Vinson issues stay of his own ruling

[Polk]

An arbitrary ration that is causing insurers to choose between reclassifying administrative expenses as medical expenses, or simply paying every claim they receive without checking them for fraud. Another fine example of just how good the law is.

I want to thank you again, that had slipped my mind.

Spare me the sob story for insurers. They won't reclassify administrative expenses as medical ones (unless they want to get busted for fraud) and they'll still be perfectly able to check claims to make sure they are not fraudulent. Even after full enactment, the administrative cost portion allowed for private insurances will be five times that of Medicare.

Maybe you should try living in the real world.

Wonk Room » WellPoint Reclassifies Costs As ‘Medical Care’ To Meet Reform’s Medical Loss Ratio Requirement

Which you realize constitutes fraud, right?

 

[Quantum Windbag]

How can you claim "Obama had a problem" with it? He did oppose the individual mandate during the primary, but his argument was that he felt it wasn't necessary, not so deep-rooted ideological objection. I'd also challenge the notion that the bill is unaffordable. The reality is that without aggressive movements on medical cost containment, our existing obligations, without ACA, are unaffordable. The bill represents a first step toward cost containment. If you're really worried about the fiscal health of the nation, you'd be looking at working together to fund programs which prove to be effective at reducing cost, while eliminating those that do not. This process will require multiple rounds of policy experimentation if it's going to work.

The fact that he sees exactly the same problems with the mandate that Republicans do? Nice of you to argue that he did not really mean what he said about it though.



By the way, the mandate is not about containing anything, it is about spreading the costs to more people. The PPACA does absolutely nothing to contains costs, so any argument that it does is based on a false premise. It does not address anything that anyone raised as methods of containing the costs of health care.

If you cared about the fiscal health of this nation you would join me in combating this law because it is useless, and only raises the cost of doing business.

How does requiring insurers to pay for office visits reduce costs? How does requiring them to cover everyone, no matter how sick, for the same price, reduce cost? Can you point to a single provision in the PPACA that actually reduces costs? If not, stop lying about what it does. If so, I will admit I am wrong.

The clip is not making the same argument Republicans make. Republicans claim the mandate is an absolute affront to liberty. He's arguing the issue of some technical details of implementation.

I did not state the mandate is about containing cost. And yes, the bill contains tons of cost containment measures, including funding for research into best practices, the aforementioned medical loss ratio requirements, requiring insurance policies cover preventive care (cheaper to make sure someone doesn't get diabetes than to pay to treat it), and funding for the digitalization of medical records.

Furthermore, yes, I will argue that the mandate reduces costs in the long-run. If people have insurance, they'll be able to get treatment when they first fall ill, instead of waiting around until the suffering is unbearable, then flopping in to the ER.

I posted one clip, and you assumed that is all Obama ever said. Should I post the clip where he said that the individual mandate is the same as mandating everyone buy a house to solve homelessness? That particular quote was actually part of Vinson's reasoning behind the ruling that the PPACA is unconstitutional.

Prevetive care is not a cost reduction method, but thanks for trying.

When Preventive Care Costs More - NYTimes.com

Preventive care results in a lot of things, including better health, but a reduction in cost is not one of them.

Medical loss ratios do not reduce costs either, they just arbitrarily decide how much insurers can spend on their own expenses.

Digital records might, conceivably, save money, but that is not why those are being pushed. They are being pushed because it makes it easier to track, and bill, for health care. The savings benefits, if they actually show up, will come after a massive expenditure to design, and implement, a system that works nationwide.

 

[Quantum Windbag]

Spare me the sob story for insurers. They won't reclassify administrative expenses as medical ones (unless they want to get busted for fraud) and they'll still be perfectly able to check claims to make sure they are not fraudulent. Even after full enactment, the administrative cost portion allowed for private insurances will be five times that of Medicare.

Maybe you should try living in the real world.

Wonk Room » WellPoint Reclassifies Costs As ‘Medical Care’ To Meet Reform’s Medical Loss Ratio Requirement

Which you realize constitutes fraud, right?

Which is why they are announcing it openly, because people who commit fraud always advertise the fact that they are doing so.

