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(Some ACA Wonk)   Despite its many flaws, at least ObamaCare protects people against medical bankruptcy...(reads fine print)... OH COME ON   (nakedcapitalism.com) divider line 265
    More: Asinine, obamacare, Families USA, America's Health Insurance Plans, HMO, anesthesiologists, HAMP  
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2415 clicks; posted to Politics » on 19 Nov 2013 at 1:20 PM (43 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-11-19 03:47:00 PM

CPennypacker: Cost control?


Wages ARE a cost when it comes to services.
 
2013-11-19 03:47:41 PM

BojanglesPaladin: CPennypacker: Cost control?

Wages ARE a cost when it comes to services.


wha?
 
2013-11-19 03:49:04 PM

CPennypacker: wha?


I cannot help you here.
 
2013-11-19 03:49:44 PM
This thread sure looks like it is filled with three accounts that show up in the same threads all the time posting similar idiocy in a rotating schedule.

I'm just impressed anusboy posted more than once.
 
2013-11-19 03:50:09 PM

dinomyar: Government says I can charge X, but I want to make 2X. How is that not wage controls?


BojanglesPaladin: Can you explain how dictating what a person who provides a service can be paid for that service is not wage control? Especially when many doctors are paid per procedure performed, many doctors are independent contractors, and many doctors are sole practitioners?


Not all income from the sale of products and services go directly to wages.  The business decides what portion of their income is allocated to wages.  Limiting their income from some or all their offered products or services does not remove their ability to decide what portion is allocated to wages.  Thus a control on their income is not a control on their wages.

Short version: It's not wage control because it's not controlling wages, dipshiats.
 
2013-11-19 03:50:43 PM

BojanglesPaladin: Arkanaut: Did he promise that?

You tell me.

From the 2008 Debate:
"OBAMA: Well, I think it should be a right for every American. In a country as wealthy as ours, for us to have people who are going bankrupt because they can't pay their medical bills ..."

From the 2007 Primary Debate:
"OBAMA: You know, my mother died of ovarian cancer when she was 53 years old. And I remember in the last month of her life, she wasn't thinking about how to get well, she wasn't thinking about coming to terms with her own mortality, she was thinking about whether or not insurance was going to cover the medical bills and whether our family would be bankrupt as a consequence. That is morally wrong. It's objectionable. That's why I put forward a comprehensive legislation for universal health care so that all people could get coverage. 

From the 2012 Debate:
"OBAMA: Well, four years ago, it wasn't just that small businesses were seeing costs skyrocket, but it was families who were worried about going bankrupt if they got sick."

From Take Back America Conference 2006:
"OBAMA: We know that as progressives we believe in affordable health care for all Americans, and that we're going to make sure that Americans don't have to choose between a health care plan that bankrupts the government and one that bankrupts families, the party that won't just throw a few tax breaks at families who can't afford their insurance, but will modernize our health care system and give every family a chance to buy insurance at a price they can afford.

From the Democratic Primary Debate 2007:
"Let me tell you what [my health care plan] would do. Number one, we should have a national pool that people can buy into if they don't have health insurance, similar to the ones that most of us who are in Congress enjoy right now. It doesn't make sense to me that my bosses, the taxpayers, may not have health insurance that I enjoy. And we can provide subsidies for those who can't afford the group rates that are available. T ...


None of those quotes actually constitute a promise -- they're statements of concerns or goals at best.  Four of those six quotes are from before the ACA was even introduced to Congress, never mind being debated or amended.  The closest he gets is to say that we want to help families avoid bankruptcy, which we can say is a weasel word.
 
2013-11-19 03:50:49 PM

dinomyar: Harbinger of the Doomed Rat: Regulating what a business can charge for a given product or service ≠ governmental wage control

Government says I can charge X, but I want to make 2X. How is that not wage controls?


I'll jump on this and say that, yes, I support price controls for healthcare, which will function as wage caps of a sort for healthcare workers. (Mostly the independent-contractor ones like doctors; nurses, techs and the like are usually salaried and their wages don't tie to prices).

It's the only thing that works to contain health care costs.

I do not support price/wage controls in industries that have a functioning market; market mechanisms are superior in those cases. Health care does not have a functioning market, and can't.

Provider shortages, if they erupt, can be met with supply-side changes (more medical school slots), subsidization, or other such tools.
 
2013-11-19 03:53:09 PM

Harbinger of the Doomed Rat: dinomyar: Government says I can charge X, but I want to make 2X. How is that not wage controls?

