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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  
•       •       •

2415 clicks; posted to Politics » on 19 Nov 2013 at 1:20 PM (40 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



265 Comments   (+0 »)
   
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2013-11-19 12:46:54 PM
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.
 
2013-11-19 12:52:31 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.


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.
 
2013-11-19 12:54:53 PM
When we've described some of the problems with Obamacare, some readers have piped up and insisted, "Oh, but you forget, those costly plans are still really valuable! The most you can pay in 2014 is $6,350 if you are an individual and $12,700 for a family of two or larger."

That is just not true. Those limits apply ONLY to in-network services.


Why wouldn't they only apply to only in-network services?

I don't get it.
 
2013-11-19 12:56:52 PM
bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....
 
2013-11-19 01:08:09 PM
Isn't this the same as that private fire department that showed up, and we all agreed you can't charge for a service that wasn't requested? If you go to an in-network hospital that should be the end of it.
 
2013-11-19 01:09:09 PM
How many Obamacare links is this for today?
 
2013-11-19 01:10:36 PM

BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....


Feel a little guilty, don't you?  It's okay - you didn't read the bill.  You took their word for it. You were told by the people you voted for it was one thing. It turned out to be another.

Hey, that whole "weapons of mass destruction" thing really killed me. I believed it because the guys I voted for told me it was so. They were wrong.  I learned a lesson.  Will you learn yours?
 
2013-11-19 01:11:08 PM

ManateeGag: How many Obamacare links is this for today?


Not enough. I'm about to submit another dozen or so ...
 
2013-11-19 01:11:27 PM

DamnYankees: But "Obamacare failed to fix this pre-existing issue which was already broken" isn't much of an argument; Obamacare isn't a panacea.


Translation: "Hey Guys! Stop expecting this huge bill to actually fix the things it's supposed to fix OK? That's just not FAIR! Just because Obama promised people wouldn't go bankrupt from medical bills anymore is no reason to expect the ACA to protect people from going broke from medical bills!!!"
 
2013-11-19 01:12:30 PM

ManateeGag: How many Obamacare links is this for today?


Yeah. It's weird that it is a popular topic. I'm sure many people would prefer that it not be discussed so much now that people are getting a look at it.
 
2013-11-19 01:13:24 PM

bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?  It's okay - you didn't read the bill.  You took their word for it. You were told by the people you voted for it was one thing. It turned out to be another.

Hey, that whole "weapons of mass destruction" thing really killed me. I believed it because the guys I voted for told me it was so. They were wrong.  I learned a lesson.  Will you learn yours?


I think most rational people were happy that it passed because it's a step in the right direction.  Most people knew it wasn't perfect, and in general wasn't really great in any sense of the word.  What it is, is a pivot point towards a single payer system, and serious reform of the current billing/coverage rules.

Do you really look at issues that simplistically?  derp derp derp?
 
2013-11-19 01:15:26 PM

bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?  It's okay - you didn't read the bill.  You took their word for it. You were told by the people you voted for it was one thing. It turned out to be another.

Hey, that whole "weapons of mass destruction" thing really killed me. I believed it because the guys I voted for told me it was so. They were wrong.  I learned a lesson.  Will you learn yours?

blog.jinni.com

"God, I admire you."
 
2013-11-19 01:21:47 PM

queezyweezel: bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?  It's okay - you didn't read the bill.  You took their word for it. You were told by the people you voted for it was one thing. It turned out to be another.

Hey, that whole "weapons of mass destruction" thing really killed me. I believed it because the guys I voted for told me it was so. They were wrong.  I learned a lesson.  Will you learn yours?

I think most rational people were happy that it passed because it's a step in the right direction.  Most people knew it wasn't perfect, and in general wasn't really great in any sense of the word.  What it is, is a pivot point towards a single payer system, and serious reform of the current billing/coverage rules.

Do you really look at issues that simplistically?  derp derp derp?


And here's where you are 100 percent wrong.  It was a step away from single payer in every since of the ideal.  It put more Americans into a private system and took them out of the public system. If you think that's a step toward single payer, you're not familiar with how single payer works.

Also, the problems with the government handling the IT portion of the health exchanges has been the evidence to liberals in power that they are not ready to take on the kind of task a single payer system would be.  This system was supposed to handle 35 millino people and literally work as a pass through to insurance companies.  It was a hallway, so to speak.  They failed at that.  They now know that single payer is not an option because they can't create the infrastructure to make it succesful.
 
2013-11-19 01:22:08 PM

BojanglesPaladin: DamnYankees: But "Obamacare failed to fix this pre-existing issue which was already broken" isn't much of an argument; Obamacare isn't a panacea.

Translation: "Hey Guys! Stop expecting this huge bill to actually fix the things it's supposed to fix OK? That's just not FAIR! Just because Obama promised people wouldn't go bankrupt from medical bills anymore is no reason to expect the ACA to protect people from going broke from medical bills!!!"


So you'll support passing a law to amend Obamacare to fix this problem? I agree with you, its an issue. I hope you'll join me in supporting a bill to fix it.
 
2013-11-19 01:23:21 PM
Mandate every health care provider charge the same price to every patient regardless of their method of payment.

You're welcome.
 
2013-11-19 01:23:55 PM
They passed Obamacare and people are still getting cancer? What was it all for then!??!!?
 
2013-11-19 01:24:23 PM
So does this mean we're going to scrap the ACA in its entirety, throw all the democrats into PMITA prison and go Back To The Way Things Were?
 
2013-11-19 01:25:28 PM
"Obamacare is a good first step towards truly universal single-payer coverage."

"Derp, fart... fix old, no new... drill baby drill... where's my free insurance from healthcare.gov"
 
2013-11-19 01:25:37 PM

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

You're welcome.


The docs and the hospitals cut a deal early on that this wouldn't be touched.  Sorry, they're protected.
 
2013-11-19 01:26:44 PM

bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?


Evasion noted.
 
2013-11-19 01:28:46 PM

DamnYankees: BojanglesPaladin: DamnYankees: But "Obamacare failed to fix this pre-existing issue which was already broken" isn't much of an argument; Obamacare isn't a panacea.

Translation: "Hey Guys! Stop expecting this huge bill to actually fix the things it's supposed to fix OK? That's just not FAIR! Just because Obama promised people wouldn't go bankrupt from medical bills anymore is no reason to expect the ACA to protect people from going broke from medical bills!!!"

So you'll support passing a law to amend Obamacare to fix this problem? I agree with you, its an issue. I hope you'll join me in supporting a bill to fix it.




Assuming it can be fixed, or even deal with the problems in health care instead of the health insurance industry.

It's sort if like demanding your friend help you fix up that rusty old ford pinto you bought after he warned you that it was a bad idea.
He could just say "no, get rid of the damn thing".
 
2013-11-19 01:30:01 PM
If that is unacceptable, you are welcome to demand single payer healthcare.
 
2013-11-19 01:30:15 PM

DamnYankees: So you'll support passing a law to amend Obamacare to fix this problem? I hope you'll join me in supporting a bill to fix it.


I suppose that would depend greatly on what was in the bill, don't you? There IS no such bill, and it seems unlikely that there will be one.

I doubt you intend to support any bills coming from the House Republicans to fix what is wrong with ACA, and I have no idea what bills you anticipate coming from the Senate Democrats, given that the last effort to tweak it did nothing to fix this flaw when they passed The Health Care and Education Reconciliation Act of 2010. Perhaps they need multiple tries? Or perhaps they aren't actually interested in any substantive changes.

So would I support a hypothetical non-existent bill to fix just one of the myriad and pervasive failure points of a deeply flawed and ineffective garbage pile of bad legislation? Perhaps.

But something tells me you wouldn't, if it meant actually changing ACA.
 
2013-11-19 01:30:17 PM

bradkanus: Move on.


Man, fark off. Seriously. fark off into heavy traffic.
 
2013-11-19 01:30:52 PM
The question I have from this article.

Are hospitals purposefully duping people into thinking all of their care will be in network for some extra cash or do they just not want to anger patients or have patients go elsewhere when no other option is available?
 
2013-11-19 01:31:40 PM

sigdiamond2000: When we've described some of the problems with Obamacare, some readers have piped up and insisted, "Oh, but you forget, those costly plans are still really valuable! The most you can pay in 2014 is $6,350 if you are an individual and $12,700 for a family of two or larger."

That is just not true. Those limits apply ONLY to in-network services.

Why wouldn't they only apply to only in-network services?

I don't get it.


The law specifies the most you can pay in co-pays is $6,350. This isn't an issue of copays. This is an issue of..

Joe sees medical professional XYZ who isn't in your network and overcharges for its services, lets say $10,000. Joe's insurance attempts to settle with XYZ and pays a reasonable amount, say $2,000. XYZ sees this and says, "On no, $2,000 isn't enough," and sends a bill to Joe for $12,000
 
2013-11-19 01:32:10 PM

bradkanus: queezyweezel: bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?  It's okay - you didn't read the bill.  You took their word for it. You were told by the people you voted for it was one thing. It turned out to be another.

Hey, that whole "weapons of mass destruction" thing really killed me. I believed it because the guys I voted for told me it was so. They were wrong.  I learned a lesson.  Will you learn yours?

I think most rational people were happy that it passed because it's a step in the right direction.  Most people knew it wasn't perfect, and in general wasn't really great in any sense of the word.  What it is, is a pivot point towards a single payer system, and serious reform of the current billing/coverage rules.

Do you really look at issues that simplistically?  derp derp derp?

And here's where you are 100 percent wrong.  It was a step away from single payer in every since of the ideal.  It put more Americans into a private system and took them out of the public system. If you think that's a step toward single payer, you're not familiar with how single payer works.

Also, the problems with the government handling the IT portion of the health exchanges has been the evidence to liberals in power that they are not ready to take on the kind of task a single payer system would be.  This system was supposed to handle 35 millino people and literally work as a pass through to insurance companies.  It was a hallway, so to speak.  They failed at that.  They now know that single payer is not an option because they can't create the infrastructure to make it succesful.


Wait what? Which "public system" did it take them out of?
 
2013-11-19 01:32:28 PM
I was excited for a panacea. I am disappoint
 
2013-11-19 01:33:16 PM

BojanglesPaladin: Just because Obama promised people wouldn't go bankrupt from medical bills anymore is no reason to expect the ACA to protect people from going broke from medical bills!!!


Did he promise that?
 
2013-11-19 01:33:35 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.


So you're either an obnoxious blogger or a hot redhead...choose wisely.
 
2013-11-19 01:33:39 PM

bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?


Once again, in "Morons Seeing What They Want To See Theater"....

Here's a hot tip: You do not live in other peoples' heads, and therefore have no idea what other people are thinking. Stop pretending like you do. It's warping your perception of reality.
 
2013-11-19 01:34:12 PM
what he meant was
 
2013-11-19 01:34:15 PM

The My Little Pony Killer: bradkanus: Move on.

Man, fark off. Seriously. fark off into heavy traffic.


I love how the left can't deal with their failure.  It just goes straight into wishes for the death of the people that warned them they were screwing up.  Good times.

You guys own it, you deal with it.
 
2013-11-19 01:34:42 PM

Fart_Machine: bradkanus: queezyweezel: bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?  It's okay - you didn't read the bill.  You took their word for it. You were told by the people you voted for it was one thing. It turned out to be another.

Hey, that whole "weapons of mass destruction" thing really killed me. I believed it because the guys I voted for told me it was so. They were wrong.  I learned a lesson.  Will you learn yours?

I think most rational people were happy that it passed because it's a step in the right direction.  Most people knew it wasn't perfect, and in general wasn't really great in any sense of the word.  What it is, is a pivot point towards a single payer system, and serious reform of the current billing/coverage rules.

Do you really look at issues that simplistically?  derp derp derp?

And here's where you are 100 percent wrong.  It was a step away from single payer in every since of the ideal.  It put more Americans into a private system and took them out of the public system. If you think that's a step toward single payer, you're not familiar with how single payer works.

Also, the problems with the government handling the IT portion of the health exchanges has been the evidence to liberals in power that they are not ready to take on the kind of task a single payer system would be.  This system was supposed to handle 35 millino people and literally work as a pass through to insurance companies.  It was a hallway, so to speak.  They failed at that.  They now know that single payer is not an option because they can't create the infrastructure to make it succesful.

Wait what? Which "public system" did it take them out of?


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

Please tell me you know how Medicare and Medicaid work... please.  They are two insurance companies with clever names, FYI.
 
2013-11-19 01:35:13 PM

bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?  It's okay - you didn't read the bill.  You took their word for it. You were told by the people you voted for it was one thing. It turned out to be another.

Hey, that whole "weapons of mass destruction" thing really killed me. I believed it because the guys I voted for told me it was so. They were wrong.  I learned a lesson.  Will you learn yours?


I have. There is no way I'm voting for Obama in 2016.
 
2013-11-19 01:36:22 PM

Tricky Chicken: The My Little Pony Killer: bradkanus: Move on.

Man, fark off. Seriously. fark off into heavy traffic.

I love how the left can't deal with their failure.  It just goes straight into wishes for the death of the people that warned them they were screwing up.  Good times.

You guys own it, you deal with it.


Can you please point me to the last law that was perfect upon implementation?

I'll wait.
 
