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

[chipwhich]

2). There is no such regulation. This article is merely the 40,000th case of right wing media engaging in "find something bad, and claim it's because of Obamacare, without any attempt at even making this claim remotely believable. In fact, despite the fact that someone would have to be an idiot to believe the claim." And this post is merely the 1,000th case of twa doing the same.

Care to guess which of these possibilities I suspect is actually true?

 

Let's pretend the answer is 2.  I don't know why they are dropped, and apparently you don't either, or you do but you aren't telling.  So lets assume you are correct, the answer is 2.

 

Why are the doctors being dropped?  I couldn't call a doctor stupid or a lawyer money grubbing until I understood more about the lawsuit.

[twa]

far easier to plug your ears,cover your eyes and chant .

 

you could find a reason or two to cut Drs in my last link with the change in incentives if you were so inclined.

it is happening elsewhere as well and other groups of Drs are also suing.

 

 

but I'm sure ACA changes are not a factor 

[chipwhich]

but I'm sure ACA changes are not a factor 

 

Nope, every issue should I say non issue is a result of GOP spinmeisters

 

There are no problems with the ACA

[Larry]

post 1808 rather clearly says rates are going up and choice of doctors is going down AS A RESULT OF Obamacare.

No, it rather clearly makes that claim.

But neither the author of that hit piece, nor you, have so much as attempted to invent an even fictional explanation for how it did this.

(Just like you haven't done, the other 300 times you've found something bad happening, and tried to pretend Obamacare caused it, either.)

Whereas I have pointed out why the premise that a bunch of doctors are suing an insurance company for doing something which was caused by a law, (but caused by some part of the law that nobody can find or explain or even identify), is so laughably impossible to believe that even you won't try to push that spin.

You want to try to push the notion that Obamacare is somehow causing something?

Show how it's doing it.

Point out that the mandate that says that men and women must be charged the same price, even though they don't receive the same amount of claims, causes the prices for men to go up.

(Just be prepared when I point out that yes, that's probably true. But that doing so causes the prices for women to go down. By an identical amount.)

Or pull up some other theory as to how the so-and-so clause causes so-and-so result.

Course, it'll help if your theory is remotely believable. (I know how much that limits your options.)

But I've been seeing the "find something that happened, and then claim Obamacare did it, with no support whatsoever, just make the claim" technique since, well, since years before the law even went into effect.

Kinda ruins the credibility of the "just make a claim, no support needed" technique.

[Larry]

Let's pretend the answer is 2.  I don't know why they are dropped, and apparently you don't either, or you do but you aren't telling.  So lets assume you are correct, the answer is 2.

 

Why are the doctors being dropped?  I couldn't call a doctor stupid or a lawyer money grubbing until I understood more about the lawsuit.

Gee, why would an insurance company take an action which allows said company to continue collecting money from their customers, but reduces the amount of money the insurance company has to pay out?

(An action which, granted, will piss off huge numbers of their customers. But then, they have the opportunity to do this, and blame somebody else for their action, and a lot of people will willingly point fingers at the Designated Diversion.)

Is that the ONLY possible explanation? It's the one I would consider the most likely, but I'm absolutely certain that there are others.

Is that explanation at least believable? A hurdle which the "Obamacare made them do it" theory can't clear?

 

I'm certainly not stupid enough to claim that I possess the secret knowledge of why this insurance company did this. 

 

(Frankly, I have trouble coming up with a reason why an insurance company would cut off a doctor with whom I'm already making money.  Seems to me that, if I were the insurance company, and I wanted to reduce my network, I'd cut the amount I was paying the doctors.  Some of them would refuse to take the pay cut.  I'd get a smaller network, but I'd get a smaller network which is willing to take less money.) 

 

All I'm pointing out is that the theory that

 

1)  Obamacare made the insurance company do this.

2)  But it did so in a way that no one, in the entire right wing propaganda machine, has been able to find out, in five years.

