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

[Wrong Direction]

OK, you've demonstrated that an 80 year old American spends more than an 80 year old German.

The odds of either of them making it to 81 are . . . ?

 

http://data.worldbank.org/indicator/SP.DYN.LE00.IN

 

I'm not sure what confounding to consider (has to be a lot), but the life expectancy in Germany was 81. It was 79 in the USA.

[mcsluggo]

Wow. I couldn't believe this chart when I saw it. Actually sort of an old chart, but with huge implications. First, think of the age when the divergence begins. Then think who is the primary payer for that age group.

 

  

 

this graph... is filled with all sorts of suck.   (i am assuming it is accurate)

 

 

but to your implied point (I *think* you are pointing out that at 65 is when the Fed gov starts paying for most people's healthcare, and it is also when things start costing so much for americans, right?)

 

don't ALL of those other countries have socialized medicine?

[Larry]

http://data.worldbank.org/indicator/SP.DYN.LE00.IN

I'm not sure what confounding to consider (has to be a lot), but the life expectancy in Germany was 81. It was 79 in the USA.

But life expectancy factors in the large numbers if Americans who die in their teens, from gunshots or car accidents. (Or military service).

It includes babies born three months premature who die after 5 weeks.

[Wrong Direction]

But life expectancy factors in the large numbers if Americans who die in their teens, from gunshots or car accidents. (Or military service).

It includes babies born three months premature who die after 5 weeks.

 

True, but the graph is about cost at a given age. It isn't about life expectancy.

 

As an aside, I thought this article was an interesting read. It's a conservative critique of a conservative idea. I'd provide snippets, but I'm not sure that would do the trick.

 

http://thefederalist.com/2014/05/14/the-most-popular-republican-talking-point-on-health-care-is-wrong/

Edited May 14, 2014 by Wrong Direction

[mcsluggo]

do we REALLY pay over $30k per year on AVERAGE for each and overy 80- year old??  (there are lots and lots and lots of 80 year olds in this country... and most of us will reach that age)

[RVAbrendan]

I was having a discussion about the ACA with my girlfriend, who is a R.N. at MCV here in Richmond. We both agree that it's a good thing for previously uninsured Americans to have more affordable access to health insurance... and while the ACA isn't perfect at this point, it's a step in the right direction.

 

That being said, she has heard a lot of negative feedback from doctors, mainly having to do with the exponential increase in insurance paperwork, basically bottlenecking the service. Her argument is that with all these new citizens with health insurance hitting the market at once, there is a shortage of doctors to properly care for those in need.

 

Tl:dr - Will the sudden rise of insured Americans negatively impact the quality of care given? To me, I have to say yes, at least temporarily until the supply is able to meet the demand.

 

Any thoughts on this?

[Larry]

True, but the graph is about cost at a given age. It isn't about life expectancy.

Thus making it a graph of costs, while ignoring benefits.

I've READ the CLAIM that, if an American hits age 65, then his life expectancy is better than every country in the world, but one. (Sweden?).

But I don't know if that claim is TRUE. I've only read it once, and I suspect that, if it were true, it would be a well used political talking point.

[Wrong Direction]

do we REALLY pay over $30k per year on AVERAGE for each and overy 80- year old??  (there are lots and lots and lots of 80 year olds in this country... and most of us will reach that age)

 

It really is incredible. I think the difference between us and those other countries would decline if adjusted to a standardized dollar. We pay more for most services and use more services though, so I absolutely believe a huge gulf exists.

 

Tl:dr - Will the sudden rise of insured Americans negatively impact the quality of care given? To me, I have to say yes, at least temporarily until the supply is able to meet the demand.

 

Any thoughts on this?

 

We aren't prepared for the influx in retirees, much less any massive expansion in coverage for pre-retirees. We need more healthcare workers of pretty much all kinds. The ACA took some steps to try to alleviate the problem, but I think they're somewhat misguided because they don't address the underlying problems with accreditation and available slots in med schools. I think the ACA in the aggregate will make the shortage worse. Generally more coverage is a good thing, but we haven't done enough on more health workers, particularly skilled ones.