2013-11-19 01:36:32 PM
Okay, maybe I'm missing something, but it looks like Obamacare, while not directly addressing the issue, does make it much less of an issue. Balance billing is where hospitals try to make up the slack in reimbursements or non-payers by heavily overcharging others, the article says Obamacare has the following provision:

"Your plan must pay the emergency providers the greatest of these three amounts:

1. The amount it pays in-network providers;
2. A payment based on the same methods the plan uses to pay for other out-of-network
services (for example, a percentage of usual and customary fees charged by other
providers in your area); or
3. The amount Medicare would pay for that service."

So it helps on two fronts, 1) your insurance can't say they don't cover emergency care in a non-network ER and stick you with the bill, they have to pay at least what they would have paid an in-network hospital, so you pay less, and 2) by paying out to ER visits more, and more often, the hospital will have fewer unpaid bills, so they won't have to balance bill as often, or at such exorbitant levels.

To sum up:
1. Problem existed before ACA.
2. ACA doesn't solve problem, but helps alleviate the problem.
3. ???
4. Clearly, this calls for outrage.
 
2013-11-19 01:37:21 PM
Why the fark do we even have "networks" in the first place? To me, that seems to be the retarded part of our whole system.
 
2013-11-19 01:37:31 PM
A whole lot of troll gray in this thread....
 
2013-11-19 01:37:39 PM
How cute.  People supported politicians who threw endless roadblocks in the legislative process to derail the ACA, and now they're upset that it doesn't actually provide anything useful to the average person.
 
2013-11-19 01:37:43 PM
Your blog sucks.
 
2013-11-19 01:38:18 PM

MindStalker: sigdiamond2000: When we've described some of the problems with Obamacare, some readers have piped up and insisted, "Oh, but you forget, those costly plans are still really valuable! The most you can pay in 2014 is $6,350 if you are an individual and $12,700 for a family of two or larger."

That is just not true. Those limits apply ONLY to in-network services.

Why wouldn't they only apply to only in-network services?

I don't get it.

The law specifies the most you can pay in co-pays is $6,350. This isn't an issue of copays. This is an issue of..

Joe sees medical professional XYZ who isn't in your network and overcharges for its services, lets say $10,000. Joe's insurance attempts to settle with XYZ and pays a reasonable amount, say $2,000. XYZ sees this and says, "On no, $2,000 isn't enough," and sends a bill to Joe for $12,000


Oh. Then rape him with a stick.
 
2013-11-19 01:38:40 PM

BKITU: bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?

Once again, in "Morons Seeing What They Want To See Theater"....

Here's a hot tip: You do not live in other peoples' heads, and therefore have no idea what other people are thinking. Stop pretending like you do. It's warping your perception of reality.


So you are going to tell me that liberals were wary of this bill when it passed and made public statements saying that it would not likely work in the sense it would kick millions of americans off of their current plan and fail to entice those who didn't have insurance to get insurance.  Is that what you are claiming the left was saying in 2009-2010?  I need to know because I heard something completely different.

If you werent' partisan, you would have read the law. You would have understood what it aimed to do.  Instead, you did what you were told because you knew republicans didn't like it.  Well, when you do things out of spite...well you know what happens - ACA happens.
 
2013-11-19 01:38:54 PM

12349876: Are hospitals purposefully duping people into thinking all of their care will be in network for some extra cash or do they just not want to anger patients or have patients go elsewhere when no other option is available?


MANY specialists (like anesthesiologists, some surgeons, etc.) simply don't participate in insurance networks. Meaning they don't agree ahead of time to do work for patients of certain insurance companies at a significantly reduced rate. They bill the hospital, the hospital bills you or the insurance company. Then they all fight about it, and at some point, YOU have to pay the difference. The challenge is that for scheduled surgery you sign a piece of paperwork that acknowledges this, and that you accept responsibility for all the bills, but no one actually reads it. And if you are in an accident, or unconscious, you don't have any real say in it.

If you ever get service from someone who hasn't already negotiated a reduced rate with your insurance company, then you have to manually submit that bill to the insurance company, and they get to refuse to pay it and you can all fight for a while, and YOU have to get directly involved, and you will probably end up paying a ton more.

THAT's what "in-network" is about and why it matters when people complain that the ACA networks are smaller. Last I saw, about 40% of providers polled hadn't even decided whether they would be signing on to ACA networks because it wasn't clear yet what the compensation rates would be. And we are a month and a half out.
 
2013-11-19 01:39:32 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.


No, what we said is that it's better than what we had. The general consensus among liberals once the ACA took shape was "Eh, it'll do.".

/What we want is single payer. This is a step towards that.
 
2013-11-19 01:40:10 PM

bradkanus: queezyweezel: bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?  It's okay - you didn't read the bill.  You took their word for it. You were told by the people you voted for it was one thing. It turned out to be another.

Hey, that whole "weapons of mass destruction" thing really killed me. I believed it because the guys I voted for told me it was so. They were wrong.  I learned a lesson.  Will you learn yours?

I think most rational people were happy that it passed because it's a step in the right direction.  Most people knew it wasn't perfect, and in general wasn't really great in any sense of the word.  What it is, is a pivot point towards a single payer system, and serious reform of the current billing/coverage rules.

Do you really look at issues that simplistically?  derp derp derp?

And here's where you are 100 percent wrong.  It was a step away from single payer in every since of the ideal.  It put more Americans into a private system and took them out of the public system. If you think that's a step toward single payer, you're not familiar with how single payer works.

Also, the problems with the government handling the IT portion of the health exchanges has been the evidence to liberals in power that they are not ready to take on the kind of task a single payer system would be.  This system was supposed to handle 35 millino people and literally work as a pass through to insurance companies.  It was a hallway, so to speak.  They failed at that.  They now know that single payer is not an option because they can't create the infrastructure to make it succesful.


And as we all know, if anyone ever fails at something once, they will always continue to fail at anything and everything that remotely resembles it.  That's why schools expel students the first time they fail a test or get an F on an assignment, all businesses fire employees the first time they fark something up, and our justice system executes anyone who's convicted of anything.

Though I suppose you could just be an idiot, but I'm thinking my other scenario is way more likely.
 
2013-11-19 01:40:10 PM

JerseyTim: They passed Obamacare and people are still getting cancer? What was it all for then!??!!?


That's not all. They Passed Obamacare and I still have to put gas in my car every week. Clearly the law is broken.
 
2013-11-19 01:40:16 PM

Ardilla: A whole lot of troll gray in this thread....


Once BJP appears in a thread, it has become a troll thread.  A sure sign to move on.
 
2013-11-19 01:40:30 PM

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


No, Democrats probably won't support "fixes" that will inevitably fall somewhere between "won't actually fix anything" and "deliberate sabotage".
 
2013-11-19 01:42:05 PM

Great_Milenko: How cute.  People supported politicians who threw endless roadblocks in the legislative process to derail the ACA, and now they're upset that it doesn't actually provide anything useful to the average person.


Actually, they are upset that the bill led to the non-renewal of policies they liked and replaced them with more costly policies.  It did have an effect on people whether they liked the bill or not.
 
2013-11-19 01:43:01 PM

BojanglesPaladin: MANY specialists (like anesthesiologists, some surgeons, etc.) simply don't participate in insurance networks


Be in a network or lose your license to practice medicine after two years. Boom, done.
 
2013-11-19 01:43:14 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.


This guy is right.  Gas prices are still above $3, so this ACA thing was a farking waste.
 
2013-11-19 01:43:33 PM
There seems to be a bit of a liberal bent to these little discussions.

And when I say liberal, I mean, of course, non-linear trust in the current regime.
 
2013-11-19 01:44:28 PM

bradkanus: Fart_Machine: bradkanus: queezyweezel: bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?  It's okay - you didn't read the bill.  You took their word for it. You were told by the people you voted for it was one thing. It turned out to be another.

Hey, that whole "weapons of mass destruction" thing really killed me. I believed it because the guys I voted for told me it was so. They were wrong.  I learned a lesson.  Will you learn yours?

I think most rational people were happy that it passed because it's a step in the right direction.  Most people knew it wasn't perfect, and in general wasn't really great in any sense of the word.  What it is, is a pivot point towards a single payer system, and serious reform of the current billing/coverage rules.

Do you really look at issues that simplistically?  derp derp derp?

And here's where you are 100 percent wrong.  It was a step away from single payer in every since of the ideal.  It put more Americans into a private system and took them out of the public system. If you think that's a step toward single payer, you're not familiar with how single payer works.

Also, the problems with the government handling the IT portion of the health exchanges has been the evidence to liberals in power that they are not ready to take on the kind of task a single payer system would be.  This system was supposed to handle 35 millino people and literally work as a pass through to insurance companies.  It was a hallway, so to speak.  They failed at that.  They now know that single payer is not an option because they can't create the infrastructure to make it succesful.

Wait what? Which "public system" did it take them out of?

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

Please tell me you know how Medicare and Medicaid work... please.  They are two insurance companies with clever names, FYI.


You understand that Medicade expanded under the ACA right?
 
2013-11-19 01:44:31 PM

Snapper Carr: 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.

No, what we said is that it's better than what we had. The general consensus among liberals once the ACA took shape was "Eh, it'll do.".

/What we want is single payer. This is a step towards that.


Putting 35 million people in the private insurance market was not a step toward single payer.  I'm sorry, but you don't seem to understand what single payers means.  Also, the failure of the federal government to execute an online exchange was enough to send even the most ardent liberal leaders away from the notion that the federal government could handle a 350 million person single payer system.  As an ideal in the party - it is dead.
 
2013-11-19 01:44:32 PM

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


house republicans have ZERO desire to 'fix' the ACA. they have one goal and one goal only: destroy it.

any legislation they offer is designed as either a poison pill to trap democrats or a backdoor repeal.
 
2013-11-19 01:45:35 PM

vbob: There seems to be a bit of a liberal bent to these little discussions.

And when I say liberal, I mean, of course, non-linear trust in the current regime.


I don't immediately understand this comment, and you use the word "liberal."

My only conclusion is that you are a troll, and I must put you on ignore before you climb through the screen and rape me.

Or something.

/Screw this tab.
 
2013-11-19 01:45:54 PM

DamnYankees: BojanglesPaladin: DamnYankees: But "Obamacare failed to fix this pre-existing issue which was already broken" isn't much of an argument; Obamacare isn't a panacea.

Translation: "Hey Guys! Stop expecting this huge bill to actually fix the things it's supposed to fix OK? That's just not FAIR! Just because Obama promised people wouldn't go bankrupt from medical bills anymore is no reason to expect the ACA to protect people from going broke from medical bills!!!"

So you'll support passing a law to amend Obamacare to fix this problem? I agree with you, its an issue. I hope you'll join me in supporting a bill to fix it.


A Bill to fix it? Obama doesn't believe in working through Congress. He's already 'changed' Obamacare ~27 times on his own.
 
2013-11-19 01:46:35 PM
scontent-b.xx.fbcdn.net
 
2013-11-19 01:47:25 PM

Fart_Machine: bradkanus: Fart_Machine: bradkanus: queezyweezel: bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?  It's okay - you didn't read the bill.  You took their word for it. You were told by the people you voted for it was one thing. It turned out to be another.

Hey, that whole "weapons of mass destruction" thing really killed me. I believed it because the guys I voted for told me it was so. They were wrong.  I learned a lesson.  Will you learn yours?

I think most rational people were happy that it passed because it's a step in the right direction.  Most people knew it wasn't perfect, and in general wasn't really great in any sense of the word.  What it is, is a pivot point towards a single payer system, and serious reform of the current billing/coverage rules.

Wait what? Which "public system" did it take them out of?

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

Please tell me yo ...


You do understand that the expansion of those who qualify for medicaid and medicare is still just a government subsidy to their premium.  You won't "go on medicaid" you'll just be eligible for premium assistance.

Nice try.
 
2013-11-19 01:47:28 PM

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

house republicans have ZERO desire to 'fix' the ACA. they have one goal and one goal only: destroy it.

any legislation they offer is designed as either a poison pill to trap democrats or a backdoor repeal.


Yup. Those f*ckers are bent on keeping me and millions of others from having access to affordable health care. "Pro-life," my ass. F*ck them.

/patiently waiting until January, when I will FINALLY have health insurance again after not having it for 2 years due to pre-existing conditions
 
2013-11-19 01:47:29 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 I remember correctly, we said it was better than what was extant and that single payer is much preferable. I'm amazed at the energy that is spent tearing this down rather than making concrete suggestions on how to improve things. Given the rapid response from people like you, it rather feels like your posts are what pays your bills rather than any real conviction.
 
2013-11-19 01:48:06 PM
ITT: Conservatives who can't admit the ACA was a Republican plan chastising liberals for admitting the ACA is imperfect, which they've said from the beginning
 
2013-11-19 01:48:16 PM

way south: It's sort if like demanding your friend help you fix up that rusty old ford pinto you bought after he warned you that it was a bad idea.
He could just say "no, get rid of the damn thing".


That analogy makes no sense, since this problem existed before Obamacare.
 
2013-11-19 01:49:41 PM

bradkanus: BKITU: bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?

Once again, in "Morons Seeing What They Want To See Theater"....

Here's a hot tip: You do not live in other peoples' heads, and therefore have no idea what other people are thinking. Stop pretending like you do. It's warping your perception of reality.

So you are going to tell me that liberals were wary of this bill when it passed and made public statements saying that it would not likely work in the sense it would kick millions of americans off of their current plan and fail to entice those who didn't have insurance to get insurance.  Is that what you are claiming the left was saying in 2009-2010?  I need to know because I heard something completely different.

