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Selection for the panel still not happening......sucker going to bomb from the get go. Since we're about to stop borrowing money for OEF soon we can pick up the slack from there

 daedalus wrote:
But wouldn't real-world prices sidestep that, and increase to optimum price, i.e. what the market will bear?

That is what the new optimum price would be*, as it factors in the increase in the cost of production from the increase in minimum wage. Because it represented the actual price increase you'd see across goods in the market. Look at my calculations again, and keep in mind that wages are only one portion of the cost of production, and minimum wage workers are only a portion of the overall workforce.




*Assuming perfectly inelastic demand, which is rare, but a good enough simplification for this discussion. The actual price rise would be somewhere between 0% and 3.75%


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 djones520 wrote:
No they haven't. Their rate of growth has slown, but they are still climbing. 6.3% this year, expected to be between 6.5 and 7.5% next year if we're lucky and some of the harsher forecasts of Obamacare aren't the truth. There are predictions out there that we'll see a 37% rise in price in 2017.

Long term budget projections by the CBO are improving for the first time in decades, and its entirely driven by the reduction in healthcare costs in the long term, which is driven by the Obamacare reforms.

Seb... part of the reason why the CBO say that is because the FEDS arbitrarily cut the reimbursement amount to the providers. That is sending some serious shockwaves to the providers and it's getting ugly.

And then, there is this... the ACA act was this lifelong Democrat Louisiana State Senator's last straw:

 whembly wrote:
Grundz... the reality was that the ACA act (Affordable Care Act) was sold to the public that it'll drive down healthcare cost. It's not driving down anything....

That's the issue.

But that's not true. The growth of healthcare spending is reducing. Seriously, look at the CBO estimates. For the first time in a decade you can look at the 2025 projections and not panic.

 sebster wrote:

 whembly wrote:
Grundz... the reality was that the ACA act (Affordable Care Act) was sold to the public that it'll drive down healthcare cost. It's not driving down anything....

That's the issue.

But that's not true. The growth of healthcare spending is reducing. Seriously, look at the CBO estimates. For the first time in a decade you can look at the 2025 projections and not panic.

You're missing the point.

The act was sold to the American People that it'll make their Healthcare costs more affordable. Now, to the average american voters, what does that really says?

I'll tell you, it means "it'll be cheaper than what you're paying now". That was the politics of this act, which was very misleading. Of course, after the passing, the rate of growth would be lower (remains to be seen).

 whembly wrote:
-For-profit insurance markets
-Tort laws
-Medial Malpractice markets

Tort & malpractice are a very small portion of the market. Bloated compared to elsewhere in the world, I'll grant you, but still a very minor part of the overall picture.

For profit insurance markets I'll grant you, though it isn't the 'for profit' element exactly, but the weird nature of the US healthcare market itself. Basically you have all the issues of for-profit in healthcare (as briefly as possible healthcare is way too complex for the average consumer to make an informed choice, and so exploitation is rife), but added to that, it isn't even the end consumer making the final choice - most insurance is paid for by his employer. The employer doesn't know what each employee wants in his healthcare, who'd be willing to pay more to reduce co-pays etc. With a for profit market (other than the problems of consumers lacking information), for all the problems at least the end result should reflect consumer demands... but because of the screwy structure of US healthcare you don't even have that.

But I don't think that's nearly as big an issue as the basic disfunction in the market - in most cases a patient is charged for each procedure undertaken, not simply for treatment. Consider if you got in a taxi, and instead of being charged for the distance travelled, the driver charged you for every turn, every change of lane, every instance of hitting the brake or the accelerator. You know full well that driver would find the strangest, whackiest way to the destination, that involved as many side streets and lane changes as he could justify. And that, unforunately, is what happens in healthcare. And while out and out exploitation is fairly rare, thanks to the ethics of most people in healthcare, there exists no downward price pressure from the cost of treatments - an MRI that's unecessary is done anyway, because the hospital isn't paying for it, and the end result is an overtreatment of anyone with decent insurance. Which, of course, means decent insurance costs way more than it should.

 sebster wrote:

 whembly wrote:
Grundz... the reality was that the ACA act (Affordable Care Act) was sold to the public that it'll drive down healthcare cost. It's not driving down anything....

That's the issue.

But that's not true. The growth of healthcare spending is reducing. Seriously, look at the CBO estimates. For the first time in a decade you can look at the 2025 projections and not panic.

Reduced growth means feth all, as it is STILL growth.

The ACA has Affordable in the title, yet unless that bill says in 2 years time that rates will be 50% than they are now, it does nothing. I don't care if the rates keep going up, because I can't afford them now anyway.

