The Affordable Care Act is Coming Home to Roost

[B-Large]

I want Walmart to be a TPA for catastrophic insurance, and offer to administer(manage the money) for risk pools that number in the 100ks. So, yeah, I want Walmart involved, and they sure as hell are relevant.

 

On the day-to-day stuff(doctor's visits, emergency room, scripts, etc.), I want pre-tax HSAs, run pretty much the same way 401ks are. I want cards issued that only work on machines that proviers are issued(see? I don't even make you pay for that). With....perhaps more regulation on what you can put your HSA money into. But, due to the smaller size of the average HSA account, this may not be necessary. So, we leave it unregulated for now, and see if we need to add some later.

 

You know what I've said above, and you know why it would work. Or, you don't understand health insurance very much.

 

Enough of these solutions from 1964. We have 0 need to run this as one big system. We can easily decentralize it(like we always do in my job) and have the states manage or regulate, their choice, the HSAs, while the Feds deal with the catastrophic. Big, one-size-fits-all, is precisely what the Feds do well, and that's exactly what we want for catastrophic. We also want to leverage Wal-mart's inherent economies of scale ability.

 

Meanwhile, as far as the truly needy/disabled the State/Feds can pay into the HSAs directly, but, since it's state money, the state can determine which doctors are allowed to be consulted, hospitals, etc. Everybody else is free to do as they please. This is as it should be: you don't want to pay your own way, you lose the freedom of choice. The people who are paying, should be the ones who are saying.

 

Employers can still attract employees by making payments to the HSA, AND, the HSA $ can be transferred to family members...no different than beneficiaries in any other form of insurance. If you don't use your $, you don't lose it, and you don't get taxed on it when you die.

 

This has the added benefit of killing the death tax permanently, because people will just load up their HSAs before they kick it....and that means...their family has a nice bit of security for their lives...and not money that can be blown on idiocy.

 

You want to deal with wealth inequality? Here's how you do it: putting cash into an HSA instantly creates wealth, and every single dollar counts.

 

Btw, every year of government service = the government double matches your HSA contribution. No exceptions.

 

This plan works, drives down cost, and holds every provider accountable by whom the are supposed to be held accountable: patients.

 

"The Big Insurance" companies are left to fight it out in the catastrophic market, and they can offer all sorts of plans, while being held to account by the Treasury Department(not the IRS). Finally, a small amount (variable %) of everyone's HSA is taken each quarter and put into a county, not state, WTF fund, which is used to cover overages when somebody gets their HSA drained by being unlucky. It's also used as a "get back on your feet" default(move 10k in there to start them out, but, if they leave the county, they lose that 10k = keeps the "poor" from coming to NY and welfare shopping) for people trying to rejoin the labor force(or human race, in terms of addicts). That quarterly % is decided by the county.

 

Thus, all bases are covered, and there's a built-in incentive for competition, and for those who are clue-deficient, to get one.

 

It's not difficult to construct similar/better/different parts of this that deal with the details or special circumstances, and ALL of those should be left to the county, not state, not Feds.

 

We can build systems for 100% of the people, without any "losers", provided that we realize that doing that means: decentralize, decentralize, decentralize....and throw the things that make sense being centralized(catastrophic) over the fence.

 

We can build all kinds of stuff....provided we remember one thing: it's not 1964, and, all of those programs represent "the worst way to do it".

 

OC, Cat plans still have monthly premium payments, deductibles and you can cover expenses with tax advantages HSA's/ Flex Spending. You can still buy plans that are very high deductible and you pay a ton out of pocket for expenses before your plan pays the 80%. We have a CAT plan on out open enrollment, monthly premium plus $5k dedictible.... the only real change to CAT plans with the ACA is that some preventative services will cost you zero, and the carrier is by law not allowed to charge you for them- as you now the thinking is more people will get prevention services, althoguht I am not convinced of that fact in totality, I think come people actively keep healthy others go to the doctor when they have lump or cough and money is a side thought.

 

Also, here's food for thought: Why do HSA contribution need to be tax advantaged at all? Why can't people in the US do anything for themselves a politican handing our tax gifts? Interesting, I think.