If you werent' partisan, you would have read the law. You would have understood what it aimed to do.  Instead, you did what you were told because you knew republicans didn't like it.  Well, when you do things out of spite...well you know what happens - ACA happens.


The ACA didn't force anyone's insurance to be canceled. It even has verbiage explicitly stating that nothing in the bill requires the cancellation of insurance plans.  Rather, the insurance companies decided that instead of updating their existing plans to meet the new requirements, they would cancel the plans that failed to meet muster.  Whether you like the ACA or not, the plan cancellations are entirely the decision of the insurance providers.
 
2013-11-19 01:50:26 PM

ferretman: Obama doesn't believe in working through Congress


It's hard to keep track of all the nonsensical talking points. This one I hadn't seen before.
 
2013-11-19 01:51:02 PM

coyo: 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 I remember correctly, we said it was better than what was extant and that single payer is much preferable. I'm amazed at the energy that is spent tearing this down rather than making concrete suggestions on how to improve things. Given the rapid response from people like you, it rather feels like your posts are what pays your bills rather than any real conviction.


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.
 
2013-11-19 01:51:12 PM

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. The second thing is to make sure that we control costs. We spend $2 trillion on health care in this country every year, 50% more than other industrialized nations. And yet, we don't have, necessarily, better outcomes. If we make sure that we provide preventive care and medical technology that can eliminate bureaucracy and paperwork, that makes a big difference. The third thing is catastrophic insurance to help businesses and families avoid the bankruptcies that we're experiencing all across the country and reduced premiums for families."

From Michelle Obama's Convention Speech 2012:
"He did it because he believes that here in America, our grandparents should be able to afford their medicine; our kids should be able to see a doctor when they're sick; and no one in this country should ever go broke because of an accident or illness.

We could go on and on and on, but unless you intend to launch into a debate how once again Obama's words don't actually mean the things that they say, or what "promise' means, I think we can objectively say that protecting American families from medical bankruptcy was a stated goal of the ACA as articulated by Obama.
 
2013-11-19 01:51:56 PM

DamnYankees: way south: It's sort if like demanding your friend help you fix up that rusty old ford pinto you bought after he warned you that it was a bad idea.
He could just say "no, get rid of the damn thing".

That analogy makes no sense, since this problem existed before Obamacare.


It's probably more like "my rusty old ford pinto is broken down.  Then Obamacare got passed and my rusty old ford pinto is still broken down, so Obamacare is a failure."
 
2013-11-19 01:53:05 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.


Explain just why the ACA sucks for not explicitly preventing something it wasn't ever explicitly designed to prevent. Does the ACA also suck because it doesn't give us all Wolverine-like mutant healing factor too?
 
2013-11-19 01:54:14 PM

Ambivalence: If that is unacceptable, you are welcome to demand single payer healthcare.


"Data from countries with government-run healthcare systems suggest not.

Consider Canada. Our neighbor to the north features a government-run, single-payer healthcare system where private insurance is outlawed for
procedures covered under the law. So you'd think that Canada would have a lower rate of bankruptcy than the United States, what with one big potential
cause of bankruptcy -- the cost of health care -- absorbed by the government.

But according to researchers at the Fraser Institute, a nonpartisan Canadian think tank, bankruptcy rates are statistically the same on both sides of the
49th parallel.
In both the United States and Canada, less than one-third of 1 percent of families file for bankruptcy each year.

Further, even with a socialized healthcare system, some Canadians go bankrupt because of medical expenses. Approximately 15 percent of bankrupt
Canadian seniors -- those 55 and older -- cited medical reasons, including uninsured expenses, as the main culprit for their insolvency..."
http://thehill.com/blogs/congress-blog/economy-a-budget/263547-the-m yt h-of-medical-bankruptcy


/fwiw
 
2013-11-19 01:54:22 PM
Obamacare was a doomed to start with because it never was intended to benefit the people of the US, only insurance companies and pharma . The best fix for Obamacare is doing away with all the insurance companies involved. Just have universal basic insurance for every legal resident and citizen, people could  still buy supplemental insurance along the lines of Medicare supplements. Even using current numbers spent on health insurance and government programs it would allow around $10k per person and if the only desire is for the program to remain on budget and not a need for a profit it could do a decent job and really fix some of the problems. Universal coverage is the moral and ethical thing to do and the only way to control costs long term.
 
2013-11-19 01:54:25 PM

bradkanus: BKITU: bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?

Once again, in "Morons Seeing What They Want To See Theater"....

Here's a hot tip: You do not live in other peoples' heads, and therefore have no idea what other people are thinking. Stop pretending like you do. It's warping your perception of reality.

So you are going to tell me that liberals were wary of this bill when it passed and made public statements saying that it would not likely work in the sense it would kick millions of americans off of their current plan and fail to entice those who didn't have insurance to get insurance.  Is that what you are claiming the left was saying in 2009-2010?  I need to know because I heard something completely different.

If you werent' partisan, you would have read the law. You would have understood what it aimed to do.  Instead, you did what you were told because you knew republicans didn't like it.  Well, when you do things out of spite...well you know what happens - ACA happens.


See, this is what I'm talking about.

* Where have I indicated that I'm telling you anything about what liberals were or were not wary of?

* Where have I made any claims about what the left was saying?

* What proof do you have that I'm some partisan?

* What proof do you have that "I did what I was told" in any way, shape or form?

* What proof do you have that "I do things out of spite?"

ALL OF THESE THINGS EXIST ONLY IN YOUR HEAD. You think you know something about me, so you project all kinds of false assumptions on to me, and then start attacking those assumptions.

If you're just into doing this as some kind of perverted mental masturbatory exercise, then good for you, I guess. Wipe up when you're done.

If you're actually trying to engage in meaningful discussion, then you're hopeless because you are only attacking phantoms of your own invention, and not working within the reality the rest of us are trying to occupy.
 
2013-11-19 01:54:41 PM

way south: Assuming it can be fixed, or even deal with the problems in health care instead of the health insurance industry.

It's sort if like demanding your friend help you fix up that rusty old ford pinto you bought after he warned you that it was a bad idea.
He could just say "no, get rid of the damn thing".



The analogy is more like

You: My car sucks, the brakes are shot, it has no power steering, the AC is busted, and it won't start in the winter, I'm getting a new car, there's a rusty Ford Pinto in my neighbor's driveway that looks serviceable.

Friend: If you buy that car it'll explode and kill you and everyone you've ever loved.

You: I'm pretty sure that's not true, and I really need a new car.

*buys car*

Friend: I told you, you went and bought that new car and it *still* doesn't have power steering or AC.

You: So you'll help me fix the AC?

Friend: What? No. I told you this was a bad idea, you need a new car.
 
2013-11-19 01:54:46 PM

omnibus_necanda_sunt: Be in a network or lose your license to practice medicine after two years. Boom, done.


If by "Boom, Done" you mean "Boom, no new doctors, and droves of doctors pursuing other careers", then yes.

FlashHarry: house republicans have ZERO desire to 'fix' the ACA. they have one goal and one goal only: destroy it.


But... what if, Just WHAT IF... they are right?

The ACA may have had the best of intentions, but this just isn't actually making things better on the whole.
 
2013-11-19 01:55:05 PM
I just got the flu this week. Thanks Obama.
 
2013-11-19 01:55:11 PM

BojanglesPaladin: I think we can objectively say that protecting American families from medical bankruptcy was a stated goal of the ACA as articulated by Obama.


It absolutely was. But that does not mean that it is going to be 100% effective all the time in every situation. The stated goal of a bandage is to stop bleeding - that doesn't mean that the very idea of bleeding stopped when bandages were invented. But it'd be even dumber to see someone bleed and then say "well, bandages were a dumb idea".
 
2013-11-19 01:55:30 PM
Another day, another thread of people stating that the perfect should be the enemy of the good.
 
2013-11-19 01:56:17 PM

nmrsnr: Friend: What? No. I told you this was a bad idea, you need a new car.


You: Ok, what new car should I buy?

Friend: What, you can't walk to work, you lazy piece of crap? I'm gonna plant a pipe bomb in your car to make sure you have to walk.
 
2013-11-19 01:56:30 PM

BojanglesPaladin: omnibus_necanda_sunt: Be in a network or lose your license to practice medicine after two years. Boom, done.

If by "Boom, Done" you mean "Boom, no new doctors, and droves of doctors pursuing other careers", then yes.


Sure, if by "no new doctors and droves of doctors pursuing other careers" you mean "med schools continue to be filled to capacity and no more doctors pursue other careers than before," then yes.
 
2013-11-19 01:56:30 PM

BojanglesPaladin: omnibus_necanda_sunt: Be in a network or lose your license to practice medicine after two years. Boom, done.

If by "Boom, Done" you mean "Boom, no new doctors, and droves of doctors pursuing other careers", then yes.

FlashHarry: house republicans have ZERO desire to 'fix' the ACA. they have one goal and one goal only: destroy it.

But... what if, Just WHAT IF... they are right?

The ACA may have had the best of intentions, but this just isn't actually making things better on the whole.



You keep saying that as if it were true
 
2013-11-19 01:57:02 PM

Teufelaffe: bradkanus: BKITU: bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?

Once again, in "Morons Seeing What They Want To See Theater"....

Here's a hot tip: You do not live in other peoples' heads, and therefore have no idea what other people are thinking. Stop pretending like you do. It's warping your perception of reality.

So you are going to tell me that liberals were wary of this bill when it passed and made public statements saying that it would not likely work in the sense it would kick millions of americans off of their current plan and fail to entice those who didn't have insurance to get insurance.  Is that what you are claiming the left was saying in 2009-2010?  I need to know because I heard something completely different.

If you werent' partisan, you would have read the law. You would have understood what it aimed to do.  Instead, you did what you were told because you knew republicans didn't like it.  Well, when you do things out of spite...well you know what happens - ACA happens.

The ACA didn't force anyone's insurance to be canceled. It even has verbiage explicitly stating that nothing in the bill requires the cancellation of insurance plans.  Rather, the insurance companies decided that instead of updating their existing plans to meet the new requirements, they would cancel the plans that failed to meet muster.  Whether you like the ACA or not, the plan cancellations are entirely the decision of the insurance providers.


Ummm... yeah - the president already tried that talking point and he had to back off of it.

The insurance companies did update their insurance plans. Every single letter stating they can not BY LAW renew their previous plan came with new plan options that adhered to ACA regulations.  The problem is that those new plans offer new benefits (that one may, or may not need) at a higher cost.

You do know that an Insurance companies can't just offer any insurance product they want, right?  Every product they offer has to get the state insurance department's seal of approval.  Their old plans were not approved for use because the ACA's new rules.
 
2013-11-19 01:58:34 PM

DamnYankees: It absolutely was. But that does not mean that it is going to be 100% effective all the time in every situation.


I think you are missing the point here. It not only failed to address the issue at all, with smaller networks, it makes the problem WORSE.

DamnYankees: But it'd be even dumber to see someone bleed and then say "well, bandages were a dumb idea".


Not as dumb as seeing that the "new" sandpaper bandage opens the would and now there is even more bleeding.
 
2013-11-19 01:59:02 PM

BojanglesPaladin: But... what if, Just WHAT IF... they are right?


Then they should start offering alternative proposals and concrete criticism instead of their current "back to the bad old days" plan and vague whining about socialism.
 
2013-11-19 01:59:21 PM
bradkanus:
Also, the problems with the government handling the IT portion of the health exchanges has been the evidence to liberals in power that they are not ready to take on the kind of task a single payer system would be.  This system was supposed to handle 35 millino people and literally work as a pass through to insurance companies.  It was a hallway, so to speak.  They failed at that.  They now know that single payer is not an option because they can't create the infrastructure to make it succesful.

Nice jump to conclusions with that last sentence.  Because a website temporarily doesn't perform as expected, there is no way that single payer health care will work.

Wow. Absolute wow.
 
2013-11-19 01:59:58 PM

DamnYankees: BojanglesPaladin: I think we can objectively say that protecting American families from medical bankruptcy was a stated goal of the ACA as articulated by Obama.

It absolutely was. But that does not mean that it is going to be 100% effective all the time in every situation. The stated goal of a bandage is to stop bleeding - that doesn't mean that the very idea of bleeding stopped when bandages were invented. But it'd be even dumber to see someone bleed and then say "well, bandages were a dumb idea".


People are really stupid if they can't see a system that is designed to reduce the number of medical bankruptcies isn't the same as something designed to (or at least promising to) eliminate all medical bankruptcies.

And lets not forget which side wanted most consumer protections pulled from the ACA... it wasn't the political party that really that  BradKAnus seems to support.
 
2013-11-19 02:00:03 PM

BojanglesPaladin: 12349876: Are hospitals purposefully duping people into thinking all of their care will be in network for some extra cash or do they just not want to anger patients or have patients go elsewhere when no other option is available?

MANY specialists (like anesthesiologists, some surgeons, etc.) simply don't participate in insurance networks. Meaning they don't agree ahead of time to do work for patients of certain insurance companies at a significantly reduced rate. They bill the hospital, the hospital bills you or the insurance company. Then they all fight about it, and at some point, YOU have to pay the difference. The challenge is that for scheduled surgery you sign a piece of paperwork that acknowledges this, and that you accept responsibility for all the bills, but no one actually reads it. And if you are in an accident, or unconscious, you don't have any real say in it.