3)  And the doctors, and their attorneys, either know this, and are suing anyway, or don't know it. 

 

is so outrageously unbelievable that even twa won't try to sell it. 

[chipwhich]

Gee, why would an insurance company take an action which allows said company to continue collecting money from their customers, but reduces the amount of money the insurance company has to pay out?

 

I still don't follow you, I apologize but I am trying to track with what you are saying.

 

They didn't reduce the amount of money they paid out, they reduced the in network doctors available to the senior citizens who used that insurance.  So if your mom had a doctor she loved, and he was suddenly taken away....

 

I am just asking why they were dropped.  You are claiming it isn't Obamacare or you are claiming you wont believe it without definitive proof.

[Larry]

I still don't follow you, I apologize but I am trying to track with what you are saying.

They didn't reduce the amount of money they paid out, they reduced the in network doctors available to the senior citizens who used that insurance. So if your mom had a doctor she loved, and he was suddenly taken away....

I am just asking why they were dropped. You are claiming it isn't Obamacare or you are claiming you wont believe it without definitive proof.

Well, granted, it's just a theory. But I've heard of this theory that when you reduce the supply of a product (by making it harder for customers to find an in-network doctor), you reduce the demand for it (because some people will decide that it's too difficult to go to the doctor, so they'll just skip it).

I assumed that you were familiar with it.

[chipwhich]

Well, granted, it's just a theory. But I've heard of this theory that when you reduce the supply of a product (by making it harder for customers to find an in-network doctor), you reduce the demand for it (because some people will decide that it's too difficult to go to the doctor, so they'll just skip it).

I assumed that you were familiar with it.

 

Gotcha so your theory is United Healthcare wanted to increase their profits by firing doctors so seniors can't or won't use their medical insurance and hoping those same seniors will stay with them and continue to pay their premiums.

 

Wow that sounds like a brilliant plan. 

 

Maybe they stood up death panels too.

Edited January 4, 2014 by chipwhich

[PleaseBlitz]

Gotcha so your theory is United Healthcare wanted to increase their profits by firing doctors so seniors can't or won't use their medical insurance and hoping those same seniors will stay with them and continue to pay their premiums.

 

Wow that sounds like a brilliant plan. 

 

Maybe they stood up death panels too.

 

 

If I were an insurance company, I would treat old people like ****.  Their premiums don't come close to covering their expenses (which is the entire point of Obamacare) so I would try my best to remove them from my rolls or, alternatively, prevent them from making any claims.  

[Larry]

Gotcha so your theory is . . .

Actually, I haven't proposed a theory, you might note. Or at least, not tried to assert that a particular theory is actually The Right One. Closest I've come to one was when you asked me to come up with one. Which I specifically noted was merely the most simplistic possible theory I could come up with.

There are lots more, but they're more complicated. I went with the shortest one.

But I'm sure there are lots more. Including a vast array of possibilities that I'm simply to ignorant to dream up.

 

Although, I'm willing to bet that all of them, the #1 motive for that theory, the #1 reason for why it was done, was "to make more money for the insurance company".

Granted, I've never been the CEO of an insurance company. Never even met one. But I've been in lots of other businesses. And every decision that was made, in every single one of those businesses? "Making more money" was the #1 motive, in all of them.

That said, though, if you seriously wish to assert that it is completely inconceivable that an insurance company would ever make a decision that screwed their customers, so that the company could make more money in the short term, but it might tick off their customers, down the road, then well, I guess that's your opinion. We are, after all, discussing the credibility of various theories, which neither of us have the ability to actually speak authoritatively on.

If I were an insurance company, I would treat old people like ****.  Their premiums don't come close to covering their expenses (which is the entire point of Obamacare) so I would try my best to remove them from my rolls or, alternatively, prevent them from making any claims.  

 

Curious as to where you get this theory that insurance companies chose, simply as a general rule, to sell them insurance at far below the company's cost. 

 

I have lots of completely unsupported theories as to what the motives of insurance companies are.  But I have to say, stupid and generous are not among them. 