BojanglesPaladin: Can you explain how dictating what a person who provides a service can be paid for that service is not wage control? Especially when many doctors are paid per procedure performed, many doctors are independent contractors, and many doctors are sole practitioners?

Not all income from the sale of products and services go directly to wages.  The business decides what portion of their income is allocated to wages.  Limiting their income from some or all their offered products or services does not remove their ability to decide what portion is allocated to wages.  Thus a control on their income is not a control on their wages.

Short version: It's not wage control because it's not controlling wages, dipshiats.


Sure, they can always keep wages the same and use older crappy equipment, cut corners on procedures, etc. Lot's of ways to cut costs other than wages, so that is sort of true...
 
2013-11-19 03:55:47 PM

Gaseous Anomaly: dinomyar: Harbinger of the Doomed Rat: Regulating what a business can charge for a given product or service ≠ governmental wage control

Government says I can charge X, but I want to make 2X. How is that not wage controls?

I'll jump on this and say that, yes, I support price controls for healthcare, which will function as wage caps of a sort for healthcare workers. (Mostly the independent-contractor ones like doctors; nurses, techs and the like are usually salaried and their wages don't tie to prices).

It's the only thing that works to contain health care costs.

I do not support price/wage controls in industries that have a functioning market; market mechanisms are superior in those cases. Health care does not have a functioning market, and can't.

Provider shortages, if they erupt, can be met with supply-side changes (more medical school slots), subsidization, or other such tools.


Is it really that healthcare doesn't have a functional market, so much that healthcare laws and practices have separated consumers from market forces? e.g. when was the last time you price compared MRIs?
 
2013-11-19 03:56:11 PM

CPennypacker: dinomyar: revrendjim: All the plans I am looking at have an absolute cap on out of pocket expenses, in my case around $6k. That would sting but wouldn't lead to bankruptcy.

The cap is for in-network providers. You can still get a bigger bill that you will have to pay.

Actually it depends on the plan. My health insurance plan's max out of pocket includes payments to out of network providers.


Watch out - they may say they cover out-of-network services "at 100%" when you hit that out of pocket max. But that 100% will be 100% of some "UCR" that is approximately the contracted in-network rate. They don't and can't protect you from balance-billing by out-of-network providers, because there's no limit (contractual, legal or logical) on how much those providers can bill you.

I could be wrong if it's a Goldman Sachs-style $42000/year plan or something. Maybe those cover balance-bills and just hope no provider bills them $1M for setting a broken leg...
 
2013-11-19 04:03:17 PM

EWreckedSean: Is it really that healthcare doesn't have a functional market, so much that healthcare laws and practices have separated consumers from market forces? e.g. when was the last time you price compared MRIs?


Price opacity is the entire reason TFA's scenario is a problem. There is no law or regulation preventing or hindering providers from posting a price list and actually billing people those prices.

Even with pricing transparency and/or price controls, there are still plenty of market failures to go around. We don't have the stomach, as a society, to make health care excludable by ability/willingness to pay. (Nor should we IMO). We have significant supply-side barriers to entry (and most are for good reason, e.g. the FDA). Information asymmetries abound, even on the supply side - e.g. lots of doctors don't know which patients do better on low-dose aspirin than on coronary stents. Likewise there are principal-agent problems, as one would expect in an industry where consumers are almost always less informed than producers.
 
2013-11-19 04:05:06 PM

Harbinger of the Doomed Rat: Not all income from the sale of products and services go directly to wages.


I am asking specifically about services. Which would be predominantly driven by wage costs, especially in instances where we are talking about a surgeon, a sole practitioner or a contract.

Anyway, I'm sure we can split hairs and count dancing angels in the spaces between wage controls and Service cost controls. Either you agree or disagree that top-down federal price controls are the appropriate means of controlling costs.
 
2013-11-19 04:20:51 PM

bradkanus: Not a "panacea?"  Uh, then what were you so excited about when it passed?  It seems like a lot of people who cheered on the law because they are partisan before they are anything else, are now backpeddling on the law.

You guys said it was good.


Jesus, man. Does that kind of compartmentalized thinking hurt? Because it damn sure should.
 
2013-11-19 04:32:50 PM

EWreckedSean: Serious Black: EWreckedSean: Serious Black: Mandate every health care provider charge the same price to every patient regardless of their method of payment.

You're welcome.

Because that can't have any problems? Say goodbye to anybody with Medicare or Medicaid seeing a doctor again.