If you ever get service from someone who hasn't already negotiated a reduced rate with your insurance company, then you have to manually submit that bill to the insurance company, and they get to refuse to pay it and you can all fight for a while, and YOU have to get directly involved, and you will probably end up paying a ton more.

THAT's what "in-network" is about and why it matters when people complain that the ACA networks are smaller. Last I saw, about 40% of providers polled hadn't even decided whether they would be signing on to ACA networks because it wasn't clear yet what the compensation rates would be. And we are a month and a half out.


Aca is an insurance provider with its own networks?

Interesting.

Go do some googling, ask all your doctor friends or whatever, and clarify what you mean by aca networks.

Does the existence of an exchange and minimum coverage requirements force insurers to shrink networks?

Wtf are you trying to say?
 
2013-11-19 02:00:47 PM

BojanglesPaladin: I think you are missing the point here. It not only failed to address the issue at all, with smaller networks, it makes the problem WORSE.


Yes, it might. I already said I agree with you this is a problem. But again, its not an ACA-specific problem, and it can and should be fixed independent of the ACA. In what sense is that not true?
 
2013-11-19 02:02:40 PM

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.
 
2013-11-19 02:03:09 PM

BojanglesPaladin: The ACA may have had the best of intentions, but this just isn't actually making things better on the whole.


[citation needed]
 
2013-11-19 02:03:54 PM

omnibus_necanda_sunt: BojanglesPaladin: MANY specialists (like anesthesiologists, some surgeons, etc.) simply don't participate in insurance networks

Be in a network or lose your license to practice medicine after two years. Boom, done.


The solution is price controls (insurance networks are a privately-run, partial approximation of this). It's the only thing that works to contain health care costs.

People freak out when you mention price controls because they don't work nearly as well as a free market. But there is no free market in health care, nor will there ever be in the US. Not least because of pricing opacity, the problem under discussion!

 Single-payer systems implement price controls by setting their reimbursement rates (taking the "insurance network" concept to its logical conclusion). NHS-type systems just set the prices. Singapore, often held up as a "market" health care system, has pure-fiat price controls.
 
2013-11-19 02:04:20 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.


This is rich
 
2013-11-19 02:04:21 PM

Crotchrocket Slim: Explain just why the ACA sucks for not explicitly preventing something it wasn't ever explicitly designed to prevent. Does the ACA also suck because it doesn't give us all Wolverine-like mutant healing factor too?


Wait, was that an option?!?

s2.quickmeme.com
 
2013-11-19 02:04:22 PM
NEWSFLASH!

People STILL don't know how to read their insurance plan!

Seriously, this has been the same for every insurance plan since the invention of 'networks'.  It has nothing to do with the ACA.  But yanno, gobble gobble little right wing nutjobs, it's almost Thanksgiving.
 
2013-11-19 02:05:25 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.


Good not perfect perhaps?
 
2013-11-19 02:05:28 PM

Gaseous Anomaly: The solution is price controls (insurance networks are a privately-run, partial approximation of this).


You don't even need that. What you basically need is a public option or a Medicare opt-in. The government has sufficient bargaining power that it can bring prices down that way; if you can't compete with the price the government is offering, you won't get any business. You don't need to put a firm price control in place.
 
2013-11-19 02:07:11 PM

dave2198: Tricky Chicken: The My Little Pony Killer: bradkanus: Move on.

Man, fark off. Seriously. fark off into heavy traffic.

I love how the left can't deal with their failure.  It just goes straight into wishes for the death of the people that warned them they were screwing up.  Good times.

You guys own it, you deal with it.

Can you please point me to the last law that was perfect upon implementation?

I'll wait.


Probably Public Law 113-27 (Aug 2013).  But it is a minor law directing accomodation for wounded veterans flying commercial air.  So far it hasn't been challenged or ammended.

It has nothing to do with it being perfect.  It has to do with the ACA being a train wreck and forced through with single party support.  Now the Democrats own everything good in the act, but also everything that has made it a huge embarassment so far.
 
2013-11-19 02:07:34 PM

MarshHawk: bradkanus:
Also, the problems with the government handling the IT portion of the health exchanges has been the evidence to liberals in power that they are not ready to take on the kind of task a single payer system would be.  This system was supposed to handle 35 millino people and literally work as a pass through to insurance companies.  It was a hallway, so to speak.  They failed at that.  They now know that single payer is not an option because they can't create the infrastructure to make it succesful.

Nice jump to conclusions with that last sentence.  Because a website temporarily doesn't perform as expected, there is no way that single payer health care will work.

Wow. Absolute wow.


You do realize that the website is simply a portal that sends folks off to private insurers, right?  You do know that it's the most basic function of pass through purchasing the internet has to offer and the federal government can't even get that right.  Now imagine if they had to actually function as a giant insurance provider handling everything from sign ups to pay outs to secure data storage...  yeah - not possible.
 
2013-11-19 02:08:14 PM

bradkanus: Ummm... yeah - the president already tried that talking point and he had to back off of it.

The insurance companies did update their insurance plans. Every single letter stating they can not BY LAW renew their previous plan came with new plan options that adhered to ACA regulations.  The problem is that those new plans offer new benefits (that one may, or may not need) at a higher cost.

You do know that an Insurance companies can't just offer any insurance product they want, right?  Every product they offer has to get the state insurance department's seal of approval.  Their old plans were not approved for use because the ACA's new rules.


Most of the "sticker shock" people were seeing was because of community rating, not because of the minimum benefits.

In the former individual market, only healthy people had coverage - anyone else was outright refused, or priced out. Healthy people are cheap to cover (by definition) so their premiums weren't bad. Now that they share a risk pool with sick people, their premiums are going up. This was, by design, the entire point of Obamacare.
 
2013-11-19 02:08:15 PM
I want to hear more about these Medicaid premiums that low income people pay to be a part of a state Medicaid program.

Since these premiums only exist in the imaginations of Fark Right Wing talking point generators, I'll wait for one of them to explain it to me.
 
2013-11-19 02:08:51 PM

Tricky Chicken: dave2198: Tricky Chicken: The My Little Pony Killer: bradkanus: Move on.

Man, fark off. Seriously. fark off into heavy traffic.

I love how the left can't deal with their failure.  It just goes straight into wishes for the death of the people that warned them they were screwing up.  Good times.

You guys own it, you deal with it.

Can you please point me to the last law that was perfect upon implementation?

I'll wait.

Probably Public Law 113-27 (Aug 2013).  But it is a minor law directing accomodation for wounded veterans flying commercial air.  So far it hasn't been challenged or ammended.

It has nothing to do with it being perfect.  It has to do with the ACA being a train wreck and forced through with single party support.  Now the Democrats own everything good in the act, but also everything that has made it a huge embarassment so far.


What law isn't "forced through" with single party support nowadays when one party just votes against anything the other one wants?
 
2013-11-19 02:09:01 PM

Tricky Chicken: Now the Democrats own everything good in the act, but also everything that has made it a huge embarassment so far.


This is 100% true. The Democrats own the ACA. I don't think that's a bad thing though.
 
2013-11-19 02:09:55 PM
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.
 
2013-11-19 02:10:11 PM

bradkanus: MarshHawk: bradkanus:
Also, the problems with the government handling the IT portion of the health exchanges has been the evidence to liberals in power that they are not ready to take on the kind of task a single payer system would be.  This system was supposed to handle 35 millino people and literally work as a pass through to insurance companies.  It was a hallway, so to speak.  They failed at that.  They now know that single payer is not an option because they can't create the infrastructure to make it succesful.

Nice jump to conclusions with that last sentence.  Because a website temporarily doesn't perform as expected, there is no way that single payer health care will work.

Wow. Absolute wow.

You do realize that the website is simply a portal that sends folks off to private insurers, right?  You do know that it's the most basic function of pass through purchasing the internet has to offer and the federal government can't even get that right.  Now imagine if they had to actually function as a giant insurance provider handling everything from sign ups to pay outs to secure data storage...  yeah - not possible.


Uh, they already are a giant insurance provider
 
2013-11-19 02:11:32 PM

Crotchrocket Slim: People are really stupid if they can't see a system that is designed to reduce the number of medical bankruptcies isn't the same as something designed to (or at least promising to) eliminate all medical bankruptcies.


I don't think anyone here is expecting an elimination of all medical bankruptcies. But again you are overlooking that not only does the ACA do nothing to reduce the likelihood, leaving one of the primary reasons why even people with insurance ho bankrupt untouched, when combined with the predicted smaller networks under ACA plans, it actually make it more likely.

BEST Case seems to be that ACA did absolutely nothing to fix a problem it was purported to address,

DamnYankees: But again, its not an ACA-specific problem, and it can and should be fixed independent of the ACA. In what sense is that not true?


If you are placing your goal-posts on "The problem did not originate with ACA", that's fine. But it's not really what we are talking about is it? We agree this is a long standing issue. We know this because it was one of the main things that Obama and others cited as a reason why we NEEDED drastic reform.

The discussion here (for me at least) is why the ACA didn't fix THIS problem either.
 
2013-11-19 02:12:04 PM

BojanglesPaladin: DamnYankees: So you'll support passing a law to amend Obamacare to fix this problem? I hope you'll join me in supporting a bill to fix it.

I suppose that would depend greatly on what was in the bill, don't you? There IS no such bill, and it seems unlikely that there will be one.

I doubt you intend to support any bills coming from the House Republicans to fix what is wrong with ACA, and I have no idea what bills you anticipate coming from the Senate Democrats, given that the last effort to tweak it did nothing to fix this flaw when they passed The Health Care and Education Reconciliation Act of 2010. Perhaps they need multiple tries? Or perhaps they aren't actually interested in any substantive changes.

So would I support a hypothetical non-existent bill to fix just one of the myriad and pervasive failure points of a deeply flawed and ineffective garbage pile of bad legislation? Perhaps.

But something tells me you wouldn't, if it meant actually changing ACA.


You don't have to make a radical change to ObamaCare to resolve this problem. All-payer regulations like what I suggested earlier are pretty simple and could be overlaid on top of the Frankenstein's monster of a coverage scheme we have today.
 
2013-11-19 02:12:17 PM

Gaseous Anomaly: omnibus_necanda_sunt: BojanglesPaladin: MANY specialists (like anesthesiologists, some surgeons, etc.) simply don't participate in insurance networks

People freak out when you mention price controls because they don't work nearly as well as a free market. But there is no free market in health care, nor will there ever be in the US. Not least because of pricing opacity, the problem under discussion!

 Single-payer systems implement price controls by setting their reimbursement rates (taking the "insurance network" concept to its logical conclusion). NHS-type systems just set the prices. Singapore, often held up as a "market" health care system, has pure-fiat price controls.


And you have a wonderful point about price controls and people generally not understanding that the health care market already has a huge price control compenent in the medicare and medicaid reimbursement rates.  With one part of the system regulated by price controls and an entire other part not regulated, you get exactly what we have here - insanity.  The docs and hospitals made their deal early in the process so that they wouldn't have to face price controls put in place by the government outside of the existing medicare and medicaid system (which is actually giving way to insurance in the form of subsidies).

I think Docs and Hospitals have to be regulated on what they can charege across the entire market - not just the government backed part.
 
2013-11-19 02:13:11 PM

Satan's Bunny Slippers: NEWSFLASH!

People STILL don't know how to read their insurance plan!

Seriously, this has been the same for every insurance plan since the invention of 'networks'.  It has nothing to do with the ACA.  But yanno, gobble gobble little right wing nutjobs, it's almost Thanksgiving.


I think ACA will make the problem a little worse, because of two things:

1) The newly insured that don't know to watch for this
2) Insurers shrinking their networks to keep utilization (and therefore costs) down

Neither of those reflect poorly on the ACA itself.

If ACA's implementation and outreach budgets hadn't been gutted, there could be a PSA blitz reminding people to never, ever go out of network for anything. Thanks, Tea Party!
 
2013-11-19 02:13:48 PM
My stapler ran out of staples. Thanks, Obamacare.
 
2013-11-19 02:13:52 PM

KellyX: [scontent-b.xx.fbcdn.net image 400x352]


Yes please!  Scrap ACA and do this!  ACA is nothing but a bad Idea that will screw us all.
 
2013-11-19 02:14:09 PM
bradkanus:

You do realize that the website is simply a portal that sends folks off to private insurers, right?  You do know that it's the most basic function of pass through purchasing the internet has to offer and the federal government can't even get that right.  Now imagine if they had to actually function as a giant insurance provider handling everything from sign ups to pay outs to secure data storage...  yeah - not possible.

Yep, I do realize that.  I also realize that other countries somehow managed single care health care well before the Internet of today existed.
 
2013-11-19 02:15:08 PM

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

You're welcome.


Have a complete single-payer system, so no patient ever has to pay anything (or more than a nominal copay) for medical services, like they do in every other civilized country in the world.

You're welcome
 
2013-11-19 02:15:30 PM

Gaseous Anomaly: bradkanus: Ummm... yeah - the president already tried that talking point and he had to back off of it.

The insurance companies did update their insurance plans. Every single letter stating they can not BY LAW renew their previous plan came with new plan options that adhered to ACA regulations.  The problem is that those new plans offer new benefits (that one may, or may not need) at a higher cost.

