Obamacare...(new title): GOP DEATH PLAN: Don-Ryan's Express

[JMS]

It's (Obamacare) RAPIDLY driving up the demand for High Deductible insurances plans.

So as I read that statement, the insinuation is that Obamacare is driving up costs.

The reality is since 2010 when Obamacare was passed, healthcare costs have been rising at their slowest rates since those rates started being recorded.

Since healthcare costs are rising SLOWER than prior to Obama, if anything the flight to high deductible plans which weren't even part of Obamacare until just a month ago, shouldn't logically be increasing. With costs rising slower, the flight to cheaper high deductible pans should be slowing.

 

New Report from the Council of Economic Advisers: The Recent Slowdown in Health Care Cost Growth and the Role of the Affordable Care Act

1. Health care spending is growing at the slowest rate on record: According to the most recent projections, real per capita health care spending has grown at an estimated average annual rate of just 1.3 percent over the three years since 2010. This is the lowest rate on record for any three-year period and less than one-third the long-term historical average stretching back to 1965. This slower growth in spending is reflected in Medicare, Medicaid, and private insurance.

Posted by Jason Furman on November 20, 2013

http://www.whitehouse.gov/blog/2013/11/20/new-report-council-economic-advisers-recent-slowdown-health-care-cost-growth-and-rol

 

U.S. healthcare rate of growth at 53-year low

Jan. 7, 2014

Read more: http://www.upi.com/Health_News/2014/01/07/US-healthcare-rate-of-growth-at-53-year-low/UPI-44241389073908/#ixzz2yUvbl4N7

 

Medical-Price Inflation Is at Slowest Pace in 50 Years

 

Data Signal Relief for Governments, Businesses as Plans Make Consumers Pick Up More of the Tab

 

Sept. 17, 2013 9:11 p.m. ET

Medical prices are rising at their slowest pace in a half century, a shift in the health-care industry that could provide relief to government and businesses' budgets while also signaling consumers are being left with a larger share of the bill.

The prices paid for medical care in July rose just 1% from a year earlier, the slowest annual rate of growth since the early 1960s, according to Commerce Department data. Health-care increases now trail overall inflation, which itself has been historically slow in recent years.

 

http://online.wsj.com/news/articles/SB10001424127887323342404579081312680485476

Edited April 10, 2014 by JMS

[chipwhich]

So as I read that statement, the insinuation is that Obamacare is driving up costs.

The reality is since 2010 when Obamacare was passed, healthcare costs have been rising at their slowest rates since those rates started being recorded.

Since healthcare costs are rising SLOWER than prior to Obama, if anything the flight to high deductible plans which weren't even part of Obamacare until just a month ago, shouldn't logically be increasing. With costs rising slower, the flight to cheaper high deductible pans should be slowing.

 

 

I have explained this to you before, but you don't listen.

 

Healthcare costs are rising SLOWER due to the increase in high deductible plans.  Insurance companies figured out if the patients have to pay out of pocket they will be less likely to run to the doctor.  The PROBLEM is out of pocket costs to YOU the consumer will skyrocket.

[JMS]

One of the stories you'll never see in the press is the complete waste of money that a good chunk of Comparative Effective Research has become. I can't speak for NIH allocations because I don't know those folks as well, but many of the other HHS allocations of that money have been a waste. There will be a time when exchange data will be able to be pared with other health data (probably another 6-8 years, if further financial support is made available), but for now private data is more or less useless for medical product research. Plus, even once you have the data in a format to compare, the work to actually do so is immense. It requires much more than SAS programmers.

Traditionally health records were spread out across various doctors offices who performed various procedures for you. There was no consolidated place where an individual could see or concentrate all his own records.

Obama's national data warehouse did something which Healthcare professionals had been asking for for a long time. Create that one location where all the records would be held.

Having said that I agree their is a lot of waste in the US Healthcare system, pre and post Obamacare. By looking at other nations who's healthcare delivery systems perform similarly the wast in the US system could be higher than 50%...

Likewise It wouldn't surprise me if the folks compiling the national repository were doing so in a brain dead manor which obfuscated it's utility to be used in the manor prescribed for data mining. Brain dead software folks is a national issue since we decided to remove ourselves from the technology marketplace.. That last one is my personal feelings on the matter. I've seen a lot of seemingly simple projects flounder and fail due to moronic behavior and or non techies being in charge.

[JMS]

I have explained this to you before, but you don't listen.

 

Healthcare costs are rising SLOWER due to the increase in high deductible plans.  Insurance companies figured out if the patients have to pay out of pocket they will be less likely to run to the doctor.  The PROBLEM is out of pocket costs to YOU the consumer will skyrocket.

