Obamacare overcharged healthy & young people that needed insurance to help fund the cost of insurance for sick people

[Marener]

But yes also, that unique accounting concept is certainly abused.

Please provide substantiation of this allegation.

It’s a marketplace after all. An insurer who pads their premiums to build large reserves is going to be less competitive to consumers.

 

[debbiedowner]

Like I said, linguistic sleight of hand is at work. Think of it, even the term obamacare isn't a real thing. The bottom line remains, insurance plans put in the exchange established by the law charge premiums to customers.

Whether in or out of an exchange they still fall under the law.

 

[debbiedowner]

Right, insurance has driven the cost of procedures up. I mean it really is pretty simple. For profit health insurance on the ACA require a loss ratio of at least 60%. WTF. Think about it. Insurance pays out $600,000 in claims, but that means they can collect one million dollars in premiums. The beneficiaries get precisely sixty cents on the dollar for their premiums. The insurance company gets forty cents out of every dollar in premium. That is outrageous.

Hell, Medicare Advantage plans are required to have an 85% loss ratio. Instead of trying to eliminate the ACA why not make the loss ratio requirement higher? But then again, that whole MLR, Medical Loss Reserve, is a completely fabricated number. Included as a medical expenses in the calculation, the loss reserves of the company. Money set aside to pay future claims not yet incurred, yet they can write that money off just like an expense. Let's put numbers to it.

Insurance company collects your one thousand a month premium. They spend four hundred dollars on claims for you and other beneficiaries of your plan. They spend two hundred dollars on salaries, office space, computers, and of course, those nice annual meetings at the country club for the executives. The other four hundred dollars, well two hundred goes to the shareholders of the company and two hundred goes to the loss reserves. They are legit, 60% MLR.

Think about it. Two hundred from you every month. Two hundred from millions of people every month. Two hundred dollars in the loss reserves. Two hundred dollars invested in real estate, stocks, bonds, hell, even artwork. Two hundred dollars in assets that are listed as a liability on the balance sheet. Insurance is the ONLY business in the world that gets that kind of break.

Who do you think owns that mall where you go shopping? An insurance company, part of their loss reserves. Who owns that office building downtown? An insurance company, part of their loss reserves. We are not talking billions, we are talking TRILLIONS of dollars, untaxed, earning income, also untaxed.

In the above example, which is really quite generous to the insurance companies, clearly indicates that you are not getting sixty cents on the dollar for your premium payments. You are getting forty cents on the dollar and the insurance company is getting twenty cents of every dollar, tax free, and investing it to glean even more money out of the system. It is time this shitshow stopped.

It's 80% not.... ACA require a loss ratio of at least 60%

 

[JoeB131]

Now this makes no sense.

We have more COVERED medical options, and insurance has driven the price UP for them. The medical options for things not covered were kept affordable.

Sure it does. If you had a heart attack back in the day, you probably died. Now they have a whole lot of options.

Here's the thing: Medicine is practically a license to steal, because we don't have a single payer controlling costs.

I went to the emergency room last week. Didn't want to; I wanted to go to an urgent care, but with the symptoms I described, they told me to go directly to the ER. ( I was having severe chest pains caused by a Upper GI issue)

Well got the bill this week. Total cost of a five-hour visit, most of it sitting in a waiting room? $6383.99

Now, you ask, what did I get for this princely sum?

Well, they took an EKG ($516.00)
They drew blood for labs. ($1372.00
They took two X-rays. ($742.00)
Took some vitals.
They claimed to do IV Therapy, but that was just putting in a needle and leaving it there for four hours.) $369.00
They gave me some meds, which I think were Mylanta and aspirin. ($120.00)
Then there was a big one called "Emergency Room" for $3243.00. I honestly can't see anything they did that really justified that cost, as most of the time, (after they determined I wasn't in cardiac arrest), they just had me wait around until the labs and x-rays were finished.

 

[JoeB131]

Defense rests. 15 yrs old. Looks like a nice house. Why are they not working at White Castle or doing homework? Giddyup.