You do know that an Insurance companies can't just offer any insurance product they want, right?  Every product they offer has to get the state insurance department's seal of approval.  Their old plans were not approved for use because the ACA's new rules.

Most of the "sticker shock" people were seeing was because of community rating, not because of the minimum benefits.

In the former individual market, only healthy people had coverage - anyone else was outright refused, or priced out. Healthy people are cheap to cover (by definition) so their premiums weren't bad. Now that they share a risk pool with sick people, their premiums are going up. This was, by design, the entire point of Obamacare.


You are a 100 percent right.  New benefits new costs make up some of the increase.  However,  with age bands being limited to 3 to 1, the young healthy folks had to see an increase to cover the old sick people.  Now, if young healthy people aren't mandated to participate, shiat is going to hit the fan.  The market is going to be overloaded with very sick people and no healthy people and insurance companies are going to have to adjust rates accordingly.  It turns into one huge high risk pool!
 
2013-11-19 02:15:43 PM

FlashHarry: [citation needed]


Start with the article linked to this thread.

Gaseous Anomaly: The solution is price controls (insurance networks are a privately-run, partial approximation of this). It's the only thing that works to contain health care costs.


I disagree (strongly). I am of the opinion that the problems with out current system were birthed with the HMO legislation of the early 70s under Nixon and Ted Kennedy, and I think it has been demonstrated throughout the 79s that government price controls are generally a terrible idea. Not everyone agrees on this, and that's fine.

But even if you are right, you highlight another fundamental flaw of the ACA - it doesn't really do much to prevent rising costs of healthcare and rising costs of insurance by means of direct price controls or other.
 
2013-11-19 02:16:06 PM
Dear fellow hippy liberal types,

It is time to nut up and admit you got suckered in by this piece of shiat legislation under the guise of "doing something" and "it might not be perfect but its a start" happy feelgood support of Our Guy.  I will remind you now, as I did then, that "do something" is exactly the same mentality that got us into Iraq and was parroted about those supporting *that* particular bad bit of policy by those supporting Their Guy.

Much like Iraq, we are going to suffer the ill effects of this bill, primarily uncontrolled costs, for another 20 years.  Hopefully at that time  we will decide that hey, maybe next time when Our Guy comes up with a bad idea, we call him on it and demand single payer.

Sincerely,

Rent Party
 
2013-11-19 02:16:27 PM

BojanglesPaladin: We know this because it was one of the main things that Obama and others cited as a reason why we NEEDED drastic reform.


It was? I don't remember that. In fact, I can't remember Obama ever talking about this particular issue - can you cite something? A single time he talked about people with insurance going bankrtupt because a non-network medical bill was snuck in without their knowledge? I mean, I suppose its possible that this was one of the main tentpoles of the ACA push, but I'm pretty politically aware and I'd never heard of this issue until today.

You need to stop conflating the general idea of medical bankruptcy with the very specific issue in TFA. They aren't the same thing.
 
2013-11-19 02:16:45 PM

MarshHawk: bradkanus:

You do realize that the website is simply a portal that sends folks off to private insurers, right?  You do know that it's the most basic function of pass through purchasing the internet has to offer and the federal government can't even get that right.  Now imagine if they had to actually function as a giant insurance provider handling everything from sign ups to pay outs to secure data storage...  yeah - not possible.

Yep, I do realize that.  I also realize that other countries somehow managed single care health care well before the Internet of today existed.


Do those countries have 300 million people?
 
2013-11-19 02:17:03 PM
Ummm... yeah... Because balance billing (healthcare providers aren't supposed to do it but they do it anyway) and doctors not being in networks didn't exist before Obamacare. The problem can't possibly be providers and insurance companies, noooooope. Gotta be the blah guy and his socialist health care. ::eyeroll::
 
2013-11-19 02:18:01 PM

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.


Not if you ever go out-of-network for anything, knowingly or not, because of balance billing. That's the point of TFA.

Anaesthesiologists are in general known for this. You can go to an in-network hospital, see an in-network surgeon for a surgery, and the anaesthesiologist will be out-of-network. Therefore that practice can literally bill you for any arbitrarily large amount and you're on the hook. Your insurer will pay them some percentage of the contracted rate they'd pay someone in-network. The practice can and will bill you much more, and there's nothing you can do but threaten and/or implement bankruptcy. The insurer can't help because they can't control what that practice charges.

Five-fold markups are reasonably common (I've experienced one, with hospital charges).
 
2013-11-19 02:19:41 PM

Serious Black: You don't have to make a radical change to ObamaCare to resolve this problem.


Good. Let's all hold our breath waiting for Harry Reid and Nancy Pelosi to offer up a bill to fix even this one issue. It's not a surprise, and been there since before day one. They didn't tackle in 2010 when they last revised it, but I'm sure they are just about to.

bradkanus: And you have a wonderful point about price controls and people generally not understanding that the health care market already has a huge price control compenent in the medicare and medicaid reimbursement rates. With one part of the system regulated by price controls and an entire other part not regulated, you get exactly what we have here...


You also get fewer and fewer providers participating. Especially when the promised and much delayed 30% reimbursement rates finally go into effect.
 
2013-11-19 02:19:49 PM

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

You're welcome.

Have a complete single-payer system, so no patient ever has to pay anything (or more than a nominal copay) for medical services, like they do in every other civilized country in the world.

You're welcome


You'd be surprised by how many countries don't actually have a single-payer health insurance system. France, Switzerland, Japan, the Netherlands, Germany...
 
2013-11-19 02:21:02 PM

Gaseous Anomaly: Satan's Bunny Slippers: NEWSFLASH!

People STILL don't know how to read their insurance plan!

Seriously, this has been the same for every insurance plan since the invention of 'networks'.  It has nothing to do with the ACA.  But yanno, gobble gobble little right wing nutjobs, it's almost Thanksgiving.

I think ACA will make the problem a little worse, because of two things:

1) The newly insured that don't know to watch for this
2) Insurers shrinking their networks to keep utilization (and therefore costs) down

Neither of those reflect poorly on the ACA itself.

If ACA's implementation and outreach budgets hadn't been gutted, there could be a PSA blitz reminding people to never, ever go out of network for anything. Thanks, Tea Party!


Exactly.  But the nutjobs are incapable of dealing with that.

Just like the ACA will end up being a bit more expensive for a very few, and a bit of a hassle due to trolling insurance companies cancelling policies that didn't need cancelled and blaming the ACA.

But it will all work out eventually.

/single payer
 
2013-11-19 02:21:03 PM

bradkanus: MarshHawk: bradkanus:

You do realize that the website is simply a portal that sends folks off to private insurers, right?  You do know that it's the most basic function of pass through purchasing the internet has to offer and the federal government can't even get that right.  Now imagine if they had to actually function as a giant insurance provider handling everything from sign ups to pay outs to secure data storage...  yeah - not possible.

Yep, I do realize that.  I also realize that other countries somehow managed single care health care well before the Internet of today existed.

Do those countries have 300 million people?


www.operationworld.org
 
2013-11-19 02:21:42 PM

bradkanus: with age bands being limited to 3 to 1, the young healthy folks had to see an increase to cover the old sick people.  Now, if young healthy people aren't mandated to participate, shiat is going to hit the fan.  The market is going to be overloaded with very sick people and no healthy people and insurance companies are going to have to adjust rates accordingly.  It turns into one huge high risk pool!


At first I was concerned that some of the "fixes" being bandied about (keep-your-plan, mandate delays, website problems etc.) might bring about such an adverse selection death spiral. But the first couple years of Obamacare have some features to limit that possibility. There's risk corridors (which I don't understand), and a reinsurance fund (for bailing out insurers that get too many high-risk enrollees).

Also, since the silver premium is always the same at the same level of income, there's some protection against increasing premiums driving people out of the risk pool. (At the cost of more subsidy expenses).
 
2013-11-19 02:22:22 PM

Gaseous Anomaly: 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.

Not if you ever go out-of-network for anything, knowingly or not, because of balance billing. That's the point of TFA.

Anaesthesiologists are in general known for this. You can go to an in-network hospital, see an in-network surgeon for a surgery, and the anaesthesiologist will be out-of-network. Therefore that practice can literally bill you for any arbitrarily large amount and you're on the hook. Your insurer will pay them some percentage of the contracted rate they'd pay someone in-network. The practice can and will bill you much more, and there's nothing you can do but threaten and/or implement bankruptcy. The insurer can't help because they can't control what that practice charges.

Five-fold markups are reasonably common (I've experienced one, with hospital charges).


Man, it's almost like some bureaucrat insurance accountant is picking your doctor for you.

/ Gubbermint BAD
// MARKETZ GOOOD
/// derp
 
2013-11-19 02:22:34 PM

BojanglesPaladin: Crotchrocket Slim: People are really stupid if they can't see a system that is designed to reduce the number of medical bankruptcies isn't the same as something designed to (or at least promising to) eliminate all medical bankruptcies.

I don't think anyone here is expecting an elimination of all medical bankruptcies. But again you are overlooking that not only does the ACA do nothing to reduce the likelihood, leaving one of the primary reasons why even people with insurance ho bankrupt untouched, when combined with the predicted smaller networks under ACA plans, it actually make it more likely.

BEST Case seems to be that ACA did absolutely nothing to fix a problem it was purported to address,


It remains to be seen whether Obamacare will fix this issue. The reason these charges are so high is that the doctors have to recoup money they will never be paid for other services they rendered (partially to the uninsured). If they don't have to recoup those costs (because more people are paying because they have insurance) then they don't HAVE TO charge the huge amounts. But, you have to have more people paying before the Doctors will drop their prices. Since Obamacare hasn't really gone into affect yet, this obviously hasn't happened.

Whether it will happen is very much up for debate and largely determines the success of the bill.
 
2013-11-19 02:23:06 PM

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

You're welcome.

Have a complete single-payer system, so no patient ever has to pay anything (or more than a nominal copay) for medical services, like they do in every other civilized country in the world.

You're welcome

You'd be surprised by how many countries don't actually have a single-payer health insurance system. France, Switzerland, Japan, the Netherlands, Germany...


Japan doesn't?  Whatever they have sure seemed like it, but I didn't understand how everything works exactly.  I think if you are a citizen and pay taxes or something, you are basically covered by national insurance.  How does it really work there?
 
2013-11-19 02:23:51 PM

bradkanus: coyo


bradkanus: coyo: 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 I remember correctly, we said it was better than what was extant and that single payer is much preferable. I'm amazed at the energy that is spent tearing this down rather than making concrete suggestions on how to improve things. Given the rapid response from people like you, it rather feels like your posts are what pays your bills rather than any real conviction.

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.


It's more expensive in edge cases, I suppose, but not the average cases.
 
2013-11-19 02:24:18 PM

MarshHawk: bradkanus:

You do realize that the website is simply a portal that sends folks off to private insurers, right?  You do know that it's the most basic function of pass through purchasing the internet has to offer and the federal government can't even get that right.  Now imagine if they had to actually function as a giant insurance provider handling everything from sign ups to pay outs to secure data storage...  yeah - not possible.

Yep, I do realize that.  I also realize that other countries somehow managed single care health care well before the Internet of today existed.


Including the USA, though I hear that today Medicare has a pretty good website.

/single payer wouldn't need exchanges, subsidies, or means-testing
 
2013-11-19 02:25:23 PM

DamnYankees: You need to stop conflating the general idea of medical bankruptcy with the very specific issue in TFA. They aren't the same thing


Ah. So THAT's where you wish to move your goalposts to. When Obama was talking about people with insurance still going bankrupt (like his oft-cited story of his mother dying of cancer) because many things weren't covered, he wasn't really talking about people going bankrupt because many things weren't covered.

So just to be clear, Obama and the ACA advocates and proxies, when discussing the ways that ACA was needed top protect Americans from bankruptcy, they meant "except for when the crippling bankruptcy inducing bills are a result of out-of-network billing".

Got it.
 
2013-11-19 02:25:43 PM

bradkanus: MarshHawk: bradkanus:

You do realize that the website is simply a portal that sends folks off to private insurers, right?  You do know that it's the most basic function of pass through purchasing the internet has to offer and the federal government can't even get that right.  Now imagine if they had to actually function as a giant insurance provider handling everything from sign ups to pay outs to secure data storage...  yeah - not possible.

Yep, I do realize that.  I also realize that other countries somehow managed single care health care well before the Internet of today existed.

Do those countries have 300 million people?


Ah, so population size is what is preventing us from successfully implementing single payer health care!  That's interesting, since the federal government is somehow able to manage 300 million Americans' income tax returns every year, and is also able to collect communication and metadata from 300 million Americans.

The website is but a temporary problem.  It will be fixed given time.  It has nothing to do with the ability to manage a health care system.  In fact, I would argue that ceteris paribus, the infrastructure required for a single-payer system would be much simpler than what is currently being dealt with.
 
2013-11-19 02:26:10 PM

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

You're welcome.

Have a complete single-payer system, so no patient ever has to pay anything (or more than a nominal copay) for medical services, like they do in every other civilized country in the world.

You're welcome

You'd be surprised by how many countries don't actually have a single-payer health insurance system. France, Switzerland, Japan, the Netherlands, Germany...

Japan doesn't?  Whatever they have sure seemed like it, but I didn't understand how everything works exactly.  I think if you are a citizen and pay taxes or something, you are basically covered by national insurance.  How does it really work there?


You have a 30% co-pay, access to supplemental insurance, universal care selection, a public insurance option, and the government picks up the rest.