 

Thus making it a graph of costs, while ignoring benefits.

I've READ the CLAIM that, if an American hits age 65, then his life expectancy is better than every country in the world, but one. (Sweden?).

But I don't know if that claim is TRUE. I've only read it once, and I suspect that, if it were true, it would be a well used political talking point.

 

At 3:1 or greater, I'm guessing there's (at best) a law of diminishing returns here. 

 

The real problem for policy makers is figuring out a way to maximize access to helpful care while paying correctly and eliminating fraud, waste and abuse (FWA). The feds have gone overboard on access. As a result, while there are still geographic and cultural barriers to access that need to be addressed, there's also a massive FWA issue on the other side of the spectrum. Add in that politicians can't hold down payments and have taken away a patient's incentive to do so (basically eliminating cost sharing) and you have a system with massive unnecessary costs. 

 

In a perfect world, we would spend our money perfecting access (to get any benefits in outcomes you're alluding to) while running an efficient system that prices correctly and disallows unnecessary care and payment. That's the panacea. 

[The Sisko]

Wow. I couldn't believe this chart when I saw it. Actually sort of an old chart, but with huge implications. First, think of the age when the divergence begins. Then think who is the primary payer for that age group.

 

  

 

This does little to make your point as there are a number of other variables in play that aren't addressed in this single chart. How much of this is due to pent up demand from previously uninsured folks who age into Medicare insurance? How does implicit rationing affect costs for previously uninsured patients prior to Medicare enrollment? How does the way we manage end of life decisions affect system-wide costs? How much of these later life costs are due to our Tubby McLardbutt lifestyle compared to the other countries? There's plenty more but my point is that you can't really draw any firm conclusions from this single graph. Also, as someone else mentioned, the other countries in this comparison have socialized medicine. It certainly appears that they do a much better job of holding down later life medical costs than our allegedly free market system does.

[BRAVEONAWARPATH]

http://www.msnbc.com/politicsnation/obamacare-saved-consumers-billions

 

 

 

 

 

Obamacare saved consumers billions, new report finds

 

A new analysis finds American consumers saved billions in 2011 and 2012 thanks to a key provision of the Affordable Care Act. 

 

The report from The Commonwealth Fund released Tuesday finds the medical loss ratio provision, which caps profits for health insurance companies, benefited consumers by about $3 billion over the past two years through a combination of rebates from insurance companies and reduced overhead spending.

 

The law’s provision limits insurance companies to spending a minimum of 80-85% of premiums specifically on treatment and medical costs, rather than overhead and profits.

The rebate receipts sent to consumers hit $1 billion in 2011 and about $500 million in 2012, an indication that insurance providers successfully shifted business models to fit the new spending requirements. In addition to the rebates provided to consumers, insurers reduced profits and spending on general overhead by about $1.4 billion, the report finds. 

 

 

 

“The medical loss ratio requirement of the Affordable Care Act creates a higher-value insurance product for consumers,” said The Commonwealth Fund President David Blumenthal said in the report. “It ensures that a substantial portion of their premium dollar pays for medical care, as opposed to administrative costs and profits. It also encourages insurers to improve the care their customers receive, by investing in initiatives that will help achieve better outcomes for patients.”

 

Critics of the provision have argued it would force smaller insurance companies out of the market, but the report concludes so far that “hasn’t substantially reduced competition in health insurance markets or consumers’ choice of insurance plans.” 

 

Edited May 18, 2014 by BRAVEONAWARPATH

[Larry]

Now that at least seems like a rather well supported claim. The amount if the rebates, themselves, is pretty guard to argue against. And it's seems pretty hard to argue against Obamacare being the causation.

Yeah, I assume that $3B isn't really that big a number, in context. But it does seem to be much better supported than a lot of the claims I've been seeing made.

[twa]

the rebates are nice(even if small), but how much debt are we adding?