The fact that health coverage for a family of 4 is equal to the average rent for a 2 bedroom apartment in which that family likely lives is insane.

 whembly wrote:
You're missing the point.

The act was sold to the American People that it'll make their Healthcare costs more affordable. Now, to the average american voters, what does that really says?

I'll tell you, it means "it'll be cheaper than what you're paying now". That was the politics of this act, which was very misleading. Of course, after the passing, the rate of growth would be lower (remains to be seen).

See, what you're describing there is the problem of selling a responsible, long term cost control bill to the people. Because all the people ask is 'what's in it for me'. Explaining that it will put a limit on the cost to the country as a whole, and therefore play a major role in ensuring long term budget stability just doesn't register.

Which, along with Democratic cowardice, is why this bill has been sold so poorly to the population.


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 Aerethan wrote:
Reduced growth means feth all, as it is STILL growth.

The what? Everything grows. The only sensible questions are whether a thing is growing in line with overall economic growth, and if it is more than that whether that higher growth can be sustained in the long term.

 sebster wrote:

 whembly wrote:
-For-profit insurance markets
-Tort laws
-Medial Malpractice markets

Tort & malpractice are a very small portion of the market. Bloated compared to elsewhere in the world, I'll grant you, but still a very minor part of the overall picture.

For profit insurance markets I'll grant you, though it isn't the 'for profit' element exactly, but the weird nature of the US healthcare market itself. Basically you have all the issues of for-profit in healthcare (as briefly as possible healthcare is way too complex for the average consumer to make an informed choice, and so exploitation is rife), but added to that, it isn't even the end consumer making the final choice - most insurance is paid for by his employer. The employer doesn't know what each employee wants in his healthcare, who'd be willing to pay more to reduce co-pays etc. With a for profit market (other than the problems of consumers lacking information), for all the problems at least the end result should reflect consumer demands... but because of the screwy structure of US healthcare you don't even have that.

But I don't think that's nearly as big an issue as the basic disfunction in the market - in most cases a patient is charged for each procedure undertaken, not simply for treatment. Consider if you got in a taxi, and instead of being charged for the distance travelled, the driver charged you for every turn, every change of lane, every instance of hitting the brake or the accelerator. You know full well that driver would find the strangest, whackiest way to the destination, that involved as many side streets and lane changes as he could justify. And that, unforunately, is what happens in healthcare. And while out and out exploitation is fairly rare, thanks to the ethics of most people in healthcare, there exists no downward price pressure from the cost of treatments - an MRI that's unecessary is done anyway, because the hospital isn't paying for it, and the end result is an overtreatment of anyone with decent insurance. Which, of course, means decent insurance costs way more than it should.

It's actually way more convoluted than that... let me see if I can break it down for you.

I'm going to use "me" as an example of a typical health insurance plan provided by the employer.

A) My employer pays a premium per employee for said plan and offers it to my as part of my compensation.
-Every year, I'm ask to pick from 3 different "plans". THis is misleading as the plan is the same, the only difference is what my CO-PAY would be, and which doctor's group I can select from. Think of it as the BRONZE, SILVER or GOLD plan with that the copays are cheaper the higher you go, but you pay "a little bit more" out of the paycheck depending on how high you go.

B) Regular Doctor's visit... head cold, sprained wrist, essentially non-life threatening ailments, you make an appointment (usually within that week), pay your co-pay (Mine is $25) per visit. Based on that visit's outcome, you may be prescribed with medications (Mine range from free up to $30/perscription) or you'd get referred to a specialist.

C) Going to specialist, is another copay ($30 to $50) per visit and general treatment are usually covered (ie, x-ray, MRI, consultation).
-getting the picture?

D) Let's talk about catastrophic events. I had kidney stones (I have only one left) and I'm telling ya, it's fething brutal. I was driven to nearest emergency room (ED) and the nurse took one look at me and escorted my ass to a room and started pumping me fluid and dilaudid (greatest pain meds eva!). I barely got my name out and allergies before she shot me up. That whole trip with all medications, xray, whathave you costed me $100. The next day, I had surgery to manually remove the stones (I could pass that fether).

Here's the kicker, my insurance pays a flat rate for my diagnosis (Kidney Stones with some renal failure) to that provider. This is part of the problem... there's no transparency in the inner workings how insurances pays to the provider. Some providers negotiates better/cheaper rates for certain insurance... there's a huge "industry" with that and there's no transparent consistency in this process. The only consist thing is that most insurance re-imbursement rates to the providers are set to what Medicare/Medicaid pays.

