no preapprovals for tests. Everyone takes it. I go for cosmetic surgery, they will probably pay for it. So you whiners keep on working to keep me covered
Do you have a Medicare supplemental policy? If so, any recommendations. I'll be on it next year, although still working. Looks like Humana got bought out; they were pretty much the leader in supplemental policies.
It's the same government solution to everything. Pass a huge bureaucratic law that costs a lot of money to say you fixed a problem, when you really didn't
Quote:
1 in 4 adults had insurance but still couldn’t afford medical care
But even with the gains under the health-care law, 25.2 percent of adults who bought insurance on their own last year said they went without medical tests or treatments, prescription drugs or doctor visits because of cost.
Had been leveling off to small increases over the 10 years directly before Obamacare was implemented. Plus, remember the 5 years of premiums versus 3 years of payments ruse. It will only get worse .
NY state cancer survivor here. We are going up 15 % 1-1. But, wait, Krugman, we are the classic heavily mandated, no-prior-history-exclusion,role-model of a state. The rest of the country was supposed to be catching up to us, premium-wise. PS not really .
1. If you like your plan you can keep your plan.
2. The average American family will save $3500 annually with Affordable Care Act.
that Obamacare was sold on some big promises. You can keep your plan and your doctor - not true. You will save $2500 a year in premiums - laughably not true. So it was shoved through on Christmas Eve with every legislative trick in the book and many of the dem reps and Senators who voted for it lost their seats (good, IMO).
Meanwhile it has done nothing to rein in costs and they will keep going up. It's absurd to say this is working in any rational way.
Actually you could keep your plan and your doctor. The insurance companies lied to people and tricked them into giving up their grandfathered in plans which essentially covered nothing to begin with. Their is a class action lawsuit ongoing regarding this now. The truth shall set you free - ( New Window )
I'm beginning to believe it's going to be necessary for most working people. Today's health care costs are crippling.
Let most of the funding come from taxes on the nation's wealthiest 2%. They have raped this country's working class for years and now it's time to try and set things a little more fair.
All expenses for health care need to be evaluated to see where issues of greed, private or corporate are. Then mandatory caps must be applied so that organizations/providers/labs involved in healthcare can make a profit but may not overcharge.
Finally, every member of congress, the President and SCOTUS, needs to have the same exact healthcare plan that they voted for the People.
I feel sorry for the poor working bastards who aren't covered by company insurance. 20% of their net salary goes to insurance.
Well the increase Horizon got in New Jersey was "only" 9%, but you'd be paying more for a family plan given that you're almost an old fart. Nationwide the increases are far more than promised when the ACA was being considered.
The good news for me is the premiums for the Pediatric Dental Care Plan I'm required to be enrolled in remains at zero. As long as I don't answer a knock at my door and face some teenager who exclaims "DADDY!!!" they'll stay that was. But as long Horizon still has to go through the paperwork to notify ne of this and supply an insurance card I can't say the ACA is doing much to reduce the paperwork and bureaucracy.
went up too. I have always had an awesome plan through work. Everything is covered so it was not one of those "shitty" plans that the left likes to talk about. Costs started going up a year ago and our company cited increases due to the ACA.
Now, some people are going to say that the insurance companies used this as an opportunity to raise rates or for companies to shift costs to the employees.
If that is true, then the architects of the program did NOT take all of these factors into consideration and make sure this could not happen. OR, they knew it would happen and just did not care.
Had been leveling off to small increases over the 10 years directly before Obamacare was implemented. Plus, remember the 5 years of premiums versus 3 years of payments ruse. It will only get worse .
NY state cancer survivor here. We are going up 15 % 1-1. But, wait, Krugman, we are the classic heavily mandated, no-prior-history-exclusion,role-model of a state. The rest of the country was supposed to be catching up to us, premium-wise. PS not really .
1. If you like your plan you can keep your plan.
2. The average American family will save $3500 annually with Affordable Care Act.
What is your source for costs leveling off? Because in the previous decade premiums were up well over 100%.
Not everybody benefits the same amount from the same health care. So people get to chose whats worth it and whats not. Selecting higher co-pays covers castastrophic stuff, is cheaper and allows you more choice over what you pay for.
Turns out smokers don't want to pay for lung screening. A smoker buys a plan that would cover screening 100% would be very expensive. Cover it 80% and the smoker skips the exam and saves money. It their choice to smoke and bear the responsibility. Is that bad?
Seems like the ACA gave some hope and change to the millions of uninsured Americans who would have died had they gotten a serious illness.
My Dad is a physician, and my families income is greatly impacted by Obamacare. It's always an internal battle between my desire to make sure my family can maintain the level of income they've had in the past, and the desire to make sure we don't have a high number of uninsured citizens for whom an illness would have disastrous consequences beyond their health.
it's just continuing in a manner that is unsustainable.
My share of my family's insurance premiums has increased by >10% of our gross monthly incomes since 2011. We just see every year that it goes up by another $150-$200. The thing that made this year special was they cut all our benefits to boot. We basically had our deductible and out of pockets doubled while we've had our coverage reduced.