All of which was taken off the table by "liberal" Obama when trying to get this clusterfark bill passed.
 
2013-11-19 02:26:12 PM

netcentric: the Fraser Institute, a nonpartisan Canadian think tank


Hahahaha!

ohwaityoureserious.jpg
 
2013-11-19 02:27:22 PM

BojanglesPaladin: Serious Black: You don't have to make a radical change to ObamaCare to resolve this problem.

Good. Let's all hold our breath waiting for Harry Reid and Nancy Pelosi to offer up a bill to fix even this one issue. It's not a surprise, and been there since before day one. They didn't tackle in 2010 when they last revised it, but I'm sure they are just about to.


And clearly I suck Harry Reid's cock and want to eat Nancy Pelosi's pink fish taco.

Nobody is trying to solve this problem really on the federal level. The only movement on these issues is from Massachusetts with their global budget targeting and Maryland with continued reform efforts to their cost-setting commission that has been around since the 70s. It's frustrating, not the least because I think the lack of movement is because of narrow interests arguing against a policy that would benefit the general welfare of the nation.
 
2013-11-19 02:27:43 PM

Rosecitybeaver: The reason these charges are so high is that the doctors have to recoup money they will never be paid for other services they rendered (partially to the uninsured).


You should know that uncompensated health care in America is about 2% of the total healthcare provided (look it up, 6% if you include charity). Does that change your assessment? That getting 2-6% of that money will change pricing significantly?
 
2013-11-19 02:27:55 PM
csb: i got my Open Enrollment package for my health insurance through my employer. I grabbed my calculator, crunched the numbers (vision and dental are now paid for seperately rather than included) and discovered that I will pay exactly the same amount for the same coverage next year as I have been this year.

Truly, this is history's greatest blunder.
 
2013-11-19 02:28:30 PM

BojanglesPaladin: DamnYankees: You need to stop conflating the general idea of medical bankruptcy with the very specific issue in TFA. They aren't the same thing

Ah. So THAT's where you wish to move your goalposts to. When Obama was talking about people with insurance still going bankrupt (like his oft-cited story of his mother dying of cancer) because many things weren't covered, he wasn't really talking about people going bankrupt because many things weren't covered.

So just to be clear, Obama and the ACA advocates and proxies, when discussing the ways that ACA was needed top protect Americans from bankruptcy, they meant "except for when the crippling bankruptcy inducing bills are a result of out-of-network billing".

Got it.


So you would support amending the ACA to close this loophole?

Got it.
 
2013-11-19 02:28:30 PM

Serious Black: And clearly I suck Harry Reid's cock and want to eat Nancy Pelosi's pink fish taco.


Who said that? I don't think that is clear at all, but you would know better than I.

Serious Black: Nobody is trying to solve this problem really on the federal level.


Exactly. But ACA was supposed to.
 
2013-11-19 02:31:10 PM

BojanglesPaladin: So just to be clear, Obama and the ACA advocates and proxies, when discussing the ways that ACA was needed top protect Americans from bankruptcy, they meant "except for when the crippling bankruptcy inducing bills are a result of out-of-network billing".

Got it.


I'm not sure what you want me to say to this. It's a hole that needs to be fixed. Let's fix it. Do you want me to rend my garments over the fact that ACA is not a perfect bill, and that the people that drafted and supported it couldn't imagine every future scenario which might escape its coverage?
 
2013-11-19 02:32:52 PM
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.
 
2013-11-19 02:34:43 PM

Uranus Is Huge!: So you would support amending the ACA to close this loophole?


Asked and answered above.
 
2013-11-19 02:35:45 PM

BojanglesPaladin: Rosecitybeaver: The reason these charges are so high is that the doctors have to recoup money they will never be paid for other services they rendered (partially to the uninsured).

You should know that uncompensated health care in America is about 2% of the total healthcare provided (look it up, 6% if you include charity). Does that change your assessment? That getting 2-6% of that money will change pricing significantly?


Apparently true, but that does happen to equal 40 Billion a year...  which someone pays for.
 
2013-11-19 02:36:28 PM

DamnYankees: Do you want me to rend my garments over the fact that ACA is not a perfect bill, and that the people that drafted and supported it couldn't imagine every future scenario which might escape its coverage?


I think that you could go the last step and just acknowledge that in this issue, the ACA did not address one of the principle issues it was supposed to address.
 
2013-11-19 02:38:05 PM

BojanglesPaladin: I think that you could go the last step and just acknowledge that in this issue, the ACA did not address one of the principle issues it was supposed to address.


I've acknowledged that - I'll do it again here: it appears the ACA does not protect people against this particular aspect of medical costs.

What's next? Should I lash myself? At what point do we stop pretending like this is anything but a routine policy issue which we should fix?
 
2013-11-19 02:38:48 PM

PanicMan: JerseyTim: They passed Obamacare and people are still getting cancer? What was it all for then!??!!?

That's not all. They Passed Obamacare and I still have to put gas in my car every week. Clearly the law is broken.


They Passed Obamacare and I still have to clean the kitty litter.  Clearly the law is broken.
 
2013-11-19 02:39:25 PM

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.
 
2013-11-19 02:39:30 PM

Rosecitybeaver: Apparently true, but that does happen to equal 40 Billion a year... which someone pays for


To be sure. However, it does kind of kill your "free rider fallacy" explanation that health care providers are charging so very much to offset that loss, and that therefore with it "gone" (which isn't actually going to happen, but let's skip that) health care costs would therefore be reduced.

Or am I misunderstanding your point?
 
2013-11-19 02:41:17 PM

BojanglesPaladin: Serious Black: And clearly I suck Harry Reid's cock and want to eat Nancy Pelosi's pink fish taco.

Who said that? I don't think that is clear at all, but you would know better than I.

Serious Black: Nobody is trying to solve this problem really on the federal level.

Exactly. But ACA was supposed to.


ObamaCare did do a lot on the cost control front. ACOs, the IPAB, the Center for Medicare/Medicaid Innovation, the PCORI, the co-op insurance program, the Cadillac excise tax, the minimum medical loss ratio rules...these all will have some impact on costs. It's not perfect, but then no system is.
 
2013-11-19 02:42:16 PM

DamnYankees: I've acknowledged that - I'll do it again here: it appears the ACA does not protect people against this particular aspect of medical costs. What's next? Should I lash myself? At what point do we stop pretending like this is anything but a routine policy issue which we should fix?


You keep asking me if I want you to do damage to yourself. I do not.

I think the next question is if this is a "routine policy issue" that was known well before they even started drafting the ACA, and that it was not addressed in the ACA, nor was it addressed in the 2010 revision of the ACA, and there are currently no bills on the table to address it even today... but the policy makers are surely aware of it (or SHOULD be)...

Is anyone in congress even interested in addressing it?
 
2013-11-19 02:44:27 PM

BojanglesPaladin: Is anyone in congress even interested in addressing it?


Good question. I have no idea. I find it highly unlikely any such fix could pass the House, but hey, maybe the House GOP will surprise us. Obviously Democrats should be in favor of somehow fixing this, and those who are not would, in my opinion, be wrong to oppose it.
 
2013-11-19 02:45:39 PM
Liberals: There's something wrong w/ the ACA, we should replace it w/ single payer.
Democrats: There's something wrong w/ the ACA, we should fix it.
Republicans: There's something wrong w/ the ACA, we should repeal it.
Tea Party: DANGNABBIT 0BUMMER SOSHULIS MUSLIN COMMIE *wheezing* GOOOOOD BLESS UHMERIKUH!!!!
 
2013-11-19 02:46:54 PM

DamnYankees: I've acknowledged that - I'll do it again here: it appears the ACA does not protect people against this particular aspect of medical costs.


But it does, indirectly. Like I said above, the reasons for balance billing is that hospitals are under-compensated for some people, so they need to overcharge others. The ACA 1) reduces the number of uninsured people, meaning that there will be fewer instances of ER visits without the ability to pay at all, 2) requires insurance companies to at least pay hospitals what they would pay in-network ERs, so not only are hospitals seeing more covered patients, but being paid more on average per patient, so 3) in general the practice of balance billing should be reduced since hospitals are being more well compensated, and 4) it helps individuals since their insurance has to pay for the equivalent of in-network hospitals even at out-of-network ERs, so even emergency visits will be less expensive for individuals, which are generally the most expensive medical bills.
 
2013-11-19 02:47:02 PM

Serious Black: ObamaCare did do a lot on the cost control front. ACOs, the IPAB, the Center for Medicare/Medicaid Innovation, the PCORI, the co-op insurance program, the Cadillac excise tax, the minimum medical loss ratio rules...these all will have some impact on costs.


Do you have any hard numbers on this? I know there have been a lot of proposed measures and additional bureaucracy and regulations that ideally might in some way produce some potential savings, but the numbers I have seen from the CBO show us paying more than if we had done nothing and predicting rising healthcare costs per capita over the next decade or more. I have not seen any hard numbers showing a net reduction in either insurance premiums or health care costs, and minimal, if any, reduction in the RATE of growth. But I may have missed some key information.

I assume you have looked into it. What have you found that convinces you otherwise?
 
2013-11-19 02:49:25 PM

DamnYankees: BojanglesPaladin: So just to be clear, Obama and the ACA advocates and proxies, when discussing the ways that ACA was needed top protect Americans from bankruptcy, they meant "except for when the crippling bankruptcy inducing bills are a result of out-of-network billing".

Got it.

I'm not sure what you want me to say to this. It's a hole that needs to be fixed. Let's fix it. Do you want me to rend my garments over the fact that ACA is not a perfect bill, and that the people that drafted and supported it couldn't imagine every future scenario which might escape its coverage?


Of course that's what he wants.  It would be a nice touch if you set them on fire as well, all the while begging your goper betters for forgiveness.

That would make him happy.
 
2013-11-19 02:49:31 PM

bradkanus: queezyweezel: bradkanus: BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....

Feel a little guilty, don't you?  It's okay - you didn't read the bill.  You took their word for it. You were told by the people you voted for it was one thing. It turned out to be another.

Hey, that whole "weapons of mass destruction" thing really killed me. I believed it because the guys I voted for told me it was so. They were wrong.  I learned a lesson.  Will you learn yours?

I think most rational people were happy that it passed because it's a step in the right direction.  Most people knew it wasn't perfect, and in general wasn't really great in any sense of the word.  What it is, is a pivot point towards a single payer system, and serious reform of the current billing/coverage rules.

Do you really look at issues that simplistically?  derp derp derp?

And here's where you are 100 percent wrong.  It was a step away from single payer in every since of the ideal.  It put more Americans into a private system and took them out of the public system. If you think that's a step toward single payer, you're not familiar with how single payer works.

Also, the problems with the government handling the IT portion of the health exchanges has been the evidence to liberals in power that they are not ready to take on the kind of task a single payer system would be.  This system was supposed to handle 35 millino people and literally work as a pass through to insurance companies.  It was a hallway, so to speak.  They failed at that.  They now know that single payer is not an option because they can't create the infrastructure to make it succesful.


Yeah it's not like they've gotten Medicare or Social Security to work at all, those aren't very big.  No one is saying things are perfect but this argument is just garbage.  The issue here <conspiracy hat on> is that the government has had to interface with hundreds or thousands of private providers who frankly don't have much incentive to be on top of their game.  I'm sure NONE of them sandbagged testing or just outright told the builders "yeah it's working fine" when it wasn't.  I mean after all, who's going to be in the news when that bug shows up in prod, Joe's discount healthcare or the big old federal government.

This is going to follow the same trajectory as gay marriage.  Right now we're in the "People will be able to marry turtles!" phase.  But mark my words, those of you that fight universal healthcare are going to find yourselves on the wrong side of history, AGAIN for many of you.

My hope is that it occurs in your lifetime so you have to live through some of it, like that girl that was screaming at the black kids trying to walk to school after desegregation.  She has to live with that every day, more so on anniversaries when she gets interview requests (just saw one last year).  Let that sink in for a minute before you regurgitate your stale talking points again.
 
2013-11-19 02:54:55 PM

DamnYankees: Obviously Democrats should be in favor of somehow fixing this, and those who are not would, in my opinion, be wrong to oppose it.


My issue is that they are simply uninterested in fixing what is wrong with it. I think it is safe to say that the Republican's plan is simply to repeal it, and I appreciate that a lot of Americans don't want to see the baby thrown out with the bathwater, even if they now see just how filthy the bathwater is.

But the Democrats SHOULD have a vested interest in making this thing actually work. If for no other reason than political self preservation. But for years now, they have been playing a political game of see no evil, hear no evil on ACA and doing nothing for fear of any attempts to do so being the camel's nose for the Republicans.

And so... nothing. And the dirty little secret that Democrats can't bring themselves to face is that the ACA isn't workable, and it's only going to get worse as it unfolds. And they sold it to America with a lot of slick salesmanship and we all bought it. But it's not exactly working like it said in the brochure and now they are refusing to do the needed warranty work on it.
 
2013-11-19 03:00:52 PM

bradkanus: Actually, they are upset that the bill led to the non-renewal of policies they liked and replaced them with more costly policies.


[citation needed]
 
2013-11-19 03:01:29 PM

BojanglesPaladin: DamnYankees: Obviously Democrats should be in favor of somehow fixing this, and those who are not would, in my opinion, be wrong to oppose it.