Essentially, the way to look at it... it's like this. Say you complain about "Chest Pains" and go into the ED. That provider is going to get "x dollars" from either the patient's private insurance or from Medicare (government pays lower usually). It does NOT matter what kind of treatement is done... which meds were given, what labs were done... if the providers pay more in the treatment of the patients than what they recieved, they're SOL (which is extremely common). This is why care providers are purposely "disconnected" from the business side of this whole operation, so that their clinical judgement don't get clouded by how much things costs.

Also, fraud... MOST fraud comes in the form of the provider's administrators CODING the patient's visit to a particular diagnosis. I can't remember the statistic, but most fraud are accidental rather than intential. It's because this whole process is insanely complicated. These codes are what the government/insurances determines the re-imbursement rates to the providers. Case in point, a provider receives less payment for early onset renal diseases than ESRD (end stage renal disease), because generally ESRD treatment are more expensive.

Then you throw in the variation to the population who are able to pay...

Weird medication/supply costs across the industry...

Providors spending more money to maintain compliance to new Regulation (It's called Meaningful Use (MU) in ACA). Providors are spending so much money to qualify for MU that any additional $$$ from the government won't cover it (the expectation was that the providers would get a boon... now, it's looking like a boondogle).

The ACA essentially doubled-down on the CURRENT MODEL.... if the health care model pre-ACA was gakky, it's still going to be gakky moving forward. The CBO doesn't account for future industry changes, so it shouldn't be used as gospel.

Doctor's offices and Hosptials are cutting staff and in some cases shutting down ahead of this.

There's not enough time for the State Exchange to be setup, which REALLY NEEDS to be ready by the end of the year. The providers are the ones who'll get screwed, if the exchange are not setup in time.

In the hospital system that I work for, 58% of the patient's walking through our doors where charity cases... meaning, we didn't get one cent from their visit. It's only going to get worst in the next couple of years. Tell me how an operation can maintain that figure?

Point being, ACA is a gak sandwich...

*shrugs*

My job will be interesting in the next couple of years. o.O


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 sebster wrote:

 whembly wrote:
You're missing the point.

The act was sold to the American People that it'll make their Healthcare costs more affordable. Now, to the average american voters, what does that really says?

I'll tell you, it means "it'll be cheaper than what you're paying now". That was the politics of this act, which was very misleading. Of course, after the passing, the rate of growth would be lower (remains to be seen).

See, what you're describing there is the problem of selling a responsible, long term cost control bill to the people. Because all the people ask is 'what's in it for me'. Explaining that it will put a limit on the cost to the country as a whole, and therefore play a major role in ensuring long term budget stability just doesn't register.

Which, along with Democratic cowardice, is why this bill has been sold so poorly to the population.

Right... now you're seeing it.

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 Aerethan wrote:
Reduced growth means feth all, as it is STILL growth.

The what? Everything grows. The only sensible questions are whether a thing is growing in line with overall economic growth, and if it is more than that whether that higher growth can be sustained in the long term.

See Seb, that's another example of the messaging.

 whembly wrote:
It's actually way more convoluted than that... let me see if I can break it down for you.

I know the system, I've read about in a fair bit of detail.

And yeah, a consumer ending up with a list of three options that only change the co-pays is exactly what I'm talking about - a whole world of insurance options out there, and the end consumer doesn't actually gets to choose anything but the co-pay.

Here's the kicker, my insurance pays a flat rate for my diagnosis (Kidney Stones with some renal failure) to that provider. This is part of the problem... there's no transparency in the inner workings how insurances pays to the provider.

Absolutely. The spaghetti string mess of how stuff gets paid for is another major part of the problem. Not only for the horrendous administration cost of following the money trail through all those people, and also because it makes it really hard to drive economic rationalisation through the system.

Essentially, the way to look at it... it's like this. Say you complain about "Chest Pains" and go into the ED. That provider is going to get "x dollars" from either the patient's private insurance or from Medicare (government pays lower usually). It does NOT matter what kind of treatement is done... which meds were given, what labs were done... if the providers pay more in the treatment of the patients than what they recieved, they're SOL (which is extremely common). This is why care providers are purposely "disconnected" from the business side of this whole operation, so that their clinical judgement don't get clouded by how much things costs.

As I've been told, that disconnect exists in only some parts of the industry. The idea is to have that disconnect put through more of the system, to remove the cost incentive of over-treatment.

Also, fraud... MOST fraud comes in the form of the provider's administrators CODING the patient's visit to a particular diagnosis. I can't remember the statistic, but most fraud are accidental rather than intential.