Meanwhile, my doctor just moved into a brand-new, gorgeous new office. The center has the feel of a high-end hotel. I took my father-in-law to his new doctor two weeks ago to find them in a brand-new facility as well. Absolutely stunning.
Meanwhile, we just voted down a bond that would have replaced a leaky roof at one of our schools. The district doesn't have the funds to perform even basic maintenance anymore. One school has taken to doling out bottles of water and turning off the drinking fountain because they don't have enough money to repair the plumbing and make the drinking water safe.
And did I mention - the football team and cheerleaders all got new uniforms again - for the 5th year in a row? $1300 in uniform and camp expenses for each of my daughters to be cheerleaders again.
The ACA banned the exclusion of pre-existing conditions Â
It says that this problem where the insurance companies are making it too expensive for basic coverage pre-dated the Affordable Care Act.
Like Social Security and Medicare the Affordable Care Act will become a good example of how government is helpful to a large portion of the county.
But it's gotten worse, much worse under Obamacare. Before you could get a high deductible plan but the premiums were much lower. Ironically those were labeled as 'crappy' plans by Obamacare proponents. So now we have high deductible with high premiums. It's backwards.
BTW, Social Security, while a good idea, has been abused and is going bankrupt. I don't think that's a good example to bring up.
that Obamacare was sold on some big promises. You can keep your plan and your doctor - not true. You will save $2500 a year in premiums - laughably not true. So it was shoved through on Christmas Eve with every legislative trick in the book and many of the dem reps and Senators who voted for it lost their seats (good, IMO).
Meanwhile it has done nothing to rein in costs and they will keep going up. It's absurd to say this is working in any rational way.
Actually you could keep your plan and your doctor. The insurance companies lied to people and tricked them into giving up their grandfathered in plans which essentially covered nothing to begin with. Their is a class action lawsuit ongoing regarding this now. The truth shall set you free - ( New Window )
You are a lying sack of dog excrement. The insurance companies didn't lie, the WH lied. Yes you could keep your plan IF it covered 8 certain minimum items (as required by ACA) - including maternity coverage even for people past that point. If your plan didn't cover those minimum requirements you lost your plan and had to get a newer more expensive one.
that Obamacare was sold on some big promises. You can keep your plan and your doctor - not true. You will save $2500 a year in premiums - laughably not true. So it was shoved through on Christmas Eve with every legislative trick in the book and many of the dem reps and Senators who voted for it lost their seats (good, IMO).
Meanwhile it has done nothing to rein in costs and they will keep going up. It's absurd to say this is working in any rational way.
Actually you could keep your plan and your doctor. The insurance companies lied to people and tricked them into giving up their grandfathered in plans which essentially covered nothing to begin with. Their is a class action lawsuit ongoing regarding this now. The truth shall set you free - ( New Window )
You are a lying sack of dog excrement. The insurance companies didn't lie, the WH lied. Yes you could keep your plan IF it covered 8 certain minimum items (as required by ACA) - including maternity coverage even for people past that point. If your plan didn't cover those minimum requirements you lost your plan and had to get a newer more expensive one.
My insurance plan didn't change one iota with Obamacare. I suspect this was true for a lot of folks.
The average American family will save $3500 annually with Affordable Care Act.
No matter how you spin this, it's NOT true. No one is saving money. I work in health care field daily. I have yet to meet a single person who says their insurance cost went DOWN after ACA. I have, however, met people who had NO insurance, who is now getting a subsidized plan at little or no cost to them.
The government mixes these plans in with the ones that are going up and calls it a savings. It cannot be a savings because SOMEONE is paying for those people to have insurance. Those with us with higher premiums are paying more monthly, higher copay, etc. Then on top of that, we have to pay ever increasing taxes, which also goes to help pay off the free insurance for someone else.
I do not mind helping someone who needs a hand. I have been there, we all probably have.
Another issue with people having insurance, they don't know how to use it. So they are increasing cost for the ones who pay indirectly as well. They still use hospital ERs as their source of medical care. Why? Because they have no out of pocket expense. I see them on a daily basis call EMS to come pick them up, to take to ER because they want to bypass the waiting room lines. This is egregious management of their benefits, but they DON'T care because they don't have to pay for it to start with.
I think these things are what upsets people. There are fundamental problems driving healthcare cost up, and the ACA was a trillion dollar shovel of dirt to cover it up for a few years. I would say this has set healthcare back instead of carrying it forward.
The problem was affordable healthcare. So instead of making it affordable congress created a massive entitlement. No tort reform, no prescription drug cost reduction, no one held accountable for the overprescription of drugs, no fraud prevention. It's kind d of like the Iran deal, he felt he had to do something, it's just not the right thing
True, elections do have consequences. But the country is still evenly divide, and when one side completely shuts out the other side on something so important, and so far reaching, Obamacare is the mess that you get. Which is a big reason why many of those involved were shown the door during the last two election cycles.