Who said that would necessarily be the result? Maryland's Health Services Cost Review Commission sets prices for everything, and Medicare and Medicaid are included in these rate settings. I haven't seen a mass of horror stories about patients with Medicare or Medicaid being unable to see a doctor in Maryland recently.

That is because Maryland has been given a Waiver from the federal law on pricing for Medicare/Medicaid that all other states have to follow.


So every state gets a waiver once they establish one of these commissions. That's not so hard.

BojanglesPaladin: I think they were exempted from the ACA rules though weren't they?


I haven't heard of exemptions for them, but I could be wrong. I know they're seeking a modification to their previous waiver that would allow them to put a global cap on cost growth along with some other initiatives like bundling payments.
 
2013-11-19 04:34:11 PM
Brought my car in for an oil change only to find out Obamacare didn't cover it!
Thanks Obama!
 
2013-11-19 04:40:17 PM

Serious Black: EWreckedSean: Serious Black: EWreckedSean: Serious Black: Mandate every health care provider charge the same price to every patient regardless of their method of payment.

You're welcome.

Because that can't have any problems? Say goodbye to anybody with Medicare or Medicaid seeing a doctor again.

Who said that would necessarily be the result? Maryland's Health Services Cost Review Commission sets prices for everything, and Medicare and Medicaid are included in these rate settings. I haven't seen a mass of horror stories about patients with Medicare or Medicaid being unable to see a doctor in Maryland recently.

That is because Maryland has been given a Waiver from the federal law on pricing for Medicare/Medicaid that all other states have to follow.

So every state gets a waiver once they establish one of these commissions. That's not so hard.


So how many billions of dollars to the cost of Medicaid/Medicare go up then? The Waiver allows Maryland to not follow those federal cost guidelines...
 
2013-11-19 04:48:39 PM

EWreckedSean: Serious Black: EWreckedSean: Serious Black: EWreckedSean: Serious Black: Mandate every health care provider charge the same price to every patient regardless of their method of payment.

You're welcome.

Because that can't have any problems? Say goodbye to anybody with Medicare or Medicaid seeing a doctor again.

Who said that would necessarily be the result? Maryland's Health Services Cost Review Commission sets prices for everything, and Medicare and Medicaid are included in these rate settings. I haven't seen a mass of horror stories about patients with Medicare or Medicaid being unable to see a doctor in Maryland recently.

That is because Maryland has been given a Waiver from the federal law on pricing for Medicare/Medicaid that all other states have to follow.

So every state gets a waiver once they establish one of these commissions. That's not so hard.

So how many billions of dollars to the cost of Medicaid/Medicare go up then? The Waiver allows Maryland to not follow those federal cost guidelines...


In the short term, yes, costs might go up. But remember that their waiver was conditioned on Maryland being able to keep cost growth below the average for the nation. Since the waiver was granted, costs in Maryland have gone from about 26% above the national average to about 2% below the national average; this cost growth was the second-lowest in the country. Ultimately, that's what this endeavour is about: bending the cost curve.
 
2013-11-19 04:52:41 PM

Serious Black: EWreckedSean: Serious Black: EWreckedSean: Serious Black: EWreckedSean: Serious Black: Mandate every health care provider charge the same price to every patient regardless of their method of payment.

You're welcome.

Because that can't have any problems? Say goodbye to anybody with Medicare or Medicaid seeing a doctor again.

Who said that would necessarily be the result? Maryland's Health Services Cost Review Commission sets prices for everything, and Medicare and Medicaid are included in these rate settings. I haven't seen a mass of horror stories about patients with Medicare or Medicaid being unable to see a doctor in Maryland recently.

That is because Maryland has been given a Waiver from the federal law on pricing for Medicare/Medicaid that all other states have to follow.

So every state gets a waiver once they establish one of these commissions. That's not so hard.

So how many billions of dollars to the cost of Medicaid/Medicare go up then? The Waiver allows Maryland to not follow those federal cost guidelines...

In the short term, yes, costs might go up. But remember that their waiver was conditioned on Maryland being able to keep cost growth below the average for the nation. Since the waiver was granted, costs in Maryland have gone from about 26% above the national average to about 2% below the national average; this cost growth was the second-lowest in the country. Ultimately, that's what this endeavour is about: bending the cost curve.


How is it only short term though?
 
2013-11-19 04:57:15 PM

bulldg4life: This thread sure looks like it is filled with three accounts that show up in the same threads all the time posting similar idiocy in a rotating schedule.

I'm just impressed anusboy posted more than once.


I got my post count reduced to 76 with one weird and simple trick!
 
