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

[Tulane Skins Fan]

How about affordable health care with coverage instead of catastrophic insurance.

 

Isn't that the difficulty of it all?

 

The philosophy behind Obamacare is that the companies will compete on the exchanges for these people and the premiums will come down and coverage get better.  It is a conservative, free-market approach to the problem.

 

The other way is to institute government into the equation, either with regulations or programs, i.e. public option, single payer.  

 

But yes, the goal is better coverage for cheaper.  Easier said than done.

Wait, we aren't entitled to it?  Then why is the government forcing us to use it?

 

The government is forcing you to use it because they believe you are entitled to it, but that the entitlement comes with responsibilities also.  

[Lombardi's_kid_brother]

You wanting to avoid the issues as usual?

 

I'm complaining about both premiums rising and the higher deuctibles,and smaller provider networks ...and a lot more

 

That's been the trend in health insurance for 25 years. 

[chipwhich]

Isn't that the difficulty of it all?

 

The philosophy behind Obamacare is that the companies will compete on the exchanges for these people and the premiums will come down and coverage get better.  It is a conservative, free-market approach to the problem.

 

The problem I have with it is people can't afford their bills now.  Throw on health insurance with high deductibles and all you got is more bills.

But if you have  heart attack, you at least only have to pay the $5K, $10K, $12K deductible!

[PokerPacker]

The philosophy behind Obamacare is that the companies will compete on the exchanges for these people and the premiums will come down and coverage get better.  It is a conservative, free-market approach to the problem.

When people are forced into a market, it is never a free-market.

[twa]

When people are forced into a market, it is never a free-market.

 

Yep,  Neither is one where benefits are determined by the govt

[CrabR]

The more I see of Obamacare the more I hate it. Our #1 expense each month is health care are rates are going up and the end of this period. Obamacare is a nightmare for people who already have insurance. I was for healthcare reform but not this crap. The Dems pushed this through to say they gave us healthcare without any forethought

[Tulane Skins Fan]

When people are forced into a market, it is never a free-market.

 

Health insurance is not a free market at all though, and that is the problem.  First of all, you would pay anything for a heart transplant, wouldn't you?  If I told you that you needed a heart transplant to live, and I could do it, and you would survive, wouldn't you buy it?  It is an extremely inelastic good that has a tremendously high value.  

 

Second, insurance companies do not compete on a free market now.  Not the way other companies do.  We do not want insurance companies to go out of business, which is a necessary part of any free market.  But if Blue Cross/Blue Shield goes out of business tomorrow, millions of people are just screwed over.  We don't like that.  So, we allow insurance companies to share information, and we set up huge frameworks to make sure they do not fail.  They are "too big to fail" already.  Too important to fail, perhaps.

 

So, in one sense I agree with you.  Health care does not work as a free market.  Its not one, and forcing a square peg into a round hole might not work.  But, it is the most free market way to try to address this problem.

 

The problem I have with it is people can't afford their bills now.  Throw on health insurance with high deductibles and all you got is more bills.

But if you have  heart attack, you at least only have to pay the $5K, $10K, $12K deductible!

 

People who can't afford their bills are eligible for expanded Medicaid, and also for government subsidies.  You do not have to buy insurance on the exchanges.  

 

You can also apply for a waiver based on financial hardship.

 

It is not black and white, like you suggest.

 

Yep,  Neither is one where benefits are determined by the govt

 

The government doesn't determine your benefits if you buy PRIVATE insurance on the exchange?  What are you even talking about?  Better question, why do I bother with responding to your posts?  I bet you were the guy who held up the sign to keep the government out of your medicare.

[Bliz]

Health insurance is not a free market at all though, and that is the problem.  First of all, you would pay anything for a heart transplant, wouldn't you?  If I told you that you needed a heart transplant to live, and I could do it, and you would survive, wouldn't you buy it?  It is an extremely inelastic good that has a tremendously high value.  

 

Second, insurance companies do not compete on a free market now.  Not the way other companies do.  We do not want insurance companies to go out of business, which is a necessary part of any free market.  But if Blue Cross/Blue Shield goes out of business tomorrow, millions of people are just screwed over.  We don't like that.  So, we allow insurance companies to share information, and we set up huge frameworks to make sure they do not fail.  They are "too big to fail" already.  Too important to fail, perhaps.