The same thing will happen to the republicans when they are back in the driver’s seat, if they take the same attitude that they don’t have to include the other side in such critical legislation.
My healthcare went up exponentially after obamacare Â
1. I have yet to meet someone whose out of pocket healthcare costs have decreased. NOT A SINGLE PERSON
2. For those who are now forced to buy healthcare when they didn't have it before, it is NOT affordable for them...AT ALL.
3. The fine for not buying healthcare is cheaper than buying healthcare....and you can still walk into a hospital and get treated.
4. The creators of the ACA said that they need everyone under the age of 30 to sign up so that the whole thing can get funded. Without them, the whole thing is financially upside down. So, WHY add the provision that people 26yrs and younger can be covered under their parent's plan? Where is the money supposed to come from?
Just curious, where in the process the GOP was shut out? The months of hearings? The months of negotiations? The more that 160 GOP sponsored amendments that were accepted in the Senate bill? Or is it just that in a staggeringly cynical move, the GOP rejected the concept of the individual mandate which had previously been on its platform and which had been supported by McCain and enacted by Romney before the big bad Obama was for it. Indeed, Obama only ever pursued the individual mandate as a compromise -- foolishly believing that the GOP would not be so cynical as to reject its own policy proposal out of hand.
The GOP wasnt shut out. They simply voted against the bill.
Just curious, where in the process the GOP was shut out? The months of hearings? The months of negotiations? The more that 160 GOP sponsored amendments that were accepted in the Senate bill? Or is it just that in a staggeringly cynical move, the GOP rejected the concept of the individual mandate which had previously been on its platform and which had been supported by McCain and enacted by Romney before the big bad Obama was for it. Indeed, Obama only ever pursued the individual mandate as a compromise -- foolishly believing that the GOP would not be so cynical as to reject its own policy proposal out of hand.
The GOP wasnt shut out. They simply voted against the bill.
It just doesn't matter what happened 6 years ago. System is still broke and needs fixed.
We changed the law of the land, not by much, and our health system is still out of control.
but if you just want to reform the system, you need to identify the culprit.
- It's not the drug cos: drug spend just isnt that big
- It's not the insurance cos: they're actually working to reduce spending, although not that hard except on drugs
- It's not the plaintiff's lawyers: someone mentioned tort reform, but where enacted it did not lead to cheaper care, less testing (ie defensive medicine), or lower malpractice premiums. It was a red herring in the reform movement.
So who is the bad guy? Hospitals. Plain and simple. Particularly hospitals in midsize/smaller markets who are buying up medical practices and rivals and effectively ending competition, and then dictating massive rate increases. You cant sell medical insurance within 50 miles of Pittsburgh and not have the university medical center on your plan, because they've bought up all competition. The university knows it, and charges monopoly prices. Insurance cos dont totally care -- so long as everyone has to pay the hire rates, the cost can be passed along to policy holders.
There are a lot more fixes, but getting some cost control in the hospital market would be huge (especially as private doctors offices are being bought up and hospitalized -- that is getting the higher reimbursement rates paid for in-hospital treatment rather than private office treatment).
you get to the PP&E spend. Grossly unnecessary expansions costing 8 and 9 figures.
And the equipment. Oh the equipment. You have a perfectly fine $3 million MRI. It's a few years old. But you're a "leading medical center" and god damnit there is a new shiny. So you buy the new shiny. And then you jack up your MRI charge because, god damnit, it's a new generation machine so its better and in any event you need to earn your investment back. So you also go to your doctors and remind them that there is this great new MRI and we need to use it and MRIs are great and by the way it helps the hospital to do more MRIs. Everyone gets the drill. That new MRI is a fucking cash cow ... for about 3 years, when a newer shiny comes on the market.
into the bill. No tort reform, no selling insurance across state lines, nothing.
The idea that the GOP wanted individual mandates is silly. It was one person who proposed it and it never went anywhere.
Tort reform is not a serious proposal. It doesnt move the needle one inch (and states are free to address them). Selling insurance across state lines is a red herring -- there is plenty of competition among insurer in big states and the costs are still spiraling. The problem isnt that big insurers are excluded from smaller states; the problem is that the healthcare services market in this country is really thousands of separate markets (e.g. Pittsburgh-area), and as to each of those markets the hospitals tend to have the bargaining power, b/c the Univ. of Pittburgh can do without Deej Ins. Co's business, but Deej Ins. Co cant really sell insurance near Pittsburgh if it doesnt have a contract with the dominant hospital "system".
These are just not serious proposals. It's painting the trim and re-potting flowers on a burned down building.
some very smart people argue that while single payer could have been implemented 50 years ago, there is simply no way to convert America to a single payer at this point.
I dont have an opinion on that, but it is worth acknowledging that we cant snap our fingers and be where other countries are easy-peasy.
It's not "hospital centralization", unless you consider a Â
predominantly Northeastern problem representative of the United States as a whole.