Well, if it ain't on purpose it ain't fraud... but otherwise that's just backing up what I already said, direct exploitation of the system is quite rare

The ACA essentially doubled-down on the CURRENT MODEL.... if the health care model pre-ACA was gakky, it's still going to be gakky moving forward. The CBO doesn't account for future industry changes, so it shouldn't be used as gospel.

Of course, the current bill falls a long way short of the massive overhaul the industry needs. But rejecting the bill because some other bill would have been better is just not practical, when you look at the political shitstorm created just to get this half measure to fall over the line.

Greater reforms is just no practical in this current political climate.

Right... now you're seeing it.

Now I'm seeing it? I was making that point before the bill passed...

 sebster wrote:

 whembly wrote:

Essentially, the way to look at it... it's like this. Say you complain about "Chest Pains" and go into the ED. That provider is going to get "x dollars" from either the patient's private insurance or from Medicare (government pays lower usually). It does NOT matter what kind of treatement is done... which meds were given, what labs were done... if the providers pay more in the treatment of the patients than what they recieved, they're SOL (which is extremely common). This is why care providers are purposely "disconnected" from the business side of this whole operation, so that their clinical judgement don't get clouded by how much things costs.

As I've been told, that disconnect exists in only some parts of the industry. The idea is to have that disconnect put through more of the system, to remove the cost incentive of over-treatment.

That's just it... it really isn't "over treatment", unless you're describing defensive medicine? There's a whole debate shebang on that topic. o.O

As to the "system", I'm hoping in my lifetime, we'd going with the Canadian or German model.

Right... now you're seeing it.

Now I'm seeing it? I was making that point before the bill passed...

I remember the last time this thread popped up. Were a lot more supporter of Obamacare behind this then there are now.....W...T....F.....Chuck..

 whembly wrote:
That's just it... it really isn't "over treatment", unless you're describing defensive medicine? There's a whole debate shebang on that topic. o.O

No, I mean over-treatment, procedures that are far greater than what's necessary. It's pretty basic agency stuff, when the person deciding the course of treatment takes on the risk of failure, but someone else takes on the cost of the process, you end up with a bias towards the least risky, most expensive option. Which means MRI scans where the likelihood of them detecting anything unexpected is minute, and it means pills being proscribed for stuff that simply doesn't need treatment.


And yeah, preventative medicine is also badly needed. Unfortunately that also comes back to the bad economic structures of the current system - when a person's healthcare is not tied to their provider, but to their employer, why would the healthcare provider invest in preventative options for patients? You might improve the health of those workers, but most of them will move employers within five years and you've crapped away your money. But change that relationship, so people buy their own healthcare, and you change the market - suddenly insurers can expect, and reward, consumers staying with one healthcare provider. Preventative medicine becomes a sensible option, to some extent (though optimum amounts would likely still require government action, per the experience in other markets).

As to the "system", I'm hoping in my lifetime, we'd going with the Canadian or German model.

I think the German, or perhaps more likely the Swiss model, is something that the US could transition to fairly pratically, over a decade or two. They're still pretty expensive models, but at least you can see them from where you're standing now, if you get my meaning

That's true...

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 Jihadin wrote:
I remember the last time this thread popped up. Were a lot more supporter of Obamacare behind this then there are now.....W...T....F.....Chuck..

And the numbers in creationist threads around the internet* are scarily close to even. Until you realise that there's always more reason for a person to take up for their cause when they aren't the status quo. ACA is rolling in, becoming the norm, what's to be gained from arguing it again?




*Thankfully on Dakka for the last year or so they've been pretty one sided towards sanity...

Seb... I'm not sure you appreciate the dichotomy of this.

Obama promised that premiums would go down by $2,500 by the end of his first term...

The average employer premium has actually gone up by $3,065...

 whembly wrote:
Seb... I'm not sure you appreciate the dichotomy of this.

Obama promised that premiums would go down by $2,500 by the end of his first term...

The average employer premium has actually gone up by $3,065...

If you have a business, who would be damaged by something that you can help counteract by raising prices (and as a bonus make more profit), would you?

of the top 5 insurance providers, 4 of them had a 10% -> 30% increase in profit in over the last year, if they're raising prices because of obamacare cost, where is that profit coming from?

 Grundz wrote:

 whembly wrote:
Seb... I'm not sure you appreciate the dichotomy of this.

Obama promised that premiums would go down by $2,500 by the end of his first term...

The average employer premium has actually gone up by $3,065...

If you have a business, who would be damaged by something that you can help counteract by raising prices (and as a bonus make more profit), would you?

Of course, anyone with at least two neurons to rub together who pays attention to what's going knows that is what will (and has) happen.

The issue is that the low-information voter trusted/believe what the Dems/Obama promised... and now, we are all paying for it.