[PleaseBlitz]

 

 

Curious as to where you get this theory that insurance companies chose, simply as a general rule, to sell them insurance at far below the company's cost. 

 

I have lots of completely unsupported theories as to what the motives of insurance companies are.  But I have to say, stupid and generous are not among them. 

 

 

It's not a theory, nor a choice for the insurance companies.  By law, the maximum amount that an insurance company can vary rates based on age has been set at 300%.  A typical older person spends far more than 3 times as much on healthcare as a typical younger person, in fact, nearly one-third of lifetime expenditures is incurred during middle age, and nearly half during the senior years.  The majority of the remaining 17% is child birth related.  Therefore, with the vast majority of costs being focused on older people, and the amount that they can modify rates to conform to the actuarial tables being limited, insurance companies are forced to under-charge older people and therefore over-charge younger people if they want to stay in business.

 

Your last sentence makes no sense and makes me think you completely miss-read my post.  I didnt say insurance companies were stupid and generous, I said exactly the opposite.  

[Larry]

It's not a theory, nor a choice for the insurance companies.  By law, the maximum amount that an insurance company can vary rates based on age has been set at 300%.

Far as I'm aware, said law applies only to insurance sold through the exchanges, and has been in effect for two whole days.

(And I haven't actually seen any support for the claim that seniors, before Obamacare, cost vastly more than 3x younger folks, either. But, I haven't seen it disputed, either.)

I at least got the impression that you were talking about a long standing fact.

But it's possible that I misread your post.

Edited January 4, 2014 by Larry

[PleaseBlitz]

Far as I'm aware, said law applies only to insurance sold through the exchanges, and has been in effect for two whole days.

(And I haven't actually seen any support for the claim that seniors, before Obamacare, cost vastly more than 3x younger folks, either. But, I haven't seen it disputed, either.)

I at least got the impression that you were talking about a long standing fact.

But it's possible that I misread your post.

 

Its both, the maximum ratio set by federal law before Obamacare was 500%, and I believe this applies to all plans.  The economics still therefore apply to all plans, past and future, and the end result is the same, just to a lesser extent.  Regardless, insurance companies make money off of healthy people (read: young people) and lose money on sick people (read: old people).  Ipso facto, insurers want to make it unappealing for old folks to sign up and/or remain on their rolls.  Limiting their options for doctors, treatment, etc is one way of pushing them away.  

[Larry]

Its both, the maximum ratio set by federal law before Obamacare was 500%, and I believe this applies to all plans.

1) I've never heard such a previous law mentioned. Although I'll freely admit that there are whole bunches of laws I've never heard of.

2) You want to try to claim that old people consume more than 5 times as much health case as young people? (Wonder why this fact hasn't been mentioned, in all of the articles I've read about Obamacare mandating a 3x ratio. In fact, I haven't seen anybody even support the claim that it's more than 3x.)

Regardless, insurance companies make money off of healthy people (read: young people) and lose money on sick people (read: old people).

Insurance companies make money off of people who consume less health care than the average member of their cohort. And lose money on the people who consume more.

If sick people consume twice as much as healthy people, but their premiums are three times as much, then the insurance company makes big money off of sick people.

Yes, I certainly assume that the average 60 year old consumes more health care than the average 20 year old. He also pays much more.

[PleaseBlitz]

1) I've never heard such a previous law mentioned. Although I'll freely admit that there are whole bunches of laws I've never heard of.

2) You want to try to claim that old people consume more than 5 times as much health case as young people? (Wonder why this fact hasn't been mentioned, in all of the articles I've read about Obamacare mandating a 3x ratio. In fact, I haven't seen anybody even support the claim that it's more than 3x.)

Insurance companies make money off of people who consume less health care than the average member of their cohort. And lose money on the people who consume more.

If sick people consume twice as much as healthy people, but their premiums are three times as much, then the insurance company makes big money off of sick people.