My issue is that they are simply uninterested in fixing what is wrong with it. I think it is safe to say that the Republican's plan is simply to repeal it, and I appreciate that a lot of Americans don't want to see the baby thrown out with the bathwater, even if they now see just how filthy the bathwater is.

But the Democrats SHOULD have a vested interest in making this thing actually work. If for no other reason than political self preservation. But for years now, they have been playing a political game of see no evil, hear no evil on ACA and doing nothing for fear of any attempts to do so being the camel's nose for the Republicans.

And so... nothing. And the dirty little secret that Democrats can't bring themselves to face is that the ACA isn't workable, and it's only going to get worse as it unfolds. And they sold it to America with a lot of slick salesmanship and we all bought it. But it's not exactly working like it said in the brochure and now they are refusing to do the needed warranty work on it.


Blah blah blah
 
2013-11-19 03:01:38 PM

bradkanus: coyo: 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 I remember correctly, we said it was better than what was extant and that single payer is much preferable. I'm amazed at the energy that is spent tearing this down rather than making concrete suggestions on how to improve things. Given the rapid response from people like you, it rather feels like your posts are what pays your bills rather than any real conviction.

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.


Says the guy who keeps inserting the same thing into each of his many posts.  I'm sure you've read the bill cover to cover, and did so before forming your completely objective opinion, even though the word liberal is pejoratively multiple times, but conservative is nowhere to be found.

I'm off to update my favorites to give you a nice troll yellow color.
 
2013-11-19 03:01:45 PM

PanicMan: JerseyTim: They passed Obamacare and people are still getting cancer? What was it all for then!??!!?

That's not all. They Passed Obamacare and I still have to put gas in my car every week. Clearly the law is broken.


I'm trying not to laugh at work, you asshole.

/funnied
 
2013-11-19 03:04:13 PM

CPennypacker: Blah blah blah


Thank you for your insight.
 
2013-11-19 03:04:23 PM
Isn't the lifetime maximum supposed to handle this sort of thing?
 
2013-11-19 03:05:00 PM

BojanglesPaladin: CPennypacker: Blah blah blah

Thank you for your insight.


How exactly should someone respond to you making things up?
 
2013-11-19 03:05:41 PM

BojanglesPaladin: CPennypacker: Blah blah blah

Thank you for your insight.


You're just mad that I can say absolutely nothing in way less words than it takes you to
 
2013-11-19 03:06:20 PM

BojanglesPaladin: DamnYankees: Obviously Democrats should be in favor of somehow fixing this, and those who are not would, in my opinion, be wrong to oppose it.

My issue is that they are simply uninterested in fixing what is wrong with it. I think it is safe to say that the Republican's plan is simply to repeal it, and I appreciate that a lot of Americans don't want to see the baby thrown out with the bathwater, even if they now see just how filthy the bathwater is.

But the Democrats SHOULD have a vested interest in making this thing actually work. If for no other reason than political self preservation. But for years now, they have been playing a political game of see no evil, hear no evil on ACA and doing nothing for fear of any attempts to do so being the camel's nose for the Republicans.

And so... nothing. And the dirty little secret that Democrats can't bring themselves to face is that the ACA isn't workable, and it's only going to get worse as it unfolds. And they sold it to America with a lot of slick salesmanship and we all bought it. But it's not exactly working like it said in the brochure and now they are refusing to do the needed warranty work on it.


With the current status, the ACA cannot be fixed.  The house won't pass anything that actually 'improves' the bill, and the Democrats don't have the seats to force anything through like they did when it passed in the first place.  The republicans 'win' by not allowing anything through that would fix it and just sitting back and pointing out the flaws.

When you say 'then pass a bill fixing the flaws', all they have to do is say 'there are too many flaws to fix, we need to repeal and start over'.
 
2013-11-19 03:07:01 PM

12349876: Are hospitals purposefully duping people into thinking all of their care will be in network for some extra cash or do they just not want to anger patients or have patients go elsewhere when no other option is available?


It's intentional for the extra money. I live in AZ but my emergency surgeon (for 6 stitches in my finger) ended up being "based in Oklahoma City" which of course is out of network. I'm lucky that my insurance caps my emergency room very low, so I didn't owe anymore (I was told "Just fax that to us we'll take care of it").
 
2013-11-19 03:07:17 PM
Not informing you that not all doctors on a procedure are in network sounds like fraud. How can I even vet that? Last surgery I had was scheduled by my doctor with no consultation on price. Granted at the time I had a cadillac insurance plan that cover everything at 100% with no deductible, co-pay or monthly premium. I guess this is something I have to worry about now.
 
2013-11-19 03:07:43 PM

un4gvn666: How exactly should someone respond to you making things up?


I do not specify. All are welcome to respond in the manner they see fit.

But perhaps you should acquaint yourself with concepts like "Opinion", "Analysis", and "Discussion" if you plan on participating on an online discussion forum where opinions and analysis are discussed and debated.
 
2013-11-19 03:08:33 PM

Serious Black: BojanglesPaladin: Serious Black: And clearly I suck Harry Reid's cock and want to eat Nancy Pelosi's pink fish taco.

Who said that? I don't think that is clear at all, but you would know better than I.

Serious Black: Nobody is trying to solve this problem really on the federal level.

Exactly. But ACA was supposed to.

ObamaCare did do a lot on the cost control front. ACOs, the IPAB, the Center for Medicare/Medicaid Innovation, the PCORI, the co-op insurance program, the Cadillac excise tax, the minimum medical loss ratio rules...these all will have some impact on costs. It's not perfect, but then no system is.


If anyone is without healthcare for any reason then the ACA is a failure and all health insurance regulations should be scrapped.

I believe that sums up the trolls' views.
 
2013-11-19 03:09:07 PM
You see, if he says a bunch of bullshiat then it is his "opinion" but if you reply to his BS with disdain then you "aren't contributing to the discussion"
 
2013-11-19 03:09:38 PM

BojanglesPaladin: But the Democrats SHOULD have a vested interest in making this thing actually work. If for no other reason than political self preservation. But for years now, they have been playing a political game of see no evil, hear no evil on ACA and doing nothing for fear of any attempts to do so being the camel's nose for the Republicans.


I just see a different reality than you. Democrats in office, and especially liberals who dominate the policy class, are all about fixing the thing. There's just nothing they can do right now while the House is controlled by the GOP. Not sure what you want them to do.

BojanglesPaladin: And the dirty little secret that Democrats can't bring themselves to face is that the ACA isn't workable, and it's only going to get worse as it unfolds. And they sold it to America with a lot of slick salesmanship and we all bought it. But it's not exactly working like it said in the brochure and now they are refusing to do the needed warranty work on it.


Oh, wait. Nevermind. I thought you were actually engaging in a policy discussion and how it intersects with the reality of Washington politics. I was mistaken.
 
2013-11-19 03:10:06 PM

CPennypacker: You see, if he says a bunch of bullshiat then it is his "opinion" but if you reply to his BS with disdain then you "aren't contributing to the discussion"


It's almost as if he does it for the attention.

Hmm...
 
2013-11-19 03:10:22 PM
BojanglesPaladin:

But the Democrats SHOULD have a vested interest in making this thing actually work. If for no other reason than political self preservation. But for years now, they have been playing a political game of see no evil, hear no evil on ACA and doing nothing for fear of any attempts to do so being the camel's nose for the Republicans.

This misunderstands the long game. My belief is that it is a high stakes game of chicken. The purpose of the ACA was to move the ball enough so that there is no going back for the country. The hope is that when people see how bad the ACA actually is in practice the population will be ready to move on to single payer and not move back to the broken system.

I am not convinced that the American public will ever move on to single payer. Part of the problem for the ACA is that it has gotten attached to larger social forces that have nothing to do with health care. There is a real risk that rather than pushing people to the conclusion that single payer is the only viable option it pushes people to the conclusion that big government doesn't work. In which case not only will we not see single payer the country may wind up with something worse than what it started with.

But I do believe that the ACA was always meant to fail in the sense that it was always meant to be a stepping stone in the same way that the original confederacy of the states was a prelude to the constitutional convention and a stronger union.
 
2013-11-19 03:11:05 PM
Smackledorfer:

If anyone is without free healthcare that I don't have to help pay for for any reason then the ACA is a failure and all health insurance regulations should be scrapped.  BECAUSE THAT'S WHAT OBAMMY PROMISED

I believe that sums up the trolls' views.

FTFY
 
2013-11-19 03:13:28 PM

BojanglesPaladin: Serious Black: ObamaCare did do a lot on the cost control front. ACOs, the IPAB, the Center for Medicare/Medicaid Innovation, the PCORI, the co-op insurance program, the Cadillac excise tax, the minimum medical loss ratio rules...these all will have some impact on costs.

Do you have any hard numbers on this? I know there have been a lot of proposed measures and additional bureaucracy and regulations that ideally might in some way produce some potential savings, but the numbers I have seen from the CBO show us paying more than if we had done nothing and predicting rising healthcare costs per capita over the next decade or more. I have not seen any hard numbers showing a net reduction in either insurance premiums or health care costs, and minimal, if any, reduction in the RATE of growth. But I may have missed some key information.

I assume you have looked into it. What have you found that convinces you otherwise?


ACOs seem to be having a positive impact. Several have reported cost reductions so far with no negative consequences on the quality of care. The Massachusetts pilot with AQCs for BCBS is showing similar results.

Nobody has been named to the IPAB, it is only legally empowered to make cost-saving suggestions when costs exceed the target growth rate of GDP+1% (by 2019, indexed to CPI-U before then), and it can only do thinks after the beginning of 2015, so it has had no impact whatsoever.

I haven't seen much from the Center for Medicare and Medicaid Innovation, but their website suggests they are pushing a ton of pilot projects for payment reforms along the lines of bundled payments and primary care transformation. I wouldn't be surprised if a pilot all-payer system came out of them at some point.

Given its nature as an agency for comparative effectiveness research, we likely won't see much out of the PCORI for a long time. What gains we do see would almost certainly just get plowed back into spending on better care.

The only news I've heard on the co-ops is that several states have established them and are selling plan with them on their exchanges. They've been competitively priced and are often the lowest cost plans available. As we've seen, the more competitors on an exchange, the lower the average premiums are.

The Cadillac excise tax won't do anything until 2018.

The MLR rules have already resulted in giving over a billion dollars in rebates back to beneficiaries. They'll continue to either push these rebates out or will push premiums down as companies adjust to only spending 15-20% of their money on administrative expenses.
 
2013-11-19 03:13:33 PM

Tricky Chicken: When you say 'then pass a bill fixing the flaws', all they have to do is say 'there are too many flaws to fix, we need to repeal and start over'.


I do not disagree with you. But the point was made a couple times that we should be supporting a (non-existent, hypothetical) bill that would address this issue. To which I observed that the Democrats are not offering such a bill either, and they neglected to address it in 2010 when they amended it.

lockers: Not informing you that not all doctors on a procedure are in network sounds like fraud. How can I even vet that?


You sign paperwork to that effect in the stack of papers you sign as part of your pre-surgery release. The problem is often that NONE of certain specialties are in-network.
 
2013-11-19 03:13:45 PM

un4gvn666: CPennypacker: You see, if he says a bunch of bullshiat then it is his "opinion" but if you reply to his BS with disdain then you "aren't contributing to the discussion"

It's almost as if he does it for the attention.

Hmm...


Like a kid slamming his head into the wall
 
2013-11-19 03:18:30 PM

Tomahawk513: Liberals: There's something wrong w/ the ACA, we should replace it w/ single payer.
Democrats: There's something wrong w/ the ACA, we should fix it.
Republicans: There's something wrong w/ the ACA, we should repeal it.
Tea Party: DANGNABBIT 0BUMMER SOSHULIS MUSLIN COMMIE *wheezing* GOOOOOD BLESS UHMERIKUH!!!!


God damn it, I choked on my cookie!  it almost shot out my nose!
 
2013-11-19 03:21:08 PM

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.

bradkanus: I think Docs and Hospitals have to be regulated on what they can charege across the entire market - not just the government backed part.


So you are for governmental wage controls? Why do you think the government can tell one group of people how much money they can make, but not another group? Currently, all the liberals are complaining about how much the government says that low skilled people can make is not enough, they want minimum wages raised. But you say they should also lower what a highly skilled worker should be able to make, even if it doesn't compensate them for the amount of effort and time put into learning those skills? Where is the line drawn?
 
2013-11-19 03:21:32 PM

Tricky Chicken: The house won't pass anything that actually 'improves' the bill, and the Democrats don't have the seats to force anything through like they did when it passed in the first place


In other news, getting more votes than the opposition means you've "forced" a bill through.
 
2013-11-19 03:22:42 PM

BojanglesPaladin: DamnYankees: But "Obamacare failed to fix this pre-existing issue which was already broken" isn't much of an argument; Obamacare isn't a panacea.

Translation: "Hey Guys! Stop expecting this huge bill to actually fix the things it's supposed to fix OK? That's just not FAIR! Just because Obama promised people wouldn't go bankrupt from medical bills anymore is no reason to expect the ACA to protect people from going broke from medical bills!!!"


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.

Cause that would've been really nice last time.
 
2013-11-19 03:25:39 PM

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.
 
2013-11-19 03:27:07 PM

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.

bradkanus: I think Docs and Hospitals have to be regulated on what they can charege across the entire market - not just the government backed part.