Doesn't make it any less of a gak sammich.

 whembly wrote:

Of course, anyone with at least two neurons to rub together who pays attention to what's going knows that is what will (and has) happen.
The issue is that the low-information voter trusted/believe what the Dems/Obama promised... and now, we are all paying for it.
Doesn't make it any less of a gak sammich.

Sorry I edited while you were typing this so I"ll go again

these places are raising rates because it makes them more money, and they have an excuse to, it has the bonus of weakening a law that will hurt them in the long run.

The reduced-cost projection did not take into account that rich dirtbags will be rich dirtbags, and also the cost savings wont come into play until actual implementation, which has been problematic.

 Grundz wrote:

 whembly wrote:

Of course, anyone with at least two neurons to rub together who pays attention to what's going knows that is what will (and has) happen.
The issue is that the low-information voter trusted/believe what the Dems/Obama promised... and now, we are all paying for it.
Doesn't make it any less of a gak sammich.

Sorry I edited while you were typing this so I"ll go again

these places are raising rates because it makes them more money, and they have an excuse to, it has the bonus of weakening a law that will hurt them in the long run.

The reduced-cost projection did not take into account that rich dirtbags will be rich dirtbags, and also the cost savings wont come into play until actual implementation, which has been problematic.

You do know you're providing evidence in a round-a-bout way how crappy this bill is... dontcha?

You're kinda right and kinda wrong.

Obamacare's provision (efficiency rules) that 80% of the funds insurances receive must go towards the plan... that started LAST YEAR.

In practice what this does is force the Insurers who failed to meet Obamacare's arbitrary efficiency rules to send rebates... which last year averages about $71. o.O This year, it's going to be about half that.

So, Grundz... your soapbox that insurance companies are the main driver of cost is not totally accurate. It's way more complicated than that.

 Grundz wrote:

The reduced-cost projection did not take into account that rich dirtbags will be rich dirtbags, and also the cost savings wont come into play until actual implementation, which has been problematic.

If only there was a means for a set of rich dirtbags to predict how other rich dirtbags were going to react to the Act.

 whembly wrote:


So, Grundz... your soapbox that insurance companies are the main driver of cost is not totally accurate. It's way more complicated than that.

You're right, its not that revenue goes up by 5% or 8% and profits go up by 20 or 30% which is funded by artificially higher rates.
Its Obama

So here's the problem, from my small, market-centric point of view.

Obamacare is ultimately, long-term, going to lower insurance premiums.

This lowering of cost is going to be done by an increasing of competition (more/broader provider pool) and by increasing the number of healthy people in the pool (mandatory participation).

Over the SHORT term, what this does is radically increase the amount of money injected into the insurance industry. This is what will long-term create more competition, by creating a rich enough incentive (profits) for others to step up and compete for a slice of the pie. For now, though, the people with the pie simply get more pie.

The confounding factor here is that congruent with this big short term boost in revenue is an increase in complexity, regulation, and oversight (to a business person this translates to cost) that requires a responsible business person to then increase their prices to cover costs. This is what we've already felt over the last year or so.

At the same time, the big increase in complexity, regulation, and oversight also creates a much higher hurdle for a new operator (that new competition that is supposed to help lower costs) reducing the likelihood that they can enter.

So over the near-term, which is likely 5 years or so, what Obamacare does by mandating participation but also increasing uncertainty and barrier to entry really just creates a windfall of profits for existing, large insurance operators. They've got cover to raise their prices pre-emptively and increased competition is probably minimal in the meantime because we still do not truly understand what Obamacare actually is or does, exactly.

You also have the complication of young people opting to pay the penalty because that will be a lower cost than going on Obamacare. In the event that they do get sick, they simply go onto Obamacare THEN.

Long story short, the money that we, in aggregate, pay out to the healthcare industry has gone up and will continue to go up for the resaonable forseeable future.

And this is the exact opposite of what was promised by the administration.

 sourclams wrote:
So here's the problem, from my small, market-centric point of view.

Obamacare is ultimately, long-term, going to lower insurance premiums.

This lowering of cost is going to be done by an increasing of competition (more/broader provider pool) and by increasing the number of healthy people in the pool (mandatory participation).

Over the SHORT term, what this does is radically increase the amount of money injected into the insurance industry. This is what will long-term create more competition, by creating a rich enough incentive (profits) for others to step up and compete for a slice of the pie. For now, though, the people with the pie simply get more pie.

The confounding factor here is that congruent with this big short term boost in revenue is an increase in complexity, regulation, and oversight (to a business person this translates to cost) that requires a responsible business person to then increase their prices to cover costs. This is what we've already felt over the last year or so.

