Heeeeeeere's Obamacare!

[Unabogie]

Is that the real reason?

I assumed that those rates are what a company would have to charge to cover all preexisting conditions and to have no cap on outlays per client. That sounds to me like an expensive proposition that would virtually necessitate high premiums.

If other states can have private companies cover the same requirements for markedly lower premiums and still make a profit, something does not compute - and I think it goes beyond Red State/Blue State.

But I would like it made clearer exactly why that rate page for GA is as it is.

How else do you explain why Minnesota is so much cheaper than Wisconsin, when they share the same demographics?

http://www.usatoday.com/story/news/...-health-care-law-minnesota-wisconsin/3465247/

It's because leaving people off Medicaid costs everyone else more money in premiums, and refusing to force rates downward results in higher premiums.

I'm sure there's more to it, but Minnesota/Wisconsin is a nice apples to apples demonstration.

 

[MattusMaximus]

Obama: Affordable Care Act Enrollment Hits 8 Million

 

[Alferd_Packer]

8 million 8 million 8 million 8 million 8 million 8 million 8 million 8 million 8 million 8 million 8 million 8 million 8 million 8 million 8 million 8 million 8 million 8 million 8 million

 

[Grizzly Bear]

Factual and logical discussion of problems with the Affordable Care Act is appreciated in this group. Repetition of false claims, use of logical fallacies and posting baseless conspiracy theories is not.

Heh... I hate to admit to having my biases on this topic and as much as I try not to express it, I'm not always successful. I do try to make up for my slip ups though by trying to see the same issue from the other angle... which was the point I was alluding at earlier. Unfortunately, as you've probably experienced on your end enough times not everyone reads your attempts to argue rationally as "rational".

I'm one of those people that would rather see the law "repealed".... though I have to admit that for the pessimism I have over the law itself:

A) I'd rather keep the law intact than repeal it without first having a decent alternative in place that accounts for the laws current state of implementation. Doing otherwise would put the industry in even deeper turmoil that the original status quo or this frankly.

B) I don't see the law as "all" bad. I'm not fond of the politics behind it, but some implementations like the market place idea are good starting points to improving how people shop for coverage. If as a system it gets improved I wouldn't be beyond taking those ideas into an alternative down the line if it can work without having to resort to a European style single payer system.

And in case it wasn't obvious enough... my use of the term "repeal" here doesn't mean kill the law and go back to the previous situation. I'd just rather see the law amended so we don't eventually wind up reling on a single payer model, which I've long suspected this of setting the eventual stage for. At any rate... for the most part I don't see supporting the law itself as a "bad" thing... people see it as a solution, maybe not one I agree with but...

 

[Peephole]

Heh... I hate to admit to having my biases on this topic and as much as I try not to express it, I'm not always successful. I do try to make up for my slip ups though by trying to see the same issue from the other angle... which was the point I was alluding at earlier. Unfortunately, as you've probably experienced on your end enough times not everyone reads your attempts to argue rationally as "rational".

I'm one of those people that would rather see the law "repealed".... though I have to admit that for the pessimism I have over the law itself:

A) I'd rather keep the law intact than repeal it without first having a decent alternative in place that accounts for the laws current state of implementation. Doing otherwise would put the industry in even deeper turmoil that the original status quo or this frankly.

B) I don't see the law as "all" bad. I'm not fond of the politics behind it, but some implementations like the market place idea are good starting points to improving how people shop for coverage. If as a system it gets improved I wouldn't be beyond taking those ideas into an alternative down the line if it can work without having to resort to a European style single payer system.

And in case it wasn't obvious enough... my use of the term "repeal" here doesn't mean kill the law and go back to the previous situation. I'd just rather see the law amended so we don't eventually wind up reling on a single payer model, which I've long suspected this of setting the eventual stage for. At any rate... for the most part I don't see supporting the law itself as a "bad" thing... people see it as a solution, maybe not one I agree with but...

So you're opposed to single-payer for some reason (it works too good?), but you don't want Obamacare either (the right-wing alternative to more European style health care systems)?

There really is no functioning alternative, you know.

 

[Fast Eddie B]

How else do you explain why Minnesota is so much cheaper than Wisconsin, when they share the same demographics?

http://www.usatoday.com/story/news/...-health-care-law-minnesota-wisconsin/3465247/

It's because leaving people off Medicaid costs everyone else more money in premiums, and refusing to force rates downward results in higher premiums.

I'm sure there's more to it, but Minnesota/Wisconsin is a nice apples to apples demonstration.

Thanks for the link. Read it last night and it is informative.