 

meanwhile the uncertainty continues on both subsidies and who is paying

 

http://www.washingtonpost.com/national/health-science/federal-health-care-subsidies-may-be-too-high-or-too-low-for-more-than-1-million-americans/2014/05/16/8f544992-dd14-11e3-8009-71de85b9c527_story.html

 

The government may be paying incorrect subsidies to more than 1 million Americans for their health plans in the new federal insurance marketplace and has been unable so far to fix the errors, according to internal documents and three people familiar with the situation.

The problem means that potentially hundreds of thousands of people are receiving bigger subsidies than they deserve. They are part of a large group of Americans who listed incomes on their insurance applications that differ significantly — either too low or too high — from those on file with the Internal Revenue Service, documents show.

 

luckily there is a cap on how much the govt can collect for over paying on subsidies.....lucky for the ones receiving them anyway   

 

http://www.cnbc.com/id/101636761

A new report from the House Republicans says the number of non-payers is a stunning 33 percent. The administration has countered without any number of its own but it rightly says the GOP isn't using enough data. Thanks to the Health and Human Services policy not to release payment numbers promptly, the speculation will continue and it has no one to blame but itself.

No matter what the exact number is, there's no doubt the percentage of non-paying Obamacare enrollees will be much, much higher than anything private insurers have dealt with in the past. Default rates in that business usually run in the very low single digits.The kind of responsible and engaged people who got their own health insurance in the past tended to also be responsible enough to pay their bills on time. That's one of the things that made the health insurance self-coverage business so good for so long. 

But no one should be surprised by what looks like a serious problem with payments under the ACA. Because the same force that stopped tens of millions of Americans from getting health-care coverage of any kind even before the ACA is still at work now … and you still can't fix stupid.

[BRAVEONAWARPATH]

http://thehill.com/business-a-lobbying/205441-insurer-says-80-percent-of-its-obamacare-enrollees-have-paid

 

 

Insurers say 80 percent of ObamaCare enrollees have paid premiums

 

Major health insurers say at least 80 percent of the people enrolled in their ObamaCare plans have paid their first premium.

 

Aetna, which offers ObamaCare plans in 17 states, told a House committee roughly 500,000 of their 600,000 enrollees had paid a premium by the third week of April.

 

Paul Wingle, an executive with Aetna, said the company's payment rate has been in the "low- to mid-80 percent range" and suggested it would rise.

 

"These are dynamic figures and do not reflect final enrollment numbers, as some enrollees have not yet reached their payment due dates," Wingle said.

 

Frank Coyne, a vice president of Blue Cross Blue Shield, also confirmed about 80 to 85 percent of their ObamaCare insured have so far paid their first premium.

 

Health insurance provider Wellpoint, which serves 14 federal and state exchanges, says up to 90 percent of those who have signed up for their plans and have met their premium deadlines have paid up.

 

However, when looking at total number of applicants who have signed up but have not necessarily hit their payment deadlines, Dennis Matheis a president at Wellpoint, said about 70 percent have made payments.

 

Darren Rodgers, senior vice president of Health Care Service Corporation, also testified before the committee that 83 to 93 percent of its ObamaCare enrollees have paid their premiums.

 

Cigna was the only insurance provider present at the meeting who could not provide data on premium payments.

 

Democrats are touting the administration's report that 8 million people have signed up for health insurance under the health law, but Republicans have argued at least a third of those enrolled have yet to pay for their insurance.

 

The insurers emphasized their enrollment numbers are not final.

 

Edited May 18, 2014 by BRAVEONAWARPATH

[twa]

http://www.cagle.com/2014/05/the-flaw-in-obamacare/

[Duckus]

http://thehill.com/business-a-lobbying/205441-insurer-says-80-percent-of-its-obamacare-enrollees-have-paid

Yea, but, ummm....

Benghazi!!

Edited May 18, 2014 by Duckus

[twa]

Yea, but, ummm....