Minimum age to hire a teen is 16, not 15.

But you almost have a point. Doing a menial, Minimum Wage job was once a right of passage for teens. Not so much anymore. Maybe because their parents don't have fond memories of doing those jobs themselves.

 

[DonGlock26]

Sure it does. If you had a heart attack back in the day, you probably died. Now they have a whole lot of options.

Here's the thing: Medicine is practically a license to steal, because we don't have a single payer controlling costs.

I went to the emergency room last week. Didn't want to; I wanted to go to an urgent care, but with the symptoms I described, they told me to go directly to the ER. ( I was having severe chest pains caused by a Upper GI issue)

Well got the bill this week. Total cost of a five-hour visit, most of it sitting in a waiting room? $6383.99

Now, you ask, what did I get for this princely sum?

Well, they took an EKG ($516.00)
They drew blood for labs. ($1372.00
They took two X-rays. ($742.00)
Took some vitals.
They claimed to do IV Therapy, but that was just putting in a needle and leaving it there for four hours.) $369.00
They gave me some meds, which I think were Mylanta and aspirin. ($120.00)
Then there was a big one called "Emergency Room" for $3243.00. I honestly can't see anything they did that really justified that cost, as most of the time, (after they determined I wasn't in cardiac arrest), they just had me wait around until the labs and x-rays were finished.

How do you think hospitals pay for illegal aliens and indigent patients treatments? They overcharge insured persons.
Would you support ER's being able to turn away illegal aliens and the indigent?

 

[JoeB131]

How do you think hospitals pay for illegal aliens and indigent patients treatments? They overcharge insured persons.
Would you support ER's being able to turn away illegal aliens and the indigent?

No, I would be in favor of single payer where the poor and indigent aren't using an ER for minor ailments.

You know, like every other civilized country does it.

 

[DonGlock26]

No, I would be in favor of single payer where the poor and indigent aren't using an ER for minor ailments.

You know, like every other civilized country does it.

Who would the single payer be?

 

[JoeB131]

Who would the single payer be?

I'm not going to engage in stupid sophistry with you.

 

[DonGlock26]

I'm not going to engage in stupid sophistry with you.

You are running away?

 

[JoeB131]

You are running away?

I don't engage in dishonest conversations. If you want to have an honest conversation about the merits of single payer (which would be the government) vs. Insurance companies working for profit), then I'd be happy to talk.

Who pays for it is irrelevant. It's how that money is spent that's the problem.

 

[CowboyTed]

There's actually a place for government in healthcare, and that's in the diagnostic arena. It's relatively lower cost, making it free to everyone at the point of sale would make it more attractive for people to get checked out, and it yields big dividends down the road because problems such as cancer are easier to treat when they're caught early. That would allow for catastrophic care plans for bigger problems.

Naturally, politicians would find ways to mess that up and drive costs through the roof, but that's politics.

Look at Europe with there big socialist Healthcare systems costing less and giving better results...

The US system would take a generation to fix at least...

First would be to digitalise all records, this holy grail of healthcare... This could be US moonshot and they actually have the ability to do it... This would yield massive savings both in the private and public...

 

[CowboyTed]

I don't engage in dishonest conversations. If you want to have an honest conversation about the merits of single payer (which would be the government) vs. Insurance companies working for profit), then I'd be happy to talk.

Who pays for it is irrelevant. It's how that money is spent that's the problem.

JoeB,

Don't disagree with you much but who is paying makes a big difference...

Public systems start with investment in Public healthcare like better food and free testing... They want prevent first... Europeans are just amazed at how many drug ads are on TV in the US, they are banned in Europe... What we have is a lot of ads about living healthy and getting access to free services...
There is a much more holistic approach.. Italy is the king of this, life style, food, stress control....

Another is the diabetes in Ireland is completely free... Every type-2 Diabetes patient gets Ozempic for free.. Diabetic shoes for free , eye tests, metformin, test packs, follow up appointments....

