Heeeeeeere's Obamacare!

[WildCat]

I have to give you credit on that one (in terms of debating skill, not accuracy) because that argument is one of the best false arguments I've seen on this topic. The sieve metric where you screen large numbers of people for a rare condition is accurate in terms of cost of testing to cost savings. However, that metric is in isolation. It doesn't take into consideration the benefit of having a family doctor. In the real world, you don't use broad screening for rare conditions; you let people see a doctor on their own whenever they notice a problem. This is quite cost effective, but it relies on having a doctor you know.

Err, if they have a problem that's not preventive care.

 

[barehl]

Err, if they have a problem that's not preventive care.

You can surely make an argument that is not based solely on word games (or at least I hope you can). I have a friend who had a MRSA infection. Because she had insurance, she scheduled an appointment with a doctor and got it treated. Without insurance, people tend to put off things like that and the resulting treatment costs a lot more. In her case, instead of getting a prescription for oral antibiotics, she likely would have ended up in a hospital taking intravenous antibiotics and may have needed surgery to debride the tissue. By any normal pattern of logic, this is preventive.

 

[Newtons Bit]

You can surely make an argument that is not based solely on word games (or at least I hope you can). I have a friend who had a MRSA infection. Because she had insurance, she scheduled an appointment with a doctor and got it treated. Without insurance, people tend to put off things like that and the resulting treatment costs a lot more. In her case, instead of getting a prescription for oral antibiotics, she likely would have ended up in a hospital taking intravenous antibiotics and may have needed surgery to debride the tissue. By any normal pattern of logic, this is preventive.

That's not preventive care. That's just "health care". Preventive care are screenings to detect diseases before symptoms occur.

 

[Neally]

Kinda shocking - and they call this the Affordable Care Act!

Please, don't confuse the Obamacare fans. They experience extreme cognitive dissonance with post's like yours. The upside is that mental health is now covered, so that they can regain their composure. Still it's not nice...

 

[Ziggurat]

Enlighten us. What are the other motives?

Placating patient demands is one reason. Defensive medicine (ie, avoid a lawsuit) is another.

Well, they could until they lose their medical license and spend time in prison.

For what? Taking longer with each patient than they absolutely need to? That's not a crime. But if you're paying for time and not for services, you can expect that.

I have to give you credit on that one (in terms of debating skill, not accuracy) because that argument is one of the best false arguments I've seen on this topic. The sieve metric where you screen large numbers of people for a rare condition is accurate in terms of cost of testing to cost savings. However, that metric is in isolation. It doesn't take into consideration the benefit of having a family doctor.

We weren't talking about having a family doctor, we were talking about preventive medicine. These are not synonymous.

In the real world, you don't use broad screening for rare conditions; you let people see a doctor on their own whenever they notice a problem.

As Wildcat mentioned, that is not preventive medicine.

The policies that were changed were written in 2010. So, why weren't these policies challenged in Federal court since (according to you) there was no legal authority to write them?

You are evidently confused about what I'm referring to. I'll give you one explicit example (and it's not the only one):
http://www.washingtontimes.com/news...cement-discretion-obamacare-changes/?page=all
Notice the date. This wasn't done in 2010. And the courts haven't addressed this issue yet.

I know that this claim has been pumped up a lot by Fox, Rush Limbaugh, NewsMax, and the Weekly Standard. However, I'm not aware of any credible source that is making this claim such as the dean of a major law school (Columbia, Harvard, Yale, etc.).

There's a lot you're not aware of, including what the claim actually is (see above).

 

[Ziggurat]

You can surely make an argument that is not based solely on word games (or at least I hope you can). I have a friend who had a MRSA infection. Because she had insurance, she scheduled an appointment with a doctor and got it treated. Without insurance, people tend to put off things like that and the resulting treatment costs a lot more. In her case, instead of getting a prescription for oral antibiotics, she likely would have ended up in a hospital taking intravenous antibiotics and may have needed surgery to debride the tissue. By any normal pattern of logic, this is preventive.

No, barehl. This isn't an issue of "normal logic", nor is it solely a word game. The term "preventive medicine" has meaning within the health care industry, it has that meaning for a reason, and it's not the meaning you apparently believed. You are simply wrong about the definition.

