View Full Version : Obamacare insurance premium increase.
eagle2
05-18-2017, 04:03 PM
The problem is that older people need, on average, much more than 3x the care that the younger people do. Shifting the premium multiple from 3x to 5x just allows insurance companies to more accurately allocate the true costs of care. That way I no longer have to pay higher premiums for five people just to pay for the care of early retirees and other "older" people.
Oh, and the insurance for a 25 year old is not "free" just because she is on a parent's plan. If it is an individual marketplace plan, then the parent also has to pay a bloated premium on the child's coverage in order to finance the artificially low premiums charged to the aforementioned early retirees. But not all 25 year olds have parents who are able or willing to extend coverage anyway, so let's not assume facts not in evidence. ;)
Oh yeah, and those numbers are goofy for the following reasons: (1) Many young individuals can get coverage at far lower than 8k per year; and (2) tax credits would also apply unless the older person is wealthy, in which case he/she can afford to pay for his/her medical coverage anyway.
and the CBO estimates that if that goofy plan you support gets passed, 24 million people will lose their health insurance. If you don't make enough money with your goofy business to make ends meet, then get a job with benefits, instead of taking health insurance away from 24 million people. You could also stop contributing money to your goofy church that protects priests who rape children and fights to take contraception away from women, and use that to pay for your health insurance.
Since you're incapable of disagreeing with someone without making nasty, condescending comments, this will be my last response to you. I'm placing you on ignore. I should have done this long ago.
rickdugan
05-18-2017, 05:16 PM
and the CBO estimates that if that goofy plan you support gets passed, 24 million people will lose their health insurance. If you don't make enough money with your goofy business to make ends meet, then get a job with benefits, instead of taking health insurance away from 24 million people. You could also stop contributing money to your goofy church that protects priests who rape children and fights to take contraception away from women, and use that to pay for your health insurance.
Since you're incapable of disagreeing with someone without making nasty, condescending comments, this will be my last response to you. I'm placing you on ignore. I should have done this long ago.
Eagle, as far as I know, the CBO hasn't scored the current version of the bill, which went through a lot of changes since the last version. We should probably wait before the CBO actually issues its score for the current bill before we debate how many people might lose insurance and whether that might be a net positive for many of them.
As far as the rest, ouch. I just said that your numbers were a bit extreme and they were. I admit that I could have found a better word than "goofy" to convey that message, but there was no need for a meltdown over it.
But I find your solutions interesting. My church, rapey priests and all, also happens to be the largest charitable organization in the world, doing more good works than I can count for the poorest in this country and in many others, including feeding hundreds of thousands of people, if not millions, every single day. For that matter, my small business, as well as the many other small businesses that are being put under strain by all of this, also feed a lot of people in terms of jobs and payments to vendors. So are you suggesting that all of those people should be left hungry so that early retirees can lay on the beach instead of seeking out gainful employment? So these early retirees, many of whom voluntarily reduce their income in order to retire early because someone else now has to pay for their healthcare, have more of a right to my money than hungry children? :)
Rispy_Girl
05-19-2017, 07:54 AM
I've got a neurologist calling and ranting at me the past two mornings. Why can't a large group of people start an insurance company ourselves? One that won't cheat doctors to the point that they aren't making money on their services, but the tests instead. Medicare is being dropped everywhere because they aren't converting basic costs (it isn't just the doctor's time, it's also the time the staff spend on the patient, the insurance, the building and general costs, the training staff have to go through yearly,etc).
Set this unit up so whoever is head has an income cap based on the economy. Cut out sales reps and keep everything streamlined. Start it so preexisting conditions aren't accepted into a predetermined threshold of money saved is hit. Over all have checks to make sure to make sure there isn't over formatting and everyone is paid fairly. Also have checks like I'm Europe that cap the amount that can be spent on a patient. If you pay $1000 for 60 years you will never pay in a million, so perhaps a million is a good cap. A little over, especially since hopefully premiums won't be $1000, but stops stupid crazy spending on one person.
Perhaps also have it so insurance for each doctor is processed monthly to help reduce man power instead of per patient. Just some ideas. Anyone have thoughts?
Zofia
05-20-2017, 12:50 PM
I've got a neurologist calling and ranting at me the past two mornings. Why can't a large group of people start an insurance company ourselves?
That is what is known as a mutual insurance company. There are a few out there. The bottom line though is there are enormous state and federal law barriers to entry. This creates obstacles for new players to enter the field. Look at the new and even higher barriers imposed by the ACA. Now, on exchange lots of states are down to just two or even one company offering plans. Off exchange there are a few more, in some states. In a few states there are more companies offering health care savings account plans that are pretty good. (Unfortunately not so in my state.) Reducing legal barriers to entry, allowing companies and mutuals to offer either cafeteria plans or multiple plans might work. But, government doesn't like to reduce barriers to anything. Even the AHCA, which is a step in the right direction, doesn't really reduce the barriers to entry all that much.
Z
KatyBoleyn
06-19-2017, 10:10 PM
The US is doomed on the whole healthcare thing until the public and medical workers of all stripes can accept that not all medicine is "for profit". In most of the rest of the world, you have a public option of some kind, and then private clinics. Private clinics are competing against the government option...and costs stay down for everyone. I had my second child in Ukraine, at a "Cadillac level" maternity clinic...$7000 total, all inclusive. Western doctors, ultrasounds every time I walked in the door, the latest cutting edge equipment and post-natal care...the works. Considering they had to import these things, its even more impressive.