2013-11-19 05:02:18 PM

Gaseous Anomaly: CPennypacker: dinomyar: revrendjim: All the plans I am looking at have an absolute cap on out of pocket expenses, in my case around $6k. That would sting but wouldn't lead to bankruptcy.

The cap is for in-network providers. You can still get a bigger bill that you will have to pay.

Actually it depends on the plan. My health insurance plan's max out of pocket includes payments to out of network providers.

Watch out - they may say they cover out-of-network services "at 100%" when you hit that out of pocket max. But that 100% will be 100% of some "UCR" that is approximately the contracted in-network rate. They don't and can't protect you from balance-billing by out-of-network providers, because there's no limit (contractual, legal or logical) on how much those providers can bill you.

I could be wrong if it's a Goldman Sachs-style $42000/year plan or something. Maybe those cover balance-bills and just hope no provider bills them $1M for setting a broken leg...


The only thing we use it for is for a doctor my wife sees weekly for a chronic issue. We reach the out of pocket max in about June and my insurance covers the rest. In all honesty its probably better than what they have at Goldman, but then again I work for a French bank.
 
2013-11-19 05:06:20 PM

EWreckedSean: Serious Black: EWreckedSean: Serious Black: EWreckedSean: Serious Black: EWreckedSean: Serious Black: Mandate every health care provider charge the same price to every patient regardless of their method of payment.

You're welcome.

Because that can't have any problems? Say goodbye to anybody with Medicare or Medicaid seeing a doctor again.

Who said that would necessarily be the result? Maryland's Health Services Cost Review Commission sets prices for everything, and Medicare and Medicaid are included in these rate settings. I haven't seen a mass of horror stories about patients with Medicare or Medicaid being unable to see a doctor in Maryland recently.

That is because Maryland has been given a Waiver from the federal law on pricing for Medicare/Medicaid that all other states have to follow.

So every state gets a waiver once they establish one of these commissions. That's not so hard.

So how many billions of dollars to the cost of Medicaid/Medicare go up then? The Waiver allows Maryland to not follow those federal cost guidelines...

In the short term, yes, costs might go up. But remember that their waiver was conditioned on Maryland being able to keep cost growth below the average for the nation. Since the waiver was granted, costs in Maryland have gone from about 26% above the national average to about 2% below the national average; this cost growth was the second-lowest in the country. Ultimately, that's what this endeavour is about: bending the cost curve.

How is it only short term though?


Because at some point, a line with a lower slope will intercept a line with a bigger slope? That's basic algebra.
 
2013-11-19 05:09:34 PM

BojanglesPaladin: I doubt you intend to support any bills coming from the House Republicans to fix what is wrong with ACA


I for one will consider what the Plutocrat Party proposes to fix the ACA when the Plutocrat Party starts to act in good faith and ditches the one-note agenda of "git that dagburn Dimmycrat varmint."

/Not holding my breath
//Lead, follow or get the hell out of the way
 
2013-11-19 05:09:42 PM
Obama lied and people will died.
 
2013-11-19 05:11:33 PM
That actually happened to me when my in-network doctor sent my labs to an out of network lab, and I got a bill for over $1,000 (because that's what a woman's annual exam labs cost, apparently.)

I actually got out of paying it by arguing that I do not control where my labs are sent, and that I am not responsible for enforcing the contracts between the insurance company and my doctor, but if they would like me to take that on in the future, I charge $200/hour for those sorts of services.  It's not like the doctor hands you the samples they take and you take it to the lab.  And how could anyone assume that an in-network doctor's lab of choice would somehow NOT be in network?

It's insanity, the things they get away with.
 
2013-11-19 05:16:30 PM
I fully support BojanglesPalin's efforts to get these loopholes in the ACA fixed as quickly as possible to prevent any more needless suffering due to insurance company/hospital shenanigans.
 
2013-11-19 05:18:35 PM

bradkanus: You guys said it was good.

It's not.

Move on.


We said it was better.

It is.

Shut up.
 
2013-11-19 05:43:06 PM

BojanglesPaladin: CPennypacker: You keep saying that as if it were true

I do, because I believe it is true. And every day, and week and month, we see more hard facts, and more statistics, and more real world consequences of ACA that support my assessment. I acknowledge readily and always have that ACA has a few good reforms in it. I have never objected to reforming a system in desperate need of reforming. I object to doing it badly, and I think ACA is doing very badly indeed.

I accept that others may weight and prioritize aspect of ACA differently than me, and that not everyone is exposed or even interested in many of the consequences because they are not directly affected by them.