Does it not to some extent show flaws in the Affordable Care Act, as implemented, for whatever reason?

And expanded Medicaid, while perhaps a good thing overall, is not like free money - it must come from somewhere.

Complicated situation, and hope it works out for the best.

 

[Grizzly Bear]

So you're opposed to single-payer for some reason (it works too good?), but you don't want Obamacare either (the right-wing alternative to more European style health care systems)?

There really is no functioning alternative, you know.

My dislike of the single payer system has to do with the fact that I see it as being no different than a monopoly. And I dont subscribe to the false choice fallacy that there can be no functioning alternatives. Politicians just choose to believe that

 

[plague311]

My dislike of the single payer system has to do with the fact that I see it as being no different than a monopoly. And I dont subscribe to the false choice fallacy that there can be no functioning alternatives. Politicians just choose to believe that

So what do you feel would be a viable alternative? Also, how does a single payer make it a monopoly?

ETA: How would a monopoly in this case be a bad thing? Especially if it provides people with healthcare when and if they need it, without bankrupting them. Maybe I don't understand what a monopoly is, but that seems like the opposite of a monopoly.

 

[Neally]

Sheesh, of course there are some people who ended up paying more.

So Harry Reid was lying when he talked about people lying about being worse off under Obamacare? Why would he do that?

Yes, those people lying about the law need to stop it.

Is he one of the people that need to quit lying about it that you referred to above?

 

[Unabogie]

Thanks for the link. Read it last night and it is informative.

Does it not to some extent show flaws in the Affordable Care Act, as implemented, for whatever reason?

And expanded Medicaid, while perhaps a good thing overall, is not like free money - it must come from somewhere.

Complicated situation, and hope it works out for the best.

I agree. Recall that the whole reason to allow states to implement their own exchanges was a sop to conservatives like Chuck Grassley. It's pretty obvious that there should be national rather than state exchanges. This makes the bargaining power stronger and also smoothes out the state by state disparities.

And expanding Medicaid may not be free, but who ever said health care came free? If you support universal health care, you support it because you think everyone should see a doctor when they get sick, even if they don't have any money. But poor people are also young and healthy sometimes, and they sometimes stop being poor, in which case they should pay more. Other countries manage to do this without becoming socialist hell holes, and we can too. This is a good first step, but to make it work, we'd need make fixes that Republicans will fight, namely added more cost controls on both the insurance and the hospital sides, and making Americans more healthy through policies that encourage better diet and exercise (remember the freakout over Michelle Obama telling kids to eat more veggies and get outside once in a while?)

But I think momentum is already shifting, and even conservatives in Red States see that their liberal enemies fellow Americans are getting a better deal than they are and they'll start demanding that their representatives keep fighting that gay atheist muslim agenda, but also get them some cheaper insurance and take some Medicaid money, dammit!

 

[Peephole]

My dislike of the single payer system has to do with the fact that I see it as being no different than a monopoly. And I dont subscribe to the false choice fallacy that there can be no functioning alternatives. Politicians just choose to believe that

Present your functioning alternative.

 

[thaiboxerken]

Repeal the ACA and the health insurance/care system in the USA will fix itself. Also, cut off funding to welfare and food assistance programs and those will programs will fix themselves as well.

 

[Emily's Cat]

The standard talking point seems to be that the success in a small state like Massachusetts can't possibly be scaled up to a nation as large and diverse as the US.

It's also worthwhile to remember that it took many years for MA to reach a point where it could be considered stable and solvent. The first few years were a mess.

 

[Emily's Cat]

Not possible. Harry Reid says so,
"Despite all that good news, there's plenty of horror stories being told. All of them are untrue, but they're being told all over America."


http://www.weeklystandard.com/blogs/harry-reid-denies-all-obamacare-horror-stories-all-are-untrue_783449.html

Again, all the people worse off are lying. Or racist. Or both.

I'm not good at picking up sarcasm in text without clear contextual cues... so help a girl out. I really don't know how to read your post.

 

[Emily's Cat]

I could be wrong, but I would guess EC is not criticizing the ACA from the standpoint of someone who wants to repeal the entire law and go back to the broken status quo we had before, which the fascists in the GOP are doing.

You are not wrong. My criticisms are from a long-term sustainability perspective, and almost exclusively from the viewpoint of an actuary in this field.

 

[jhunter1163]

I don't see why single-payer is considered such a Bad Thing™. Frankly, I think Medicare-for-all is probably inevitable, and the sooner it comes about the better. The difficulty with MFA is that it's a Big Thing™ and the Congress we have now can't do the little things, much less a Big Thing™.