 

[Polk]

Preventive care does reduce cost. The reason studies say preventive care may not reduce costs is because the savings will be cancelled out by people living longer. If that's your affordability measure, we can solve growing health care costs tomorrow by going Logan's Run.

Medical loss ratios reduce cost by removing the incentives for arbitrary rate increases.

Digital records will save money, and you note that yourself without even realizing. If it's easier to track and bill procedures, it's also cheaper to track and bill procedures. It costs less money to fill out and submit a form than it does to do so twenty times.

 

[The T]

Preventive care does reduce cost. The reason studies say preventive care may not reduce costs is because the savings will be cancelled out by people living longer. If that's your affordability measure, we can solve growing health care costs tomorrow by going Logan's Run.

Medical loss ratios reduce cost by removing the incentives for arbitrary rate increases.

Digital records will save money, and you note that yourself without even realizing. If it's easier to track and bill procedures, it's also cheaper to track and bill procedures. It costs less money to fill out and submit a form than it does to do so twenty times.

And where does the responsibility lie?

*The Individual*

 

[Polk]

Maybe you should try living in the real world.

Wonk Room » WellPoint Reclassifies Costs As ‘Medical Care’ To Meet Reform’s Medical Loss Ratio Requirement

Which you realize constitutes fraud, right?

Which is why they are announcing it openly, because people who commit fraud always advertise the fact that they are doing so.

They didn't announce it openly. It was nestled in the pages of a report to shareholders. The reason they can announce it publicly is that they feel they have a legal argument to claim it's not fraudulent.

 

[Polk]

Preventive care does reduce cost. The reason studies say preventive care may not reduce costs is because the savings will be cancelled out by people living longer. If that's your affordability measure, we can solve growing health care costs tomorrow by going Logan's Run.

Medical loss ratios reduce cost by removing the incentives for arbitrary rate increases.

Digital records will save money, and you note that yourself without even realizing. If it's easier to track and bill procedures, it's also cheaper to track and bill procedures. It costs less money to fill out and submit a form than it does to do so twenty times.

And where does the responsibility lie?

*The Individual*

I agree, which is why I think people should be required to pay for their own health care if they have the money, instead of foisting the costs on to me by waiting until they're critical ill and running to the ER.

 

[Greenbeard]

Actual implication, Polk is completely wrong when he says the regulations will prevent insurance hikes. Again, check on you reading comprehension.

Back peddle all you want, you clearly said that it won't prevent unjustified insurance hikes because HHS isn't empowered to stop them. And indeed it does remain primarily a state matter. Federal authority is not the answer to all things.

Why do we need to spend money to test something that has been demonstrated to work in different places? How do you improve quality by adding another layer of bureaucracy? How do you reduce cost by keeping the burden of health care on employers instead of on individuals?

PDSA, disseminate, then repeat. Over and over again.

 

[code1211]

I'd need to go back and look at the specific text, but I was referring to the "medical loss" ratio.

An arbitrary ration that is causing insurers to choose between reclassifying administrative expenses as medical expenses, or simply paying every claim they receive without checking them for fraud. Another fine example of just how good the law is.

I want to thank you again, that had slipped my mind.

Spare me the sob story for insurers. They won't reclassify administrative expenses as medical ones (unless they want to get busted for fraud) and they'll still be perfectly able to check claims to make sure they are not fraudulent. Even after full enactment, the administrative cost portion allowed for private insurances will be five times that of Medicare.

I'm not going to try to defend the profitability of private insurance companies. I've seen too many very nice buildings to not believe that these guys make money.

However, I've seen too many cost calculations from the government that say we are saving bundles of cash and then end up spending more than we spent previously. Unless the 1/5 figure is supported by something outside of government fantasy figures, i would tend to think that it's either an unintentional lie or an intentional one.

The lie is not yours. I've heard that figure elsewhere. Still, it challenges credulity that the government can do something cheaply when there is no incentive to do anything cheaply.