And this is where the US fails. ALL medical facilities are either "for profit" or paying prices for equipment and facilities to compete with "for profit" and paying the same costs...not the other way around. Doctors may also want to heal the sick, but primarily they need to pay for their million dollar homes, $200,000+ in med school bills, and fake wives with fake tits at the fake country club. European doctors do live much better than their neighbors...they have the nicer house, have the vacation home in the Alps or on the Black Sea, drive the high end Mercedes...but nowhere near the scale US doctors aspire to. They don't spend half their working hours sitting on the hospital boards scheming about how to jack up prices even more because they deserve it.
It isn't just the doctors either. Medical technology/devices are surcharged 500-5000% more for the US market. Pharmaceuticals are insane. Medical schools aren't free (or extremely low cost) for anyone that can qualify like in most of the world - you get out of school $200,000 in debt and see what kind of arrogant jackass you become. I'm not invalidating their feelings at all.
I never ever see that conversation though when we talk about health care. I'm not even getting into what's allowed into the American food supply that absolutely shits on your health in later life...chemicals and practices that are illegal in most of the rest of the world.
Nope, people just want to debate how insurance works. There's no way out of the rabbit hole if you only limit the conversation to that. If the root causes of healthcare costs aren't addressed, no insurance program in the US will ever work in the long term.
baer45
06-19-2017, 10:44 PM
............
Nope, people just want to debate how insurance works. There's no way out of the rabbit hole if you only limit the conversation to that. If the root causes of healthcare costs aren't addressed, no insurance program in the US will ever work in the long term.
Yes, you tell them girl!
Everyone wants to take a piece of pie in this healthcare profit. Every ring of this system! Everyone is trying to use its power to make a profit. Insurance companies act like sole broker of this deal. Hospitals, doctors, pharmaceuticals, they all want to charge you a crazy amount because they can! They all have made up their reasons why their services are so expensive except the outside world all have done the same thing a few times cheaper. if you can't afford it, you are doomed. But don't worry, we can always spare a few trillions to feed these blood sucking vampires.
Zofia
06-22-2017, 07:38 PM
The US is doomed on the whole healthcare thing until the public and medical workers of all stripes can accept that not all medicine is "for profit".
Profit is not the problem. Salaries, equipment, malpractice insurance, and the sort are far bigger problems than profits.
" In most of the rest of the world, you have a public option of some kind, and then private clinics. Private clinics are competing against the government option...and costs stay down for everyone. I had my second child in Ukraine, at a "Cadillac level" maternity clinic...$7000 total, all inclusive. Western doctors, ultrasounds every time I walked in the door, the latest cutting edge equipment and post-natal care...the works. Considering they had to import these things, its even more impressive."
Yep, and a Ukrainian M.D. makes about 1/3 what his/her American counter-part makes same for the nurses and other medical professionals. In Ukraine, there is very little medical malpractice cost because it is difficult to impossible to successfully sue a doctor, hospital, pharmaceutical company or medical device maker.
And this is where the US fails. ALL medical facilities are either "for profit"...."
No, really they are not. Much of the U.S. medical system is not for profit. Their charges are close to the same as the for profit hospitals. Profit or non-profit just determines your tax rate. (Hint, non-profits don't pay income taxes.) In fact, there are good and efficient for profit hospitals and not for profit hospitals.
Profit is not a four letter word. Remember, without profits, there are no jobs.
Z
Eric Stoner
06-27-2017, 12:00 PM
Without profits there are no jobs ; no new drugs ; no medical advances ; no charity.
Cuba has so called "free" medical care. How many medical advances came out of Cuba since the Revolution ? None.
Single payer sounds great until you take a hard look at it. California and New York both have proposed plans. Jerry Brown vetoed the California version because it was simply unaffordable. Estimates of its cost range as high as another $100 Billion a year ( for starters and then it will increase ) depending on who is doing the math and how they are calculating. It is supposed to be affordable based on savings and efficiencies on administrative costs and massive tax increases on the so called "rich" i.e. anyone making over $100,000 a year.
The big problem with single payer is that no one has any incentive to innovate or otherwise control costs. Look how Medicaid and Medicare have exploded in their 50 years of existence. Thus the only way to keep it anything resembling affordable is to control payments to doctors and other providers and ration care - "you are too old to get this cancer treatment " ; "too sick for a bypass" ; "don't perfectly fit the profile for this drug" etc. etc.
eagle2
06-27-2017, 03:45 PM
Profits aren't necessary for jobs, new drugs, or medical advances. You only need revenue. There are numerous corporations that aren't profitable, but still provide jobs and fund research. Amazon was unprofitable for many years. The US government is the biggest funder of scientific and medical research. There is also a significant amount of research that is done at non-profit universities.
Cuba is a much poorer country than the US, but still has approximately the same life expectancy and a lower infant mortality rate.
eagle2
06-27-2017, 07:14 PM
Of course there's nothing wrong with businesses making profits, if it's done ethically, but it's not the only way to make advances.
KatyBoleyn
06-28-2017, 08:07 AM
Without profits there are no jobs ; no new drugs ; no medical advances ; no charity.
