USian health care

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josh

While the outcome is still in doubt, the origin, and problem, with the plan is clear:

 

 

The essence of Obamacare, as of Romneycare, is a three-legged stool of regulation and subsidies: community rating requiring insurers to make the same policies available to everyone regardless of health status; an individual mandate, requiring everyone to purchase insurance, so that healthy people don’t opt out; and subsidies to keep insurance affordable for those with lower incomes. The original Heritage plan from 1989 had all these features. These days, Heritage strives mightily to deny the obvious; it picks at essentially minor differences between what it used to advocate and the plan Democrats actually passed, and tries to make them seem like a big deal. But this is disinformation. The essential features of the ACA — above all, the mandate — are ideas Republicans used to support.

 http://krugman.blogs.nytimes.com/2011/07/27/conservative-origins-of-obamacare/?_r=0

Permitting private insurers to continue to monopolize the non-Medicare/Medicaid market, without a public option, is the the ACA's fatal flaw.

josh

And the law's bright spot so far, no surprise, is the Medicaid expansion. Despite the Supreme Court decision permitting states to opt out:

http://www.usatoday.com/story/news/nation/2013/11/14/medicaid-numbers-close-to-400000/3528069/

ygtbk

If people talk about the "essence" of a thing, rather than the abysmally-FUBAR'd actual rollout of the thing that was passed with the support of exactly one party, you might suspect that there's an issue that they are avoiding.

josh

The Krugman quote was from 2011.

 

ygtbk

josh wrote:

The Krugman quote was from 2011.

I'm talking about you, not him. But since you raise the point...

Does he have an update for reality as we know it in 2013, or does Krugtron not do that?

josh

The "rollout" is not the "essence" of the problem; it's the plan itself. At least the non-public portion of it. I suggest if you are that concerned about his updates, you consult his web page.

ygtbk

@josh: I'm glad to know that such a flawed plan was the entire Obama-Pelosi-Reid idea when they used reconciliation to pass it. FTW!

Anyway, on later communications from Krugtron, brilliant suggestion. See:

http://krugman.blogs.nytimes.com/2013/10/14/obamacare-success/?_r=0

If only he had known that Obama would completely undercut him one month later. Blinded by ideology is no way to go through life.

josh

Things could look a lot different a month, or a year, from now. There will be winners and losers. Had there been a public option, there would have been a lot more winners than losers.

abnormal

Meanwhile the techies are claiming that the Obamacare website can't be fixed.

http://www.thefiscaltimes.com/Articles/2013/11/13/No-Hope-Left-Obamacare-s-Website-Techies-Say

 

 

 

ygtbk

Right up there with "If you like your plan, you can keep your plan. PERIOD." is the claim that costs will drop by thousands of dollars:

http://www.dailymail.co.uk/news/article-2507489/Obamacare-plans-cost-cases-WITH-government-subsidies-Obama-administration-admits-time.html

josh

A lot of those who had bare bones individual policies will pay more because they are, in most cases, getting more coverage. Others who had better individual coverage may, and have, seen their cost for coverage drop for similar plans through the exchange.

ygtbk

@josh: I see you are not addressing the points in post #59, so you are implicitly admitting that Obama lied. Good start. That "more coverage" you talk about typically comes with higher deductibles. In the meantime:

http://www.reuters.com/article/2013/11/15/us-usa-healthcare-veto-idUSBRE9AE03X20131115

So when Congress does it they are economic terrorists, but when the President does it it's all good.

Obamacare is full of fail all the way down. I think a new word, "clusterfractal", might be required here. Definition of "clusterfractal": if you look at it, it's obviously a clusterf*ck. But when you take a closer look, it's a clusterf*ck composed of clusterf*cks. And if you take a magnifying glass to it, you discover, oddly enough, that it's clusterf*cks all the way down. It's a Mandelbrot set of fail!

ygtbk

And for additional info:

http://bloom.bg/1a9d0Jf

josh

I'm not sure the point you're driving at with all your rambling, but Obama was clearly wrong, and foolish, to make that promise. Whether he was lying, I don't know. Vetoing a bill and shutting down the government and threatening default are in no way comparable. The overarching point is that keeping private insurer monopoly over health insurance for non-senior, non-poor, patients, was bad, counterproductive policy. That's why I opposed the ACA. Without a public option, it's just more of the same, but with more people pissed off than pleased.

ygtbk

josh wrote:

I'm not sure the point you're driving at with all your rambling, but Obama was clearly wrong, and foolish, to make that promise. Whether he was lying, I don't know. Vetoing a bill and shutting down the government and threatening default are in no way comparable. The overarching point is that keeping private insurer monopoly over health insurance for non-senior, non-poor, patients, was bad, counterproductive policy. That's why I opposed the ACA. Without a public option, it's just more of the same, but with more people pissed off than pleased.

