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Insurance Costs Under Obamacare - Page 14

post #196 of 739
I'm a fan of basic universal healthcare; Medicare is anything but basic. Unfunded Medicare liability is what will truly bankrupt the US. Also people love Medicare just like they love anything else: until they use it and find it lacking. For instance when a senior stays in the hospital for two days and finds out he/she has a 1.2k deductible they suddenly don't like Medicare (or the hospital) too much. I would suspect, and this would actually be a really good study to conduct, that chronic over utilizers do not like Medicare as much as your typical health senior does. Those frequent flyers are also usually dead beats.
Quote:
Originally Posted by indesertum View Post

I thought you were a fan of medicare for all with allowance for a secondary private market where people could pay more for better quicker treatment

So Chicagoron when you say successful are you referring to where she calls it effective and popular? Because medicare is indeed widely supported across multiple swaths of the population as shown in multiple studies. Medicaid is less popular but the core concept is widely supported. Effectiveness is far more difficult to ascertain. What markers and goals would medicare have to hit for you to agree that it is effective? Patients are highly satisfied with their treatment. Doctors are less satisfied with the payments and although the acceptance rate for medicare is lower than private insurance the vast majority of doctors you meet will accept medicare. IMO the payments are fair as they've considered margins for material cost, human capital cost, profit for business, geographical differences in cost of living and the amount paid out is still higher than in the vast majority of countries

I'm sure piobaire could point out wrongs in my statement but this is my impression.

This efficient market argument you put out just doesn't work in this case and I would argue in a lot of real world cases. High effectiveness and appeal don't always cause policy ideas to be adopted as there are many more aspects that need to be faced. One example I can think of is the disclose act which had high appeal among the populations and previous similar but lesser laws had good effectiveness and even passed the house and had a majority vote, in fact one vote away from 60, in the senate but got stalled at cloture.


I'm very bad at writing. I should ask l'incandescent or erictheobscure to train me
post #197 of 739
Quote:
Originally Posted by indesertum View Post

I thought you were a fan of medicare for all with allowance for a secondary private market where people could pay more for better quicker treatment

So Chicagoron when you say successful are you referring to where she calls it effective and popular? Because medicare is indeed widely supported across multiple swaths of the population as shown in multiple studies. Medicaid is less popular but the core concept is widely supported. Effectiveness is far more difficult to ascertain. What markers and goals would medicare have to hit for you to agree that it is effective? Patients are highly satisfied with their treatment. Doctors are less satisfied with the payments and although the acceptance rate for medicare is lower than private insurance the vast majority of doctors you meet will accept medicare. IMO the payments are fair as they've considered margins for material cost, human capital cost, profit for business, geographical differences in cost of living and the amount paid out is still higher than in the vast majority of countries

I'm sure piobaire could point out wrongs in my statement but this is my impression.

This efficient market argument you put out just doesn't work in this case and I would argue in a lot of real world cases. High effectiveness and appeal don't always cause policy ideas to be adopted as there are many more aspects that need to be faced. One example I can think of is the disclose act which had high appeal among the populations and previous similar but lesser laws had good effectiveness and even passed the house and had a majority vote, in fact one vote away from 60, in the senate but got stalled at cloture.


I'm very bad at writing. I should ask l'incandescent or erictheobscure to train me

I was alluding to the "effective" part ... popular means very little to me. To be effective, in my layman's opinion, a comprehensive healthcare plan (focused on treatment, assuming public health concerns are handled elsewhere) would need to:

  1. Improve the quality of treatment over time while
  2. Reduce the cost of treatment over time
  3. Foster Innovation

In order to do that - you need to shift the payer situation away from insurance for a lot of the services that are currently covered. I am not opposed to doing this through cash transfers to the poor and a single-payer catastrophic plan with fairly strict guidelines on end-of-life. The problem with liberals is they want the single payer without any of the trade-offs. Piob, feel free to post the Robert Reich vid again. And here is my ceremonial repost of the best article I've read on fixing healthcare:

http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/307617/
post #198 of 739
I've started reading this, but I take issue with referring to hospital complications, particularly blood clots, as mistakes. It isn't clear that all or even most patients can be put on blood thinners. For example in neurosurgery, with patients who have had brain operations or head injuries with intracranial bleeding, we don't know how the risk of worsening bleeding in or around the brain compares with the risk of blood clots. We could put every patient on blood thinners after surgery or after a head injury, but if people start dying from intracranial hemorrhage we're going to be faulted for making "mistakes."
Now, at my institution we're undertaking a study to determine which patients can safely be anticoagulated and which can't, but in the meantime it's safer (presumably for patients but decidedly for physicians) to not use blood thinners and instead to use less effective methods like "leg squeezers." This study is going to take time, and some patients will continue to have blood clots (and pneumonia, and bed sores, and urinary tract infections, and all of the other things that come with laying in bed for extended periods of time), but that doesn't indicate a "mistake," it indicates that we have a lack of knowledge about the matter but we're doing everything possible to increase our knowledge.
post #199 of 739
Quote:
Originally Posted by hopkins_student View Post

I've started reading this, but I take issue with referring to hospital complications, particularly blood clots, as mistakes. It isn't clear that all or even most patients can be put on blood thinners. For example in neurosurgery, with patients who have had brain operations or head injuries with intracranial bleeding, we don't know how the risk of worsening bleeding in or around the brain compares with the risk of blood clots. We could put every patient on blood thinners after surgery or after a head injury, but if people start dying from intracranial hemorrhage we're going to be faulted for making "mistakes."
Now, at my institution we're undertaking a study to determine which patients can safely be anticoagulated and which can't, but in the meantime it's safer (presumably for patients but decidedly for physicians) to not use blood thinners and instead to use less effective methods like "leg squeezers." This study is going to take time, and some patients will continue to have blood clots (and pneumonia, and bed sores, and urinary tract infections, and all of the other things that come with laying in bed for extended periods of time), but that doesn't indicate a "mistake," it indicates that we have a lack of knowledge about the matter but we're doing everything possible to increase our knowledge.

Excellent post from a clinical perspective but it does point out one of the huge flaws with the US system: litigation fears and "standard of care" incenting docs on staying inside the box. Granted inside the box is often (usually?) the best place to be but sometimes it's clearly not and that puts the doc and institution at risk. IMO, it should not be this way.
post #200 of 739
Need health care coverage? Just dial 1-800-FUCKYO to reach Obamacare’s national hotline
Quote:
Far from being a mistype, that’s the official number that Health and Human Services wants Americans to dial when seeking health care.

After allowing for the lack of letters attached to 1 on a traditional American telephone keypad, the number spells out a clear message. For every duped voter, every young invincible weighing the cost of a penalty versus a newly tripled yearly deductible, every ailing old granny in a wheelchair (whom, remember, Paul Ryan wants to push off a cliff) who needs adequate and affordable health care, Obama’s message is:

1-800-3(F) 1 8(U) 2(C) 5(K) 9(Y) 6(O).

That’s 1-800-FUCKYO. Sadly, the Obama administration failed to swap the useless 1 for a more functional 8 to complete the heartfelt message, perhaps in consolation to former White House Chief of Staff Rahm Emanuel’s tragically shortened middle finger.

Read more: http://dailycaller.com/2013/10/03/need-health-care-coverage-just-dial-1-800-fuckyo-to-reach-obamacares-national-hotline

Too bad it's not 100% accurate.
post #201 of 739
Quote:
Originally Posted by hopkins_student View Post

I've started reading this, but I take issue with referring to hospital complications, particularly blood clots, as mistakes. It isn't clear that all or even most patients can be put on blood thinners. For example in neurosurgery, with patients who have had brain operations or head injuries with intracranial bleeding, we don't know how the risk of worsening bleeding in or around the brain compares with the risk of blood clots. We could put every patient on blood thinners after surgery or after a head injury, but if people start dying from intracranial hemorrhage we're going to be faulted for making "mistakes."
Now, at my institution we're undertaking a study to determine which patients can safely be anticoagulated and which can't, but in the meantime it's safer (presumably for patients but decidedly for physicians) to not use blood thinners and instead to use less effective methods like "leg squeezers." This study is going to take time, and some patients will continue to have blood clots (and pneumonia, and bed sores, and urinary tract infections, and all of the other things that come with laying in bed for extended periods of time), but that doesn't indicate a "mistake," it indicates that we have a lack of knowledge about the matter but we're doing everything possible to increase our knowledge.

Fair point, but that does not detract from the underlying theme of decreasing third-party payment, with good examples of how cash transfer programs could overall improve coverage for poor and those with pre-existing conditions.
post #202 of 739
Ahhh... liberals getting a dose of Obamacare reality. Now that's something we all can enjoy!
Quote:
Cindy Vinson and Tom Waschura are big believers in the Affordable Care Act. They vote independent and are proud to say they helped elect and re-elect President Barack Obama.

