The Health Care Debate

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im2kull
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Re: The Health Care Debate

Postby im2kull » Thu Aug 21, 2014 12:36 pm

aknowledgeableperson wrote:If he represents all the people, Obama should remember that for 85 percent of Americans, the great health-care crisis is about cost. For about 15 percent, it is about extending coverage. Yet his plan does little about the first and focuses mostly on the second. It promotes too little of the real discipline that would force costs down, and instead throws in a few ideas, experiments, and pilot programs that could, over time and if rigorously expanded, do so. It is a bill written by legislators to ensure that they never have to do anything unpopular.


Quoted, because it deserves to be not forgotten.

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Re: The Health Care Debate

Postby grovester » Thu Aug 21, 2014 1:22 pm

Our company is transitioning from employer offered to ACA. I'll be getting similar coverage for the same price or less without subsidies. I would say 50% of our small company will qualify for subsidies. The premium trajectory over the past 10 years for our company has been horrendous and unsustainable. People had already dropped out of the company plan and bought individual policies for less (no subsidies either). If you pay attention to the details of the plans you're looking at you'll be fine.

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Re: The Health Care Debate

Postby beautyfromashes » Thu Aug 21, 2014 1:31 pm

^^^
That's pathetic. Why won't your company eat the cost of providing Health Care instead of passing the buck to the government to subsidize half of those covered? I hope they give you all a raise instead of the owner(s) just pocketing a check by reducing costs.

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Re: The Health Care Debate

Postby aknowledgeableperson » Thu Aug 21, 2014 1:48 pm

Why should the company eat the cost when the government is willing to eat it?

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beautyfromashes
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Re: The Health Care Debate

Postby beautyfromashes » Thu Aug 21, 2014 1:57 pm

aknowledgeableperson wrote:Why should the company eat the cost when the government is willing to eat it?


"It's just business.", right?

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Re: The Health Care Debate

Postby aknowledgeableperson » Thu Aug 21, 2014 2:05 pm

To a certain degree yes. If the ACA really wanted businesses to continue providing or encouraging them to provide coverage to employees then it would have be worded differently. But the legislation does provide an incentive for employers to drop the coverage.

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beautyfromashes
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Re: The Health Care Debate

Postby beautyfromashes » Thu Aug 21, 2014 2:39 pm

^^
Then we can't complain about the rich being 'too rich'. The law allows for the removal of an expense to a business owner and puts it on Joe Taxpayer. And, no, the business owner will not pass the lower cost onto the customer in the form of lower prices. The government just bought this business owner a boat.

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Re: The Health Care Debate

Postby aknowledgeableperson » Thu Aug 21, 2014 3:20 pm

Not quite that simple. If you were in the business owners' shoes I doubt you would do much different.

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Re: The Health Care Debate

Postby beautyfromashes » Thu Aug 21, 2014 4:54 pm

aknowledgeableperson wrote:Not quite that simple. If you were in the business owners' shoes I doubt you would do much different.


I am in the business owners shoes and I do much different. I provide 100% coverage for all my employees. No copay until $6K and 100% coverage over $10k per family.

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grovester
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Re: The Health Care Debate

Postby grovester » Thu Aug 21, 2014 5:59 pm

beautyfromashes wrote:^^^
That's pathetic. Why won't your company eat the cost of providing Health Care instead of passing the buck to the government to subsidize half of those covered? I hope they give you all a raise instead of the owner(s) just pocketing a check by reducing costs.


The company has been providing the same percentage of coverage that it always has. It was not their decision, but the employees. And yes, they will be compensating us for the burden they no longer have to pay.

No offense, but that sounded like a knee jerk political response. "Eat the cost" SOCIALIST!

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Re: The Health Care Debate

Postby grovester » Thu Aug 21, 2014 6:05 pm

beautyfromashes wrote:
aknowledgeableperson wrote:Not quite that simple. If you were in the business owners' shoes I doubt you would do much different.


I am in the business owners shoes and I do much different. I provide 100% coverage for all my employees. No copay until $6K and 100% coverage over $10k per family.


congrats, you unfortunately are an outlier.