Cuba has so called "free" medical care. How many medical advances came out of Cuba since the Revolution ? None.
https://www.wired.com/2015/05/cimavax-roswell-park-cancer-institute/
http://abcnews.go.com/Health/cubas-major-medical-achievements/story?id=43844344
Cuba spends a tiny fraction on healthcare what we do, and both quality of life and life expectancy are about the same...and they still manage to do some cool new things.
Cuba is a bad example trying to make this case.
Single payer sounds great until you take a hard look at it. California and New York both have proposed plans. Jerry Brown vetoed the California version because it was simply unaffordable. Estimates of its cost range as high as another $100 Billion a year ( for starters and then it will increase ) depending on who is doing the math and how they are calculating. It is supposed to be affordable based on savings and efficiencies on administrative costs and massive tax increases on the so called "rich" i.e. anyone making over $100,000 a year.
Single payer isn't the only solution, there are "public-private" models around the world as well. You don't like Romania or Ukraine, try Switzerland or France or Taiwan for more examples that are working well.
The big problem with single payer is that no one has any incentive to innovate or otherwise control costs. Look how Medicaid and Medicare have exploded in their 50 years of existence. Thus the only way to keep it anything resembling affordable is to control payments to doctors and other providers and ration care - "you are too old to get this cancer treatment " ; "too sick for a bypass" ; "don't perfectly fit the profile for this drug" etc. etc.
Now you're touching on much bigger issue...for profit blocs and their ability to throw money at politicians. We have one of the most corrupt political systems in the world due to the unlimited amounts of money anyone can spend to influence our politics...and its all legal. The government should be at odds with and using their power to collectively bargain on behalf of "we, the people". Instead, you get regulations and price controls written BY THE LOBBY that is receiving the money.
As for rationing care, that's a complete non-starter. Care will always be "rationed" in the sense that there are not unlimited amounts of resources to make us all immortal. At the moment (or a few years ago anyways) it was rationed by how rich you were. Being poor means a much shorter life-span and QOL, and much of that is due to access to medical care. In any rational government system, the poor will get a sane baseline and the rich will still have the option to get the maximum...that's the difference.
Eric Stoner
06-28-2017, 11:11 AM
https://www.wired.com/2015/05/cimavax-roswell-park-cancer-institute/
http://abcnews.go.com/Health/cubas-major-medical-achievements/story?id=43844344
Cuba spends a tiny fraction on healthcare what we do, and both quality of life and life expectancy are about the same...and they still manage to do some cool new things.
Cuba is a bad example trying to make this case.
Single payer isn't the only solution, there are "public-private" models around the world as well. You don't like Romania or Ukraine, try Switzerland or France or Taiwan for more examples that are working well.
Now you're touching on much bigger issue...for profit blocs and their ability to throw money at politicians. We have one of the most corrupt political systems in the world due to the unlimited amounts of money anyone can spend to influence our politics...and its all legal. The government should be at odds with and using their power to collectively bargain on behalf of "we, the people". Instead, you get regulations and price controls written BY THE LOBBY that is receiving the money.
As for rationing care, that's a complete non-starter. Care will always be "rationed" in the sense that there are not unlimited amounts of resources to make us all immortal. At the moment (or a few years ago anyways) it was rationed by how rich you were. Being poor means a much shorter life-span and QOL, and much of that is due to access to medical care. In any rational government system, the poor will get a sane baseline and the rich will still have the option to get the maximum...that's the difference.
Katy- Quality of life in Cuba is comparable to that of the U.S. ? Set aside the income and material differences; but just living in an apartment in Havana presents the daily risk of a building collapse for many residents ; old buildings that haven't been maintained. For the elite in Cuba , medical care is good. For the average Cuban, not so much.
Many drugs are not available ; routine treatments available in the U.S. and elsewhere are not available or limited. Plus the Cuban model doesn't seem to travel very well.
Do a search on Venezuela's collapsing hospital and health care system.
What drugs have the Cubans invented ? Medical advances ? What are they ?
I agree with you on Taiwan and Switzerland. France's system is going broke.
I personally want to see free markets and competition = co-ops ; pre-paid plans ; tax free health savings accounts and other market solutions. Obamacare has resulted in shrinkage of the insurance markets in most states. Most are down to one or two carriers. In many counties there is only ONE !
Most single payer and restrictive systems expand the number of those subject to rationing. There are a myriad of reasons why health care in the U.S. costs so much and why as a result health insurance costs so much. NONE of them are the fault of a free market. One way or another it is government policy that jacks up costs.
Eric Stoner
06-28-2017, 11:25 AM
Profits aren't necessary for jobs, new drugs, or medical advances. You only need revenue. There are numerous corporations that aren't profitable, but still provide jobs and fund research. Amazon was unprofitable for many years. The US government is the biggest funder of scientific and medical research. There is also a significant amount of research that is done at non-profit universities.
Cuba is a much poorer country than the US, but still has approximately the same life expectancy and a lower infant mortality rate.
Without profits just how exactly do the salaries and benefits get paid ? I am genuinely flabbergasted that YOU ( a liberal but with a healthy dose of sanity and some respect for facts ) would ever post something like that. These corporations that don't make a profit - you mean like Solyndra - Just how long are they going to last without showing a profit ? At some point the stockholders are going to revolt.
Yes the government funds a lot of research. But as has been shown repeatedly that is a double-edged sword. Yes, we get advances but we also get a LOT of waste , boondoggles and inflated costs. Non-profit universities do a lot of research. I have no problem with privately funded research. For the government funded kind we get a lot of waste ( do fish get drunker on Tequila than Vodka ? - that is a Bill Proxmire "Golden Fleece Award " classic ), boondoggles , duplication , compounding of group-think, conventional thinking and inflated costs.