 

[Fast Eddie B]

To be fair, the plans offered are an improvement over what we have now.

Albeit at about triple the cost.

Our collective annual deductible is $20,000, and the plans here will not have a cap, which I assume ours does,

Still, even the lowest premium listed equals my monthly social security check.

And my wife and I are pretty healthy - we rarely spend anywhere close to $1,000/yr each, barring the occasional colonoscopy.

If our numbers are representative of what others are seeing, I predict major problems ahead.

Oh, and as Obama promised that this would be covered and that would be covered and no one could be denied and no caps and on and on, I always mentally added the words, "At what cost?"

I guess we're all finding out!

And the "up to" $2,500 a year the typical family would save? I always found that laughable - but I'll bet a lot of voters were influenced by it.

 

[Unabogie]

To be fair, the plans offered are an improvement over what we have now.

Albeit at about triple the cost.

Our collective annual deductible is $20,000, and the plans here will not have a cap, which I assume ours does,

Still, even the lowest premium listed equals my monthly social security check.

And my wife and I are pretty healthy - we rarely spend anywhere close to $1,000/yr each, barring the occasional colonoscopy.

If our numbers are representative of what others are seeing, I predict major problems ahead.

Oh, and as Obama promised that this would be covered and that would be covered and no one could be denied and no caps and on and on, I always mentally added the words, "At what cost?"

I guess we're all finding out!

And the "up to" $2,500 a year the typical family would save? I always found that laughable - but I'll bet a lot of voters were influenced by it.

Hang on, you're on Social Security? Then don't you qualify for subsidies?

 

[Fast Eddie B]

Hang on, you're on Social Security? Then don't you qualify for subsidies?

Our total annual income seemed to preclude that.

I've tried to invest wisely enough over the years so that my Social Security check is only a portion of what we live on.

Without going into specifics, the minimum threshold for a couple to qualify for subsidies showed as somewhere in the mid 60's, and we're typically just a hair above that.

 

[Unabogie]

Our total annual income seemed to preclude that.

I've tried to invest wisely enough over the years so that my Social Security check is only a portion of what we live on.

Without going into specifics, the minimum threshold for a couple to qualify for subsidies showed as somewhere in the mid 60's, and we're typically just a hair above that.

Well good for you. We try to do the same. I've said this before, but this is byproduct of voting Republican. In states where they made an effort to make the law work, the premiums are a fraction of what they are in Georgia. That's a scandal. For instance, if you lived in Oregon, you could both be covered on a Silver plan with a $3500 deductible for $829, or about $415 each. That's just a hair over what you pay now, but for vastly better coverage. Your state failed you, not the ACA.

See for yourself.

http://www.valuepenguin.com/ppaca/exchanges/or

 

[Ziggurat]

For instance, if you lived in Oregon, you could both be covered on a Silver plan with a $3500 deductible for $829, or about $415 each.

Oregon, you say?

 

[Fast Eddie B]

For instance, if you lived in Oregon, you could both be covered on a Silver plan with a $3500 deductible for $829, or about $415 each. That's just a hair over what you pay now, but for vastly better coverage.

I may not have been clear.

Our $363/month premium is our total premium.

So, $829 is a bit more than a hair higher than $363.

It would put a huge dent in our monthly disposable income.

I did not want to turn this into a Democrat vs Republican debate, just pointing out our experience. If the act turns health insurance into a state-by-state crap shoot, some of the fault must reasonably be placed on the way the act is written, and/or implemented.

Shouldn't it?

 

[Unabogie]

I may not have been clear.

Our $363/month premium is our total premium.

So, $829 is a bit more than a hair higher than $363.

It would put a huge dent in our monthly disposable income.

I did not want to turn this into a Democrat vs Republican debate, just pointing out our experience. If the act turns health insurance into a state-by-state crap shoot, some of the fault must reasonably be placed on the way the act is written, and/or implemented.

Shouldn't it?

Actually not really, since a huge driver of those costs is the Medicaid expansion and the refusal of some states to adopt it, which puts a huge number (something like 5 million people in Texas alone) of people with no coverage, which drives up premium costs. That falls squarely on the Supreme Court, who ruled that Medicaid expansion was optional, and the states who are refusing. I would agree that the law put the regulation of rates in the hands of states, and that if this was done on a federal level it could be more uniform, but whose fault is it that the ACA didn't contemplate a state in which they'd purposefully refuse to make insurance cheaper for their citizens?

