Obama Care Mess

[SanTropez]

This country and this government CAN'T AFFORD Obamacare as it is designed, plus the care people (may) receive will be sub-standard. There will be lots of exceptions on what it WON'T cover. Plus insurance premiums are going to be astronomical. The thought was interesting........but the implementation is a disaster.

 

[LilOlLady]

Nothing imperfect man puts his hands on is never perfect.We have never has a perfect government. None of our social service programs are perfect. ObamaCare will help most of the people and other will not see benefits. But any care is better then NoCare.

 

[SFC Ollie]

ObamaCare is a disaster that has already began to happen.......It could be the destruction of the Union........

 

[Underhill]

Can someone point me toward any evidence of this disaster?

And I'm not talking about projections from partisan hacks, but real evidence.

Because all this propaganda is just over the top.

The program may raise cost. But who the **** knows since so many people continually pull numbers straight out their ass.

The program will probably mean shortages of care in some places. But this is only because before some people were getting no care. So adding them to the system leaves it over burdened.

But I see no evidence of any end of the world scenarios unfolding. And I have looked for it.

 

[Flopper]

People may dislike “the health reform law” when asked about it that way, but their negative views are rooted largely in ignorance. Strong majorities favor most of the law’s key provisions. Two-thirds favor the so-called guaranteed issue, which bars discrimination against people with pre-existing conditions. More than 70% support expanding Medicaid to cover people living below 138% of the poverty level. Some 76% like the rule that allows kids to stay on their parents’ plans through age 25, and even higher proportions favor health insurance exchanges, better drug coverage for Medicare participants, and tax credits to help small businesses sponsor health plans for their employees (chart). All told, the public favors 10 of Obamacare’s 11 key provisions, and Republicans favor seven of the 11.

Happy Birthday, Obamacare ? MSNBC

You mean to tell me that a lot of people like the fact that someone else is going to pay for something for them????

That's been the lowbrow sales-pitch for insurance since the first policy was sold. But it's a come-on and we've finally got all the evidence we need to realize that in the long run, it doesn't work that way. Insurance adds unnecessary overhead to every transaction it 'covers'. Insurance is a gamble, and in the end the house always wins.

Insurance makes sense as a way to hedge your bets; to 'cover' unlikely losses that would bankrupt you outright. As a means of paying for day-to-day health care expenses it's irrational and poisonous to the health care market.

You apparently consider routine healthcare a yearly checkup and an occasional prescription. That may be true for some but not for many millions. My wife has three prescription that she must take or she'll be in the hospital. The cost is over $800/mo. plus office visits and tests. Her total medical cost are over $15,000 a year and she's not even sick. These are routine costs and are enough to bankrupt a lot of families if they don't have some type of insurance coverage.

Most of what you call routine costs goes to the treatment of chronic diseases such as asthma, diabetes, heart disease, COPD, and arthritis. More than 75% of health care costs are due to chronic conditions. About 133 million Americans, nearly 1 in 2 adults live with at least one chronic illness. Routine treatment often runs in the thousands of dollars/yr.

We are approaching a point where health insurance,either private or government is not an option. For many millions it's the difference between being able to lead a productive life and not living at all.

 

[Flopper]

I have a friend who is wife died of kidney cancer. They had insurance but they paid very little of her care which added up quickly in the tune of over a half million dollars. How many of us can afford that medical bill? They didn't save her so where is the justification in those costs?

These insurance companies find any excuse not to pay and it has got to stop considering they keep raising premiums. What are they really doing with all of our money? The only item that insurance companies are good for is their fee schedule.

Insurance companies make money by collecting premiums, not paying benefits.

 

[dblack]

You mean to tell me that a lot of people like the fact that someone else is going to pay for something for them????

That's been the lowbrow sales-pitch for insurance since the first policy was sold. But it's a come-on and we've finally got all the evidence we need to realize that in the long run, it doesn't work that way. Insurance adds unnecessary overhead to every transaction it 'covers'. Insurance is a gamble, and in the end the house always wins.

Insurance makes sense as a way to hedge your bets; to 'cover' unlikely losses that would bankrupt you outright. As a means of paying for day-to-day health care expenses it's irrational and poisonous to the health care market.