 

They are attributing it to many factors.  Obamacare is one of the top 3 factors according to one expert in the articles I posted.    There is no consensus yet by healthcare experts based upon the articles I read, why this is occurring.

 

 

(1) high deductible plans aren't even part of Obamacare for small businesses. The GOP just added them 4 days ago.

 

4 days ago.

Why Did The GOP Just Expand Obamacare Choices?

WASHINGTON (AP) — At the prodding of business organizations, House Republicans quietly secured a recent change in President Barack Obama's health law to expand coverage choices, a striking, one-of-a-kind departure from dozens of high-decibel attempts to repeal or dismember it.

...

The provision itself was relatively minor. It eliminated a cap on deductibles for small group policies offered inside the law's health care exchanges as well as outside; the cap was set at $2,000 for individuals and $4,000 for families.

Republicans said they sought it so small businesses can offer high-deductible plans that could be purchased by individuals who also have health savings accounts.

http://talkingpointsmemo.com/news/gop-seeks-coverage-choices-health-law-they-hate

Edited April 10, 2014 by JMS

[Larry]

(1) high deductible plans aren't even part of Obamacare for small businesses. The GOP just added them 4 days ago.

From what I've read, yes, there was a cap in the law, BUT, Obama had already unilaterally exempted that cap, delaying it till 2015. The change in the law simply makes the delay, permanent.

[JMS]

From what I've read, yes, there was a cap in the law, BUT, Obama had already unilaterally exempted that cap, delaying it till 2015. The change in the law simply makes the delay, permanent.

 

Yeah I read the GOP's new modification allows small businesses to take advantage of features previously reserved for larger companies...  Increasing the deductible cap on high deductible plans.

[Wrong Direction]

Traditionally health records were spread out across various doctors offices who performed various procedures for you. There was no consolidated place where an individual could see or concentrate all his own records.

Obama's national data warehouse did something which Healthcare professionals had been asking for for a long time. Create that one location where all the records would be held.

Having said that I agree their is a lot of waste in the US Healthcare system, pre and post Obamacare. By looking at other nations who's healthcare delivery systems perform similarly the wast in the US system could be higher than 50%...

Likewise It wouldn't surprise me if the folks compiling the national repository were doing so in a brain dead manor which obfuscated it's utility to be used in the manor prescribed for data mining. Brain dead software folks is a national issue since we decided to remove ourselves from the technology marketplace.. That last one is my personal feelings on the matter. I've seen a lot of seemingly simple projects flounder and fail due to moronic behavior and or non techies being in charge.

 

You may not understand the distinction between research uses for EHRs (which are not being consolidated for research at this time) and private claims data (for which efforts to research are highly complex and generally failing).

 

Some private research is done on private claims data, but it has significant limitations. Claims data from private plans (which will include exchange data) is very far away from being usable for robust research purposes through any government facilitation.

Edited April 10, 2014 by Wrong Direction

[Tulane Skins Fan]

I have explained this to you before, but you don't listen.

 

Healthcare costs are rising SLOWER due to the increase in high deductible plans.  Insurance companies figured out if the patients have to pay out of pocket they will be less likely to run to the doctor.  The PROBLEM is out of pocket costs to YOU the consumer will skyrocket.

 

So, is that good or bad?  Because I think I've read that the GOP doesn't like high deductible plans.  

 

(Even though Ryan just proposed using them to reform healthcare.)

[chipwhich]

So, is that good or bad?  Because I think I've read that the GOP doesn't like high deductible plans.  

 

(Even though Ryan just proposed using them to reform healthcare.)

 

Well I guess it's good if you can afford it and bad if you can't.

 

What good is a poor person having insurance if they can't afford to go to the doctor.  Sure if they have a heart attack it will save them from bankruptcy.  But if a doctors visit and prescription costs up to $100, $500, $1000's of dollars out of pocket, who wins?

You may not understand the distinction between research uses for EHRs (which are not being consolidated for research at this time) and private claims data (for which efforts to research are highly complex and generally failing).

 

Some private research is done on private claims data, but it has significant limitations. Claims data from private plans (which will include exchange data) is very far away from being usable for robust research purposes through any government facilitation.

 

This.

Edited April 10, 2014 by chipwhich

[Duckus]

 

Enrollment hits 7.5 million.  

 

Health and Human Services Secretary Kathleen Sebelius said Thursday at a congressional hearing that Obamacare enrollment had ticked up to 7.5 million in the past week.