 

[code1211]

How can you claim "Obama had a problem" with it? He did oppose the individual mandate during the primary, but his argument was that he felt it wasn't necessary, not so deep-rooted ideological objection. I'd also challenge the notion that the bill is unaffordable. The reality is that without aggressive movements on medical cost containment, our existing obligations, without ACA, are unaffordable. The bill represents a first step toward cost containment. If you're really worried about the fiscal health of the nation, you'd be looking at working together to fund programs which prove to be effective at reducing cost, while eliminating those that do not. This process will require multiple rounds of policy experimentation if it's going to work.

The fact that he sees exactly the same problems with the mandate that Republicans do? Nice of you to argue that he did not really mean what he said about it though.



By the way, the mandate is not about containing anything, it is about spreading the costs to more people. The PPACA does absolutely nothing to contains costs, so any argument that it does is based on a false premise. It does not address anything that anyone raised as methods of containing the costs of health care.

If you cared about the fiscal health of this nation you would join me in combating this law because it is useless, and only raises the cost of doing business.

How does requiring insurers to pay for office visits reduce costs? How does requiring them to cover everyone, no matter how sick, for the same price, reduce cost? Can you point to a single provision in the PPACA that actually reduces costs? If not, stop lying about what it does. If so, I will admit I am wrong.

The clip is not making the same argument Republicans make. Republicans claim the mandate is an absolute affront to liberty. He's arguing the issue of some technical details of implementation.

I did not state the mandate is about containing cost. And yes, the bill contains tons of cost containment measures, including funding for research into best practices, the aforementioned medical loss ratio requirements, requiring insurance policies cover preventive care (cheaper to make sure someone doesn't get diabetes than to pay to treat it), and funding for the digitalization of medical records.

Furthermore, yes, I will argue that the mandate reduces costs in the long-run. If people have insurance, they'll be able to get treatment when they first fall ill, instead of waiting around until the suffering is unbearable, then flopping in to the ER.

This can only be supported by the typical Unicorn logic of Government Spending.

All insurance premiums rise, 30 million people are forced to pay for insurance that never paid before for it before, Employers who won't provide or stop their insurance are forced to pay fines, people who don't buy insurance will be forced to pay fines and the general tax revenue expended to support this in addition to all other increases in the costs is 1 Trillion dollars across 10 years.

If the costs are dropping, why are all the costs rising?

 

[code1211]

Except that the law doesn't demand rate increases, so you're simply making things up. Waivers issued were for "mini med", which are effectively like not having insurance in the first place.

But if the LAW is so great? WHY the need for 700+ Waivers?

Answer is easy. The LAW is dead...and has been and the present Florida Ruling will be upheld in the SCOTUS. The Statists know this.

There isn't a practical need for the waivers. It's a political consideration that people will be pissed if they lose their "mini med" policy, even though it wouldn't cover much of anything if they got sick.

I'm glad you are a psychic though and can predict how the Supreme Court will rule.

Does this reduction of choice indicate the promised expansion of choice?

 

[Polk]

An arbitrary ration that is causing insurers to choose between reclassifying administrative expenses as medical expenses, or simply paying every claim they receive without checking them for fraud. Another fine example of just how good the law is.

I want to thank you again, that had slipped my mind.

Spare me the sob story for insurers. They won't reclassify administrative expenses as medical ones (unless they want to get busted for fraud) and they'll still be perfectly able to check claims to make sure they are not fraudulent. Even after full enactment, the administrative cost portion allowed for private insurances will be five times that of Medicare.

I'm not going to try to defend the profitability of private insurance companies. I've seen too many very nice buildings to not believe that these guys make money.

However, I've seen too many cost calculations from the government that say we are saving bundles of cash and then end up spending more than we spent previously. Unless the 1/5 figure is supported by something outside of government fantasy figures, i would tend to think that it's either an unintentional lie or an intentional one.

The lie is not yours. I've heard that figure elsewhere. Still, it challenges credulity that the government can do something cheaply when there is no incentive to do anything cheaply.

It's actually pretty simple when you think about it. Medicare handles so many claims that is has massive economics of scale.

 

[Polk]

The fact that he sees exactly the same problems with the mandate that Republicans do? Nice of you to argue that he did not really mean what he said about it though.

http://www.youtube.com/watch?v=7AOJBiklP1Q

By the way, the mandate is not about containing anything, it is about spreading the costs to more people. The PPACA does absolutely nothing to contains costs, so any argument that it does is based on a false premise. It does not address anything that anyone raised as methods of containing the costs of health care.