The problem with continuing the employer provided health insurance is that it's an untaxed benefit. People who don't pay for a benefit use no discretion using it, which drives up health care cost overall. It needs to become a commodity that is subject to the same market pressures of other services. Either that or single payer. I really don't care which, but the previous status quo was on a path to implosion.

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Re: The Health Care Debate

Postby aknowledgeableperson » Fri Sep 05, 2014 10:21 am

An interesting look at health insurance,

Worried about health insurance? That's common

By Jay MacDonald • Bankrate.com

Despite the health reforms of Obamacare, more than half of all Americans worry that they won't be able to afford health insurance or pay future medical bills, according to the latest Bankrate Health Insurance Pulse survey.

Among those surveyed, 55 percent said they were either very or somewhat worried that they might not have health insurance in the future. An equal percentage expressed similar concern that medical bills may one day overwhelm their finances.

Highlights:
•46% of those who identify themselves as Democrats are either very or somewhat worried about winding up without affordable health insurance, versus 63% of Republican respondents and 62% of independents.
•60% of women are worried about their future health insurance, compared with 50% of men.
•60% of Americans between ages 30 and 64 are very or somewhat worried that they won't have affordable health coverage at some point, versus 49% of those in other age groups

Highlights:
•80% of people earning $75,000 a year or more have more emergency savings than medical debt, while just 6% of these high earners say their medical debt is greater.
•44% of those making less than $30,000 per year say they have more medical debt than emergency savings, while 30% in the lowest-income group say their greater amount is emergency savings.
•34% of parents with children under 18 say they have more medical debt than emergency savings, compared with 22% of respondents without kids who say this.

Tom Baker, a professor of insurance law at the University of Pennsylvania Law School, points out that a majority of working adults receive their health insurance through their employer and thus have largely been spared a direct impact from the Obama health care law. But the survey's concerned majority may partially reflect uneasiness about employer-based plans.

"It's a legitimate concern because, before the Affordable Care Act, employer-based insurance was declining; that continues today and is presently under attack," he says. "It seems plausible to me that it won't continue to exist."

"With the Affordable Care Act, anybody who now wants insurance can get it," Cusano says. "The question now becomes: 'Can I afford to use it?' When you think about people confronting out-of-pocket maximums at around $7,000 or deductibles of $5,000 for a family, that's a lot of money. You throw prescription drug copays into the mix, and I can see where you would be worried."

When respondents were asked which is larger, their emergency savings or their medical debt, the savers outnumbered the debt holders by a ratio of 2-to-1, with 51 percent in the black column versus 25 percent in the red.

Baker says those findings appear more encouraging than other recent studies.

"There is research being done on liquidity, or 'financial fragility,' where they asked people if they could come up with $2,000 to pay for a major medical bill in the next month," he says. "I think 40 percent of respondents said they either couldn't or it would be very difficult. That suggests that people are financially fragile."

During the past 12 months, survey responses about Obamacare's effect on one's own health care have been remarkably stable. This time around, 16 percent said they felt more positive about the law's personal impact than they did a year ago; 28 percent felt more negative; and 51 percent said their opinion was unchanged.

Cusano sees the relative stability of those numbers as an optimistic sign going into the fall midterm elections.

"There really hasn't been a lot of fluctuation, positive or negative, despite a lot of negative political messaging around the Affordable Care Act," he says. "If we can get ahead of some of that negative messaging and do a better job of educating consumers … I would be hopeful that consumers would say they are in a better place."

Read more: http://www.bankrate.com/finance/insuran ... z3CSEmBcdm
Follow us: @Bankrate on Twitter | Bankrate on Facebook

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Re: The Health Care Debate

Postby phuqueue » Fri Sep 05, 2014 11:52 am

That's not really a "look at health insurance" at all, it's a look at attitudes about health insurance. And while it's important that people feel secure, it's also important to bear in mind that if you ask somebody whether they're "worried" that they might not have health insurance in the future, many of their responses will be colored by the immense amount of negative -- and often downright dishonest -- rhetoric that has polluted the national discussion.