So we both oppose the ACA. I agree with you, perhaps for the first time.

josh

Yes, but I'm sure for totally different reasons. And, again, I only oppose the private portion of the law. The Medicaid expansion was good.

wage zombie

ygtbk wrote:

If people talk about the "essence" of a thing, rather than the abysmally-FUBAR'd actual rollout of the thing that was passed with the support of exactly one party, you might suspect that there's an issue that they are avoiding.

I don't get how the rollout got so abysmally FUBARed, it's not like the ACA has been actively sabotaged for he last 4 years, has it?

wage zombie

ygtbk wrote:

Right up there with "If you like your plan, you can keep your plan. PERIOD." is the claim that costs will drop by thousands of dollars:

http://www.dailymail.co.uk/news/article-2507489/Obamacare-plans-cost-cases-WITH-government-subsidies-Obama-administration-admits-time.html

Right.  Like people people weren't seeing their premiums going up every year without the ACA.  People have been "losing their plans" and seeing their premiums go up for years.  That's why action on health care was so necessary.

ygtbk

@wage zombie - apparently you missed this:

http://www.youtube.com/watch?v=_o65vMUk5so

josh

wage zombie wrote:

ygtbk wrote:

If people talk about the "essence" of a thing, rather than the abysmally-FUBAR'd actual rollout of the thing that was passed with the support of exactly one party, you might suspect that there's an issue that they are avoiding.

I don't get how the rollout got so abysmally FUBARed, it's not like the ACA has been actively sabotaged for he last 4 years, has it?

 

 

Hee hee. Good point.

abnormal

josh wrote:

A lot of those who had bare bones individual policies will pay more because they are, in most cases, getting more coverage. Others who had better individual coverage may, and have, seen their cost for coverage drop for similar plans through the exchange.

That's not correct.

Quote:
... the Manhattan Institute released the most comprehensive analysis yet conducted of premiums under Obamacare for people who shop for coverage on their own. Here’s what we learned. In the average state, Obamacare will increase underlying premiums by 41 percent. As we have long expected, the steepest hikes will be imposed on the healthy, the young, and the male. And Obamacare’s taxpayer-funded subsidies will primarily benefit those nearing retirement—people who, unlike the young, have had their whole lives to save for their health-care needs.

snip ...

... the average state will face underlying premium increases of 41 percent. Men will face the steepest increases: 77, 37, and 47 percent for 27-year-olds, 40-year-olds, and 64-year-olds, respectively. Women will also face increases, but to a lesser degree: 18%, 28%, and 37% for 27-, 40-, and 64-year-olds.

Eight states will enjoy average premium reductionsunder Obamacare: New York (-40%), Colorado (-22%), Ohio (-21%), Massachusetts (-20%), New Jersey (-19%), New Hampshire (-18%), Rhode Island (-10%), and Indiana (-3%). 

snip ...

The eight states that will face the biggest increases in underlying premiums are largely southern and western states: Nevada (+179%), New Mexico (+142%), Arkansas (+138%), North Carolina (+136%), Vermont (+117%), Georgia (+92%), South Dakota (+77%), and Nebraska (+74%).

snip ...

The key thing to understand about our before-and-after comparison is that it is an average. If you’re healthy today, you will face steeper rate increases than these figures indicate. If you have a serious medical condition, however, and haven’t been able to find affordable health coverage as a result, you will do much better under Obamacare than the average person. Men will face steeper increases than women in most states, because women consume more health care than men do, and Obamacare forbids insurers to charge different prices on the basis of gender.