As they say, your mileage may vary. It is possible for people to have the same set of facts and arrive at different conclusions.


So, it's bad because it's bad, and is badly bad at badding.

Would you like to copy and paste the exact words of the affordable care act that you would say is among the problems? I hear all of these horrible stories, that always turn out to be lies, but I never hear you, Hannity, Beck, or anyone really actually say WHAT is actually so BAD about the affordable care act?

When I read the bill, and see it's implementation, I was underwhelmed but ready to compromise and accept it, considering how the Republicans wouldn't allow for any expansion of medicare to cover everyone.  I was unsure of the individual mandate, however I have come to accept it as a viable option, considering it's already in use in two other first world nations quite successfully. The subsidies to those who cannot afford it seem to be sufficient, and the tax rate increase will only cost me 3 pennies on the dollar for every dollar I make after the first $20,800/month ($250,000 a year).

I see that I cannot be denied access to health insurance for any preexisting conditions, they cannot kick me off of the plan when I become sick, and they cannot put a cap on my yearly treatments (if I ever need them). I see that there is now even more competition in the marketplace due to the exchanges, and as they become more popular they will continue to fall in prices. I can see also that my brother, who busted a disc in his back at the age of 22 is able to continue to see the therapist on my parent's health insurance, even though he's 25 now.

What I would like to see is what you can find in this law, specifically, that is causing you to believe it is soooooo terrible.

Here', let me google that for you.

http://www.hhs.gov/healthcare/rights/law/index.html  Don't let the .gov scare you, in this link you get some fluffy summary crap, but also get the actual bill with the actual law as written and signed.
 
2013-11-19 05:44:25 PM

DamnYankees: While the issue in TFA is a problem, it has absolutely nothing to do with Obamacare. It's just a general problem with the medical industry. Should we fix it? Sure. But "Obamacare failed to fix this pre-existing issue which was already broken" isn't much of an argument; Obamacare isn't a panacea.


If Obamacare does not fix every single problem related to health care, no matter how tenuous the relationship, Obamacare is a complete failure and Obama is a liar. That's why we need to follow the Republican plan, which consists of:

The plan is to allow those things that had been proposed over many years to reform a health-care system in America that certainly does need more help so that there's more competition, there's less tort reform threat, there's less trajectory of the cost increases, and those plans have been proposed over and over again. And what thwarts those plans? It's the far left. It's President Obama and his supporters who will not allow the Republicans to usher in free market, patient-centered, doctor-patient relationship links to reform health care.

Come on, you can't argue with that.
 
2013-11-19 06:02:47 PM

Rent Party: Rosecitybeaver: But apparently it's not better.  It's more expensive and your doctor options more narrow (with good reason).  I think you should have read the bill instead of just receiving the talking points.


Why on earth would it be more expensive?  The total insurance paid in America = the total medical costs + insurance company profits. Obamacare reduces company profits (it was like 25% and is not capped at...I think 20%). How do you imagine that the bill will increase medical costs? By having more people get procedures they needed but couldn't get?  How is that possibly bad?

All Obamacare really does is redistribute the costs of medical treatment more evenly over the population.

Fifth grade math quiz time!

If I am an insurance company CEO and I am told by the fed that I must spend 80% of my revenue on paying claims, but I am not limited in any way in how much I can charge for a plan, what is a very simple way to make up the net loss?

Show your work.


.....Are you saying that the CEO could have been charging more the whole time, even without the caps, but chose not to? Why not? Why didn't he raise the rates for insurance 100 fold before or after the ACA? I think I know why. It's because the market wouldn't bare it, and his competition would destroy his company.

If Bluecross Blueshield wanted to raise their rates, but their competitors don't, then BCBS won't raise their rates. If 9 out of 10 companies went that route, then 1 out of 10 companies will be making GOBS of money from their new customers the next fiscal year. This 80% requirement does not give the insurance companies a reason to raise rates at all, because if they could convince the public to pay a penny more, they would already be charging that penny today. Demand sets prices, not profit.

So, basically,the insurance companies cannot raise premiums to offset their lost ability to price gouge the sick and poor. If they could, they already would have.  Rates will only go up as much as their competition allows them, and it doesn't matter how much profit they WANT, it's the profit that they get, and I think 80% isn't unreasonable.
 
2013-11-19 06:09:12 PM

ManateeGag: How many Obamacare links is this for today?


i.imgur.com
 
2013-11-19 06:12:56 PM

Dedmon: .Are you saying that the CEO could have been charging more the whole time, even without the caps, but chose not to? Why not?