So you are for governmental wage controls? Why do you think the government can tell one group of people how much money they can make, but not another group? Currently, all the liberals are complaining about how much the government says that low skilled people can make is not enough, they want minimum wages raised. But you say they should also lower what a highly skilled worker should be able to make, even if it doesn't compensate them for the amount of effort and time put into learning those skills? Where is the line drawn?


Regulating what a business can charge for a given product or service ≠ governmental wage control
 
2013-11-19 03:29:21 PM

BeesNuts: BojanglesPaladin: DamnYankees: But "Obamacare failed to fix this pre-existing issue which was already broken" isn't much of an argument; Obamacare isn't a panacea.

Translation: "Hey Guys! Stop expecting this huge bill to actually fix the things it's supposed to fix OK? That's just not FAIR! Just because Obama promised people wouldn't go bankrupt from medical bills anymore is no reason to expect the ACA to protect people from going broke from medical bills!!!"

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.

Cause that would've been really nice last time.


Could you imagine this level of scrutiny on the war in Iraq?  I was promised we would be greeted as liberators.  I was promised the mission was accomplished.  I was promised a few weeks/months TOPS.

And here we have Republicans biatching about how sure a bill fixes SOME of the things but not ALL of the things.

Goddamn.
 
2013-11-19 03:31:12 PM

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.
 
2013-11-19 03:32:18 PM

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?)
 
2013-11-19 03:32:52 PM

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?
 
2013-11-19 03:34:17 PM

BojanglesPaladin: lockers: Not informing you that not all doctors on a procedure are in network sounds like fraud. How can I even vet that?

You sign paperwork to that effect in the stack of papers you sign as part of your pre-surgery release. The problem is often that NONE of certain specialties are in-network.


I don't remember signing any paperwork relating to planned billing, what was in network and not, etc... Doesn't mean I didn't. It was over a decade ago.
 
2013-11-19 03:35:01 PM

Harbinger of the Doomed Rat: 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.

bradkanus: I think Docs and Hospitals have to be regulated on what they can charege across the entire market - not just the government backed part.

So you are for governmental wage controls? Why do you think the government can tell one group of people how much money they can make, but not another group? Currently, all the liberals are complaining about how much the government says that low skilled people can make is not enough, they want minimum wages raised. But you say they should also lower what a highly skilled worker should be able to make, even if it doesn't compensate them for the amount of effort and time put into learning those skills? Where is the line drawn?

Regulating what a business can charge for a given product or service ≠ governmental wage control


No it just equals stupid. Do you think every hospital/doctors office pays the same per foot in rent/mortgage, salary and benefits, utilities, property tax, and so and and so forth to the hundreds of factors that go into charging for a service outside of profit?
 
2013-11-19 03:35:25 PM

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.
 
2013-11-19 03:36:12 PM

lockers: BojanglesPaladin: lockers: Not informing you that not all doctors on a procedure are in network sounds like fraud. How can I even vet that?

You sign paperwork to that effect in the stack of papers you sign as part of your pre-surgery release. The problem is often that NONE of certain specialties are in-network.

I don't remember signing any paperwork relating to planned billing, what was in network and not, etc... Doesn't mean I didn't. It was over a decade ago.


That's why it is called fine print?
 
2013-11-19 03:36:16 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.


As is mine.  My OOP is $4750 in network, $10.5K out of network.  Yes, a large disparity, but it wouldn't send me to bankruptcy.
 
2013-11-19 03:36:19 PM

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


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?
 
2013-11-19 03:38:04 PM

Wendy's Chili: I was excited for a panacea. I am disappoint


panacea, not Pantera.

I'm disappointed to, I guess i'll Walk.
 
2013-11-19 03:42:20 PM

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.
 
2013-11-19 03:42:48 PM

lockers: I don't remember signing any paperwork relating to planned billing, what was in network and not, etc... Doesn't mean I didn't. It was over a decade ago.


It's part of your general release paperwork. It's the part where you agree to be responsible for the bill, regardless of whether or not insurance covers it. If insurance covers everything, you will never need worry about it. Also, most decent plans provide coverage for out of network, though the caps are much higher. Some cover out of state, etc.

The complaint is that the ACA plans DON'T include adequate coverage for stuff outside of network, like most good plans do. In the past, you could opt to get extra protection, with an ACA plan, you may be SOL.  I find it hard to believe it's a big fat ZERO for out of network.

Can anyone confirm that ACA plans have ZERO coverage out of network, or is it just that they pay a portion only, and there is no limit on your OOP?
 
2013-11-19 03:43:25 PM

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

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?


Cost control?
 
2013-11-19 03:43:38 PM

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.


More detail:

"The Maryland law gave the HSCRC authority to set hospital rates for all payers. However, federal 
law, which takes precedence, governed the methods by which Medicare and Medicaid paid 
hospitals. The HSCRC believed that hospitals should operate under consistent payment incentives 
and that the payment methods of Medicare and Medicaid, which were cost-based at that time, were 
contrary to the interests of efficient hospitals arid to those of the citizens of Maryland. Therefore, 
the HSCRC negotiated with representatives of both Medicare arid Medicaid and, effective July 1, 
1977, obtained a waiver of federal law that required Medicare and Medicaid to begin paying 
hospitals on the basis of HSCRC-approved rates. 
3, 4 Thus, while the HSCRC has been approving 
hospital rates since 1974, those rates have covered all payers only since the Medicare Waiver was 
granted in1977. "

http://www.hscrc.state.md.us/documents/HSCRC_PolicyDocumentsReports/ Ge neralInformation/MarylandAll-PayorHospitalSystem.pdf
 
2013-11-19 03:44:02 PM

Serious Black: 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.


I think they were exempted from the ACA rules though weren't they?
 
2013-11-19 03:46:08 PM

Teufelaffe: Tricky Chicken: The house won't pass anything that actually 'improves' the bill, and the Democrats don't have the seats to force anything through like they did when it passed in the first place

In other news, getting more votes than the opposition means you've "forced" a bill through.


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?
 
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.
 
2013-11-19 10:04:10 PM

BeesNuts: 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.


Quite probably. there are always binary politicos who swear allegiance to party over evaluating policy. I find them to be in roughly equal numbers with willfully blind partisan zealots equally distributed between the two parties. One could equally counter that for all the people foaming at the mouth rabid in their hatred of Bush over the Patriot act and civil rights violations, they are remarkably acquiescent about "their team's guy" doing massive NSA spying, warrantless wiretapping and a secret kill list used to kill American citizens without due process.

So I would be cautious of claiming any "my side/ your side" superiority in terms of objective criticisms. But then again, I advise against party allegiances in the first place, so we may have differing views on the topic.

Dedmon: 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?


I can't speak to what asshat paid provocateurs like Beck and Hannity spew, but if you would like some actual examples of the flaws in ACA, I would recommend that you start with the article of this thread?
 
2013-11-19 10:28:13 PM
 
2013-11-19 11:21:46 PM

BojanglesPaladin: BeesNuts: 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.

Quite probably. there are always binary politicos who swear allegiance to party over evaluating policy. I find them to be in roughly equal numbers with willfully blind partisan zealots equally distributed between the two parties. One could equally counter that for all the people foaming at the mouth rabid in their hatred of Bush over the Patriot act and civil rights violations, they are remarkably acquiescent about "their team's guy" doing massive NSA spying, warrantless wiretapping and a secret kill list used to kill American citizens without due process.

So I would be cautious of claiming any "my side/ your side" superiority in terms of objective criticisms. But then again, I advise against party allegiances in the first place, so we may have differing views on the topic.

Dedmon: 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?

I can't speak to what asshat paid provocateurs like Beck and Hannity spew, but if you would like some actual examples of the flaws in ACA, I would recommend that you start with the article of this thread?


No, really, point to the parts of the law itself that you disagree with. If you want to be listened to, you need to be constructive, not reactionary. The article addresses a problem, but hasn't pointed to what clause in the bill is forcing the situation. Perhaps it could be changed, if necessary, if the republicans wish to participate in the governing process.
 
2013-11-19 11:27:50 PM

Dedmon: No, really, point to the parts of the law itself that you disagree with

I

I'm not sure what conversation you think you are having, but perhaps you should review earlier comments in the thread. In particular, you may notice that many of my criticism are about what is ABSENT from the bill, including things like protections from 'balance billing'.
 
2013-11-20 12:17:01 AM

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.


Because it was great before we started mucking with it, eh?
 
2013-11-20 01:27:54 AM

BojanglesPaladin: if you would like some actual examples of the flaws in ACA, I would recommend that you start with the article of this thread?


The article could be summarized as "here's a problem with insurance that the ACA only partially resolves".  That's not really a "flaw" in the law.  It makes things better, but of course it isn't going to fully resolve every problem with the healthcare industry.

 

bintherdunthat: www.upi.com/blog/2013/05/29/Maine-doctor-cuts-prices-in-half-by-refus i ng-health-insurance/3571369847964/?spt=mps&or=2


Part of that is that the 'before' prices were quite high.  $70 is about the national average for a routine office visit at a typical level of service.

But yes, the level of overhead added by dealing with insurance can be staggering for a small practice.  It's one of the reasons small practices are dying out, as providers are absorbed into larger and larger groups - there's an economy of scale that the smaller clinics just can't compete with.  The clinics that see half a dozen people a day are going the way of mom & pop stores.
 
2013-11-20 01:41:06 AM

BojanglesPaladin: In particular, you may notice that many of my criticism are about what is ABSENT from the bill, including things like protections from 'balance billing'.


Do you think Congress could have actually passed a law which would effectively mandate what prices doctors could charge for their services - or that it would pass Constitutional muster if they did?  Even for as broad as the commerce clause is, I don't think the current Supreme Court would let that stand.

The only comparable precedents at the federal level were the wage and price controls during WW2, which almost certainly would have been legally challenged if the country hadn't been at war.
 
2013-11-20 05:40:06 AM
I don't get this Obamacare at all.

network of doctors that you are allowed to use?
Still have a co-pay?
out of pocket pay of above 6k if you are single?

How shiatty was your health care if that is an improvement?

/obviously not American
 
2013-11-20 06:01:16 AM

BKITU: bradkanus: 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.

Today, in "Morons Seeing What They Want To See Theater"....


Except my insurance has always negotiated with the hospital and each physician independently.  My wife had a procedure (test) and I still got bills from people that I have no idea even who the hell they were.  That's not right.

One time I went to the emergency room and the wife needed care and they took us back pretty fast.  We set there in the room for over 2 hours waiting.  They came in, treated my wife and then when the bill came in we got a bill for "exteded emergency room visit".  It had nothing to do with the procedure and everything to do with the hospital raping our insurance (and me in the process).  Of course, this was before the ACA so I wonder how they're going to go crazy when a story comes out about that. 

I guess I'll wait.
 
2013-11-20 06:29:39 AM

BojanglesPaladin: Dedmon: No, really, point to the parts of the law itself that you disagree with

I I'm not sure what conversation you think you are having, but perhaps you should review earlier comments in the thread. In particular, you may notice that many of my criticism are about what is ABSENT from the bill, including things like protections from 'balance billing'.


I think I'm hitting on something profound here. Are you saying there's nothing wrong with the bill as written, and it should instead be supplemented with additional laws to further expand its scope?
 
2013-11-20 10:50:22 AM

Dedmon: I never hear [someone else], Hannity, Beck, or anyone really actually say WHAT is actually so BAD about the affordable care act?


I read an analysis once, from people who interviewed actual Republicans and tried to take them seriously, and this is the gist.

Inside the right-wing reality bubble:
- America is 47% moochers.
- Obamacare is a new entitlement program.
- It will push America over the 50%-moocher tipping point.
- After this point, since moochers are reliable Democratic voters, Republicans will be unable to affect policy.
- After this point, the country will collapse due to moocher death spiral as everyone votes for more and more "free stuff"
- Therefore, Obamacare is a threat to the very existence of America.
 
2013-11-20 02:08:51 PM

Gaseous Anomaly: Dedmon: I never hear [someone else], Hannity, Beck, or anyone really actually say WHAT is actually so BAD about the affordable care act?

I read an analysis once, from people who interviewed actual Republicans and tried to take them seriously, and this is the gist.

Inside the right-wing reality bubble:
- America is 47% moochers.
- Obamacare is a new entitlement program.
- It will push America over the 50%-moocher tipping point.
- After this point, since moochers are reliable Democratic voters, Republicans will be unable to affect policy.
- After this point, the country will collapse due to moocher death spiral as everyone votes for more and more "free stuff"
- Therefore, Obamacare is a threat to the very existence of America.


What?  no "looters" in the equation?   You'd think that looter influence, if not raw numbers, would provide at least 3% more to the "moocher" side.
 
2013-11-20 03:22:33 PM

Dedmon: I think I'm hitting on something profound here.


I think you are wrong.
 
2013-11-20 09:13:10 PM
 

BojanglesPaladin: Dedmon: I think I'm hitting on something profound here.

I think you are wrong.


Are you saying there's nothing wrong with the bill as written, and it should instead be supplemented with additional laws to further expand its scope?
 
2013-11-20 09:23:53 PM

Dedmon: Are you saying there's nothing wrong with the bill as written, and it should instead be supplemented with additional laws to further expand its scope?


That sounds like something you would say, and doesn't resemble anything I have said.

What I would say, I did. In the thread above. Which you are welcome to review.

Have a pleasant evening.
 
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