You apparently consider routine healthcare a yearly checkup and an occasional prescription. That may be true for some but not for many millions. My wife has three prescription that she must take or she'll be in the hospital. The cost is over $800/mo. plus office visits and tests. Her total medical cost are over $15,000 a year and she's not even sick. These are routine costs and are enough to bankrupt a lot of families if they don't have some type of insurance coverage.

Most of what you call routine costs goes to the treatment of chronic diseases such as asthma, diabetes, heart disease, COPD, and arthritis. More than 75% of health care costs are due to chronic conditions. About 133 million Americans, nearly 1 in 2 adults live with at least one chronic illness. Routine treatment often runs in the thousands of dollars/yr.

We are approaching a point where health insurance,either private or government is not an option. For many millions it's the difference between being able to lead a productive life and not living at all.

Think about that. If you'll allow the paraphrase, it sounds like you're saying that health care has become so expensive that only the insured (and the very rich) can afford it. I'd have to agree that's case. And it's getting worse.

But what do you think would happen to the prices for those drugs and services if suddenly far fewer of them were covered by insurance? If most of us were paying out of pocket for most of our health care, and relying on insurance only for catastrophic coverage, prices would fall dramatically. It would also increase demand for cost effective alternative treatments and more efficient delivery systems - something we now have to coax out of providers with ad-hoc "incentives".

As counter-intuitive as it might seem, I'm convinced that the only way to fix the health care market is to minimize and reverse the damage done to it by our abuse of insurance. And the first step in doing that is to remove all the incentives for over-insuring built into current legislation. (i.e. stop making things worse).

Unfortunately, we're moving in the opposite direction. I don't know whether our leaders don't understand this, or don't care. (The third option, that I'm just wrong, isn't currently under consideration. )

I know that many progressives support PPACA, even though they admit it won't do much good, because of the harm it will do to the health care market. But I think they're misguided in their assumption that destroying the health care market will bring about socialized medicine. As PPACA has shown, our leaders want corporatism, not socialism - and that's what we're doing to get.

 

[BillyV]

Can someone point me toward any evidence of this disaster?

And I'm not talking about projections from partisan hacks, but real evidence.

Because all this propaganda is just over the top.

The program may raise cost. But who the **** knows since so many people continually pull numbers straight out their ass.

The program will probably mean shortages of care in some places. But this is only because before some people were getting no care. So adding them to the system leaves it over burdened.

But I see no evidence of any end of the world scenarios unfolding. And I have looked for it.

Here's an interesting piece from the Wall Street Journal; the author argues (persuasively) that the individual insurance market will suffer dramatic premium increases and the small employer market somewhat less but still significant.

Start with people who have individual and small-group health insurance. These policies are most affected by ObamaCare's community-rating regulations, which require insurers to accept everyone but limit or ban them from varying premiums based on age or health. The law also mandates "essential" benefits that are far more generous than those currently offered.

According to consultants from Oliver Wyman (who wrote on the issue in the January issue of Contingencies, the magazine of the American Academy of Actuaries), around six million of the 19 million people with individual health policies are going to have to pay more—and this even after accounting for the government subsidies offered under the law. For example, single adults age 21-29 earning 300% to 400% of the federal poverty level will be hit with an increase of 46% even after premium assistance from tax credits.

Determining the number of individuals who will be harmed by changes to the small-group insurance market is harder. According to the Medical Expenditure Panel Survey, conducted by the Department of Health and Human Services, around 30 million Americans work in firms with fewer than 50 employees, and so are potentially affected by the small-group "reforms" imposed by ObamaCare.

Around nine million of these people, plus six million family members, are covered by employers who do not self-insure. The premium increases for this group will be less on average than those for people in the individual market but will still be substantial. According to analyses conducted by the insurer WellPoint for 11 states, small-group premiums are expected to increase by 13%-23% on average.

This average masks big differences. While some firms (primarily those that employ older or sicker workers) will see premium decreases due to community rating, firms with younger, healthier workers will see very large increases: 89% in Missouri, 91% in Indiana and 101% in Nevada.