 

[JoeB131]

JoeB,

Don't disagree with you much but who is paying makes a big difference...

Public systems start with investment in Public healthcare like better food and free testing... They want prevent first... Europeans are just amazed at how many drug ads are on TV in the US, they are banned in Europe... What we have is a lot of ads about living healthy and getting access to free services...
There is a much more holistic approach.. Italy is the king of this, life style, food, stress control....

Another is the diabetes in Ireland is completely free... Every type-2 Diabetes patient gets Ozempic for free.. Diabetic shoes for free , eye tests, metformin, test packs, follow up appointments....

I agree that socialized medicine countries put a lot more emphasis on prevention and wellness over treatment, which is important.

I am not sure that would work in this country. Look how many people absolutely lost their shit over Covid Vaccine Mandates. Now imagine if these same people heard the government telling them to exercise and diet.

I have no problem with banning pharma commercials. Although I love making fun of some of them.

 

[Blisterfinger]

That’s literally how insurance works.

Until you can't afford it

 

[JGalt]

Obamacare has wrecked the health care of Americans because it is masked socialism.
It gave coverage to some by raising costs on most other people.

That was the whole purpose of the insurance mandate in the ACA. The architects of the ACA erroneously thought that by forcing everyone to have insurance, it would broaden the risk pool and help balance out the costs associated with covering sicker and older individuals.

Thankfully President Trump eliminated the federal penalty for the individual mandate with his Tax Cuts and Jobs Act of 2017. That was what effectively drove a wooden stake through the heart of the Affordable Care Act.

 

[SeaMajor7]

I'm hearing this morning in news stories about the end of the Schumer shutdown this notion of "the Republican Healthcare crisis".
WTF is THAT?
I'll tell you what that is.....GASLIGHT BULLSHIT.
The ACA is ALL a Democrat PROBLEM.
They OWN IT.
Not ONE Republican voted for Obama's SCAM.
So sick of the FALSE NARRATIVES from the demented LEFT.

 

[DonGlock26]

I don't engage in dishonest conversations. If you want to have an honest conversation about the merits of single payer (which would be the government) vs. Insurance companies working for profit), then I'd be happy to talk.

Who pays for it is irrelevant. It's how that money is spent that's the problem.

So, you want socialized medicine. You are a socialist.

 

[JoeB131]

That was the whole purpose of the insurance mandate in the ACA. The architects of the ACA erroneously thought that by forcing everyone to have insurance, it would broaden the risk pool and help balance out the costs associated with covering sicker and older individuals.

Thankfully President Trump eliminated the federal penalty for the individual mandate with his Tax Cuts and Jobs Act of 2017. That was what effectively drove a wooden stake through the heart of the Affordable Care Act.

Not really, since the exchanges still exist and the government still has to fund them.

It's been nine years since Cheeto Hitler said he was going to come up with his ObamaCare replacement. Where is it?

 

[JoeB131]

So, you want socialized medicine. You are a socialist.

No, I'm a pragmatist.

Capitalism is fine when you are selling corn chips.

The model doesn't work with health care.

I can always choose not to eat chips if they are too expensive. I can't decide to leave health issues untreated. In an unregulated market, that means the Hospitals can charge whatever the hell they want, which is why a visit to the ER for what I thought might be a heart attack (thankfully it wasn't) costs $6300.00.

I would have liked to not go to the ER, but my GP wasn't able to squeeze me in for another two weeks, and I called the urgent care, and they told me to go to the ER with the symptoms I was having.

Here's the reality- PRIVATE INSURANCE IS A FORM OF SOCIALISM.

Everyone is paying into a pool.

If you pay into the pool of 10% of your salary, and you don't have any medical issues that year, you are subsidizing everyone else's health care.

If you even have a minor incident like I had last week, other people are subsidizing your care.

Now insurance works fine for cars or houses, because statistically, you just aren't going to have that many catastrophic events.

It doesn't work so well for people because, everyone gets sick and everyone dies, eventually.