The Affordable Care Act is Coming Home to Roost

[3rdnlng]

Beats me but my former company hasn't had a premium increase of less than 17% a year in 7 years. If this exchange program beats that, it's on par.

 

Of course we checked the in and out of network providers. I know that I'm supposed to knee jerk hate ACA but the exchange will save me about 6K this year.

My premise is that the young and healthy will stay away from Obamacare and mess up the theory of large numbers. The theory of large numbers is the basis for insurance. Take your chances, but Obamacare does nothing to reduce healthcare costs--it's about insurance cost, and that's not sustainable over the years. Glad I'm a Vet, got what is now a Cadillac Plan.

[Alaska Darin]

Neither of you seem capable of making actual arguments. Just your typical Ad Hominem logical fallacies out of your mouths.

There's little reason to argue with someone who believes fixing costs for a segment of the population actually controls costs for an entire program. No wonder you think Obamacare is going to be both efficient and cost effective.

[TheMadCap]

My premise is that the young and healthy will stay away from Obamacare and mess up the theory of large numbers. The theory of large numbers is the basis for insurance. Take your chances, but Obamacare does nothing to reduce healthcare costs--it's about insurance cost, and that's not sustainable over the years. Glad I'm a Vet, got what is now a Cadillac Plan.

 

Do you get your plan through the VA? Is it immune to the 40% excise tax on "Cadillac Plans" in 2015? Just wondering, I hope it is for your sake, if anyone deserves NOT to get screwed by the new law, it's the veterans...

[DC Tom]

Do you get your plan through the VA? Is it immune to the 40% excise tax on "Cadillac Plans" in 2015? Just wondering, I hope it is for your sake, if anyone deserves NOT to get screwed by the new law, it's the veterans...

 

He probably has Tricare at least.

 

Which, based on all I've heard from everyone I know on it, is more of an "AMC Pacer Plan."

[B-Man]

Obamacare’s Silent Insurers

by Jonah Goldberg

 

When will the insurers revolt?

 

It’s a question that’s popping up more and more. On the surface, the question answers itself. We’re talking about pinstriped insurance-company executives, not Hells Angels. One doesn’t want to paint with too broad a brush, but if you were going to guess which vocations lend themselves least to revolutionary zeal, actuaries rank slightly behind embalmers.

 

Still, it’s hard not to wonder how much more these people are willing to take. Even an obedient dog will bite if you kick it enough. Since Obamacare’s passage, the administration has constantly moved the goalposts on the industry. For instance, when the small-business mandate proved problematic in an election year, the administration delayed it, putting its partisan political needs ahead of its own policy and the needs of the industry.

 

 

But the insurers kept their eyes on the prize: huge guaranteed profits stemming from the diktat of the health-insurance mandate. When asked how he silenced opponents in the health industry during his successful effort to socialize medicine, Aneurin Bevan, creator of the British National Health Service, responded, “I stuffed their mouths with gold.”

 

Hence, the insurers were ready on October 1. They rejiggered their industry. They sent out millions of cancellation letters to customers whose plans no longer qualified under the new standards set by the Affordable Care Act. They told their customers to go to the exchanges to get their new plans.

 

But because President Obama promised Americans “if you like your health-care plan, you can keep it” (PolitiFact’s “lie of the year”), those cancellations became a political problem of Obama’s own making.

 

In response, the president blamed it on the insurance companies or “bad apple” insurers. White House spokesman Jay Carney insisted that it was the insurance companies that unilaterally decided not to grandfather existing plans. (The Washington Post’s “fact checker” columnist, Glenn Kessler, gave this claim “three Pinocchios.”)

 

Then, just last week, Health and Human Services secretary Kathleen Sebelius announced that she was “urging” insurers to ignore both their contracts and the law and simply cover people on the honor system — as if they were enrolled and paid up. She also wants doctors and hospitals to take patients, regardless of whether they are in a patient’s insurance network or even if the patient is properly insured at all. Just go ahead and extend the deadline for paying, she urged insurers; we’ll work out the paperwork later.

 

Of course, urging isn’t forcing. But as Avik Roy of Forbes notes, the difference is subtle. HHS also announced last week that it will consider compliance with its suggestions when determining which plans to allow on the exchanges next year. A request from HHS is like being asked a “favor” by the Godfather; compliance is less than voluntary.