Cuba's stats on life expectancy and infant mortality have been discredited by many researchers who went beyond the official government numbers e.g. A lot of dead babies were counted as aborted fetuses even though they were born alive but died within a week or so. There are a number of similar ways that the Socialist Paradise has cooked the books. Partly with U.N. connivance.
eagle2
06-28-2017, 11:56 AM
Stockholders are more concerned about stock price than profit. I don't think Tesla has made any profit yet, but I doubt their shareholders are complaining. I'm not saying businesses shouldn't be trying to make a profit, but that businesses can grow without showing profit, as long as they're able to cover their expenses. Just because a business isn't earning a profit doesn't mean they don't have revenue coming in. If a business uses all of their revenue to build the business or increase market share, over the long term, the business could be better off, as long as they're able to meet their expenses. A lot of business startups put all of their revenue into growing the business, rather than paying the owner(s) or shareholders.
baer45
06-28-2017, 02:38 PM
Damn it! SB-562 was put on hold...
"If there's a smart path to single payer healthcare in California, we haven't found it yet"
Eric Stoner
07-05-2017, 06:58 AM
Damn it! SB-562 was put on hold...
"If there's a smart path to single payer healthcare in California, we haven't found it yet"
Be glad. Be VERY glad.
Eric Stoner
07-05-2017, 07:05 AM
Stockholders are more concerned about stock price than profit. I don't think Tesla has made any profit yet, but I doubt their shareholders are complaining. I'm not saying businesses shouldn't be trying to make a profit, but that businesses can grow without showing profit, as long as they're able to cover their expenses. Just because a business isn't earning a profit doesn't mean they don't have revenue coming in. If a business uses all of their revenue to build the business or increase market share, over the long term, the business could be better off, as long as they're able to meet their expenses. A lot of business startups put all of their revenue into growing the business, rather than paying the owner(s) or shareholders.
Hmmm. Yeah. Up to a point. But be careful and try to avoid a myopic focus on just stock price. Remember the Internet Bubble ? A lot of those companies ( most of which should NEVER have publicly issued stock ) never showed a profit ; some never even had earnings and collapsed.
Growth and reinvestment are fine but at some point a company MUST be profitable. Otherwise where would they get the money for pay increases ; money for R & D ; charity ; income TAXES and dividends ?
baer45
07-20-2017, 07:47 AM
What the hell is going on now?
Eric Stoner
07-20-2017, 10:48 AM
What the hell is going on now?
Good question. It LOOKS like the Republicans may be stumbling into a place where THEY own the current situation. That's as far as I dare go on that subject because of the politics ban.
baer45
07-28-2017, 08:19 AM
'We had a wonderful life': Mother and father jump to their deaths 'because they can't afford health care leaving their children behind in Manhattan office building'
Just be clear, they can't afford the " Affordable health care".
http://www.dailymail.co.uk/news/article-4739512/Couple-commit-suicide-health-care-costs.html
I am going to say it:
Republicans, if you don't have anything good to replace obamacare, stop playing games, you are useless to us Americans.
Trump, stop being an asshat. Your promise was not repealing obamacare or wait for its doom day. your promise was replacing dying obamacare with something better. You failed. Don't even try to sugar coat it.
dpacrkk
07-28-2017, 11:22 AM
Trump, stop being an asshat. Your promise was not repealing obamacare or wait for its doom day. your promise was replacing dying obamacare with something better. You failed. Don't even try to sugar coat it.
Not that two wrongs make a right, but who's the bigger asshat: the pathological liar who made empty promises in exchange for populist support, or the throngs of people who believed a pathological liar and trusted emotion over mounds of evidence?
Nyla19
07-28-2017, 11:43 AM
Not that two wrongs make a right, but who's the bigger asshat: the pathological liar who made empty promises in exchange for populist support, or the throngs of people who believed a pathological liar and trusted emotion over mounds of evidence?
This!!!! Yes!!! They're easily brainwashed cult members. As stated roughly by Bill Maher.
baer45
07-28-2017, 12:25 PM
Not that two wrongs make a right, but who's the bigger asshat: the pathological liar who made empty promises in exchange for populist support, or the throngs of people who believed a pathological liar and trusted emotion over mounds of evidence?
I hope you didn't vote for anyone just like me. Otherwise, you do need to ask yourself that question. And I hope you have answer for it. either in 2008, 2012 or 2016.
dpacrkk
07-28-2017, 12:47 PM
I hope you didn't vote for anyone just like me. Otherwise, you do need to ask yourself that question. And I hope you have answer for it. either in 2008, 2012 or 2016.
I did vote, and although the question was rhetorical, for sake of this exercise, my answer would be the latter. But what exactly is the relevance and for what am I answering? I didn't vote for a pathological liar, and I used a completely objective and candidate-agnostic methodology (http://www.isidewith.com) to determine and vote for the candidate who shares the most common ground with my desired platforms, instead of giving into baseless emotion or misinformed partisan identification.
baer45
07-28-2017, 02:04 PM
Everyone has his/her own opinion. So you are entitled to yours. For the sake of exercise, I did vote for obama in 2008 and did not vote in 2012. I didn't vote in 2016. I dislike Hillary and trump both. Ididnt bother to vote.