In addition, our comparison ignores other differences between pre-Obamacare and post-Obamacare plans. For example, in some cases, people looking for comparably-priced coverage on the exchanges will need to accept higher deductibles and other cost-sharing arrangements.

etc ...

http://www.forbes.com/sites/theapothecary/2013/11/04/49-state-analysis-obamacare-to-increase-individual-market-premiums-by-avg-of-41-subsidies-flow-to-elderly/

As for "better" coverage, from the same article.

Quote:
... post-Obamacare exchange plans will typically have narrow networks of physicians and hospitals, especially excluding those tied to prestigious medical schools

This article is worth reading as well.

http://www.forbes.com/sites/theapothecary/2013/07/01/wsj-health-insurance-rates-could-double-or-even-triple-for-healthy-consumers-in-obamacares-exchanges/

As an unrelated observation, OHIP would be labelled a substandard plan because it doesn't provide all the coverages required by Obamacare.

 

 

 

 

josh

The Manhattan Institute? Forbes? The WSJ? Right. I'll wait for a somewhat unbiased source.

ygtbk

josh wrote:

wage zombie wrote:

ygtbk wrote:

If people talk about the "essence" of a thing, rather than the abysmally-FUBAR'd actual rollout of the thing that was passed with the support of exactly one party, you might suspect that there's an issue that they are avoiding.

I don't get how the rollout got so abysmally FUBARed, it's not like the ACA has been actively sabotaged for he last 4 years, has it?

Hee hee. Good point.

I'm more inclined to believe that Sibelius and HHS are just incompetent, rather than wreckers, but YMMV.

abnormal

josh wrote:

The Manhattan Institute? Forbes? The WSJ? Right. I'll wait for a somewhat unbiased source.

Not sure how their "bias" can impact things.  They aren't presenting a philosophical argument - they're presenting a simple comparison of pre and post Obamacare data - premiums are going up an average of 41% (in some cases they're doubling or tripling) and deductibles are generally increasing.

 

wage zombie

Paul Krugman: The Obamacare Worm Turns

Quote:

I suggested yesterday that we’re probably heading for a turning point in the health reform discussion. Conservatives are operating on the assumption that it’s an irredeemable disaster that they can ride all the way to 2016; but the facts on the ground are getting better by the day, and Obamacare will turn into a Benghazi-type affair where Republicans are screaming about a scandal nobody else cares about.

And it’s already starting to happen.

Quote:

At this rate, the whole horrors-of-Obamacare meme will be gone in weeks, not months. But the GOP echo chamber won’t be able to let it go.

DaveW

Krugman has been a voice of sanity throughout the whole rollout, and also the legislative/Supreme Court/Presidential-election prequel;

one NYT reader gets it right:

Human nature being what it is, Americans will gradually find their way to the health insurance exchanges, and when they see better prices they will buy--especially with subsidies.

The people will select the plans that are equal but least expensive. Those plans will drive down prices in other plans.

wage zombie
ygtbk

I think that the Democrats are panicking. They are now talking openly about repeal, which up until now has been unthinkable:

http://www.whitehouse.gov/sites/default/files/docs/national_cost_of_repeal_report.pdf

abnormal

And he's done it again!!

http://www.washingtonpost.com/national/health-science/obama-administration-relaxes-rules-of-health-care-law-four-days-before-deadline/2013/12/19/81bc3132-690b-11e3-8b5b-a77187b716a3_story.html

Except this time he's waived the central tenet of the entire law.

Apparently the part of the Presidential Oath of Office that requires the POTUS to enforce the law of the land really means "selectively enforce".  [img]http://oi43.tinypic.com/dma983.jpg[/img]

 

 

 

 

josh

Sorry.  The power to grant waivers by administrative rule is authorized by the law.

abnormal

josh wrote:

Sorry.  The power to grant waivers by administrative rule is authorized by the law.

Where?

 

josh
abnormal

Thanks

DaveW

I agree:

http://www.newrepublic.com/article/116105/obamacare-will-lead-single-payer-michael-moore

...  yet I’m still much more sympathetic to Obamacare than [Michael] Moore. He thinks it’s awful. I consider it a deceptively sneaky way to get the health care system both of us really want.

abnormal

wage zombie wrote:

ygtbk wrote:

Right up there with "If you like your plan, you can keep your plan. PERIOD." is the claim that costs will drop by thousands of dollars:

http://www.dailymail.co.uk/news/article-2507489/Obamacare-plans-cost-cases-WITH-government-subsidies-Obama-administration-admits-time.html

Right.  Like people people weren't seeing their premiums going up every year without the ACA.  People have been "losing their plans" and seeing their premiums go up for years.  That's why action on health care was so necessary.