 

 

Keep reading at the link:

[3rdnlng]

Do you get your plan through the VA? Is it immune to the 40% excise tax on "Cadillac Plans" in 2015? Just wondering, I hope it is for your sake, if anyone deserves NOT to get screwed by the new law, it's the veterans...

 

When i called it a "Cadillac" plan i was being somewhat facetious, but not totally so. I have no deductible, co-pays are low and I've never waited more than 5 minutes to be seen after a scheduled appointment. I can go to any hospital in an emergency and all I have to do is inform the VA that I'm there. As far as specialists go, they use many of the same ones I had under private insurance. I don't know if it's cost efficient, but I have no complaints about the VA Healthcare.

[TakeYouToTasker]

I forsee much of this in the future for vulnerable congressional Democrats:

 

http://www.youtube.com/watch?v=hYyMMs-WO4U

[B-Large]

 

I just believe in equality, thats all... lol

[JuanGuzman]

http://tucsoncitizen.com/medicare/2010/06/07/va-health-care-system-rated-highly-in-government-report/

 

"A recent report by the Congressional Budget Office (CBO) says the VA  (U.S. Department of Veterans Affairs) does a much better job controlling health care costs than the private sector delivery system which is used by Medicare and all private sector insurance plans.

 

The CBO estimates that the VA’s health care cost per enrollee grew by only 1.7 % from 1999 to 2005, which amounts to 0.3% annually. Medicare’s costs grew 29.4 % per capita over that same period, or 4.4 % per year.  In the private sector insurance market (employer and individual plans) premiums increased by more than 70% during this period.

 

The CBO report also says that the VA scores better than the private sector when it comes to patient/customer satisfaction. In 2005, the VA achieved a satisfaction score of 83 out of 100 for inpatient care and 80 out of 100 for outpatient care.  The same survey showed private-sector providers of got 73 for inpatient care and 75 for outpatient care."

 

 

I know that VA had trouble dealing with the influx of veterans after Iraq and Afghanistan but to 3rdning comments this form of government health care has performed well in terms of cost control

[keepthefaith]

http://tucsoncitizen...ernment-report/

 

"A recent report by the Congressional Budget Office (CBO) says the VA (U.S. Department of Veterans Affairs) does a much better job controlling health care costs than the private sector delivery system which is used by Medicare and all private sector insurance plans.

 

The CBO estimates that the VA's health care cost per enrollee grew by only 1.7 % from 1999 to 2005, which amounts to 0.3% annually. Medicare's costs grew 29.4 % per capita over that same period, or 4.4 % per year. In the private sector insurance market (employer and individual plans) premiums increased by more than 70% during this period.

 

The CBO report also says that the VA scores better than the private sector when it comes to patient/customer satisfaction. In 2005, the VA achieved a satisfaction score of 83 out of 100 for inpatient care and 80 out of 100 for outpatient care. The same survey showed private-sector providers of got 73 for inpatient care and 75 for outpatient care."

 

 

I know that VA had trouble dealing with the influx of veterans after Iraq and Afghanistan but to 3rdning comments this form of government health care has performed well in terms of cost control

 

No, the devil is in the details and what happened back then is not terribly relevant now.

[3rdnlng]

http://tucsoncitizen...ernment-report/

 

"A recent report by the Congressional Budget Office (CBO) says the VA (U.S. Department of Veterans Affairs) does a much better job controlling health care costs than the private sector delivery system which is used by Medicare and all private sector insurance plans.

 

The CBO estimates that the VA's health care cost per enrollee grew by only 1.7 % from 1999 to 2005, which amounts to 0.3% annually. Medicare's costs grew 29.4 % per capita over that same period, or 4.4 % per year. In the private sector insurance market (employer and individual plans) premiums increased by more than 70% during this period.

 

The CBO report also says that the VA scores better than the private sector when it comes to patient/customer satisfaction. In 2005, the VA achieved a satisfaction score of 83 out of 100 for inpatient care and 80 out of 100 for outpatient care. The same survey showed private-sector providers of got 73 for inpatient care and 75 for outpatient care."

 

 

I know that VA had trouble dealing with the influx of veterans after Iraq and Afghanistan but to 3rdning comments this form of government health care has performed well in terms of cost control

 

That the VA works has no bearing on what a mandatory insurance plan with little enforcement will do. I couldn't read the article you linked, but did it mention anything about cost per patient in comparison or just the increased percentage comparison?