I accept trump when he became the president and hope he can do something about the healthcare ( it's not looking good so far). To me, Hillary is proven sociopathic liar. Trump, he has a couple more years to prove he's not a lair. If he turns out to be a lair. I have no trouble to call him POS, as I stated at very beginning. To get back to your rhetoric question, i don't have an answer. At least not a meaningful one. I am going to stop right here. Too much politics.
My original comment is still healthcare related. Trump and republicans failed. What's next? Try again?
dpacrkk
07-28-2017, 02:28 PM
Everyone has his/her own opinion. So you are entitled to yours. For the sake of exercise, I did vote for obama in 2008 and did not vote in 2012. I didn't vote in 2016. I dislike Hillary and trump both. Ididnt bother to vote.
I accept trump when he became the president and hope he can do something about the healthcare ( it's not looking good so far). To me, Hillary is proven sociopathic liar. Trump, he has a couple more years to prove he's not a lair. If he turns out to be a lair. I have no trouble to call him POS, as I stated at very beginning. To get back to your rhetoric question, i don't have an answer. At least not a meaningful one. I am going to stop right here. Too much politics.
My original comment is still healthcare related. Trump and republicans failed. What's next? Try again?
It's not opinion though, decisions can be based on evidence and facts (http://www.isidewith.com/) (click link, expand answers, answer questions, fill in importance, see match) to ensure that one doesn't vote against their own interests, unlike score of other people.
As for what's next for healthcare: if you're idealistic, governing instead of obstructing; if you're realistic, 3.5 more years of the last 6-7 years of legislation.
Eric Stoner
08-09-2017, 06:49 AM
And the hits just keep on coming. Anthem Blue Cross Blue Shield is leaving the Nevada market.
RyanXO
08-09-2017, 08:09 AM
And the hits just keep on coming. Anthem Blue Cross Blue Shield is leaving the Nevada market.
In Texas we just have Medicaid-style plans with very high deductibles. This is not getting better...somethings gotta give eventually!
Eric Stoner
08-09-2017, 10:35 AM
^^^ It's worse than that. In many states , young and healthy people without dependents were pushed onto the Medicaid rolls thus crowding the care for the genuinely needy; for whom Medicaid is supposedly intended.
Personally , I think trying to reform health insurance is pointless unless we also try to reform health care. As our population ages and thus needs more and more care the situation is only going to get worse.
Zofia
08-12-2017, 06:11 PM
Health care is expensive for two reasons: drug costs and payroll. Our drugs are the most expensive in the world. Our medical professionals and administrators are the best paid in the world. Nobody is going to agree to a pay cut. So, the only thing we can do on the expense side is reduce the cost of pharmaceuticals and reduce the cost of medical malpractice claims. On the medical practice part of the equation, we can push more people to use midwives and Nurse Practitioners. We can force hospitals, especially public hospitals to set up "minute clinics" in front of their emergency rooms and triage patients there. Send the true emergencies to the ER and divert the cold and flu sufferers to the "minute clinic." And that is about as good as it gets if you don't want to cut pay or take on the pharma companies and their pricing strategies.
eagle2
08-12-2017, 07:02 PM
There is also high administrative costs because of the complexity of medical billing, unnecessary medical procedures because providers have financial incentives to perform as many medical procedures as they can, since they will get paid for it. There also isn't price competition as there is with most other products. When consumers buy a house or a car, the price of the product is a major factor in their decision to make a purchase. If a consumer needs a major medical procedure, the price of the procedure generally is not a factor at all in the decision as to where to get the procedure, unless the consumer is paying for it himself, which is generally not the case.
Zofia
08-13-2017, 04:07 AM
These are good points as there are lots of areas of inefficiency in medical care. Note that none of them were addressed by either political effort at "reform."
baer45
08-13-2017, 11:19 AM
The "reforms" only touched tax payer (increasing budget) and insurance company( but achieved nothing). Most of the politicans are bought anyway.
The ideal solution doesn't exist for the moment but some possible improvements aren't that hard to figure out: a procedure currently cost $10,000 in here but only cost $3000 in euro, make it $5000. If it cost a hospital $5000 to do it, the insurance company should be obliged to pay that amount, no negotiation is allowed. Hospitals need to get rid of unecessary personales who are just adding cost to the bill. Lower doctor & others' salary and hospital covers medical malpractice insurance cost. Insurance companies all subject to a standard loss ratio. a severe fine or premium reduction locked for 5 years if the balance sheet doesn't compliant with the ratio. FDA needs to give more flexibility to pharms before the drugs hit the market, but given the power to cease the sale if the profit percentage is ridiculous(eg. anything more than 300%). I know this might upset people who love free market principle. But this is critical to people's health, people's lives, it's not your laptop, or clothes, cars. I am in for some regulations.
rickdugan
08-13-2017, 02:52 PM
And the hits just keep on coming. Anthem Blue Cross Blue Shield is leaving the Nevada market.
Since Blue Cross is the only coverage option I now have, I have actually been hoping they would pull out of FL individual market too, but no such luck. Sounds strange for someone to wish to have no health insurance options, but that is what I've been reduced to now. Because of course if this happened, then I would be exempted from the penalty provision of Obamacare and could keep all of the $20,000 per year I pay in premium money and just pay cash instead for health services for my family. As I described before, it's not like I'm getting almost anything back from it now anyway.