Even more importantly, of course, there are people out there who still can't afford health insurance, or who wouldn't be able to afford it if they lost it through their employer, or who would have a hard time with their share of costs when they tried to use it (deductible, copays, etc), which is all to say that yes, some of those who are worried have good cause, and no, ACA isn't perfect or anything close to it. It's better than what we had before, but what we really need is still a single payer system. It seems to me that all of the criticisms of ACA are implicitly making this point even though the critics themselves typically want nothing to do with universal health care.

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Re: The Health Care Debate

Postby chaglang » Fri Sep 05, 2014 6:08 pm

Huh. It's almost as if having one party spend most of its time trying to kill the bill - and then cripple the law - has had an effect on the quality of it. Weird.

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Re: The Health Care Debate

Postby aknowledgeableperson » Thu Jun 25, 2015 3:19 pm

Another GOP argument bites the dust in the court system, this time 6 - 3. Wonder what the GOP response in Congress will be?

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Re: The Health Care Debate

Postby smh » Thu Jun 25, 2015 4:54 pm

aknowledgeableperson wrote:Another GOP argument bites the dust in the court system, this time 6 - 3. Wonder what the GOP response in Congress will be?


I assume impotent rage.

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Re: The Health Care Debate

Postby aknowledgeableperson » Thu Nov 05, 2015 8:17 am

The latest. Government run health care co-ops that started with Obamacare or the ACA are going under leaving those using these plans having to make a decision on commercial insurance, usually at a much higher cost. Of course depending on which side of the aisle you are on these failures are either the result of needed government support or just that these plans were doomed to fail without large government subsidies.

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grovester
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Re: The Health Care Debate

Postby grovester » Thu Nov 05, 2015 9:32 am

Not sure if trolling...

I think you're referring to some providers pulling out of markets?

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Re: The Health Care Debate

Postby flyingember » Thu Nov 05, 2015 10:45 am

http://www.thefiscaltimes.com/2015/11/0 ... are-Co-ops

These were nonprofit startups based on government loans.

The government run private business marketplaces were as much an idea to see if the government providing a framework for more competition would work. The loans appear to have been with the idea of kickstarting competition and then let the market take over. A clear conservative idea of giving money to business and let them pick how to run their business.

And clearly this did not work.

So it does help lead to the idea that insurance is best provided by very large entities with basic actuarial economy of scale behind them. Either we accept this with very large for profit entities, Anthem buying Cigna is leading to this, or move to fully government run where profit isn't the motive.


My guess is health insurance is going to lead to be more like crop insurance where the government takes in data and uses is to figure the cost and reimbursement for private companies, with tax dollars being used to directly fund a baseline for all healthcare.

So if I go to a doctor with a problem, say they diagnoses me with strep. If they have done these set standard tests and then subscribe me certain drugs and meet certain standards for cost control they will get paid 100% of their cost and I pay nothing. Doctors will have an incentive to do what's clinically proven to work for most people, which reduces independent liability and I don't get stuck with a bill.

But what it won't do is any medicine anywhere. Instead you'll have research facilities. If I have dangerous condition X I can go to select hospitals where they're working to improve outcomes for people like me and they get 100% reimbursement. So instead of 500 hospitals seeing patients with a specific condition once a year and needing to do research over and over 10 hospitals see all the patients with the condition as part of an organized clinical trial Then when those facilities find ways to take outcomes to some minimum the procedure can be done at other hospitals with 100% reimbursement if they follow the proven procedures.

And then private health insurance will come in. The big companies will sell it as a premium product with premium prices. Let them pick who they serve and what they want to cover. And at that point I can go anywhere for my premium coverage.

Everyone gets the same level of minimum life saving care paid for out of their taxes. People paying for more get more choice and can take more risks.
Hospitals make money by serving these premium customers so they don't need to charge $1000 per hour in the emergency room.

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Re: The Health Care Debate

Postby grovester » Thu Nov 05, 2015 11:41 am

Thanks, never heard of that program. Seems worthwhile to explore, but doomed from the start, particularly with opposition. Looks like everyone is still eligible for regular ACA coverage and any available subsidies though.


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