At the same time, the big increase in complexity, regulation, and oversight also creates a much higher hurdle for a new operator (that new competition that is supposed to help lower costs) reducing the likelihood that they can enter.

So over the near-term, which is likely 5 years or so, what Obamacare does by mandating participation but also increasing uncertainty and barrier to entry really just creates a windfall of profits for existing, large insurance operators. They've got cover to raise their prices pre-emptively and increased competition is probably minimal in the meantime because we still do not truly understand what Obamacare actually is or does, exactly.

You also have the complication of young people opting to pay the penalty because that will be a lower cost than going on Obamacare. In the event that they do get sick, they simply go onto Obamacare THEN.

Long story short, the money that we, in aggregate, pay out to the healthcare industry has gone up and will continue to go up for the resaonable forseeable future.

And this is the exact opposite of what was promised by the administration.

Thanks... you elaborated this much more eloquently that I ever did.

 whembly wrote:
Seb... I'm not sure you appreciate the dichotomy of this.

Obama promised that premiums would go down by $2,500 by the end of his first term...

And that's a fair criticism of Obama.

But the lies a saleman tells doesn't change what the product delivers.

The average employer premium has actually gone up by $3,065...

What's Kaiser's 2008 release got to do with it?

And yeah, the price has gone up, but only if you compare apples with telephones. The minimum standards offered in healthcare have gone up, and all these claims about what healthcare can offer are based on comparing the lowest plans pre-ACA and the lowest plans under ACA, while completely ignoring the fact that the new plans give the consumer a hell of a lot more.

 sourclams wrote:
This lowering of cost is going to be done by an increasing of competition (more/broader provider pool) and by increasing the number of healthy people in the pool (mandatory participation).

Over the SHORT term, what this does is radically increase the amount of money injected into the insurance industry. This is what will long-term create more competition, by creating a rich enough incentive (profits) for others to step up and compete for a slice of the pie. For now, though, the people with the pie simply get more pie.

Not really, as the people who are buying in to the healthcare system only because of mandatory participation typically have very shallow pockets. They're just not the big injection of money that is going to change the industry.

And in a country of 300 million, in which about 70-80% are already contributing, you just aren't going to get a meaningful change in market dynamics from a few million more contributors. What economies of scale exist in a 200 million strong industry don't change for a 300 million strong industry.

The serious, big deal that changes absolutely everything is the inability to deny coverage. I don't think people realise how big a deal that is. It used to be that anyone a private insurers deemed likely to cost more money than they could make would be denied coverage... that person would still be treated, and the cost (after the person paid what they could with whatever assets they had) would be worn by the hospital & government. Now the insurer pays that. It is a big deal.

So over the near-term, which is likely 5 years or so, what Obamacare does by mandating participation but also increasing uncertainty and barrier to entry really just creates a windfall of profits for existing, large insurance operators. They've got cover to raise their prices pre-emptively and increased competition is probably minimal in the meantime because we still do not truly understand what Obamacare actually is or does, exactly.

Actually, given the profit limits on healthcare providers, that point is pretty debateable.

 sebster wrote:

 whembly wrote:
Seb... I'm not sure you appreciate the dichotomy of this.

Obama promised that premiums would go down by $2,500 by the end of his first term...

And that's a fair criticism of Obama.

Thanks... been trying to get that outta ya.

But the lies a saleman tells doesn't change what the product delivers.

I've always said there was some stuff in ACA act that had merits.

It's like a bacon wrapped pile of gak. The bacon is awesome, but collectively... it's still bacon-wrapped gak.

The average employer premium has actually gone up by $3,065...

What's Kaiser's 2008 release got to do with it?

And yeah, the price has gone up, but only if you compare apples with telephones. The minimum standards offered in healthcare have gone up, and all these claims about what healthcare can offer are based on comparing the lowest plans pre-ACA and the lowest plans under ACA, while completely ignoring the fact that the new plans give the consumer a hell of a lot more.

What plans??


Clock is ticking....

 sourclams wrote:
This lowering of cost is going to be done by an increasing of competition (more/broader provider pool) and by increasing the number of healthy people in the pool (mandatory participation).

Over the SHORT term, what this does is radically increase the amount of money injected into the insurance industry. This is what will long-term create more competition, by creating a rich enough incentive (profits) for others to step up and compete for a slice of the pie. For now, though, the people with the pie simply get more pie.

Not really, as the people who are buying in to the healthcare system only because of mandatory participation typically have very shallow pockets. They're just not the big injection of money that is going to change the industry.