Of course, one more big premium hike like the one that we got last year (19%) and I am done anyway, even with the penalty. Then they will just have to find some other sucker to pay over $20,000 per year to fund other people's early retirements, pregnancies, birth control, etc. I have really fucking had it now.
eagle2
08-15-2017, 02:26 PM
And the hits just keep on coming. Anthem Blue Cross Blue Shield is leaving the Nevada market.
and Centene is entering the Nevada market.
http://www.businessinsider.com/centene-covering-empty-rural-nevada-obamacare-markets-brian-sandoval-2017-8
From the above link:
Gov. Brian Sandoval of Nevada on Tuesday announced that Centene, a low-cost health insurer, would enter the private health-insurance markets in 14 rural Nevada counties that previously had no insurer for 2018.
"Today we are going to announce that there will be no counties without health insurance options in the great state of Nevada," Sandoval said at a rural hospital in Silver Springs.
Tuesday's decision leaves one county in Wisconsin and one county in Ohio as the only remaining empty counties for next year. Data from the Kaiser Family Foundation suggests that 381 people currently enrolled in plans in those counties are at risk of being left without an insurer in 2018.
Centene is a relative success story in the Obamacare markets, using its slimmed-down Medicaid-like plans to achieve profits in the exchange business. Centene has expanded its Obamacare footprint in multiple states, including previously bare counties in Kansas.
lynn2009
08-22-2017, 03:12 PM
......
rickdugan
08-22-2017, 05:07 PM
Talk about the worst of all worlds. I just read an article that said that Centene is also expanding its footprint in FL. They are a "relative success story" only insofar as they have made payments for services so low that almost no doctor will accept the insurance, except for those who already accept medicaid. Now I face the real possibility that, if Blue Cross pulls out, I still won't get exempted from the penalty because Centene will offer an insurance fig leaf of a policy that will still cost a lot of money, but that none of our doctors will accept and won't cover anything anyway because of high deductibles. This will be how Obamacare finally completes the job of making all people in the individual marketplace 3rd class citizens from a healthcare standpoint, especially those of us who are unsubsidized.
Eric Stoner
08-30-2017, 10:22 AM
Tiptoeing as much as possible around the politics , Obama clearly said that "single payer" would not happen all at once. That it would be a gradual process.Now , as options become fewer and more limited ; as insureds get squeezed by rising prices and shrinking coverage ; "single payer" doesn't look so bad to a lot of people.Unless and until they look at the actual costs.
Inter alia , single payer is SUPPOSED to save on administrative costs. There are supposed to be fewer administrators doing less paperwork. If it happens it will be the first "barking cat" in American bureaucratic history. Show me one government program , just one that is not a sea of red tape, paperwork and makes anything it oversees more efficient and cost effective. The same people who run the Post Office , Medicare and the V.A. will be in charge of health care. Not just health insurance , health care.
rickdugan
08-31-2017, 06:34 AM
Idk Eric. The one huge hurdle that remains is trying to convince people with employer-based coverage to switch over, which is almost half of the U.S. population. I really don't believe that the political will exists in either party to touch the employer based market anytime soon; it sure didn't when Obamacare was passed and it is probably the single biggest reason why Obamacare is such an utter disaster. Now maybe they were hoping to get a foothold with Obamacare and sell it from there, but, if anything, this has likely backfired as the horror stories about the individual marketplace will likely entrench opposition even more.
I'll add one more mini-horror story. The other day one of my kids got very sick and our pediatrician sent us to the hospital for an IV and further testing. Despite the fact that I pay almost $20,000 per year in premiums for my family, this little trip is likely going to cost me at least a few thousand more once we receive all of the bills from the different departments involved. Why, you may ask, do I have to pay that kind of money when I already pay so much in premiums? Because my single family member deductible is $7,500. Stories like that are floating around all over the place. Good luck trying to convince people with good employer based coverage to give it up for shit "insurance" like this, which is all that is available in the individual marketplace nowadays.
dpacrkk
08-31-2017, 08:10 AM
Inter alia , single payer is SUPPOSED to save on administrative costs. There are supposed to be fewer administrators doing less paperwork. If it happens it will be the first "barking cat" in American bureaucratic history. Show me one government program , just one that is not a sea of red tape, paperwork and makes anything it oversees more efficient and cost effective. The same people who run the Post Office , Medicare and the V.A. will be in charge of health care. Not just health insurance , health care.
Here's the first "barking cat" (is this common parlance?) for you then: Medicare overhead is ~6% while private insurance industry average is 11-12% and as high as 20%, individually.
Here's a bonus second barking cat:
https://www.youtube.com/watch?v=0NYMkxA3cnU
Eric Stoner
08-31-2017, 10:13 AM
If Medicare's overhead is so low ( and there are studies questioning that claim ) then WHY do the costs of Medicare increase so much year after year ? And that is AFTER allowing for the Baby Boomers coming on stream. The per recipient costs have done nothing but go up every year so it is not just total outlay.
It IS true that Medicaid and Medicare spend a pittance on advertising.
It is also true that single payer solves SOME problems ; mostly related to accessibility and availability of coverage. But it also comes with another set of problems mostly involving overall costs and other accessibility issues. I'm not even going near the "rationing " arguments.