Premium increases due to Obamacare are a quite different animal from "normal" premium increases.  

The major component of health insurance premiums is healthcare costs.  And those costs increase at a rate in excess of inflation and have done so for pretty much forever (and there his nothing in Obamacare that will stop that).

wage zombie

abnormal wrote:

Premium increases due to Obamacare are a quite different animal from "normal" premium increases.  

Do you have any examples of any "premium increases due to Obamacare"?  Any that I've seen get debunked pretty quickly.

DaveW

we are in the very very early days of the ACA program, and relatively low enrolment numbers and glitches are THE RULE, rather than the exception, in implementing such a complex system;

Krugman points out that some states are now well beyond cruising speed, such as California, and their enrolment success is better to date than the early days of the Massachusetts plan

I agree with the counterintuitive point made by some liberal writers: this is going to be a net electoral PLUS for Dems next November, and a large voting bloc will not let go of the new insurance to which they are legally entitled under ACA -- including, crucially, hoards of previously uncovered twentysomethings now covered by their parents' health plans until age 26

 

 

abnormal

wage zombie wrote:

abnormal wrote:

Premium increases due to Obamacare are a quite different animal from "normal" premium increases.  

Do you have any examples of any "premium increases due to Obamacare"?  Any that I've seen get debunked pretty quickly.

A couple of obvious ones.

The "take all comers" provision is good for something like a 10% across the board increase.  The medical device tax flows thru premiums.  

 

 

wage zombie

Ok, I'm just looking for an actual example.  If there are so many rate increases due to Obamacare I would think you'd be able to provide one.

wage zombie
abnormal

wage zombie wrote:

Ok, I'm just looking for an actual example.  If there are so many rate increases due to Obamacare I would think you'd be able to provide one.

I just did.  That's not counting premium taxes etc that will be included in premiums.

Quote:
... ongoing operations are supposed to be covered by a 1.5 percent premium tax on private insurance sold on the exchange. MNsure's 2014 budget, set last August, is $58.1 million.

"Structurally, the way that this budget has been put together is that the vast majority of resources goes to public program enrollees while the vast majority of revenue comes from the premium withhold," said Brian Beutner, the chairman of MNsure's board of directors. "That comes to the forefront in 2015, and it's on our list as to how we handle that."

The board does have the option to raise the premium withholding to as much as 3.5 percent in 2015.

 

wage zombie

So this is somethin that might happen in 2015?  I am asking for any evidence that rates have gone up more than normal, and posted numbers in post #90 showing they have not.  You're speculating about what the rates might be in the future.

abnormal

wage zombie wrote:

So this is somethin that might happen in 2015?  I am asking for any evidence that rates have gone up more than normal, and posted numbers in post #90 showing they have not.  You're speculating about what the rates might be in the future.

It's not speculation.  And it's not something that "might" happen.

The 1.5% premium tax is in place.  The take all comers provision applies.  And the medical device tax is in the law (as a complete aside, since many medical devices find uses elsewhere - vets' offices for example) that will increase costs elsewhere).

And all you have to do is follow the news to see any number of examples of premiums increasing as well as deductibles.

abnormal

Then there's this.

[quote]The Obamacare ‘Shotgun Wedding’—Marry or Lose Your Home

The problem with solutions is that few of them tend to be perfect, even if they act in a mostly benign manner. Actions produce reactions, a principle as true in politics as it is in physics, and those tend to multiply when solutions increase in complexity.

The nature of these unintended consequences changes dramatically when complex “solutions” turn out to be poorly designed and incompetently administered.

snip ...

Here’s where the law of unintended consequences comes into Obamacare. Thanks to the exchange programming, consumers are getting enrolled in Medicaid whether they understand what that means or not, and in much greater numbers than before. (In the first month, nearly 90 percent of all the enrollees in the federal and state exchanges were Medicaid applicants.)

Unless they look at the fine print in the paperwork in Washington and other states with similar asset-forfeiture regulations, any assets they own will not pass to their heirs but to the state instead.

etc ...