If you cared about the fiscal health of this nation you would join me in combating this law because it is useless, and only raises the cost of doing business.

How does requiring insurers to pay for office visits reduce costs? How does requiring them to cover everyone, no matter how sick, for the same price, reduce cost? Can you point to a single provision in the PPACA that actually reduces costs? If not, stop lying about what it does. If so, I will admit I am wrong.

The clip is not making the same argument Republicans make. Republicans claim the mandate is an absolute affront to liberty. He's arguing the issue of some technical details of implementation.

I did not state the mandate is about containing cost. And yes, the bill contains tons of cost containment measures, including funding for research into best practices, the aforementioned medical loss ratio requirements, requiring insurance policies cover preventive care (cheaper to make sure someone doesn't get diabetes than to pay to treat it), and funding for the digitalization of medical records.

Furthermore, yes, I will argue that the mandate reduces costs in the long-run. If people have insurance, they'll be able to get treatment when they first fall ill, instead of waiting around until the suffering is unbearable, then flopping in to the ER.

This can only be supported by the typical Unicorn logic of Government Spending.

All insurance premiums rise, 30 million people are forced to pay for insurance that never paid before for it before, Employers who won't provide or stop their insurance are forced to pay fines, people who don't buy insurance will be forced to pay fines and the general tax revenue expended to support this in addition to all other increases in the costs is 1 Trillion dollars across 10 years.

If the costs are dropping, why are all the costs rising?

The increase in costs are connected to the rising cost of healthcare. It's pretty hard to argue PPACA is causing the increases when the portions you claim increase costs weren't in effect at the time of the increases you're bemoaning.

Also, as an aside, the claim that PPACA will cause companies to drop their coverage if often repeated in the press, but it doesn't make sense. If a firm currently provides insurance, it doesn't seem like logical decision to stop doing so in a world where the changes to the status quo is a subsidy (in the form of tax credits) for provision.

 

[Polk]

But if the LAW is so great? WHY the need for 700+ Waivers?

Answer is easy. The LAW is dead...and has been and the present Florida Ruling will be upheld in the SCOTUS. The Statists know this.

There isn't a practical need for the waivers. It's a political consideration that people will be pissed if they lose their "mini med" policy, even though it wouldn't cover much of anything if they got sick.

I'm glad you are a psychic though and can predict how the Supreme Court will rule.

Does this reduction of choice indicate the promised expansion of choice?

That assumes "mini med" policies are an actual choice. If you tell me you're hungry and I give you the choice between a steak, a peanut butter sandwich, and a vat of battery acid, removing the vat of acid from the list doesn't change the choice process in any meaningful way.

 

[The T]

Spare me the sob story for insurers. They won't reclassify administrative expenses as medical ones (unless they want to get busted for fraud) and they'll still be perfectly able to check claims to make sure they are not fraudulent. Even after full enactment, the administrative cost portion allowed for private insurances will be five times that of Medicare.

I'm not going to try to defend the profitability of private insurance companies. I've seen too many very nice buildings to not believe that these guys make money.

However, I've seen too many cost calculations from the government that say we are saving bundles of cash and then end up spending more than we spent previously. Unless the 1/5 figure is supported by something outside of government fantasy figures, i would tend to think that it's either an unintentional lie or an intentional one.

The lie is not yours. I've heard that figure elsewhere. Still, it challenges credulity that the government can do something cheaply when there is no incentive to do anything cheaply.

It's actually pretty simple when you think about it. Medicare handles so many claims that is has massive economics of scale.

Read this "CONTROL"

Congrats Klop.

YOU have cemented your stance as one of a fucking Statist.

 

[Quantum Windbag]

Preventive care does reduce cost. The reason studies say preventive care may not reduce costs is because the savings will be cancelled out by people living longer. If that's your affordability measure, we can solve growing health care costs tomorrow by going Logan's Run.

Medical loss ratios reduce cost by removing the incentives for arbitrary rate increases.

Digital records will save money, and you note that yourself without even realizing. If it's easier to track and bill procedures, it's also cheaper to track and bill procedures. It costs less money to fill out and submit a form than it does to do so twenty times.

