you've proven. If government is supplying the cash, than can simply mandate which services they will pay for, which they won't, how much they will pay, who is eligible, who isn't, etc, etc....

Government isn't supplying the cash...taxpayers are. Government is just the entity that makes sure the cash gets to the doctor who treated you. And right now, insurance companies already mandate what services they pay for, and they do that because of the profit motive. No profit motive = no denial of claims. The only reason a health insurer won't pay a medical claim is because doing so would affect their profit margin. That's it. That's the only reason why that would happen. In a single-payer system, that wouldn't be the case so long as the system is well-funded. A 6.2% payroll tax to replace Medicare tax and employer-provided insurance would be able to fully fund Medicare, removing the need for Parts A-D, and thus, reducing expenses for people on Medicare and on private insurance right now. It makes no sense that as a society, we spend 20 cents of every dollar to health care. That's entirely because of insurance companies. There is no other reason.

Wow.. you really don't get what a hedge is. Do some reading: Hedge (finance) - WikipediaIndividuals live with the risk that they might get sick and not be able to afford an available cure. They pay insurance companies a monthly fee (a premium) to cover some or all of the costs if the risk is realized.

Right, and that is in a for-profit model, not a single-payer model. In a single-payer model, there is no risk because everyone is in the same insurance pool. So I don't know why you all get so fixated on the "mitigating risk" while ignoring the fact that risk is only mitigated because insurance companies are profit-driven. Remove the profit motive and you remove the risk. It's that simple. Again, that's why single payer systems beat ours in nearly every measurable health metric there is, including cost. If what you're saying is true, then the universal, single-payer systems would result in more health care spending, not less. So what we have here is a case of reality clashing with fantasy. There is no way to reduce costs and provide universal coverage in a for-profit health insurance system. It is impossible. So why are we bothering with this? There is no advantage to having the transaction between an insurance company and your provider privatized. It does not improve or enhance your care at all. In fact, it restricts it. It restricts your choice of doctor. It restricts your options for treatment. And it does that in service not of your health, but of the insurance company's profit margins. By defending for-profit health insurance, you are defending price gouging, rescission, and claim denials. None of which does anything to improve or enhance your health care.

 

[The Derp]

How did everyone in this country get so confused about health insurance?

Because Conservatives lie about it.

 

[dblack]

How did everyone in this country get so confused about health insurance?

Because Conservatives lie about it.

And you believe them!