The only way you can charge more for a product once people quit buying it is to make a law that requires them to pay for it if they want it or not. Freeish market or any other economic system- once it's mandated, the price goes up. That is as good as a fact as gravity.
 
2013-11-19 06:37:31 PM
"Rep. Jim Clyburn, D-S.C., conceded that Democrats got "in bed" with insurance companies while crafting Obamacare "


No wonder costs are up.
 
2013-11-19 06:42:00 PM

OregonVet: Dedmon: .Are you saying that the CEO could have been charging more the whole time, even without the caps, but chose not to? Why not?

The only way you can charge more for a product once people quit buying it is to make a law that requires them to pay for it if they want it or not. Freeish market or any other economic system- once it's mandated, the price goes up. That is as good as a fact as gravity.


Unless you also make a law that dictates how the business' income can be spent and require that excess be refunded back to the consumer.  You know, as in exactly what the ACA does with 80/20 rule.

/Already got my refund from my insurance company this year thanks to the ACA.
 
2013-11-19 06:58:17 PM

bradkanus: Medicaid. You assistance is now applied to your insurance premium! yeah!


Citation needed.

You're probably thinking of this but it doesn't apply in all states.
 
2013-11-19 07:39:05 PM

bradkanus: DamnYankees: While the issue in TFA is a problem, it has absolutely nothing to do with Obamacare. It's just a general problem with the medical industry. Should we fix it? Sure. But "Obamacare failed to fix this pre-existing issue which was already broken" isn't much of an argument; Obamacare isn't a panacea.

Not a "panacea?"  Uh, then what were you so excited about when it passed?  It seems like a lot of people who cheered on the law because they are partisan before they are anything else, are now backpeddling on the law.

You guys said it was good.

It's not.

Move on.


If we can't fix everything, we should do nothing - Rand Paul
 
2013-11-19 08:07:25 PM

bradkanus: Not a "panacea?"  Uh, then what were you so excited about when it passed?  It seems like a lot of people who cheered on the law because they are partisan before they are anything else, are now backpeddling on the law.


I was excited about it when it passed (and now) because it's a step in the right direction, and the only serious step forward that we've taken in decades.

What I specifically most like:
* Guaranteed issue for all insurance plans
* End lifetime and annual limits on coverage
* Ends recission abuse
* Provide a common set of services that are covered, so plans can't bury exclusions deep in the fine print that screw people over
* Subsidies for low and middle-income individuals to get healthcare
* Formation of the ACO model of reimbursement, so that healthcare organizations are financially rewarded for the value, not the volume, of care they provide
* Minimum medical loss ratios force plans to not overcharge on premiums

There are certainly things I would have liked to also see, but I'm not going to be dissatisfied just because the progress wasn't as significant as I would have liked.
 
2013-11-19 08:07:54 PM

BojanglesPaladin: BeesNuts: I REALLY genuinely hope that y'all can keep this level of intense scrutiny fixed on the president and his agenda the next time a republican's in office.

I don't see why it wouldn't. I don't know who exactly you think "y'all" is.

BeesNuts: Cause that would've been really nice last time.

I think you will find that I and many others critical of ACA were critical of many of Bush's policies as well. (No Child Left Behind ring any bells?)


And I will find many, many more who are critical of ACA and will immediately shut their pretty little mouths into thin, mealy smiles when the next unfunded medicare/medicaid expansion gets shoved through by a Republican president.

The "royal" y'all.  If you will.
 
2013-11-19 08:12:02 PM

Teufelaffe: OregonVet: Dedmon: .Are you saying that the CEO could have been charging more the whole time, even without the caps, but chose not to? Why not?

The only way you can charge more for a product once people quit buying it is to make a law that requires them to pay for it if they want it or not. Freeish market or any other economic system- once it's mandated, the price goes up. That is as good as a fact as gravity.

Unless you also make a law that dictates how the business' income can be spent and require that excess be refunded back to the consumer.  You know, as in exactly what the ACA does with 80/20 rule.


All that is going to do is make things more expensive.  If I can only keep 20%, my *only* incentive is to make the 100% bigger.

So instead of charging you a dollar and keeping twenty cents, I'm going to charge you two dollars and keep forty.
 
2013-11-19 08:22:48 PM

Rent Party: All that is going to do is make things more expensive.  If I can only keep 20%, my *only* incentive is to make the 100% bigger.