Yet, like many other Bay Area residents who pay for their own medical insurance, they were floored last week when they opened their bills: Their policies were being replaced with pricier plans that conform to all the requirements of the new health care law.

Vinson, of San Jose, will pay $1,800 more a year for an individual policy, while Waschura, of Portola Valley, will cough up almost $10,000 more for insurance for his family of four.

Covered California spokesman Dana Howard maintained that in public presentations the exchange has always made clear that there will be winners and losers under Obamacare.

"Some people will see an increase who are already on the individual market purchasing insurance," he said, "but most people will not."

Covered California officials note that at least 570,000 of the 1.9 million people who buy their own insurance should be eligible for subsidies that will reduce their premiums.

Even those who don't qualify for the tax subsidies could see their rates drop because Obamacare doesn't allow insurers to charge people more if they have pre-existing conditions such as diabetes and cancer, he said.

People like Marilynn Gray-Raine.

The 64-year-old Danville artist, who survived breast cancer, has purchased health insurance for herself for decades. She watched her Anthem Blue Cross monthly premiums rise from $317 in 2005 to $1,298 in 2013. But she found out last week from the Covered California site that her payments will drop to about $795 a month.

But people with no pre-existing conditions like Vinson, a 60-year-old retired teacher, and Waschura, a 52-year-old self-employed engineer, are making up the difference.

"I was laughing at Boehner -- until the mail came today," Waschura said, referring to House Speaker John Boehner, who is leading the Republican charge to defund Obamacare.

"I really don't like the Republican tactics, but at least now I can understand why they are so pissed about this. When you take $10,000 out of my family's pocket each year, that's otherwise disposable income or retirement savings that will not be going into our local economy."

Both Vinson and Waschura have adjusted gross incomes greater than four times the federal poverty level -- the cutoff for a tax credit. And while both said they anticipated their rates would go up, they didn't realize they would rise so much.

"Of course, I want people to have health care," Vinson said. "I just didn't realize I would be the one who was going to pay for it personally."

The law also will often make some policies more expensive because it limits out-of-pocket expenses to $6,350 annually for an individual and $12,700 for a family. In addition, the law restricts the minimum and maximum premiums that people can be charged based on their age.

Now, a 64-year-old can be charged almost five times more than a 21-year-old. Beginning Jan. 1, it will be a 3-1 ratio.

Those explanations, however, don't completely satisfy Waschura and Vinson.

"I'm not against Obamacare," Waschura said. "It's just the initial shock. I'm holding out hope that there will be a correction over a handful of years."

But to Gray-Raine, the breast cancer survivor from the East Bay, that correction has already come.

"Obamacare is a huge step in the right direction for those of us without employer coverage," she said, adding that she hopes everyone will "join in and make this new legislation a success for all."

http://www.mercurynews.com/nation-world/ci_24248486/obamacares-winners-and-losers-bay-area

musicboohoo[1].gif
post #203 of 739
Quote:
"Of course, I want people to have health care," Vinson said. "I just didn't realize I would be the one who was going to pay for it personally."

Best line ever.
post #204 of 739
Quote:
Originally Posted by Piobaire View Post

Best line ever.

you beat me to it; this is pretty much the purest distillation of the views of the majority of liberals.

Of course, the purest distillation of the views of the majority of conservatives is likely equally facepalm.gif
post #205 of 739
Quote:
Originally Posted by Piobaire View Post

Best line ever.

Yeah... this is the real problem. baldy[1].gif
post #206 of 739
at least he is honest.
post #207 of 739
Quote:
Originally Posted by Piobaire View Post

Best line ever.

If I saw that in a satirical story, I would roll my eyes at the author's lack of subtlety.
post #208 of 739
I wonder if this guy understands how he came off? Rarely do you get to see this in such a naked fashion.
post #209 of 739
Quote:
Originally Posted by Piobaire View Post

I wonder if this guy understands how he came off? Rarely do you get to see this in such a naked fashion.

What, like you have never read a post by Teger?
post #210 of 739
Of the 150 languages supported by Obama's 800 # to sign up for his bullshit socialist scam it appears Esperanto is not one of them. Nor is Latin. I am outraged.
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