 

http://www.thefiscaltimes.com/Columns/2013/12/19/Obamacare-Shotgun-Weddi...

 

wage zombie

You've said that rates are increasing at greater levels with Obamacare.  You have not been able to show any numbers demonstrating that rates are increasing at higher levels.  You are also not able to proint to any real world situations where someone is seeing their rates increase, because everyt time someone steps forward with a story like this, it's quickly and easily debunked.

Now that you're talking about people being tricked into signing up for Medicaid so that the government can seize their assets, you are getting into Alex Jones territory.  I bet you're also worried about death panels.

Did Obamacare kick your dog or something?  It's over, dude.  Your inability to come up with any horror stories that are not specualtion about what's going to happen is a good indicator that the Obamacare bogeyman has left the building.

wage zombie

Bette from Spokane came up last night in the Republican response to SOTU address.  Supposedly Bette will be paying $700 a month more for insurance due to that nasty Obamacare!  Those darn premium increases.

It never takes much digging to debunk these things:

http://www.dailykos.com/story/2014/01/29/1273347/-Where-is-Cathy-McMorri...

abnormal

Not exactly fond of the source but this is interesting

http://www.weeklystandard.com/blogs/watch-employees-pennsylvania-company...

 

wage zombie

abnormal wrote:

Not exactly fond of the source but this is interesting

http://www.weeklystandard.com/blogs/watch-employees-pennsylvania-company...

Well, that didn't take long.

http://www.dailykos.com/story/2014/01/31/1273912/-LIVE-Pa-co-wrongly-thi...

wage zombie

Rabid conservative insurance broker invites a reporter & camera crew into a meeting with a small business.

Rabid conservative insurance broker reports to the small business, that due to Obamacare regulations, they have to switch to a new plan.

Employees are told that they will be facing large monthly increases for plans with higher deductibles.

One employee, Judy, will be seeing her monthly premiums increase from $929 to $1316.

The reporter & camera crew are on hand to record the employees' shock and outrage.

The small business owner, whose own monthly premiums will be jumping $584, laments, "The small businesses are the heart of America, so, how is that going to affect everybody?  It's not good."

The Weekly Standard packages it up, and abnormal jumps on to babble to report.  He's "not exactly fond of the source," but, "this is interesting."

It turns out the plans available on the small business exchange are half the cost of the plans offered by the rabid conservative insurance broker.

Additionally, it turns out a provision of the ACA is that if employee premiums make up more than 9.5% of income, those employees are eligible for the individual exchanges.  Plans on the individual exchanges are half the cost of the plans offered by the rabid insurance broker.  And will be even less for those eligible for subsidies.

Both plans on the small business exchange and plans on the individual exchange cost less than the employees were paying for their insurance this past year.

Information about these lower cost plans are easily found by searching on a web site.  That's why stories like this can  be thoroughly debunked within 24 hours.

Employees from this company will certainly hear about the better options available to them.  I wonder what will happen as more and more people have experiences like this.

I wonder how the Republicans  will do to run against Obamacare.

I wonder what will happen to this rabid conservative insurance broker's annual salary.  I guess he is just "informing" his clients about the dangers of Obamacare.

abnormal, you fall for this laughable shit, dude?  I thought you considered yourself a serious person.

abnormal

Are ACA Public Exchange Rates Unsustainable?

Bruce GilbertPresident and Chief Executive Officer at HIX Partners, LLC

"A closer analysis of the rate filing shows that Wellpoint is assuming in its rate filing that its ObamaCare-compliant health plans (sold both on and off the exchange) will be very unprofitable for 2014, but for the anticipated recoveries from the reinsurance fund. This also suggests that insurance premiums will continue to rise well into the future, as these various reinsurance mechanisms start to sunset, and insurers have to make up the difference. By 2016, the $25 billion reinsurance fund is expected to wind down entirely. Right now, without those subsidy dollars, these plans lose money as far as the eye can see."

New Data: ObamaCare Plans Are Money Losers, But For The 'Reinsurance Fund' - Forbes forbes.com

A lot of attention is being focused on the reinsurance mechanisms built into Obamacare (the so-called “three ‘Rs’). These policy tools are designed to offset the losses that insurers may take on the Obamacare plans. In part, these potential losses...

 

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