As to "barking cats" that simply means that cats don't bark like dogs and likewise bureaucrats are biologically incapable of containing and controlling costs. Your video cat just has a low voice lol. One of my cats makes similar noises.
dpacrkk
08-31-2017, 10:57 AM
If Medicare's overhead is so low ( and there are studies questioning that claim ) then WHY do the costs of Medicare increase so much year after year ? And that is AFTER allowing for the Baby Boomers coming on stream. The per recipient costs have done nothing but go up every year so it is not just total outlay.
It IS true that Medicaid and Medicare spend a pittance on advertising.
Overhead is not related to rising costs of healthcare. The fact remains: a higher percentage of Medicare costs go to actually treating patients. In many circles, one might consider this more efficient and more cost effective, ahem:
Show me one government program , just one that is not a sea of red tape, paperwork and makes anything it oversees more efficient and cost effective. The same people who run the Post Office , Medicare and the V.A. will be in charge of health care. Not just health insurance , health care.
dpacrkk
08-31-2017, 11:08 AM
As to "barking cats" that simply means that cats don't bark like dogs and likewise bureaucrats are biologically incapable of containing and controlling costs. Your video cat just has a low voice lol. One of my cats makes similar noises.
I know what you meant, my point was "if you're going to use that as an idiom, the idiom shouldn't be something that's possible."
rickdugan
08-31-2017, 11:13 AM
Overhead is not related to rising costs of healthcare. The fact remains: a higher percentage of Medicare costs go to actually treating patients. In many circles, one might consider this more efficient and more cost effective, ahem:
There are two primary reasons for these discrepancies:
First, a lot of Medicare's costs are not counted in its budget because other government agencies help administer the program. The Internal Revenue Service collects the taxes that fund the program; the Social Security Administration helps collect some of the premiums paid by beneficiaries (which are deducted from Social Security checks); the Department of Health and Human Services helps to manage accounting, auditing, and fraud issues and pays for marketing costs, building costs, and more. Private insurers obviously don't have this kind of outside or off-budget help. Medicare's administration is also tax-exempt, whereas insurers must pay state excise taxes on the premiums they charge; the tax is counted as an administrative cost.
Second, the denominator used by Medicare is driven up by the fact that its patients are sicker and older, which means that per patient spending is higher. Meanwhile, a lot of the per patient administrative costs (recordkeeping and reporting, premium collection, etc.) are fixed. Since most insurance companies have healthier and younger patients overall, their administrative costs vs. their medical outlays are naturally going to come in at a higher ratio because of the fixed cost element of patient administrative expenses.
So with all of that said, the comparison between Medicare's reported administrative burdens and those of private insurers is both inaccurate and largely inapplicable.
dpacrkk
08-31-2017, 11:33 AM
There are two primary reasons for these discrepancies:
First, a lot of Medicare's costs are not counted in its budget because other government agencies help administer the program. The Internal Revenue Service collects the taxes that fund the program; the Social Security Administration helps collect some of the premiums paid by beneficiaries (which are deducted from Social Security checks); the Department of Health and Human Services helps to manage accounting, auditing, and fraud issues and pays for marketing costs, building costs, and more. Private insurers obviously don't have this kind of outside or off-budget help. Medicare's administration is also tax-exempt, whereas insurers must pay state excise taxes on the premiums they charge; the tax is counted as an administrative cost.
Second, the denominator used by Medicare is driven up by the fact that its patients are sicker and older, which means that per patient spending is higher. Meanwhile, a lot of the per patient administrative costs (recordkeeping and reporting, premium collection, etc.) are fixed. Since most insurance companies have healthier and younger patients overall, their administrative costs vs. their medical outlays are naturally going to come in at a higher ratio because of the fixed cost element of patient administrative expenses.
So with all of that said, the comparison between Medicare's reported administrative burdens and those of private insurers is both inaccurate and largely inapplicable.
The first is a good point. Other agencies help administer Medicare and finding the true cost is difficult.
The second point is faulty though. It assumes the same or similar administrative cost for far different cost of care. And if total overhead cost happened to be the same for more expensive or comprehensive cost of care, that's a positive for Medicare. Spending the same administrative cost for simpler procedures is unnecessary. And since efficiency is a percentage, we don't care about the total anyway.
And yes, I read the same Forbes editorial that you copy and pasted from.
rickdugan
08-31-2017, 11:43 AM
The first is a good point. Other agencies help administer Medicare and finding the true cost is difficult.
The second point is faulty though. It assumes the same or similar administrative cost for far different cost of care. And if total overhead cost happened to be the same for more expensive or comprehensive cost of care, that's a positive for Medicare. Spending the same administrative cost for simpler procedures is unnecessary. And since efficiency is a percentage, we don't care about the total anyway.
And yes, I read the same Forbes editorial that you copy and pasted from.
Yet you're still arguing those points? ;)
The second point is far from faulty. Some of the per patient administrative costs are fixed expenses. So the more you pay out in medical expenses per patient, the lower your administrative costs will be as a % of health dollars spent. This is simply math. If Medicare took on younger and healthier patients, its fixed administrative expenses would increase disproportionately to its health spending and its "efficiency" would appear to decrease as its overhead ratio would rise.
But again, its not even paying a large portion of its own administrative expenses anyway. The only way to even begin to make a true comparison would be to add to its budget all of the other expenses borne by other agencies and then re-calculate it "true" administrative cost ratio.
eagle2
08-31-2017, 11:45 AM
If Medicare's overhead is so low ( and there are studies questioning that claim ) then WHY do the costs of Medicare increase so much year after year ? And that is AFTER allowing for the Baby Boomers coming on stream. The per recipient costs have done nothing but go up every year so it is not just total outlay.