And in a country of 300 million, in which about 70-80% are already contributing, you just aren't going to get a meaningful change in market dynamics from a few million more contributors. What economies of scale exist in a 200 million strong industry don't change for a 300 million strong industry.

The serious, big deal that changes absolutely everything is the inability to deny coverage. I don't think people realise how big a deal that is. It used to be that anyone a private insurers deemed likely to cost more money than they could make would be denied coverage... that person would still be treated, and the cost (after the person paid what they could with whatever assets they had) would be worn by the hospital & government. Now the insurer pays that. It is a big deal.

So over the near-term, which is likely 5 years or so, what Obamacare does by mandating participation but also increasing uncertainty and barrier to entry really just creates a windfall of profits for existing, large insurance operators. They've got cover to raise their prices pre-emptively and increased competition is probably minimal in the meantime because we still do not truly understand what Obamacare actually is or does, exactly.

Actually, given the profit limits on healthcare providers, that point is pretty debateable.

Erm... "profit limits on healthcare providers"?? What?

Don't you mean the limit on insurance industries?

 sebster wrote:


What's Kaiser's 2008 release got to do with it?

And yeah, the price has gone up, but only if you compare apples with telephones. The minimum standards offered in healthcare have gone up, and all these claims about what healthcare can offer are based on comparing the lowest plans pre-ACA and the lowest plans under ACA, while completely ignoring the fact that the new plans give the consumer a hell of a lot more.

I assume you're talking about things that haven't yet gone into effect. This year, my insurance plan changed in such a way that as far as I can tell, quite literally the only thing I'm getting from my insurance plan (which still has a monthly premium) is the ability to spend pre-tax dollars out of pocket toward, from what I can tell, full price medical expenses.

 whembly wrote:
Thanks... been trying to get that outta ya.

I've never been adverse to criticising Obama. It's just that when we chat, it's normally about the GOP talking points about Obama, which I pretty much never agree with.

Erm... "profit limits on healthcare providers"?? What?

Don't you mean the limit on insurance industries?

Yeah. My bad. What an swap I made in my head...


Automatically Appended Next Post:

 daedalus wrote:
I assume you're talking about things that haven't yet gone into effect. This year, my insurance plan changed in such a way that as far as I can tell, quite literally the only thing I'm getting from my insurance plan (which still has a monthly premium) is the ability to spend pre-tax dollars out of pocket toward, from what I can tell, full price medical expenses.

I'm talking more the minimum standards healthcare plans need to meet. A lot of the old, super cheap plans don't exist anymore, because they didn't meet the minimum standards for healthcare plans.

So the trick has been to say 'look at the cheapest plan that used to be available, and compare it to the cheapest plan available now' while ignoring that the cheapest plan in the new scheme gives a much, much better piece of insurance.

 sebster wrote:

 daedalus wrote:
I assume you're talking about things that haven't yet gone into effect. This year, my insurance plan changed in such a way that as far as I can tell, quite literally the only thing I'm getting from my insurance plan (which still has a monthly premium) is the ability to spend pre-tax dollars out of pocket toward, from what I can tell, full price medical expenses.

I'm talking more the minimum standards healthcare plans need to meet. A lot of the old, super cheap plans don't exist anymore, because they didn't meet the minimum standards for healthcare plans.

So the trick has been to say 'look at the cheapest plan that used to be available, and compare it to the cheapest plan available now' while ignoring that the cheapest plan in the new scheme gives a much, much better piece of insurance.

Was there a minimum standard for healthcare previously? I wasn't aware of that. Looking at it, I feel like instead of raising the bar, they provided a blueprint for determining how low the bar can legally be set, which happened to be lower than my bar.

Of course, I suppose the most direct thing to do would be to hate my employer and my insurance company for acting upon that rather than providing me with the same quality of insurance I had before. From what I've seen, my job is not necessarily competitive with other workplace's offerings anyway. It may be worth a change.

Bring out the popcorn...

http://www.forbes.com/sites/theapothecary/2013/06/26/massachusetts-democrats-to-force-governor-to-seek-waiver-from-obamacare-provisions/

A very interesting ACA development is taking place in Massachusetts today as the state that “inspired” Obamacare tries to reconcile its current law with the new federal law. Push back in the compliance effort is coming from an unexpected source, the senior Democratic budget writer in the State Senate, Senator Stephen Brewer, presumably with support from the Senate President as well. The amendment that was filed would force President Obama’s good friend Governor Deval Patrick (D), and his Administration, to seek a waiver from certain elements of Obamacare. The move could come to a head if the provision lands on the Governor’s desk, resulting in an embarrassing political moment for the Obama Administration since the ACA is forcing significant changes to a state law they claim acted as a model in Washington.