[B-Man]

So the Obama administration's "pajama-man" ad for the ACA (see prior page) is the hit of the internet.

 

 

 

 

 

 

 

 

 

 

Of course, no Photoshop mockery would be complete without the narcissist in chief honoring the flannel-covered spokesmodel.

 

 

[DC Tom]

Of course, no Photoshop mockery would be complete without the narcissist in chief honoring the flannel-covered spokesmodel.

 

 

 

It would have been even better if they'd put Kennedy's picture to the right of Metrosexual Spokesmodel.

[IDBillzFan]

So the Obama administration's "pajama-man" ad for the ACA (see prior page) is the hit of the internet.

 

Let me know when the MSM starts writing about how abused pajama-boy feels al a the girl that was on the front of the botched healthcare.gov site.

 

We'll hear how he had to go into hiding, change his address, etc., because he never knew the modeling gig would turn into a global joke.

[JuanGuzman]

 

 

That the VA works has no bearing on what a mandatory insurance plan with little enforcement will do. I couldn't read the article you linked, but did it mention anything about cost per patient in comparison or just the increased percentage comparison?

 

I don't think it does, those comparisons are harder because you have to adjust for how sick the average patients are. I realize the fact that VA health care works does not mean that the individual mandate will work. I post it mainly because it combats the generic argument that governments shouldn't be in the health care business. If anything VA care is the most heavy handed government health program out there as they are a provider of health services not just an insurer.

 

But if you want to see examples of a working individual mandate look at Germany or Massachusetts.

[B-Man]

Let me know when the MSM starts writing about how abused pajama-boy feels al a the girl that was on the front of the botched healthcare.gov site.

 

We'll hear how he had to go into hiding, change his address, etc., because he never knew the modeling gig would turn into a global joke.

 

 

Actually LA, since you asked............................................I can show you her reaction.

 

 

 

 

 

[OCinBuffalo]

Haha oh man, I'm supposed to believe the internet commentator ranting about his access to terrabytes of data. Yes it's all a conspiracy. Look the reality is people with sharpminds, advanced degrees have had their work peer reviewed and come to the same results about administrative costs.

 

Bllomberg Business Week:

http://www.businessw...rance-companies

 

New England Journal of Medicine:

 

http://www.nejm.org/...56/NEJMp1209711

 

I give you OECD data showing U.S. isn't getting very much bang for their buck in terms life expectancy and per-capita health spending... and you respond with blinding ignorance, nothing to see here folks.

 

I give you examples of obamacare inititiatives to lower costs such as expansion of medicaid

 

And you barely blink "oh yeh sure they doing a way better job keeping costs low but what about outcomes" keep in mind that these people can't afford insurance in the private market because insurance companies can't get an appropriate risk pool because of information assymetry e.g., the patient knows more about their health status than the insurance does. They now have access to preventative treatment.

 

 

 

what if you lost your job? thanks to Obamacare you will no longer be denied insurance because of pre-existing condition. Or what if you wanted to work as a consultant because the hours and pay was better. well than you'd be pretty happy to be able to get affordable insurance as a private individual.

 

honestly none of you have the ability to argue effective salient points on this issue (you've been swallowed whole by asinine talking points". nor is there insterest in getting to the bottom of U.S. health challenges. you just throw crap at the wall and see what sticks.... "Cadillac Health Plans are efficient" haha

http://www.newrepubl...-should-love-it

 

Conservative should love this, it's a repeal of government subsidy for insurance that cause people to over consume health services, Unions are filled with cadillac plans and I say get rid of em.

 

Or you "insert anecdote about so-so losing their insurance because of obamacare" even though the net effect on insurance rolls is positive. By 2017 the CBO expects to the number of uninsured to be reduced by 27 million people http://www.cbo.gov/s...rageEffects.pdf

 

or you say you are going to do something and don't

 

 

 

Why don't you actually do it OCinBuffalo.. crush each bullet point instead of patting your fellow idealogues on the back for making non-sensical points

 

Obamacare ain't perfect but its way better than the status quo...

1) more people will be able to get health insurance

2) per-capita spending on health care will slow because of the efficiency cost control measures in the act

3) productivity will increase as people can finally move from job to job, from employed to self employed without worrying whether they can get insurance

4) U.S. Health Outcomes will improve

What's funny is: I have been traveling, yet ALL of your silliness has been handled effectively by others here. I mean, they fully developed the "Compare the Chart of Accounts of Medicare to Private Insurance" point I made above...perfectly. Did you bother to read anything they wrote?