Daniel Kessler: The Coming ObamaCare Shock - WSJ.com

If he is even half right, there will be some very unhappy people come 2014.

 

[Underhill]

Can someone point me toward any evidence of this disaster?

And I'm not talking about projections from partisan hacks, but real evidence.

Because all this propaganda is just over the top.

The program may raise cost. But who the **** knows since so many people continually pull numbers straight out their ass.

The program will probably mean shortages of care in some places. But this is only because before some people were getting no care. So adding them to the system leaves it over burdened.

But I see no evidence of any end of the world scenarios unfolding. And I have looked for it.

Here's an interesting piece from the Wall Street Journal; the author argues (persuasively) that the individual insurance market will suffer dramatic premium increases and the small employer market somewhat less but still significant.

Start with people who have individual and small-group health insurance. These policies are most affected by ObamaCare's community-rating regulations, which require insurers to accept everyone but limit or ban them from varying premiums based on age or health. The law also mandates "essential" benefits that are far more generous than those currently offered.

According to consultants from Oliver Wyman (who wrote on the issue in the January issue of Contingencies, the magazine of the American Academy of Actuaries), around six million of the 19 million people with individual health policies are going to have to pay more—and this even after accounting for the government subsidies offered under the law. For example, single adults age 21-29 earning 300% to 400% of the federal poverty level will be hit with an increase of 46% even after premium assistance from tax credits.

Determining the number of individuals who will be harmed by changes to the small-group insurance market is harder. According to the Medical Expenditure Panel Survey, conducted by the Department of Health and Human Services, around 30 million Americans work in firms with fewer than 50 employees, and so are potentially affected by the small-group "reforms" imposed by ObamaCare.

Around nine million of these people, plus six million family members, are covered by employers who do not self-insure. The premium increases for this group will be less on average than those for people in the individual market but will still be substantial. According to analyses conducted by the insurer WellPoint for 11 states, small-group premiums are expected to increase by 13%-23% on average.

This average masks big differences. While some firms (primarily those that employ older or sicker workers) will see premium decreases due to community rating, firms with younger, healthier workers will see very large increases: 89% in Missouri, 91% in Indiana and 101% in Nevada.


Daniel Kessler: The Coming ObamaCare Shock - WSJ.com

If he is even half right, there will be some very unhappy people come 2014.

That's a piece on the opinion page.

He makes some reasonable points, but his numbers come from various sources, some individual estimates, one from a firms estimate.

And even he says the numbers are open to debate.

 

[Underhill]

That's been the lowbrow sales-pitch for insurance since the first policy was sold. But it's a come-on and we've finally got all the evidence we need to realize that in the long run, it doesn't work that way. Insurance adds unnecessary overhead to every transaction it 'covers'. Insurance is a gamble, and in the end the house always wins.

Insurance makes sense as a way to hedge your bets; to 'cover' unlikely losses that would bankrupt you outright. As a means of paying for day-to-day health care expenses it's irrational and poisonous to the health care market.

You apparently consider routine healthcare a yearly checkup and an occasional prescription. That may be true for some but not for many millions. My wife has three prescription that she must take or she'll be in the hospital. The cost is over $800/mo. plus office visits and tests. Her total medical cost are over $15,000 a year and she's not even sick. These are routine costs and are enough to bankrupt a lot of families if they don't have some type of insurance coverage.

Most of what you call routine costs goes to the treatment of chronic diseases such as asthma, diabetes, heart disease, COPD, and arthritis. More than 75% of health care costs are due to chronic conditions. About 133 million Americans, nearly 1 in 2 adults live with at least one chronic illness. Routine treatment often runs in the thousands of dollars/yr.

We are approaching a point where health insurance,either private or government is not an option. For many millions it's the difference between being able to lead a productive life and not living at all.

Think about that. If you'll allow the paraphrase, it sounds like you're saying that health care has become so expensive that only the insured (and the very rich) can afford it. I'd have to agree that's case. And it's getting worse.

But what do you think would happen to the prices for those drugs and services if suddenly far fewer of them were covered by insurance? If most of us were paying out of pocket for most of our health care, and relying on insurance only for catastrophic coverage, prices would fall dramatically. It would also increase demand for cost effective alternative treatments and more efficient delivery systems - something we now have to coax out of providers with ad-hoc "incentives".