Turns out, the conventional wisdom comparing Romneycare and Obamacare has proven to be overly simplistic, as this is the third ACA-related bill being debated in the Commonwealth. The latest sizable 100-section bill controversially writes into law an abdication of insurance regulation to the federal government and is the basis for the amendment. While state officials have known for some time that the ACA-required changes to rating factors would result in “extreme premium increases” and spike premiums for 60% of small companies (some as high as 50+%) in the state, the best the Patrick Administration could do was spread the increases out over 3 years under an agreement from CMS.

The new ACA bill produced a flurry of debate in the House last week, mostly from the Republicans, with Democrats calling it a bill of “minor technical changes.” However, in the State Senate the bill faces a surprising push back from the lead budget writer and a long serving Democrat, as numerous questions remain about the bill. See my 10 Questions About ACA Implementation in Massachusetts.

The chairman’s amendment includes the following:

SECTION 102A. The commonwealth, by and through the governor or the governor’s designee, shall formally request a federal waiver to avoid the adverse effects of rating and rule changes to the Massachusetts merged market, to protect consumers and businesses in the commonwealth and in an effort to maintain current Massachusetts rating and rule requirements. All negotiations with any federal agency concerning this waiver shall be conducted in consultation with a member of the house of representatives as appointed by the speaker of the house and a member of the senate as appointed by the senate president. The governor, or the governor’s designee shall file a detailed report describing the waiver application and waivers received, along with all documentation, including, but not limited to, all related written and verbal responses from the Department of Health and Human Services, with the clerks of the senate and house not later than October 1, 2014. The governor shall report monthly to the joint committee on health care financing and the house and senate committees on ways and means on the status of the waiver request under this section.

The amendment signals a sea change in the state as even pro-ACA business groups, such as the Associated of Industries in Massachusetts (AIM), have now joined the call for a waiver.

Administration postpones a key Obamacare provision for one year

The Obama administration is postponing for one year the requirement that businesses cover their workers under Obamacare.

The administration said late Tuesday that the move recognized that the reporting requirements – the steps businesses have to take to show they were complying with the rules — were complex and they would try to streamline them over the next year.

There will be no penalties the first year on businesses that don’t cover workers. Small businesses, with fewer than 50 workers, were already exempt from that rule. Most large businesses do cover employees now.

The move does not affect the individual mandate – the requirement that most Americans get insurance. And it doesn’t delay the new marketplaces where people and small businesses can sign up for coverage starting in October.

“The Administration is announcing that it will provide an additional year before the ACA [Affordable Care Act} mandatory employer and insurer reporting requirements begin. This is designed to meet two goals. First, it will allow us to consider ways to simplify the new reporting requirements consistent with the law. Second, it will provide time to adapt health coverage and reporting systems while employers are moving toward making health coverage affordable and accessible for their employees,” the Treasury Department said in a blog post.”

Most big businesses already cover their workers, Treasury noted.

The Treasury Department, which enforces the employer requirements, announced the news in a blog post late Tuesday afternoon. The policy change was initially reported by Bloomberg News.

Remember... this doesn't change the individual mandate.

What this tells me is that business are still uncertain as to how all this plays out... uncertaincy

 whembly wrote:

Administration postpones a key Obamacare provision for one year

The Obama administration is postponing for one year the requirement that businesses cover their workers under Obamacare.

The administration said late Tuesday that the move recognized that the reporting requirements – the steps businesses have to take to show they were complying with the rules — were complex and they would try to streamline them over the next year.

There will be no penalties the first year on businesses that don’t cover workers. Small businesses, with fewer than 50 workers, were already exempt from that rule. Most large businesses do cover employees now.

The move does not affect the individual mandate – the requirement that most Americans get insurance. And it doesn’t delay the new marketplaces where people and small businesses can sign up for coverage starting in October.

“The Administration is announcing that it will provide an additional year before the ACA [Affordable Care Act} mandatory employer and insurer reporting requirements begin. This is designed to meet two goals. First, it will allow us to consider ways to simplify the new reporting requirements consistent with the law. Second, it will provide time to adapt health coverage and reporting systems while employers are moving toward making health coverage affordable and accessible for their employees,” the Treasury Department said in a blog post.”

Most big businesses already cover their workers, Treasury noted.

The Treasury Department, which enforces the employer requirements, announced the news in a blog post late Tuesday afternoon. The policy change was initially reported by Bloomberg News.

Remember... this doesn't change the individual mandate.

What this tells me is that business are still uncertain as to how all this plays out... uncertaincy

That is going to affect a very small fraction of workers and it is going to suck REALLY HARD for those people. Brutal.