Except the price you charge is driven largely by market forces.  If the insurers could actually earn more by charging more, they already would be doing that.  Raising prices too much will simply allow your competitors to steal your market share - because it'll be more effective to raise that 100% by increasing market share versus raising prices.
 
2013-11-19 08:27:28 PM

Rent Party: Teufelaffe: OregonVet: Dedmon: .Are you saying that the CEO could have been charging more the whole time, even without the caps, but chose not to? Why not?

The only way you can charge more for a product once people quit buying it is to make a law that requires them to pay for it if they want it or not. Freeish market or any other economic system- once it's mandated, the price goes up. That is as good as a fact as gravity.

Unless you also make a law that dictates how the business' income can be spent and require that excess be refunded back to the consumer.  You know, as in exactly what the ACA does with 80/20 rule.

All that is going to do is make things more expensive.  If I can only keep 20%, my *only* incentive is to make the 100% bigger.

So instead of charging you a dollar and keeping twenty cents, I'm going to charge you two dollars and keep forty.


And who forces me to buy an extra dollar's worth of medical care?

Or will doctors collude with insurance companies on this?

Bear in mind if they would do such a collusion we are all farked even more the freer the market gets and the ONLY solution to a full collusion of that nature would be more regulation.
 
2013-11-19 08:27:42 PM

Rent Party: Teufelaffe: OregonVet: Dedmon: .Are you saying that the CEO could have been charging more the whole time, even without the caps, but chose not to? Why not?

The only way you can charge more for a product once people quit buying it is to make a law that requires them to pay for it if they want it or not. Freeish market or any other economic system- once it's mandated, the price goes up. That is as good as a fact as gravity.

Unless you also make a law that dictates how the business' income can be spent and require that excess be refunded back to the consumer.  You know, as in exactly what the ACA does with 80/20 rule.

All that is going to do is make things more expensive.  If I can only keep 20%, my *only* incentive is to make the 100% bigger.

So instead of charging you a dollar and keeping twenty cents, I'm going to charge you two dollars and keep forty.


You're not quite understanding how the 80/20 portion of the ACA works.  Let's say that Insurance company X brings in $1,000,000 in premiums in 2014.  Now, they can only spend up to $200,000 of that money on non-care related things.  This includes admin stuff, salaries, advertising, whatever.  The remaining $800,000 must be spent on care for their customers, with any remainder being distributed back to said customers.  If they spend their $200k on non-care related stuff, then only spend $750k on care, they have to give the remaining $50k back; they don't get to keep it.  Raising their premiums just means that they'll have to refund more money if they don't spend their full 80% on care.
 
2013-11-19 08:38:01 PM

Sum Dum Gai: Rent Party: All that is going to do is make things more expensive.  If I can only keep 20%, my *only* incentive is to make the 100% bigger.

Except the price you charge is driven largely by market forces.


Market forces aren't going to apply if the government has mandated that everyone has to buy my product.

This was the great failure of giving up on the public option.  It would have at least given a nod to the idea that this is anywhere close to a free market.

We don't have a free market in health care.  We never have.
 
2013-11-19 08:42:15 PM

Harbinger of the Doomed Rat: Rent Party: Teufelaffe: OregonVet: Dedmon: .Are you saying that the CEO could have been charging more the whole time, even without the caps, but chose not to? Why not?

The only way you can charge more for a product once people quit buying it is to make a law that requires them to pay for it if they want it or not. Freeish market or any other economic system- once it's mandated, the price goes up. That is as good as a fact as gravity.

Unless you also make a law that dictates how the business' income can be spent and require that excess be refunded back to the consumer.  You know, as in exactly what the ACA does with 80/20 rule.

All that is going to do is make things more expensive.  If I can only keep 20%, my *only* incentive is to make the 100% bigger.

So instead of charging you a dollar and keeping twenty cents, I'm going to charge you two dollars and keep forty.

You're not quite understanding how the 80/20 portion of the ACA works.  Let's say that Insurance company X brings in $1,000,000 in premiums in 2014.  Now, they can only spend up to $200,000 of that money on non-care related things.  This includes admin stuff, salaries, advertising, whatever.  The remaining $800,000 must be spent on care for their customers, with any remainder being distributed back to said customers.  If they spend their $200k on non-care related stuff, then only spend $750k on care, they have to give the remaining $50k back; they don't get to keep it.  Raising their premiums just means that they'll have to refund more money if they don't spend their full 80% on care.


No, you don't understand how the 80/20 thing works.

Lets say I bring in a million, and next year my board says I need to bring in 2,000,000.