Yes, I certainly assume that the average 60 year old consumes more health care than the average 20 year old. He also pays much more.

 

#1 Regarding the 5:1 age band:  http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf404637

 

#2 Yes, i will absolutely make the claim that old people consume FAR more than 5 times as much health care as young people.  Young people RARELY have any of the diseases that are the big drivers of health care expenses, i.e. heart disease, cancer, and chronic diseases resulting in never-ending prescription drugs (and tests upon tests regarding the same).  Young people often go years without seeing a doctor (leading to the moniker "young invincibles").  There are plenty of studies out there, Google it.   Or don't, just ask yourself why the individual mandate is even a thing?  A vital, mandatory, take-it-to-the-Suprme-Court thing?  (if you respond to this post, I would like you to address those last 2 sentences before you do anything else).

 

"If sick people consume twice as much as healthy people, but their premiums are three times as much, then the insurance company makes big money off of sick people."

 

This is really your problem here.  Sick people don't consumer twice as much as healthy people, they consume an amount that is tremendously higher.  A healthy person (who is by definition, healthy) spends zero or close to it (so the insurance company keeps all of their premiums).  A really sick person spends tens of thousands of dollars per year.  Year after year unless they die (dying is also REALLY expensive).  Young people RARELY get really sick, the one major driver of that being car accidents which pales in comparison to heart disease and cancer.  The amount that an older, almost certainly sedentary and overweight american who may or may not have smoked for several decades, spends on healthcare far outstrips a 5:1 or now 3:1 ratio.  

 

And going back to your second sentence, yes, you have heard about it.  This concept is often referred to as "adverse selection."

Edited January 4, 2014 by PleaseBlitz

[chipwhich]

First I heard of you lefties admitting to death panels...once their old, get them off the dole....

[PleaseBlitz]

First I heard of you lefties admitting to death panels...once their old, get them off the dole....

 

 

Huh?  Where?  Who?  

[chipwhich]

If I were an insurance company, I would treat old people like ****......so I would try my best to remove them from my rolls or, alternatively, prevent them from making any claims.  

 

Death panel

[PleaseBlitz]

Death panel

 

Yea, not at all the same thing.  Death panel refers to a group of bureaucrats that deems people worthy of care at all, not companies trying to direct sick people towards each other or towards Medicare.  

 

Also, you called me a lefty while im in here explaining why Obamacare is dumb.  You're something all right.  

Edited January 4, 2014 by PleaseBlitz

[chipwhich]

Also, you called me a lefty while im in here explaining why Obamacare is dumb.  You're something all right.  

 

Sorry PB, I thought you were part of the ES left wing establishment. 

[Larry]

Or don't, just ask yourself why the individual mandate is even a thing?  A vital, mandatory, take-it-to-the-Suprme-Court thing?

Well, pretty much every time I've read about Obamacare, the reason for it that's been given was because, with the "pre existing conditions" mandate, you have to force people to get insurance, or else they'll wait till they get sick, and then buy it. (And the only people insured, will be the ones who were already sick, before they paid their first premium.)

In short, it was sold, to me, as a case of "If you want the "pre-existing conditions" clause, then you have to have the mandated coverage clause, too.

Not to force money from the young, but to force money from the healthy.

[twa]

If I were an insurance company, I would treat old people like ****.  Their premiums don't come close to covering their expenses (which is the entire point of Obamacare) so I would try my best to remove them from my rolls or, alternatively, prevent them from making any claims.

the govt is paying most of the premiums for those in medicare.

Obamacare impacts the Advantage plans compensation,the ins companies can change the govt compensation by making it appear more cost efficient.

similar principle to corps cutting payrolls making them more profitable while gaining govt contracts.

Ins companies do not lose money providing Medicare plans,nor will they for the older pre-medicare crowd under the ACA since bailout funds are provided outside the premium structure.

the trick is what plan is better for the insurer and how to maximize compensation

[PleaseBlitz]

Well, pretty much every time I've read about Obamacare, the reason for it that's been given was because, with the "pre existing conditions" mandate, you have to force people to get insurance, or else they'll wait till they get sick, and then buy it. (And the only people insured, will be the ones who were already sick, before they paid their first premium.)