What people are seeing are large, one-time cost increases as physicians are shifted towards other centers (located around the hospital, in the hospital, or in a centralized location), where hospitals are also buying the equipment.
This "binge" has led to a considerable "cost" and "price" hike, even though it's a different good being produced. In fact, some evidence from large scale datasets have shown that costs have started to moderate, compared to non-employee physicians, partially because supply-induced demand has been eliminated (i.e., fee-for-service).
Another reason the "cost bump" has occurred is because of the patients that doctors have been seeing. They are not the same. If, in fact, you control for patient quality (or patient outcome), you get that per-patient costs are on par with hospital employed physicians.
firsthand experience with people that have lower costs because of the ACA it generalizes to the population as a whole is utter horseshit.
Firstly, the plans are different. When there is a shift in plans, costs shift. Unless you think comparing VCR's to DVD players is a viable comparison (which I don't doubt some here do), it's a pretty fucking simple statement.
Secondly, what do you think happens when HI companies are allowed to cost shift to their clientele more than what they are normally allowed to do, because of a change in the structure of the system? And that this cost shift is largely a one-time event? This didn't happen? Well, I'd love for you to meet some of the people that I know.
Thirdly, how the fuck can people think healthcare, both reform and implementation, is simple at all?
Lastly, this notion that we can evaluate cost trends of the ACA a few years after implementation is moronic. I hate the bill with a passion, but everyone with a functioning IQ would realize that there are parts of the bill (such as preventive care, mandating coverage, and mandating minimal standards of care) that may change long-term behavior.
Single payer can cut costs quite considerably by delaying or cutting care, which incentivizes either a quite significant travel market or secondary private market. Both of which we see in a variety of countries.
It's probably the best system for where we are (some form of minimal standards supported by the government with an additional private market), but has quite deficient flaws as well.
Including rather atrocious reimbursement rates for physicians.
if we are to believe that physician acquisitions are going to lead to a long-term bump in costs.
It is quite the opposite in the Southeast, Midwest, Southwest, Northwest, and West Coast.
Physicians may be acquired by insurers (such as Kaiser), but there are a variety of channels whereby costs per patient are lowered, quite considerably.
I'd hesitate to lump in reimbursement rates for physicians as one category. My doctor gets screwed on a long office visit -- gets paid less per hour than you'd pay a guy to come fix your computer. Specialists often get paid a lot more. Some procedures get great reimbursement rates. And rates paid for in-hospital evaluations, procedures etc. can often vastly exceed what is paid for the same work in non-hospital offices.
Pre-ACA I was reading about how they set Medicare reimbursement rates for doctors. It was mindboggling. Essentially the docs put together their own panel of 30 docs (20+ specialists), who ranked everything a doctor does based on stuff like necessary skill, "difficulty", and time. These rankings were the basis for the differences in pay rates for different procedures. The specialists just teamed up against the GPs, and made all the specialist work more expensive. The private insurers just plussed up the Medicare rates. So that is why GPs cant make a living (and no one goes into GP).
The reimbursement schedules of physicians is an awfully interesting topic. Although focus has been placed on readmission rates as a carrot/stick for payment, it has always been that way.
Perhaps the more interesting question is how much centralization or "contracting" can alleviate (or exacerbate) these issues.
There are a couple of other issues with regards to reimbursement, namely the rapid expansion of diagnosable illnesses (I'm not quite sure that a diagnosis related group, DRG, is a solution), but the specialists have also been able to facilitate very micro-level diagnoses, whereas GP's have limited ability to do it.
New phone and didn't have the new password when I re logged in after the hack.
Rates were going up before ACA and are now. Deductibles have surely risen.
Big fallacy. The uninsured were not being treated before the ACA. Yeah they were and being paid for by our tax dollars.
All it was is a dollar shift with the middle class taking it the butt again.
It now takes me 2/3 months to schedule a doctors apportionment. So much for reducing emergency visits.
It always gets pushed on to the the consumer.
My thoughts? Single payer is inevitable.
Where are the rich Canadians going to go?
My premiums began skyrocketing right around 2003 with the demise of the HMO. I guess I'm lucky in that we had to change to a high deductible plan back then with premiums that were also more than HMO plans in addition to contributing to an HSA.
I don't know why, but I haven't seen a difference since the ACA was put into place. My premiums haven't gone crazy, and I have pretty much the se coverage.
When my company moved away from the HMO plans, we were told that it was because they just weren't sustainable. Is it possible that my company was a little ahead of the curve and didn't try to stick with something that they knew couldn't last? Maybe.
What I can tell you that I notice whenever these threads pop up is people upset about plans (that weren't sustainable regardless of the ACA) bitching that now they are changing and blaming it on the ACA. They were going to change anyway, and I suspect that it would have been worse without the ACA.
It reminds me much of people bitching about "union retirement plans" that are unsustainable and placing all of the blame on the university me while ignoring that without the companies agreeing to them, they would have never existed.