From:
http://healthaffairs.org/blog/2011/09/20/medicare-is-more-efficient-than-private-insurance/
According to CMS, for common benefits, Medicare spending rose by an average of 4.3 percent each year between 1997 and 2009, while private insurance premiums grew at a rate of 6.5 percent per year.
dpacrkk
08-31-2017, 11:58 AM
Yet you're still arguing those points? ;)
The second point is far from faulty. Some of the per patient administrative costs are fixed expenses. So the more you pay out in medical expenses per patient, the lower your administrative costs will be as a % of health dollars spent. This is simply math. If Medicare took on younger and healthier patients, its fixed administrative expenses would increase disproportionately to its health spending and its "efficiency" would appear to decrease as its overhead ratio would rise.
Yes, because it's an editorial. Anyway, simpler procedures with fewer prerequisites should require lower overhead. We're moving in that direction with automation in prior authorization for clinical procedures, but those cost savings aren't going back to the customer.
misspandora
08-31-2017, 07:39 PM
If you want Obamacare to work, tell your GOP politicians to STOP SABOTAGING IT. That includes Trump.
I'm in a blue state (I don't count last election because of shenanigans and 3rd party votes). We have a Dem governor. It makes a huge diff. When I was in California, I got quoted for a GREAT plan. Very cheap..low deductible. Reason being, California's DEMOCRATIC government negotiates with health insurers for better rates for its citizens through the health care exchange. In fact, we should all move to California because now that Trump is trying to kill Obamacare, they're investigating producing their own signle payer health care for all California citizens.
I'm in PA, thanks to very generous state subsidies. I pay $70 a month. No joke. And I'm 50. My deductible is $1500. Dr visit co-pay is $30. Free well woman gyn pap smear visits, etc.
The only problem is here in PA we have ONE choice. Independence Blue Cross. They suck and they treat ACA customers like CRAP. I don't blame Obama for any of this. Obama helped me and a lot of other working class people tremendously during his time in office. If it wasn't for his HARP program, I might not have kept my condo. The current corrupt snake oil salesman in chief doesn't care about the average citizen one bit. If he did, he'd work with the GOP and the Dems to improve the ACA. Not kill it.
https://www.usnews.com/opinion/policy-dose/articles/2017-05-30/republicans-raised-your-health-care-premiums-not-obamacare
Also:
http://thehill.com/policy/healthcare/342804-cbo-obamacare-repeal-without-replace-would-cost-32-million-insurance
rickdugan
09-01-2017, 06:59 AM
If you want Obamacare to work, tell your GOP politicians to STOP SABOTAGING IT. That includes Trump.
I'm in a blue state (I don't count last election because of shenanigans and 3rd party votes). We have a Dem governor. It makes a huge diff. When I was in California, I got quoted for a GREAT plan. Very cheap..low deductible. Reason being, California's DEMOCRATIC government negotiates with health insurers for better rates for its citizens through the health care exchange. In fact, we should all move to California because now that Trump is trying to kill Obamacare, they're investigating producing their own signle payer health care for all California citizens.
I'm in PA, thanks to very generous state subsidies. I pay $70 a month. No joke. And I'm 50. My deductible is $1500. Dr visit co-pay is $30. Free well woman gyn pap smear visits, etc.
The only problem is here in PA we have ONE choice. Independence Blue Cross. They suck and they treat ACA customers like CRAP. I don't blame Obama for any of this. Obama helped me and a lot of other working class people tremendously during his time in office. If it wasn't for his HARP program, I might not have kept my condo. The current corrupt snake oil salesman in chief doesn't care about the average citizen one bit. If he did, he'd work with the GOP and the Dems to improve the ACA. Not kill it.
https://www.usnews.com/opinion/policy-dose/articles/2017-05-30/republicans-raised-your-health-care-premiums-not-obamacare
Also:
http://thehill.com/policy/healthcare/342804-cbo-obamacare-repeal-without-replace-would-cost-32-million-insurance
You're welcome.
Why am I saying that? Because I am one of the small pool of unsubsidized participants in the individual marketplace who is being soaked in order to support your subsidized rates and lower deductible. For starters, I pay $20,000 a year for a family of 5, with a $7,500 per person deductible to help support your $50 per month rate with a $1,500 deductible. The rest of the support for your subsidies and deductibles come from cost sharing payments, which I also pay for through the boatload of federal tax dollars I pay each year.
So you're welcome. ;)
The problem, however, is that there are just not enough of me in the individual marketplace to support all of you, which is why Obamacare is failing. This started long before Trump was elected, with many insurers running for the exit after sustaining massive losses in the exchanges. I've laid out the numbers in earlier posts so I won't repeat them, but in a nutshell there are just too many sick and/or poor people and not enough healthy affluent ones for the system to be anywhere close to self sustaining. This is also why you are being treated like crap as it has forced insurers to cut payments to the bone in order to limit losses on Obamacare plans.
There is no such thing as a free lunch. If you get an almost free healthcare plan, someone else has to pay for it. California is going to find this out if they pass universal healthcare as they simply cannot afford it, especially with a budget so dependent on the stock market for tax revenues. The state already has massive unfunded pension liabilities that are going to cripple its budget in the coming years. One long market downturn and that state is going to be begging the federal government for help (yet again), even without adding the massive costs of universal health.