 

So, in one sense I agree with you.  Health care does not work as a free market.  Its not one, and forcing a square peg into a round hole might not work.  But, it is the most free market way to try to address this problem.

 

 

 

I would piggyback on that to add, it's not a free market because there is very little competition, and the barriers to entry are so high as to be essentially insurmountable.  You can't start your own health insurance company offering better service at cheaper rates. 

 

It's an oligopoly.

[twa]

 

 

The government doesn't determine your benefits if you buy PRIVATE insurance on the exchange?  What are you even talking about?  Better question, why do I bother with responding to your posts?  I bet you were the guy who held up the sign to keep the government out of your medicare.

 

The govt obviously does determine benefits now or fine you for non-compliant plans.

 

You respond because you like to think you are correct

 

Not on medicare and if you give my money back I never will be.

[Tulane Skins Fan]

The govt obviously does determine benefits now or fine you for non-compliant plans.

 

You respond because you like to think you are correct

 

Not on medicare and if you give my money back I never will be.

 

Saying things does not make them correct.  

[chipwhich]

People who can't afford their bills are eligible for expanded Medicaid, and also for government subsidies.  You do not have to buy insurance on the exchanges.  

 

You can also apply for a waiver based on financial hardship.

 

I am not speaking of the poor.

 

[twa]

Saying things does not make them correct.  

exactly

[Wrong Direction]

I thought I’d send a few observations about the ObamaCare rollout and (a tiny bit) about the shutdown.

 

1.       With the websites failing, healthier people are less likely to really go through the trouble to enroll.

2.       With low penalties for 2014 ($95 maximum penalty next year), there’s not a huge negative incentive to encourage enrollment.

3.       With deductibles very high (on average over $4,000 for a young individual, many thousands more for a family), healthier people will see less value in enrollment.

4.       High deductibles will also diminish satisfaction rates in 2014. People will go to the Dr. and realize they have to pay the full price because they’re still in their deductible phase. In a nutshell, total out of pocket costs will be roughly $5,500-$6,000, on average, for a healthy individual before they get coverage beyond basic preventive care.

5.       The McConnell amendment added to the budget resolution requiring the federal government to verify income levels prior to providing the subsidy is much bigger than the press is letting on. The government is completely incapable of doing this in an automated fashion. Systems with the IRS and Plans are not ready. This means lower income people might not get the subsidy they need if/when they sign up. If words gets out, this will further diminish enrollment.

6.       Premiums for individual plans in most states (though not all) are pretty significantly higher than they were in 2013.

7.       A few states only have one choice. Lack of choice in those states has resulted in higher premiums and lesser access to providers. In New Hampshire, something like 10 of the 24 in-state hospitals are not in-network of the only plan option.

8.       The ACA has three things going for it right now

a.       Young people are devoted to Obama so many will enroll even if the cost-benefit is not positive.

b.      Sick people without insurance have legitimate needs.

c.       High deductibles will depress utilization, perhaps in a big way, so combined with low enrollment, overall government costs might actually be lower to the government than forecast. This is countered by the potential hit to satisfaction rates, of course.

9.       Anecdotally (though not confirmed in actual published reports), I’m hearing employer costs have gone up more than expected, on average, for 2014.

10.   Full-time employment continues to lag significantly versus historical comparisons. Part time employment continues to expand.

 

Unless these people get the websites up soon AND can convince young people to pay premiums just for the right of paying another $4-5,000 deductible, enrollment in the plans will be 1) much lower than anticipated and 2) much sicker than anticipated. This is the worst case scenario for the ACA. It is the definition of a death spiral. If this is all allowed to happen, premiums next year will be higher because of the sicker case mix and plans in the exchanges right now will be dropping out. It’s a recipe for upheaval. Factor in the fact that the employer mandate was only waived for one year, the other “connected businesses/entities” waivers are temporary, and the medical device tax is still levied on that powerful lobby, and I genuinely can’t imagine a worse rollout for this law. Even if the computers work, the high deductibles might be enough to dramatically hurt enrollment and satisfaction rates.