Anyway- I agree with you and do think single payer is where we will end up.
Of course we've also got to get people to stop eating cheeseburgers.
no preapprovals for tests. Everyone takes it. I go for cosmetic surgery, they will probably pay for it. So you whiners keep on working to keep me covered
You really are a cunt
LTS, I've always been a fan of your posts since the CJ Spiller draft, but posts like these make me an even bigger fan!
1. I have yet to meet someone whose out of pocket healthcare costs have decreased. NOT A SINGLE PERSON
2. For those who are now forced to buy healthcare when they didn't have it before, it is NOT affordable for them...AT ALL.
3. The fine for not buying healthcare is cheaper than buying healthcare....and you can still walk into a hospital and get treated.
4. The creators of the ACA said that they need everyone under the age of 30 to sign up so that the whole thing can get funded. Without them, the whole thing is financially upside down. So, WHY add the provision that people 26yrs and younger can be covered under their parent's plan? Where is the money supposed to come from?
My premiums went down last year. Deductibles went up, but not enough to offset the decrease. Also - better benefits than the year before thanks to being able to count prescriptions toward the deductible - that was ACA policy nationwide. Everyone got it.
So you can't say you never heard of one person anymore. Ny state rulz!
Do you have a Medicare supplemental policy? If so, any recommendations. I'll be on it next year, although still working. Looks like Humana got bought out; they were pretty much the leader in supplemental policies.
It's the same government solution to everything. Pass a huge bureaucratic law that costs a lot of money to say you fixed a problem, when you really didn't
But even with the gains under the health-care law, 25.2 percent of adults who bought insurance on their own last year said they went without medical tests or treatments, prescription drugs or doctor visits because of cost.
Link - ( New Window )
NY state cancer survivor here. We are going up 15 % 1-1. But, wait, Krugman, we are the classic heavily mandated, no-prior-history-exclusion,role-model of a state. The rest of the country was supposed to be catching up to us, premium-wise. PS not really .
1. If you like your plan you can keep your plan.
2. The average American family will save $3500 annually with Affordable Care Act.
Like Social Security and Medicare the Affordable Care Act will become a good example of how government is helpful to a large portion of the county.
Quote:
In comment 12453935 buford said:
Quote:
that Obamacare was sold on some big promises. You can keep your plan and your doctor - not true. You will save $2500 a year in premiums - laughably not true. So it was shoved through on Christmas Eve with every legislative trick in the book and many of the dem reps and Senators who voted for it lost their seats (good, IMO).
Meanwhile it has done nothing to rein in costs and they will keep going up. It's absurd to say this is working in any rational way.
Actually you could keep your plan and your doctor. The insurance companies lied to people and tricked them into giving up their grandfathered in plans which essentially covered nothing to begin with. Their is a class action lawsuit ongoing regarding this now. The truth shall set you free - ( New Window )
Mother Jones?
Here's another one for ya.
Lawsuits against insurance companies - ( New Window )
Let most of the funding come from taxes on the nation's wealthiest 2%. They have raped this country's working class for years and now it's time to try and set things a little more fair.
All expenses for health care need to be evaluated to see where issues of greed, private or corporate are. Then mandatory caps must be applied so that organizations/providers/labs involved in healthcare can make a profit but may not overcharge.
Finally, every member of congress, the President and SCOTUS, needs to have the same exact healthcare plan that they voted for the People.
Luckily, my cola covers the increase easily.
I feel sorry for the poor working bastards who aren't covered by company insurance. 20% of their net salary goes to insurance.
Well the increase Horizon got in New Jersey was "only" 9%, but you'd be paying more for a family plan given that you're almost an old fart. Nationwide the increases are far more than promised when the ACA was being considered.
The good news for me is the premiums for the Pediatric Dental Care Plan I'm required to be enrolled in remains at zero. As long as I don't answer a knock at my door and face some teenager who exclaims "DADDY!!!" they'll stay that was. But as long Horizon still has to go through the paperwork to notify ne of this and supply an insurance card I can't say the ACA is doing much to reduce the paperwork and bureaucracy.
Now, some people are going to say that the insurance companies used this as an opportunity to raise rates or for companies to shift costs to the employees.
If that is true, then the architects of the program did NOT take all of these factors into consideration and make sure this could not happen. OR, they knew it would happen and just did not care.
NY state cancer survivor here. We are going up 15 % 1-1. But, wait, Krugman, we are the classic heavily mandated, no-prior-history-exclusion,role-model of a state. The rest of the country was supposed to be catching up to us, premium-wise. PS not really .
1. If you like your plan you can keep your plan.
2. The average American family will save $3500 annually with Affordable Care Act.
What is your source for costs leveling off? Because in the previous decade premiums were up well over 100%.
Not everybody benefits the same amount from the same health care. So people get to chose whats worth it and whats not. Selecting higher co-pays covers castastrophic stuff, is cheaper and allows you more choice over what you pay for.