But you're right, $383 is ridiculously cheap for two 64 year olds. It's nearly half the cost of what we were paying pre-ACA, and we're in our early 40s. I am hesitant to speculate, but it must be that cheap for a good reason, since you two are in prime doctor needing stages of your lives. There must be some pretty awful fine print in those policies. Still, the state by state variances are a problem that the ACA attempted to fix, but they ran into resistance that borders on pathological.

 

[MattusMaximus]

ACA private enrollment is now up to 1.65 million, an addition of 250,000 in just two days.

 

[Tiktaalik]

Wait, $383 for two people? That's about what I pay for myself - and I'm in my 50s and am on a government workplace plan! That's a really good price!

 

[Fast Eddie B]

Wait, $383 for two people? That's about what I pay for myself - and I'm in my 50s and am on a government workplace plan! That's a really good price!

$363 for us both. My wife is a few year younger.

But it's by choice a high deductible plan, $10,000 each. A deductible we have never come even a tenth of the way of meeting to date.

It's what was known as "Major Medical" where you accept the normal little stuff but want to have some insurance against catastrophe. What is now called "Catastrophic", but discriminatorily is not available to those over 30, I think.

Still, we get some benefits without getting anywhere near our deductible.

Now, it's up to the government to decide what is good enough for us, in spite of our desires.

A certain amount of freedom of choice has vanished. It remains to be seen if a higher social good arises from all this.

 

[Unabogie]

$363 for us both. My wife is a few year younger.

But it's by choice a high deductible plan, $10,000 each. A deductible we have never come even a tenth of the way of meeting to date.

It's what was known as "Major Medical" where you accept the normal little stuff but want to have some insurance against catastrophe. What is now called "Catastrophic", but discriminatorily is not available to those over 30, I think.

Still, we get some benefits without getting anywhere near our deductible.

Now, it's up to the government to decide what is good enough for us, in spite of our desires.

A certain amount of freedom of choice has vanished. It remains to be seen if a higher social good arises from all this.

It most certainly has. There used to be millions of people for whom insurance was not available...at any price. My wife was among them. Travis was among them. Those days are over. Now, no one can be denied coverage, and for those too poor to pay, they get help. For those poorer still, they get Medicaid and SCHIP and Medicare, like you will soon. That's the higher social good. I'd love to see private insurance go away for good, and have a single payer with the ability to cap costs and pay for it solely with progressive taxes. I think we're headed that direction, but this step, wherein everyone gets used to the idea that coverage is universal, is the first step. Then we figure out the most efficient way to pay for it. Certainly "tort reform" and "buying across state lines" won't solve anything. The formulation is simple enough. Either you cut some people out from care (the old system), or you cut out the insurers, or you cap medical costs. The best systems do a little of everything in the smartest ways they can come up with. I'd support limiting liability if the trade off was 100% universal and free care. That way a person who ends up with a medical condition because of a doctor wouldn't be facing millions of dollars in costs. I'd also favor subsidized medical schooling in order to help more doctors become GPs. I'd favor higher taxes if I could give up on paying premiums or worrying what kind of insurance my job offered.

 

[Fast Eddie B]

It most certainly has.

To repeat...

...it remains to be seen.

It's hardly even implemented yet, so I think your proclamation is a bit premature.

 

[Neally]

That works in Canada because it doesn't cost a small fortune to go to medical school. To make that work in the US, you would need to change medical school as well.

Yes, that's part of the puzzle. There are many elements at play. You are not going to fix the escalating costs in the US by just fiddling with the insurance piece which Obamacare does.

It most certainly has. There used to be millions of people for whom insurance was not available...at any price.

Again, there are winners and losers with Obamacare. Some people are a lot worse off because of it. Some are a lot better off. Some are not impacted much.

 

[Drysdale]

ACA private enrollment is now up to 1.65 million, an addition of 250,000 in just two days.

I don't understand the giddiness with this.

You keep posting it like it's an affirmation of the greatness of Obamacare.

But the law is that people must sign up or face fines, penalties right?

I mean yea people are signing up, they HAVE TO its the law.

(Well, unless you get waivers like the unions, select corporations, congress etc.)