[Tulane Skins Fan]

You are making a knee jerk reaction though. It IS a market place. It people don't buy the insurance and hung for cheaper stuff, some company will fill that vacuum.

[TheGoodBits]

You are making a knee jerk reaction though. It IS a market place. It people don't buy the insurance and hung for cheaper stuff, some company will fill that vacuum.

That's assuming that there isn't collusion/price fixing. Insurance companies will do fine under ACA, but they were doing GREAT before. They understand that the best way to get rid of it is to make it unpopular, and the best way to make it unpopular is to make it expensive.

[chipwhich]

I thought I’d send a few observations about the ObamaCare rollout and (a tiny bit) about the shutdown.

 

1.       With the websites failing, healthier people are less likely to really go through the trouble to enroll.

2.       With low penalties for 2014 ($95 maximum penalty next year), there’s not a huge negative incentive to encourage enrollment.

3.       With deductibles very high (on average over $4,000 for a young individual, many thousands more for a family), healthier people will see less value in enrollment.

4.       High deductibles will also diminish satisfaction rates in 2014. People will go to the Dr. and realize they have to pay the full price because they’re still in their deductible phase. In a nutshell, total out of pocket costs will be roughly $5,500-$6,000, on average, for a healthy individual before they get coverage beyond basic preventive care.

5.       The McConnell amendment added to the budget resolution requiring the federal government to verify income levels prior to providing the subsidy is much bigger than the press is letting on. The government is completely incapable of doing this in an automated fashion. Systems with the IRS and Plans are not ready. This means lower income people might not get the subsidy they need if/when they sign up. If words gets out, this will further diminish enrollment.

6.       Premiums for individual plans in most states (though not all) are pretty significantly higher than they were in 2013.

7.       A few states only have one choice. Lack of choice in those states has resulted in higher premiums and lesser access to providers. In New Hampshire, something like 10 of the 24 in-state hospitals are not in-network of the only plan option.

8.       The ACA has three things going for it right now

a.       Young people are devoted to Obama so many will enroll even if the cost-benefit is not positive.

b.      Sick people without insurance have legitimate needs.

c.       High deductibles will depress utilization, perhaps in a big way, so combined with low enrollment, overall government costs might actually be lower to the government than forecast. This is countered by the potential hit to satisfaction rates, of course.

9.       Anecdotally (though not confirmed in actual published reports), I’m hearing employer costs have gone up more than expected, on average, for 2014.

10.   Full-time employment continues to lag significantly versus historical comparisons. Part time employment continues to expand.

 

Unless these people get the websites up soon AND can convince young people to pay premiums just for the right of paying another $4-5,000 deductible, enrollment in the plans will be 1) much lower than anticipated and 2) much sicker than anticipated. This is the worst case scenario for the ACA. It is the definition of a death spiral. If this is all allowed to happen, premiums next year will be higher because of the sicker case mix and plans in the exchanges right now will be dropping out. It’s a recipe for upheaval. Factor in the fact that the employer mandate was only waived for one year, the other “connected businesses/entities” waivers are temporary, and the medical device tax is still levied on that powerful lobby, and I genuinely can’t imagine a worse rollout for this law. Even if the computers work, the high deductibles might be enough to dramatically hurt enrollment and satisfaction rates.

 

Excellent post!

[TradeTheBeal!]

I'm against Obamacare because I have a very luxurious lifestyle which is primarily based upon explosive growth in health care costs.  The last 15 years have been a blast!

[chipwhich]

I'm against Obamacare because I have a very luxurious lifestyle which is primarily based upon explosive growth in health care costs.  The last 15 years have been a blast!

 

Oh I have a feeling your pockets will get fatter, that is unless you are an independent insurance broker.

[Hersh]

The one issue I have with Obamacare is that I think it should have opened up chance to buy insurance across state lines. I think that would have brought down prices more.

[JamesMadisonSkins]

Okay got official word today about the plan costs v. last year ...