Turns out smokers don't want to pay for lung screening. A smoker buys a plan that would cover screening 100% would be very expensive. Cover it 80% and the smoker skips the exam and saves money. It their choice to smoke and bear the responsibility. Is that bad?
Seems like the ACA gave some hope and change to the millions of uninsured Americans who would have died had they gotten a serious illness.
My Dad is a physician, and my families income is greatly impacted by Obamacare. It's always an internal battle between my desire to make sure my family can maintain the level of income they've had in the past, and the desire to make sure we don't have a high number of uninsured citizens for whom an illness would have disastrous consequences beyond their health.
My share of my family's insurance premiums has increased by >10% of our gross monthly incomes since 2011. We just see every year that it goes up by another $150-$200. The thing that made this year special was they cut all our benefits to boot. We basically had our deductible and out of pockets doubled while we've had our coverage reduced.
Meanwhile, my doctor just moved into a brand-new, gorgeous new office. The center has the feel of a high-end hotel. I took my father-in-law to his new doctor two weeks ago to find them in a brand-new facility as well. Absolutely stunning.
Meanwhile, we just voted down a bond that would have replaced a leaky roof at one of our schools. The district doesn't have the funds to perform even basic maintenance anymore. One school has taken to doling out bottles of water and turning off the drinking fountain because they don't have enough money to repair the plumbing and make the drinking water safe.
And did I mention - the football team and cheerleaders all got new uniforms again - for the 5th year in a row? $1300 in uniform and camp expenses for each of my daughters to be cheerleaders again.
Like Social Security and Medicare the Affordable Care Act will become a good example of how government is helpful to a large portion of the county.
But it's gotten worse, much worse under Obamacare. Before you could get a high deductible plan but the premiums were much lower. Ironically those were labeled as 'crappy' plans by Obamacare proponents. So now we have high deductible with high premiums. It's backwards.
BTW, Social Security, while a good idea, has been abused and is going bankrupt. I don't think that's a good example to bring up.
Quote:
that Obamacare was sold on some big promises. You can keep your plan and your doctor - not true. You will save $2500 a year in premiums - laughably not true. So it was shoved through on Christmas Eve with every legislative trick in the book and many of the dem reps and Senators who voted for it lost their seats (good, IMO).
Meanwhile it has done nothing to rein in costs and they will keep going up. It's absurd to say this is working in any rational way.
Actually you could keep your plan and your doctor. The insurance companies lied to people and tricked them into giving up their grandfathered in plans which essentially covered nothing to begin with. Their is a class action lawsuit ongoing regarding this now. The truth shall set you free - ( New Window )
You are a lying sack of dog excrement. The insurance companies didn't lie, the WH lied. Yes you could keep your plan IF it covered 8 certain minimum items (as required by ACA) - including maternity coverage even for people past that point. If your plan didn't cover those minimum requirements you lost your plan and had to get a newer more expensive one.
Quote:
In comment 12453935 buford said:
Quote:
that Obamacare was sold on some big promises. You can keep your plan and your doctor - not true. You will save $2500 a year in premiums - laughably not true. So it was shoved through on Christmas Eve with every legislative trick in the book and many of the dem reps and Senators who voted for it lost their seats (good, IMO).
Meanwhile it has done nothing to rein in costs and they will keep going up. It's absurd to say this is working in any rational way.
Actually you could keep your plan and your doctor. The insurance companies lied to people and tricked them into giving up their grandfathered in plans which essentially covered nothing to begin with. Their is a class action lawsuit ongoing regarding this now. The truth shall set you free - ( New Window )
You are a lying sack of dog excrement. The insurance companies didn't lie, the WH lied. Yes you could keep your plan IF it covered 8 certain minimum items (as required by ACA) - including maternity coverage even for people past that point. If your plan didn't cover those minimum requirements you lost your plan and had to get a newer more expensive one.
My insurance plan didn't change one iota with Obamacare. I suspect this was true for a lot of folks.
No matter how you spin this, it's NOT true. No one is saving money. I work in health care field daily. I have yet to meet a single person who says their insurance cost went DOWN after ACA. I have, however, met people who had NO insurance, who is now getting a subsidized plan at little or no cost to them.
The government mixes these plans in with the ones that are going up and calls it a savings. It cannot be a savings because SOMEONE is paying for those people to have insurance. Those with us with higher premiums are paying more monthly, higher copay, etc. Then on top of that, we have to pay ever increasing taxes, which also goes to help pay off the free insurance for someone else.
I do not mind helping someone who needs a hand. I have been there, we all probably have.
Another issue with people having insurance, they don't know how to use it. So they are increasing cost for the ones who pay indirectly as well. They still use hospital ERs as their source of medical care. Why? Because they have no out of pocket expense. I see them on a daily basis call EMS to come pick them up, to take to ER because they want to bypass the waiting room lines. This is egregious management of their benefits, but they DON'T care because they don't have to pay for it to start with.
I think these things are what upsets people. There are fundamental problems driving healthcare cost up, and the ACA was a trillion dollar shovel of dirt to cover it up for a few years. I would say this has set healthcare back instead of carrying it forward.