 

The "4% vs. 20%" myth...has been debunked here, by finance guys, school equipment guys, and a physicist who's smart enough to my job(somewhat he thinks client-side js "scales", and I direct his attention to Healthcare.gov as an object lesson in why he's wrong, or why he doesn't understand the difference between server-side js and client-side).

 

Hilarious that your entire argument is defeated: by intermediate accounting class. At my school it was called Intermediate Accounting 345, and I bet most of the people here either took it, or, they are personally involved in the Chart of Accounts at the business....they run.

 

If ANY of these "intellectuals" who generate this "research" had taken that class, and weren't chasing raw data that fits with their pre-determined conclusion? They wouldn't have bothered "driving the wrong" here in the first place.

 

*****************************************

 

 

And, look at my last post: that is peer-reviewed work by intellectuals with advanced degrees....and it's completely: wrong.

 

That's because: there are no valuable "degrees" for the kind of work I do. WE, not college professors, are where the "research" comes from. That's because we are where the "innovation" comes from. College professors take what we do, and study it, but they sure as hell don't "invent" anything on the level of what we do, or the # of things we do.

 

And, I will direct you to YAWL vs. the BPMN standard. Guess what? BMPN comes from corporate America, and it WILL be how health care, and, everybody, operates going forward. The YAWL "intellectuals" here are behind the times. They are not leading anything.

 

So, take your "advanced degrees" point and blow it out your ass: the real world doesn't work that way. Not in my business. We don't have time to get degrees, there's too much REAL work to do, and too much $ to be made, to bother with that.

 

College professor in IT/MIS = "I can't do it in the real world/I want to retire/I want to raise a family, have a picket fence, and only work 30 hours a week".

 

College professor has long been my "what I will do when I turn 55, am independently wealthy, and want to hang out on my boat most of the time" plan.

Edited December 18, 2013 by OCinBuffalo

[OCinBuffalo]

see this is my problem with you DC Tom, I ask you to explain how it was incorrect and you don't, or are unable to. Just another vague assertion that my examples don't fit your criteria.

 

I listed reforms that will achieve cost savings or deliver better services. I argue that they are efficient. Explain to me how they are not? Demonstrate a modicum of usefulness and make an argument please

Wait, so your lack of education/experience with the material, is now DC_Tom's responsibility?

 

WTF?

 

Why don't you first go out the Internet, and read about efficiency?

 

I will make it simple for you: http://www.omg.org/bpmn/Documents/Notations_and_Workflow_Patterns.pdf Notice that the author is from IBM, not Clueless State. And, there are things in that paper that are dubious, but, you aren't anywhere near ready to comprehend them, so let's just pretend that everything there is right, OK?

 

Workflow, real workflow, is how we measure work. Measurement of work, allows us to compare work. Comparsion of work allows us to see differences in lots of things, ONE of those things? Efficiency, of process, and of individual contributors, as well as managers.

 

You don't seem to realize that you are talking to people who are so far ahead of you, when it comes to this material, that "explaining" it to you seems like a complete waste of time, from our perspective. Who wants to sign up to un-teach you the nonsense, and then re-teach you the proper, and up to standard material?

 

I'm not here to be your personal professor on "efficiency" and what it actually means, and neither is anybody else. Your ignorance is your responsibility.(How liberal of you to pretend it's someone else's fault) I have given you a place to start above, so that you can start understanding what exactly we do, in the real world, to help organizations realize better efficiency, cut cost, etc.

 

If you don't realize why what you are saying is so patently ridiculous that it isn't worthy of debate, then it's on you, not us, to find out why.

[IDBillzFan]

This article by Ace of Spades, discussing the mocked Obamacare ads being run by Barack Obama, is worth the read, if only for his astute comment that, "For the love of Pete, they're a few pixels away from an ad featuring a guy asking his friend, 'Smell my finger. Does she smell insured?' "

[DC Tom]

This article by Ace of Spades, discussing the mocked Obamacare ads being run by Barack Obama, is worth the read, if only for his astute comment that, "For the love of Pete, they're a few pixels away from an ad featuring a guy asking his friend, 'Smell my finger. Does she smell insured?' "

 

Maybe not that, but I could see the administration running a "I'd like to subsidize her premiums, if ya know what I mean!" ad in the foreseeable future.