In short, it was sold, to me, as a case of "If you want the "pre-existing conditions" clause, then you have to have the mandated coverage clause, too.

Not to force money from the young, but to force money from the healthy.

 

Forcing money from the healthy IS THE SAME THING as forcing money from the young and IS THE SAME THING as forcing money from the poor.  In general, which is how insurance works, young people are both very healthy and very poor relative to older people. 

 

And, that is indeed a much better sales pitch as it sounds better than, we need to take from the poor (the young) and give to the rich (the old).  But no, the individual mandate is primarily in place to force young people to sign up so their premiums can supplement the old folks.  

 

http://www.huffingtonpost.com/2013/11/15/young-people-obamacare-problem-_n_4280469.html (im trying to use left-leaning media)

 

[quoteFears that insurance exchanges that are the linchpin of President Barack Obama's federal health care overhaul wouldn't attract the young, healthy people needed to make them financially viable are being heightened by the early results of signups in several states.

Edited January 4, 2014 by PleaseBlitz

[twa]

No, it rather clearly makes that claim.

When you change things and promise hope the blame thing comes with the job.

you of course are free to believe the changes to Medicare in ACA are totally unrelated, the DRs being dropped and their patients might view it differently.....the Drs obviously do.

[Larry]

Yea, not at all the same thing.  Death panel refers to a group of bureaucrats that deems people worthy of care at all, not companies trying to direct sick people towards each other or towards Medicare.

Actually, that label was used to refer to a group Obama wanted to create, whose mandate was to try to reduce Medicare costs, by looking at various conditions and treatments, and examining whether said treatments were really worth the money they cost.

Not for denying coverage to specific individuals, but for specific conditions and treatments.

----------

OT, but I remember, years ago, reading about a study somebody did, looking at the efficacy of four common, expensive, medical procedures.

The methodology of the study was:

They picked four common, expensive, medical procedures. One of them was cardiac bypass surgery. I think another one was hip replacement. Forget the other two.

Then they pulled the medical records of a bunch of people who had been diagnosed as needing said procedures. And then divided said patients into those who had the procedure, and those who declined it.

And they looked at now many, of each group, were still alive, five years later.

And what they found was that, for example, if you were recommended for cardiac bypass surgery, that your odds of still being alive, five years from now, are statistically the same, whether you have the procedure or not. (And results were similar, for the other three procedures.)

Now, the study did say that the procedures did increase the patient's chances of not dying from the specific condition which the procedure treated. The folks who had cardiac bypass had a lower rate of dying from heart attack than the ones who declined the procedure.

But, the folks who had the bypass, and didn't die of a heart attack? A lot of them developed some other condition, and died from the second condition, instead. At a higher rate than the "declined the procedure" group.

In fact, the study mentioned that, of the people in the "had cardiac bypass surgery, but died anyway" group? More than half of them died from an infection which they got, in the hospital.

----------

Now, IF this study is valid, (And I have to admit that I see a huge potential hole in it. It assumes that the groups who decided to get the surgery, and the ones who didn't, are identical groups. It's certainly possible that the ones who declined it were people who didn't really need it, they were generally healthy, but the doctor suggests they consider it, whereas the group who chose the surgery were people who wouldn't have lived a year, without it.), then I think it's at least something we, as society, might want to consider.

IF cardiac bypass surgery doesn't actually increase the patient's odds of living five years, then is it morally wrong to at least debate whether we want to mandate that the taxpayers pay for people to have it? (Or, to make things more complicated, to at least consider whether maybe we should have a rule that we won't pay for it, if the patient is age 80 or higher?)

I know that such discussions are repugnant and ugly. But the alternative is a policy of "we'll pay anything, without limit, for everybody, whether it actually works or not".