I'm doubling your premium, and spending 80% of that on health care.  That removes any incentive I might have as an insurance company to negotiate cheaper prices with care providers.  I can keep more if I spend more.  Brilliant!

80% of revenue simply means I bring in more revenue.  There is absolutely no incentive at all to make things cheaper.
 
2013-11-19 08:48:41 PM

Rent Party: Market forces aren't going to apply if the government has mandated that everyone has to buy my product.


Sure they will, because there are many suppliers of that product who are each competing for your business.  Just because most people will buy the product from somewhere doesn't mean there's no competition.  That would be like saying there's no market forces involved in food or groceries because people are required to eat or they will die.  Even though people are compelled to obtain food by the absolute mandate of biology, there's a lot of competition among those who would sell food.

Rent Party: Lets say I bring in a million, and next year my board says I need to bring in 2,000,000.

I'm doubling your premium, and spending 80% of that on health care.  That removes any incentive I might have as an insurance company to negotiate cheaper prices with care providers.  I can keep more if I spend more.  Brilliant!


If you doubled the premiums, you would actually earn even less money, because people would leave in droves for one of the other insurers in the area.

That's also not to even mention that medical loss ratios above 20% were uncommon except among scam plans before the overhaul.
 
2013-11-19 09:00:02 PM

Rent Party: I'm doubling your premium, and spending 80% of that on health care.  That removes any incentive I might have as an insurance company to negotiate cheaper prices with care providers.  I can keep more if I spend more.  Brilliant!


My god, you're a genius!  Who would have thought it could be so simple?  I mean, any business that wants record profits can just double, better yet TRIPLE their prices and the money will just come rolling in!

I'm sure there's some reason they don't do that though.  Hmmm...I wonder why that is?
 
2013-11-19 09:00:36 PM
WHOA! I haven't seen bradkanus take over a thread in years! This is a treat.

That boy knows how to troll. A real throwback to the old stars that really knew how to throw jabs and cut deep.
 
2013-11-19 09:24:11 PM

Rent Party: Harbinger of the Doomed Rat: Rent Party: Teufelaffe: OregonVet: Dedmon: .Are you saying that the CEO could have been charging more the whole time, even without the caps, but chose not to? Why not?

The only way you can charge more for a product once people quit buying it is to make a law that requires them to pay for it if they want it or not. Freeish market or any other economic system- once it's mandated, the price goes up. That is as good as a fact as gravity.

Unless you also make a law that dictates how the business' income can be spent and require that excess be refunded back to the consumer.  You know, as in exactly what the ACA does with 80/20 rule.

All that is going to do is make things more expensive.  If I can only keep 20%, my *only* incentive is to make the 100% bigger.

So instead of charging you a dollar and keeping twenty cents, I'm going to charge you two dollars and keep forty.

You're not quite understanding how the 80/20 portion of the ACA works.  Let's say that Insurance company X brings in $1,000,000 in premiums in 2014.  Now, they can only spend up to $200,000 of that money on non-care related things.  This includes admin stuff, salaries, advertising, whatever.  The remaining $800,000 must be spent on care for their customers, with any remainder being distributed back to said customers.  If they spend their $200k on non-care related stuff, then only spend $750k on care, they have to give the remaining $50k back; they don't get to keep it.  Raising their premiums just means that they'll have to refund more money if they don't spend their full 80% on care.

No, you don't understand how the 80/20 thing works.

Lets say I bring in a million, and next year my board says I need to bring in 2,000,000.

I'm doubling your premium, and spending 80% of that on health care.  That removes any incentive I might have as an insurance company to negotiate cheaper prices with care providers.  I can keep more if I spend more.  Brilliant!

80% of revenue simply means I bring in more revenue.  There is absolutely no incentive at all to make things cheaper.


Wow. Just wow.
 
2013-11-19 09:26:31 PM
Has rent party always been this obtuse and I never noticed?
 
2013-11-19 09:47:28 PM

netcentric: But according to researchers at the Fraser Institute, a nonpartisan Canadian think tank


www.fraserinstitute.org
Yep, looks just as about nonpartisan as Heritage Foundation or Cato Institute.
 
2013-11-19 09:59:24 PM

Tricky Chicken: Yes, yes it does. Especially when you have to sneak it through in the last minute as some of your people have been defeated and will be replaced soon. Oh, and you can't get any support from the other side making it an extremely partisan bill.

But you knew that already didn't you? You just wanted to help me make the point that it was forced through right?


This is exactly why the 2012 election was a referendum on the subject and Obama was tossed out of office.
 
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