Elections have consequences.
True, elections do have consequences. But the country is still evenly divide, and when one side completely shuts out the other side on something so important, and so far reaching, Obamacare is the mess that you get. Which is a big reason why many of those involved were shown the door during the last two election cycles.
The same thing will happen to the republicans when they are back in the driver’s seat, if they take the same attitude that they don’t have to include the other side in such critical legislation.
Rates were going up before ACA and are now. Deductibles have surely risen.
Big fallacy. The uninsured were not being treated before the ACA. Yeah they were and being paid for by our tax dollars.
All it was is a dollar shift with the middle class taking it the butt again.
It now takes me 2/3 months to schedule a doctors apportionment. So much for reducing emergency visits.
It always gets pushed on to the the consumer.
My thoughts? Single payer is inevitable.
Where are the rich Canadians going to go?
2. For those who are now forced to buy healthcare when they didn't have it before, it is NOT affordable for them...AT ALL.
3. The fine for not buying healthcare is cheaper than buying healthcare....and you can still walk into a hospital and get treated.
4. The creators of the ACA said that they need everyone under the age of 30 to sign up so that the whole thing can get funded. Without them, the whole thing is financially upside down. So, WHY add the provision that people 26yrs and younger can be covered under their parent's plan? Where is the money supposed to come from?
The GOP wasnt shut out. They simply voted against the bill.
The GOP wasnt shut out. They simply voted against the bill.
It just doesn't matter what happened 6 years ago. System is still broke and needs fixed.
We changed the law of the land, not by much, and our health system is still out of control.
Where do we go next is the question.
- It's not the drug cos: drug spend just isnt that big
- It's not the insurance cos: they're actually working to reduce spending, although not that hard except on drugs
- It's not the plaintiff's lawyers: someone mentioned tort reform, but where enacted it did not lead to cheaper care, less testing (ie defensive medicine), or lower malpractice premiums. It was a red herring in the reform movement.
So who is the bad guy? Hospitals. Plain and simple. Particularly hospitals in midsize/smaller markets who are buying up medical practices and rivals and effectively ending competition, and then dictating massive rate increases. You cant sell medical insurance within 50 miles of Pittsburgh and not have the university medical center on your plan, because they've bought up all competition. The university knows it, and charges monopoly prices. Insurance cos dont totally care -- so long as everyone has to pay the hire rates, the cost can be passed along to policy holders.
There are a lot more fixes, but getting some cost control in the hospital market would be huge (especially as private doctors offices are being bought up and hospitalized -- that is getting the higher reimbursement rates paid for in-hospital treatment rather than private office treatment).
The idea that the GOP wanted individual mandates is silly. It was one person who proposed it and it never went anywhere.
Once you take competition out, bad things happen. It's happening here and around the country.
Didn't say I agree with single payer, just where we eventually end up.
And the equipment. Oh the equipment. You have a perfectly fine $3 million MRI. It's a few years old. But you're a "leading medical center" and god damnit there is a new shiny. So you buy the new shiny. And then you jack up your MRI charge because, god damnit, it's a new generation machine so its better and in any event you need to earn your investment back. So you also go to your doctors and remind them that there is this great new MRI and we need to use it and MRIs are great and by the way it helps the hospital to do more MRIs. Everyone gets the drill. That new MRI is a fucking cash cow ... for about 3 years, when a newer shiny comes on the market.
The idea that the GOP wanted individual mandates is silly. It was one person who proposed it and it never went anywhere.
Tort reform is not a serious proposal. It doesnt move the needle one inch (and states are free to address them). Selling insurance across state lines is a red herring -- there is plenty of competition among insurer in big states and the costs are still spiraling. The problem isnt that big insurers are excluded from smaller states; the problem is that the healthcare services market in this country is really thousands of separate markets (e.g. Pittsburgh-area), and as to each of those markets the hospitals tend to have the bargaining power, b/c the Univ. of Pittburgh can do without Deej Ins. Co's business, but Deej Ins. Co cant really sell insurance near Pittsburgh if it doesnt have a contract with the dominant hospital "system".
These are just not serious proposals. It's painting the trim and re-potting flowers on a burned down building.
I dont have an opinion on that, but it is worth acknowledging that we cant snap our fingers and be where other countries are easy-peasy.
What people are seeing are large, one-time cost increases as physicians are shifted towards other centers (located around the hospital, in the hospital, or in a centralized location), where hospitals are also buying the equipment.
This "binge" has led to a considerable "cost" and "price" hike, even though it's a different good being produced. In fact, some evidence from large scale datasets have shown that costs have started to moderate, compared to non-employee physicians, partially because supply-induced demand has been eliminated (i.e., fee-for-service).
Another reason the "cost bump" has occurred is because of the patients that doctors have been seeing. They are not the same. If, in fact, you control for patient quality (or patient outcome), you get that per-patient costs are on par with hospital employed physicians.