As counter-intuitive as it might seem, I'm convinced that the only way to fix the health care market is to minimize and reverse the damage done to it by our abuse of insurance. And the first step in doing that is to remove all the incentives for over-insuring built into current legislation. (i.e. stop making things worse).

Unfortunately, we're moving in the opposite direction. I don't know whether our leaders don't understand this, or don't care. (The third option, that I'm just wrong, isn't currently under consideration. )

I know that many progressives support PPACA, even though they admit it won't do much good, because of the harm it will do to the health care market. But I think they're misguided in their assumption that destroying the health care market will bring about socialized medicine. As PPACA has shown, our leaders want corporatism, not socialism - and that's what we're doing to get.

I'm going with the third option.

I don't know of a single case where that has been done effectively. The closest thing to it is what we had prior to widespread insurance coverage. But times were completely different then. I bet the average person didn't see the doctor once a year.

 

[BillyV]

Can someone point me toward any evidence of this disaster?

And I'm not talking about projections from partisan hacks, but real evidence.

Because all this propaganda is just over the top.

The program may raise cost. But who the **** knows since so many people continually pull numbers straight out their ass.

The program will probably mean shortages of care in some places. But this is only because before some people were getting no care. So adding them to the system leaves it over burdened.

But I see no evidence of any end of the world scenarios unfolding. And I have looked for it.

Here's an interesting piece from the Wall Street Journal; the author argues (persuasively) that the individual insurance market will suffer dramatic premium increases and the small employer market somewhat less but still significant.

Start with people who have individual and small-group health insurance. These policies are most affected by ObamaCare's community-rating regulations, which require insurers to accept everyone but limit or ban them from varying premiums based on age or health. The law also mandates "essential" benefits that are far more generous than those currently offered.

According to consultants from Oliver Wyman (who wrote on the issue in the January issue of Contingencies, the magazine of the American Academy of Actuaries), around six million of the 19 million people with individual health policies are going to have to pay more—and this even after accounting for the government subsidies offered under the law. For example, single adults age 21-29 earning 300% to 400% of the federal poverty level will be hit with an increase of 46% even after premium assistance from tax credits.

Determining the number of individuals who will be harmed by changes to the small-group insurance market is harder. According to the Medical Expenditure Panel Survey, conducted by the Department of Health and Human Services, around 30 million Americans work in firms with fewer than 50 employees, and so are potentially affected by the small-group "reforms" imposed by ObamaCare.

Around nine million of these people, plus six million family members, are covered by employers who do not self-insure. The premium increases for this group will be less on average than those for people in the individual market but will still be substantial. According to analyses conducted by the insurer WellPoint for 11 states, small-group premiums are expected to increase by 13%-23% on average.

This average masks big differences. While some firms (primarily those that employ older or sicker workers) will see premium decreases due to community rating, firms with younger, healthier workers will see very large increases: 89% in Missouri, 91% in Indiana and 101% in Nevada.


Daniel Kessler: The Coming ObamaCare Shock - WSJ.com

If he is even half right, there will be some very unhappy people come 2014.

That's a piece on the opinion page.

He makes some reasonable points, but his numbers come from various sources, some individual estimates, one from a firms estimate.

And even he says the numbers are open to debate.

That's why I said "if he's even half right". By the way, before you dismiss the source as "opinion", you should consider that he has a PhD in Economics from MIT and a JD from Stanford, where he is currently a professor of law, and is an expert in health law and policy.

 

[peach174]

You can't have a large portion of the people working 30 hours a week instead of 40 hours a week and expect this to work.
I mean come on that adds up to three weeks every month, 10 hours less each week means less income for all of them. How do you expect people to be able to afford the high gas prices, high food prices and higher premiums on less income per week?
That also means less taxes paid to the government.
Add up all of the problems with this bill and it's a disaster waiting to happen.

 

[Flopper]

That's been the lowbrow sales-pitch for insurance since the first policy was sold. But it's a come-on and we've finally got all the evidence we need to realize that in the long run, it doesn't work that way. Insurance adds unnecessary overhead to every transaction it 'covers'. Insurance is a gamble, and in the end the house always wins.