 

[Emily's Cat]

Sheesh, of course there are some people who ended up paying more. But the best estimate is that it's about 1% of the total population, and they are people who make too much to get subsidies. What are more worrisome are the people like Fast Eddie who live in states where the exchanges are very expensive. We need to amend the law to allow the costs to be spread more evenly. There's no reason why Red Staters should suffer just because their representatives are intent on fighting "Obamacare". Also, there are about 5 million people who live in Red States who won't expand Medicaid, so they are not getting Medicaid and also don't qualify for subsidies. Those people need our help, no?

I would like a source for that claim, Unabogie. 1% seems too low to me. Best estimates from Kaiser have about one-third of the population making over 400% FPL (so they don't qualify for subsidies). Internal data from my work indicates that between 40% and 43% of the people in the Individual Market in my three states have FPLs over 400%. The research done in 2 of my 3 states by Milliman and Wakely indicate between 25% and 35% of those people will have higher premiums. There is uncertainty, because it depends on what metallic level they choose, and whether some of those people buy down to a bronze plan from their prior coverage. So all told, in my markets, that's 10% to 15% whose premiums will increase due to ACA... which is an order of magnitude or more than the number you're tossing about.

 

[johnny karate]

I'm not good at picking up sarcasm in text without clear contextual cues... so help a girl out. I really don't know how to read your post.

Imagine a petulant teenager lashing out with sardonic vitriol after not getting their way.

That should give you all the context you need.

 

[Emily's Cat]

I don't see why single-payer is considered such a Bad Thing™. Frankly, I think Medicare-for-all is probably inevitable, and the sooner it comes about the better. The difficulty with MFA is that it's a Big Thing™ and the Congress we have now can't do the little things, much less a Big Thing™.

Single Payer isn't a Bad Thing™. But it's also not guaranteed to be a Good Thing™.

Single Payer really only refers to who pays the bill. Yes, it would relieve the financial burden on individuals, and help ensure that everyone gets access to care. But that's not the only problem that the US is facing when it comes to health care.

Single payer by itself doesn't address the issue of ridiculously high prices. Nor does it address over utilization, duplicative services, and defensive medicine. It doesn't help with the effects of direct-to-consumer drug marketing. It doesn't smooth out the over-concentration per-capita of specialists, and the under-representation of generalists. It won't solve the problem of what to do with all the unnecessary and excess MRI and CT scan machines (among others) that we have relative to the actual illness and injury burden by geographic region. Single payer won't fix the incestuous relationship between the AMA and the university educational system. Nor will it address the lack of standards of practice in the medical community.

And Single Payer by itself isn't a plan for how to deal with the disruption caused by putting an entire industry out of business, and the inevitable unemployment shock that comes of that.

Yes, Single Payer is probably Good Thing™. But not by itself. There's a lot more that needs to be considered and planned for.

 

[plague311]

Single Payer isn't a Bad Thing™. But it's also not guaranteed to be a Good Thing™.

Single Payer really only refers to who pays the bill. Yes, it would relieve the financial burden on individuals, and help ensure that everyone gets access to care. But that's not the only problem that the US is facing when it comes to health care.

Single payer by itself doesn't address the issue of ridiculously high prices. Nor does it address over utilization, duplicative services, and defensive medicine. It doesn't help with the effects of direct-to-consumer drug marketing. It doesn't smooth out the over-concentration per-capita of specialists, and the under-representation of generalists. It won't solve the problem of what to do with all the unnecessary and excess MRI and CT scan machines (among others) that we have relative to the actual illness and injury burden by geographic region. Single payer won't fix the incestuous relationship between the AMA and the university educational system. Nor will it address the lack of standards of practice in the medical community.

And Single Payer by itself isn't a plan for how to deal with the disruption caused by putting an entire industry out of business, and the inevitable unemployment shock that comes of that.

Yes, Single Payer is probably Good Thing™. But not by itself. There's a lot more that needs to be considered and planned for.

Now that you've fully stated everything that is a problem with single payer, care to recap all the things that were wrong with the original health care? I understand that single payer doesn't have all the answers, but would it be considered the lesser of two evils? I think everyone knows that there is no "answer to every question" style health care, but it was horrible previously. At least there is change now, whether some people like it or not. I also find that your statement of at least 25% of people having increased premiums a bit overzealous. Can you actually source that? I know you're not keen on it and it's just "what you see at work", but call me skeptical. I find it tough to believe that a quarter of the population is seeing increased premiums from the ACA. Fox would be all over it.