Link - ( New Window )
Firstly, the plans are different. When there is a shift in plans, costs shift. Unless you think comparing VCR's to DVD players is a viable comparison (which I don't doubt some here do), it's a pretty fucking simple statement.
Secondly, what do you think happens when HI companies are allowed to cost shift to their clientele more than what they are normally allowed to do, because of a change in the structure of the system? And that this cost shift is largely a one-time event? This didn't happen? Well, I'd love for you to meet some of the people that I know.
Thirdly, how the fuck can people think healthcare, both reform and implementation, is simple at all?
Lastly, this notion that we can evaluate cost trends of the ACA a few years after implementation is moronic. I hate the bill with a passion, but everyone with a functioning IQ would realize that there are parts of the bill (such as preventive care, mandating coverage, and mandating minimal standards of care) that may change long-term behavior.
It's probably the best system for where we are (some form of minimal standards supported by the government with an additional private market), but has quite deficient flaws as well.
Including rather atrocious reimbursement rates for physicians.
It is quite the opposite in the Southeast, Midwest, Southwest, Northwest, and West Coast.
Physicians may be acquired by insurers (such as Kaiser), but there are a variety of channels whereby costs per patient are lowered, quite considerably.
I'd hesitate to lump in reimbursement rates for physicians as one category. My doctor gets screwed on a long office visit -- gets paid less per hour than you'd pay a guy to come fix your computer. Specialists often get paid a lot more. Some procedures get great reimbursement rates. And rates paid for in-hospital evaluations, procedures etc. can often vastly exceed what is paid for the same work in non-hospital offices.
Pre-ACA I was reading about how they set Medicare reimbursement rates for doctors. It was mindboggling. Essentially the docs put together their own panel of 30 docs (20+ specialists), who ranked everything a doctor does based on stuff like necessary skill, "difficulty", and time. These rankings were the basis for the differences in pay rates for different procedures. The specialists just teamed up against the GPs, and made all the specialist work more expensive. The private insurers just plussed up the Medicare rates. So that is why GPs cant make a living (and no one goes into GP).
Perhaps the more interesting question is how much centralization or "contracting" can alleviate (or exacerbate) these issues.
There are a couple of other issues with regards to reimbursement, namely the rapid expansion of diagnosable illnesses (I'm not quite sure that a diagnosis related group, DRG, is a solution), but the specialists have also been able to facilitate very micro-level diagnoses, whereas GP's have limited ability to do it.
Rates were going up before ACA and are now. Deductibles have surely risen.
Big fallacy. The uninsured were not being treated before the ACA. Yeah they were and being paid for by our tax dollars.
All it was is a dollar shift with the middle class taking it the butt again.
It now takes me 2/3 months to schedule a doctors apportionment. So much for reducing emergency visits.
It always gets pushed on to the the consumer.
My thoughts? Single payer is inevitable.
Where are the rich Canadians going to go?
My premiums began skyrocketing right around 2003 with the demise of the HMO. I guess I'm lucky in that we had to change to a high deductible plan back then with premiums that were also more than HMO plans in addition to contributing to an HSA.
I don't know why, but I haven't seen a difference since the ACA was put into place. My premiums haven't gone crazy, and I have pretty much the se coverage.
When my company moved away from the HMO plans, we were told that it was because they just weren't sustainable. Is it possible that my company was a little ahead of the curve and didn't try to stick with something that they knew couldn't last? Maybe.
What I can tell you that I notice whenever these threads pop up is people upset about plans (that weren't sustainable regardless of the ACA) bitching that now they are changing and blaming it on the ACA. They were going to change anyway, and I suspect that it would have been worse without the ACA.
It reminds me much of people bitching about "union retirement plans" that are unsustainable and placing all of the blame on the university me while ignoring that without the companies agreeing to them, they would have never existed.
Anyway- I agree with you and do think single payer is where we will end up.
Of course we've also got to get people to stop eating cheeseburgers.
Quote:
no preapprovals for tests. Everyone takes it. I go for cosmetic surgery, they will probably pay for it. So you whiners keep on working to keep me covered
You really are a cunt
LTS, I've always been a fan of your posts since the CJ Spiller draft, but posts like these make me an even bigger fan!
Care to answer for your anti-female post last night?
2. For those who are now forced to buy healthcare when they didn't have it before, it is NOT affordable for them...AT ALL.
3. The fine for not buying healthcare is cheaper than buying healthcare....and you can still walk into a hospital and get treated.
4. The creators of the ACA said that they need everyone under the age of 30 to sign up so that the whole thing can get funded. Without them, the whole thing is financially upside down. So, WHY add the provision that people 26yrs and younger can be covered under their parent's plan? Where is the money supposed to come from?
My premiums went down last year. Deductibles went up, but not enough to offset the decrease. Also - better benefits than the year before thanks to being able to count prescriptions toward the deductible - that was ACA policy nationwide. Everyone got it.
So you can't say you never heard of one person anymore. Ny state rulz!