Insurance makes sense as a way to hedge your bets; to 'cover' unlikely losses that would bankrupt you outright. As a means of paying for day-to-day health care expenses it's irrational and poisonous to the health care market.

You apparently consider routine healthcare a yearly checkup and an occasional prescription. That may be true for some but not for many millions. My wife has three prescription that she must take or she'll be in the hospital. The cost is over $800/mo. plus office visits and tests. Her total medical cost are over $15,000 a year and she's not even sick. These are routine costs and are enough to bankrupt a lot of families if they don't have some type of insurance coverage.

Most of what you call routine costs goes to the treatment of chronic diseases such as asthma, diabetes, heart disease, COPD, and arthritis. More than 75% of health care costs are due to chronic conditions. About 133 million Americans, nearly 1 in 2 adults live with at least one chronic illness. Routine treatment often runs in the thousands of dollars/yr.

We are approaching a point where health insurance,either private or government is not an option. For many millions it's the difference between being able to lead a productive life and not living at all.

Think about that. If you'll allow the paraphrase, it sounds like you're saying that health care has become so expensive that only the insured (and the very rich) can afford it. I'd have to agree that's case. And it's getting worse.

But what do you think would happen to the prices for those drugs and services if suddenly far fewer of them were covered by insurance? If most of us were paying out of pocket for most of our health care, and relying on insurance only for catastrophic coverage, prices would fall dramatically. It would also increase demand for cost effective alternative treatments and more efficient delivery systems - something we now have to coax out of providers with ad-hoc "incentives".

As counter-intuitive as it might seem, I'm convinced that the only way to fix the health care market is to minimize and reverse the damage done to it by our abuse of insurance. And the first step in doing that is to remove all the incentives for over-insuring built into current legislation. (i.e. stop making things worse).

Unfortunately, we're moving in the opposite direction. I don't know whether our leaders don't understand this, or don't care. (The third option, that I'm just wrong, isn't currently under consideration. )

I know that many progressives support PPACA, even though they admit it won't do much good, because of the harm it will do to the health care market. But I think they're misguided in their assumption that destroying the health care market will bring about socialized medicine. As PPACA has shown, our leaders want corporatism, not socialism - and that's what we're doing to get.

I do agree with some of your points, but I'm not confident that a free market approach is the answer because most of our healthcare dollars go to treatments of serious medical problems. Most people can't afford to pay those cost and thus must rely on insurance. When that happens, the patient isn't in control and there goes the free market.

The simple fact is you can't market healthcare like TVs and cars. You don’t know when or whether you’ll need care but if you do, the care can be extremely expensive. The big bucks are in triple coronary bypass surgery, not routine visits to the doctor’s office; and very, very few people can afford to pay major medical costs out of pocket. This tells you right away that health care can’t be sold like bread. It must be largely paid for by some kind of insurance. And this in turn means that someone other than the patient ends up making decisions about what to buy.
Why markets can't cure healthcare - NYTimes.com


So what do I think would happen to the prices for those drugs and services if suddenly far fewer of them were covered by insurance? There would be some reduction in prices but not a lot, because most of those drugs and services would be paid for by the insurance companies catastrophic coverage.

 

[Flopper]

I don't know if anyone has brought this up, but there is a huge benefit to everyone if providing healthcare doesn't have to be a part of business and individual decisions. Businesses would no longer be burden with providing healthcare coverage. You could go to work for a small start up company with no benefits even though you have a family member with a serious health problem. Employees wouldn't have to stay in dead end job just because they have good insurance. You could retire when want rather when you're eligible for Medicare. In America, this is just a fantasy. However, in many countries it's reality. They not only have less expensive healthcare but they have better care.

 

[SFC Ollie]

You just keep telling yourself that.......

 

[lynn63]

It would benefit all of us if all employers could opt out of providing health benefits. People in their late 40's and 50's wouldn't have to worry about being laid off because they have reached an age where they begin to cost more in healthcare. It is impossible to gain employment in your 50's because of healthcare insurance.
Employers now are beginning to make increasing demands on how you manage your health and its going to get a lot worst in 2014. Since the mandate is forcing employers to get involved in their employees health status, its only a matter of time when they start interviewing job applicants not only on their experience but also on what your weight is.