 

"Last week we announced that 7.1 million Americans have signed up for private insurance through the marketplace. As of this week, 400,000 additional Americans have signed up," Sebelius told the Senate Finance Committee. "And we expect that number to continue to grow.

 

 

http://talkingpointsmemo.com/livewire/obamacare-enrollment-7-5-million

 

As always, ACASignup.net has some fantastic info breaking down state-by-state numbers. 

 

Edited April 10, 2014 by Duckus

[Wrong Direction]

 

 

Enrollment hits 7.5 million.  

 

 

http://talkingpointsmemo.com/livewire/obamacare-enrollment-7-5-million

 

As always, ACASignup.net has some fantastic info breaking down state-by-state numbers. 

 

 

The aggregate numbers are somewhat lacking context.

 

http://www.forbes.com/sites/theapothecary/2014/04/09/rand-comes-clean-obamacares-exchanges-enrolled-only-1-4-million-previously-uninsured-individuals/

 

RAND Comes Clean: Obamacare's Exchanges Enrolled Only 1.4 Million Previously Uninsured Individuals

Edited April 10, 2014 by Wrong Direction

[LeesburgSkinFan]

Sec. Sebelius is out.

[Duckus]

The aggregate numbers are somewhat lacking context.

http://www.forbes.com/sites/theapothecary/2014/04/09/rand-comes-clean-obamacares-exchanges-enrolled-only-1-4-million-previously-uninsured-individuals/

RAND Comes Clean: Obamacare's Exchanges Enrolled Only 1.4 Million Previously Uninsured Individuals

Not surprisingly - Forbes doesn't understand the results of that survey. Rand survey covered extensively on acasignups.net

http://acasignups.net/14/04/08/rand-survey-out-conclusion-net-insurance-gain-93m

I seriously suggest that site. Great stuff.

Edited April 10, 2014 by Duckus

[chipwhich]

Sec. Sebelius is out.

 

Why would she resign?  Skinsmarydu is getting insurance with copays.  JMS says insurance costs are at WORLD RECORD levels and shrinking faster than Richard Simmons wasteline.  All this anti Obamacare stuff is a great big GOP lie. 

[Wrong Direction]

She resigned because it's time for resignations to start. Most political appointees don't stay for all of 2 terms. Holder should be coming soon too, though he could be a special case.

[RVAbrendan]

Why would she resign?  Skinsmarydu is getting insurance with copays.  JMS says insurance costs are at WORLD RECORD levels and shrinking faster than Richard Simmons wasteline.  All this anti Obamacare stuff is a great big GOP lie. 

 

I'd guess because she is 

1) old

2) the structure for ACA is in place, has launched, and is off and running.

 

Maybe she felt like her 'job here is done'. 

[ABQCOWBOY]

When the President took his victory lap on the supposed 7 million sign up milestone.   He never mentioned Sebelius once.   She was not presnet at the speech and that should have been the heads up for most that she was getting 86'd.

[JMS]

This.

 

Chip,  hold onto yourself there...   Wrong Direction is talking about EHR's not being tabulated for research at this time.

Something you and I haven't discussed...

 

I would just add that Electronic Health Records are being stored in XML data records, and to manipulate them for research once in this form just requires transforming the records.   Something XML is designed to allow readily.    Or to state another way....  Once all the records are centrally located and in the new XML format it becomes a technical engineering problem to use them for research,  which isn't all that large a hurdle....

 

The hurdle is getting the national repository set up and doctors to enter all these records in that national repository in a format which can be manipulated by engineers and researchers.    And that is happening.

When the President took his victory lap on the supposed 7 million sign up milestone.   He never mentioned Sebelius once.   She was not presnet at the speech and that should have been the heads up for most that she was getting 86'd.

 

Frankly I think she should be fired.   The Obamacare exchange web site roll out was a fiasco..    Now having said that,  most government software professionals should be fired too.   What do they have like a 95% failure rate in rolling out new systems...

Industry has a 75% failure rate which is pretty amazing too.   Least those where the  numbers last time I looked it up.

[ABQCOWBOY]

Chip,  hold onto yourself there...   Wrong Direction is talking about EHR's not being tabulated for research at this time.

Something you and I haven't discussed...

 

I would just add that Electronic Health Records are being stored in XML data records, and to manipulate them for research once in this form just requires transforming the records.   Something XML is designed to allow readily.    Or to state another way....  Once all the records are centrally located and in the new XML format it becomes a technical engineering problem to use them for research,  which isn't all that large a hurdle....