All the experts, all the studies, all the data, is wrong, all because you decided it is wrong. Preventative care works.

Medical loss rations, will not reduce cost because, even if the insurer actually develops a way to reduce costs, they will not benefit from it. You know why? Because they reduce the incentives to save money, because any costs they reduce will not result in increased profits.

As I said, digital records might save money, but if it does it will be long term, after a massive investment in new technology. The savings are only potential even after that. It is wonderful that you believe in rainbows and unicorns, but the rest of us live in the real world.

You know the difference between you and rdean?

Neither do I.

 

[Quantum Windbag]

Which you realize constitutes fraud, right?

Which is why they are announcing it openly, because people who commit fraud always advertise the fact that they are doing so.

They didn't announce it openly. It was nestled in the pages of a report to shareholders. The reason they can announce it publicly is that they feel they have a legal argument to claim it's not fraudulent.

Just a minor point, reports to shareholders are open. Nice try at claiming they are hiding it, and that it is fraudulent just because you say it is.

Have you noticed that every time I made a point I provided evidence to back it up? Have you noticed that all you do is spout talking points?

 

[Quantum Windbag]

Back peddle all you want, you clearly said that it won't prevent unjustified insurance hikes because HHS isn't empowered to stop them. And indeed it does remain primarily a state matter. Federal authority is not the answer to all things.

What backpeddle? Someone made a point, I refuted it.I was mocking his claim that the PPACA would keep premiums down, and I provided evidence. Somehow you managed to twist that, and my sarcasm, into me calling you a twit.

The two are completely unrelated.

PDSA, disseminate, then repeat. Over and over again.

Make a mistake, talk about it, and do the same thing again.

 

[code1211]

The clip is not making the same argument Republicans make. Republicans claim the mandate is an absolute affront to liberty. He's arguing the issue of some technical details of implementation.

I did not state the mandate is about containing cost. And yes, the bill contains tons of cost containment measures, including funding for research into best practices, the aforementioned medical loss ratio requirements, requiring insurance policies cover preventive care (cheaper to make sure someone doesn't get diabetes than to pay to treat it), and funding for the digitalization of medical records.

Furthermore, yes, I will argue that the mandate reduces costs in the long-run. If people have insurance, they'll be able to get treatment when they first fall ill, instead of waiting around until the suffering is unbearable, then flopping in to the ER.

This can only be supported by the typical Unicorn logic of Government Spending.

All insurance premiums rise, 30 million people are forced to pay for insurance that never paid before for it before, Employers who won't provide or stop their insurance are forced to pay fines, people who don't buy insurance will be forced to pay fines and the general tax revenue expended to support this in addition to all other increases in the costs is 1 Trillion dollars across 10 years.

If the costs are dropping, why are all the costs rising?

The increase in costs are connected to the rising cost of healthcare. It's pretty hard to argue PPACA is causing the increases when the portions you claim increase costs weren't in effect at the time of the increases you're bemoaning.

Also, as an aside, the claim that PPACA will cause companies to drop their coverage if often repeated in the press, but it doesn't make sense. If a firm currently provides insurance, it doesn't seem like logical decision to stop doing so in a world where the changes to the status quo is a subsidy (in the form of tax credits) for provision.

I've spoke to a few HR Proffessionals on this topic. They are in agreement that a predictable, flat rate of cost in any category of expense beats one that varies wildly and unpredictably.

Being able to count on the flat rate paid to the government instead of rates that can change based on experience is the thing that will drive this the best.

Logic resides in the conditions present and the goals of the thinker.

 

[Greenbeard]

I've spoke to a few HR Proffessionals on this topic. They are in agreement that a predictable, flat rate of cost in any category of expense beats one that varies wildly and unpredictably.

Then I would strongly suggest they push for building a state SHOP exchange based on a defined employer contribution + premium aggregator model in which employees choose whichever plan they like (perhaps in a given actuarial tier) and pay the difference between the employer contribution and their plan cost themselves. Employer premiums are then predictable and the costs of fluctuations fall on the employee.

The magic of a high-functioning insurance market.