I envision that mandatory blood tests for new job applicants to screen your blood for indications of what your diet is, whether you smoke, drugs, etc before they will consider hiring you.

 

[dblack]

I do agree with some of your points, but I'm not confident that a free market approach is the answer because most of our healthcare dollars go to treatments of serious medical problems. Most people can't afford to pay those cost and thus must rely on insurance. When that happens, the patient isn't in control and there goes the free market.

Again, and I'm sorry to keep repeating myself, but you're mixing up concerns. The amount of health care we consume isn't what's causing price inflation. Volume tends to make prices go down, if anything. So, the fact that most of "our" health care dollars go to serious medical conditions, or last-gasp end-of-life treatments, has nothing to do with that fact that ordinary health care is artificially expensive.

When it comes to dealing with serious medical conditions or catastrophic accidents, there's nothing wrong with setting up 'safety nets' - whether via private insurance or public welfare - to cover us. But it should be a backstop and not our primary plan for financing our health care. The problem comes when we see insurance as a ticket to 'free health care' - which is what most of us seem to expect out of health insurance. It's that delusion that's killing us.

The simple fact is you can't market healthcare like TVs and cars. You don’t know when or whether you’ll need care but if you do, the care can be extremely expensive.

Again, you're focused on the catastrophic stuff, and that's simply a different problem than routine care. Ordinary health care (colds, infections, broken bones, etc...) is no different economically than any other service we expect to use.

I still say we're dealing with two disctinct problems:

1. What to do about people who can't afford the health care they need.

and

2. What to do about the fact that health care is simply too expensive in the first place.

The key point I'd like to make here is that if we solve the second problem, the first one will be much easier to deal with. If, on the other hand, we ignore the second problem and simply focus on the first, we're rapidly approaching a point where very few of us can afford even basic health care. We'll have to build safety nets big enough to hold everyone.

 

[dblack]

I don't know if anyone has brought this up, but there is a huge benefit to everyone if providing healthcare doesn't have to be a part of business and individual decisions. Businesses would no longer be burden with providing healthcare coverage. You could go to work for a small start up company with no benefits even though you have a family member with a serious health problem. Employees wouldn't have to stay in dead end job just because they have good insurance. You could retire when want rather when you're eligible for Medicare. In America, this is just a fantasy. However, in many countries it's reality. They not only have less expensive healthcare but they have better care.

I'd certainly agree with the wisdom of breaking the status quo of employer-provided health insurance. Policy encouraging that has been a large part of the problem. But when it comes to the "benefit" of being relieved of the responsibility for our own health care, I can't see that as a good thing. Would it also be 'huge benefit to everyone' if providing for our own food and shelter were also no longer part of business and individual decisions?

This is really just the the socialism vs capitalism debate again. But as I've said, that's a moot argument when it comes to PPACA - it's neither.

 

[Bomboozle]

Whatever you think about corporations, employer-sponsored healthcare provides subsidized healthcare to approximately 171 million individuals and families who will be faced with financial hardship if employers decide to discontinue offering it. It is a healthcare delivery system that WORKS. Yes, companies get a tax break, but employees also enjoy affordable healthcare. Healthcare reform needed to tackle the real problems with healthcare -- namely, the individual market, low-income employees and baby-boomers aging into Medicare. Obamacare needed to complement, not destabilize employer-sponsored healthcare.

 

[dblack]

Whatever you think about corporations, employer-sponsored healthcare provides subsidized healthcare to approximately 171 million individuals and families who will be faced with financial hardship if employers decide to discontinue offering it. It is a healthcare delivery system that WORKS. Yes, companies get a tax break, but employees also enjoy affordable healthcare. Healthcare reform needed to tackle the real problems with healthcare -- namely, the individual market, low-income employees and baby-boomers aging into Medicare. Obamacare needed to complement, not destabilize employer-sponsored healthcare.

It only 'WORKS' for those who are in on it. It screws everyone else.