 

The hurdle is getting the national repository set up and doctors to enter all these records in that national repository in a format which can be manipulated by engineers and researchers.    And that is happening.

 

Frankly I think she should be fired.   The Obamacare exchange web site roll out was a fiasco..    Now having said that,  most government software professionals should be fired too.   What do they have like a 95% failure rate in rolling out new systems...

Industry has a 75% failure rate which is pretty amazing too.   Least those where the  numbers last time I looked it up.

 

Also very vulnerable, XML.

[JMS]

JMS says insurance costs are at WORLD RECORD levels and shrinking faster than Richard Simmons wasteline.  All this anti Obamacare stuff is a great big GOP lie. 

 

Healthcare  cost increases are at the lowest levels since the 1960's for four straight years under Obamacare...   That's not the same as insurance costs or even Healthcare costs being considered low.   AND JMS doesn't say that, The White House Council of Economic Advisors,  UPI, and WSJ  all said that...  I just posted the articles and headlines in post #2476 

 

You sound like you are getting bitter Chip.

 

Also very vulnerable, XML.

 

Not really...  Its not like anybody can just edit the master copies of the XML..  I'm sure they have all that under secure version control and backed up.     If they don't then they shouldn't be fired,  they should be executed.

Edited April 11, 2014 by JMS

[Wrong Direction]

The hurdle is getting the national repository set up and doctors to enter all these records in that national repository in a format which can be manipulated by engineers and researchers.    And that is happening.

 

I'm not sure this is happening. Are you talking about the clearinghouse? I'm under the impression (perhaps misinformed) that the clearinghouse doesn't actually house all of the records. It's basically a master IT switch with identifiers for people, insurance plans, pharmacy benefit managers and effective dates. This allows for routing of information from one physician office to the correct plan.

 

It may be more than that, so I'll concede if you're sure of it. I am sure that even once it's all collected, there will still be a real challenge in research. However, if you're right and the data is consolidated, that is certainly the biggest hurdle to overcome. The rest will require a lot of time and energy to work through the different insurance plan business and coverage rules, build longitudinal datasets, etc.

[ABQCOWBOY]

 

Frankly I think she should be fired.   The Obamacare exchange web site roll out was a fiasco..    Now having said that,  most government software professionals should be fired too.   What do they have like a 95% failure rate in rolling out new systems...

Industry has a 75% failure rate which is pretty amazing too.   Least those where the  numbers last time I looked it up.

 

 

Perhaps, but I think it's also true that the President and his staff were heavily envolved in the direction of this roll out over these past few years.   If you are going to say that she did a poor job, you must also say that the President also did a poor job.   Either way, she has faced the brunt of the criticsm over these past few years and I think that that should count for something.  He should not have allowed her to be dismissed so unceremoniously.   I am not a fan of Obamacare but the President should have treated her better IMO.   He is at least, as much responsible, for the disaster of a rollout that has been Obamacare IMO.

[Wrong Direction]

Cost care cost increases are at the lowest levels since the 1960's for four straight years under Obamacare...

JMS doesn't say that, The White House Council of Economic Advisors,  UPI, and WSJ  all said that...

I just posted the articles and headlines in post #2476 

 

There are any number of studies showing that healthcare inflation has been decreasing since before Obama was president and attributing the slow down to many factors, including high deductible plans and the economy. Crediting the ACA for a several year decline in growth when it has implemented coverage for 3 months now and hasn't implemented most of its Medicare cuts yet, is sort of silly.

[ABQCOWBOY]

 

Not really...  Its not like anybody can just edit the master copies of the XML..  I'm sure they have all that under secure version control and backed up.     If they don't then they shouldn't be fired,  they should be executed.

 

 

Yeah really.   XML has some real security risks associated with it. 

[JMS]

I'm not sure this is happening. Are you talking about the clearinghouse? I'm under the impression (perhaps misinformed) that the clearinghouse doesn't actually house all of the records. It's basically a master IT switch with identifiers for people, insurance plans, pharmacy benefit managers and effective dates. This allows for routing of information from one physician office to the correct plan.

 

It may be more than that, so I'll concede if you're sure of it. I am sure that even once it's all collected, there will still be a real challenge in research. However, if you're right and the data is consolidated, that is certainly the biggest hurdle to overcome. The rest will require a lot of time and energy to work through the different insurance plan business and coverage rules, build longitudinal datasets, etc.

 

I think you know a lot more about it than I do... I just remember reading they were spending a billion dollars on it...  Alot of that went to working out the EHR format,   I just assumed they would also have them inputted into a central repository because that wouldn't be all that expensive considering their budget.