 

Same plan ... except the copay for surgery went from $150 to $0 (not that I need surgery, but that's nice). Everything else remains the same ... 

 

In 2013 my insurance plan was $1,531 per quarter. In 2014 it will be $1,280 per quarter.

 

That means in 2013 my insurance will have cost $6,124 ... but next year it will drop to $5,120

 

That's $1,004 or $251 per quarter. 

 

For someone early in his career with a lower-end salary ... that's a blessing considering they had told us a couple months ago to expect the rates to go up 30% ... which would have increased the cost to $7,961 by my math ... my employer covers a base of $5,296 ... so that increase would have cost me $76 a paycheck or $152 a month, which really would have hit me prettty hard.

 

Check that, my employer does cover the base + 50% of any increase in cost. But still, saves me some decent money

Edited October 18, 2013 by JamesMadisonSkins

[Larry]

The impression I'm getting is that several of the mandates in Obamacare mean that people who weren't planning to need them, will have to pay more, but that people who did need them, will pay less.

There was an example posted here about some guy whose rates are going up. The article mentions that yeah, he's now getting coverage that he didn't have, before. (They mentioned maternity care, and mental health care for drug or alcohol addiction.) Things that he didn't have, before, and didn't need. (He's a single father. Unlikely to need maternity care.)

OTOH, I assume that people who did need maternity care, their rates will go down, because now there's more people paying into the "maternity care" pool.

I'm wondering if things like this, the pre-existing conditions rule, things like that, might well have the effect of making the cost of insurance "flatter".

[twa]

It will make it flatter by expanding healthy enrollees required to pay premiums into the pool.

 

It will certainly make my wife's coverage easier and less expensive.

 

It will also direct a significant amount of spending which will have repercussions elsewhere.

 

Those young people better get three jobs 

[TradeTheBeal!]

Some will pay more, some will pay less.  We're all in this together.

 

That said, as long as hospitals can charge $60 for an Advil, I'll be just fine.  Poolside, in fact.

[chipwhich]

Some will pay more, some will pay less.  We're all in this together.

 

That said, as long as hospitals can charge $60 for an Advil, I'll be just fine.  Poolside, in fact.

 

You will get $80 for an Advil under the ACA.  Live well my friend.

[Elessar78]

Isn't that the difficulty of it all?

 

The philosophy behind Obamacare is that the companies will compete on the exchanges for these people and the premiums will come down and coverage get better.  It is a conservative, free-market approach to the problem.

 

The other way is to institute government into the equation, either with regulations or programs, i.e. public option, single payer.  

 

But yes, the goal is better coverage for cheaper.  Easier said than done.

 

The government is forcing you to use it because they believe you are entitled to it, but that the entitlement comes with responsibilities also.  

I thought the reason the gov't is forcing people to have health insurance is to cap the overall spending on healthcare by making sure people have medical care before they need more expensive emergency room visits. 

 

TWA, like many of his persuasion, will avail himself of it and rail against it vehemently. Like those people at Tea Party rallies who are on Medicare but don't want gov't involved in their healthcare. Facepalm. 

 

We get it, you guys hate it. Rationalize it however you want, but it all comes down to you hate Obama, hate his policies—never mind the fact that this is based on a Heritage Foundation blue print (no matter how much they walk it back), never mind the fact that Romney put in play a very similar plan in Massachusetts. 

 

The arguments in this thread are circular. One side throws out half-assed, fear mongered half-truths and another side gives rational rebuttals only to be met with a change of tack. Tomatoes stain your clothes . . . well, you can get the stain out with Shout . . . Tomatoes are too acidic. 

 

It all comes down to is, if you're a business owner or rich, you don't want to pay more. Tough. To flip the script as have been used against "us" before—"If you don't like it, you can get the hell out." Don't like how gov't is pushing you around by linking desired behavior to taxation? Please be the first to give back your deductions for kids and marriage and homeownership. Yes, it's wholly unfair to have to be taxed at a higher rate for every dollar above a threshold. Go ahead, find a better deal elsewhere. Sorry, American society as a whole doesn't believe in your right to buy your third, fully-loaded BMW before certain things are taken care of.