Benghazi!!

keep polishing

http://www.californiahealthline.org/articles/2014/4/29/polls-enrollment-surges-do-little-to-sway-public-opinion-of-aca

 

http://www.realclearpolitics.com/articles/2014/03/16/the_high_costs_of_obamacare_121948.html

 

http://www.fool.com/investing/general/2014/05/18/3-obamacare-revelations-that-might-astound-and-con.aspx

[Larry]

the rebates are nice(even if small), but how much debt are we adding?

Obamacare reduces the deficit. Remember?

keep polishing

Keep spinning.

Let us know when you actually have a point that you'd like to make.

[twa]

Obamacare reduces the deficit. Remember?

deficit or debt? (accounting is a creative art)

The deficit has went down under Obama......the debt?

I remember a lot of things said ,some of them even true   

 

 

[Larry]

deficit or debt? (accounting is a creative art)

Ah,  got it. 

 

You want to repeal Obamacare (and increase the deficit), because Obamacare has not completely eliminated the federal deficit.  Right? 

 

(Or, were you just flinging intentionally dishonest claims, again?)  

 

You feel like trying to explain what, exactly, the fact that the federal deficit has not been completely eliminated has to do with Obamacare?  (You know, the thread you're attempting to hijack?) 

Edited May 18, 2014 by Larry

[twa]

you bring up deficit and I'm hijacking?

 

I am happy to watch the fruits of ya'lls labors....and laugh.

 

I'll leave you to your honesty and it's fruit

[Duckus]

keep polishing

Meanwhile....

"GOP Pollster Says Republicans Are Changing Their Tune On Obamacare"

http://www.businessinsider.com/republicans-obamacare-change-2014-5

[The Sisko]

deficit or debt? (accounting is a creative art)

The deficit has went down under Obama......the debt?

I remember a lot of things said ,some of them even true 

 

 

True or false question. Isn't it awfully difficult to decrease the debt without decreasing the deficit first? It seems one sort of follows the other.

 

Meanwhile....

"GOP Pollster Says Republicans Are Changing Their Tune On Obamacare"

http://www.businessinsider.com/republicans-obamacare-change-2014-5

It would certainly mimic their change in stance on climate change from "Absolutely, positively no such thing exists!" to "It's a natural process on which humans have no effect".

 

Oh, and FWIW, I said some time ago that as the changes go into effect and people see the benefits, the GOP's brilliant plan to run against it in 2016 wouldn't stand much of a chance.

Edited May 18, 2014 by Yusuf06

[AsburySkinsFan]

Deductible for my wife's hernia surgery last Wednesday because of Obamacare....deductible $2.51

That's it.

The Right can shove a sock in it.

[Larry]

Observing that it can be very difficult to look at something that has happened, (good or bad), and announce that it happened because of Obamacare. 

 

Even ion the case cited above, of people receiving billions in refund checks due to over charges, it's easy to look at that and say that said refunds wouldn't have happened without the law which mandates them. But is that the whole chain of cause and effect? 

 

For example, I will point out that the reason there were refunds was because the insurance company overcharged. 

 

It's possible that Obamacare was the reason for the overcharge.  That the law's uncertainties and unpredictability made the insurance companies be overly nervous about potential future expenses, leading them to overcharge. 

 

Now, saying that without the law, the companies would have just kept that money?  That's an easy cause and effect to demonstrate.  Whereas whet I've tossed out is really conjectural. 

 

If somebody were to assert that Obamacare is to blame for the overcharges, I'd dismiss their claim as essentially impossible to prove. 

 

I'm just pointing out that even in a case like the refunds, where there's a clear cause and effect relationship staring us in the face, (the refunds are mandated by the new law), it's still difficult to make clear statements about the law's total effects. 

[chipwhich]

Deductible for my wife's hernia surgery last Wednesday because of Obamacare....deductible $2.51

That's it.

The Right can shove a sock in it.

 

ASF, if you wan't to join the discussions.  Please post a fact.  There is no such thing as a deductible of $2.51 for a hernia sergia in ANY health care plan whether it's from the ACA or not.