 

Who cares?? This isn't about health care, its about handing a defeat to this President, period.

 

There is zero, zero political or practical upside to the Republican party to see the ACA succeed in any way shape or form. It why I spend as much time as possible, when I am asked, to clarify the good and bad for people about the ACA as it related to them, so at least the are prepared with actual facts instead of the often crazy fear campaign that exists in most media outlets. The hospital has done and excellent job of preparing employee to discuss it... I do however concede, there is ALOT to know, and its not always straight forward.

Edited December 27, 2013 by B-Large

[keepthefaith]

Who cares?? This isn't about health care, its about handing a defeat to this President, period.

 

The President dealt himself a sure-thing defeat when he signed the law. When the reality of a huge law change fails to live up to the big and frequent promises for most people, the scoreboard won't read in your favor. What we're watching now is the game being played.

Edited December 28, 2013 by keepthefaith

[IDBillzFan]

The President dealt himself a sure-thing defeat when he signed the law. When the reality of a huge law change fails to live up to the big and frequent promises for most people, the scoreboard won't read in your favor. What we're watching now is the game being played.

 

One of the funniest things is watching talking-point progressive dolts like gator first yelling that "It's the law. Deal with it!" before realizing what an abortion the law is and then yelling that the reason the law sucks is because the GOP is doing everything it can do to not do anything to fix the law they had nothing to do with.

[3rdnlng]

One of the funniest things is watching talking-point progressive dolts like gator first yelling that "It's the law. Deal with it!" before realizing what an abortion the law is and then yelling that the reason the law sucks is because the GOP is doing everything it can do to not do anything to fix the law they had nothing to do with.

 

No, that schit isn't the funniest. Seeing Obama caught with a program that the vast majority don't want, and a roll out that is not even amateurish level try to fix things by fiat and ignore the law is funny. His press conferences explaining the "new law" remind me of a long ago German leader.

[Nanker]

The parallels of Presidents Nixon and Obama are very strong.

[B-Man]

 

Compelling Evidence Makes the Case for a Market-Driven Health Care System.

By James C. Capretta and Kevin Dayaratna

 

The United States does not have a private-sector health insurance system, let alone a functioning competitive market for insurance or health services. In fact, the federal government has been the dominant force in American health care for decades, long before the recent massive expansion of the government’s role in the 2010 Patient Protection and Affordable Care Act (PPACA)[1] Through overly restrictive policies, Medicare, Medicaid, and tax subsidies, the federal government has dominated the operation of the U.S. health care system for the past half-century [2] It is primarily federal policies that are responsible for driving up costs and making health insurance unaffordable for so many Americans. [3]

 

The argument over the future of U.S. health care is essentially an argument over how to best allocate scarce resources in this large and important sector of the national economy. Proponents of centralized government control of health care are fond of saying that reliance on a private-sector approach in the U.S. has been tried and failed. According to their arguments, most Americans are enrolled in private insurance, costs are high, and the insurance is insecure. They claim that the private marketplace is therefore to blame for many of the problems prevalent in U.S. health care.

 

The major flaw in such arguments is that the United States is not a competitive market and never really has been. It is therefore incorrect to look at the broad performance of the largely uncompetitive American health care system and make judgments about whether a competitive health system would work well or not.

 

Assessing the value of competition in health care thus requires taking a more indirect approach to searching for evidence, most especially by looking at more isolated instances when consumers have been presented with cost-conscious choices in health care. [4] The findings from this kind of examination can then be supplemented with reviews of what has happened when other previously overregulated industries were deregulated as well as with careful critiques of the theoretical arguments that suggest that health care is fundamentally ill-suited to a competitive marketplace. From this kind of an assessment, a clear picture emerges—a competitive marketplace would not only work well in health care but would also bring great benefits to the American consumer.

 

More at link:

 

 

but (of course) since they published it on the Heritage Foundation blog, you could always just dismiss it on those grounds....................lol

[B-Man]

President Obama has gone to Hawaii on vacation, but he can’t escape the wave of disaster that is inundating his party as a result of Obamacare.

 

 

.

[Tiberius]

 

 

The President dealt himself a sure-thing defeat when he signed the law. When the reality of a huge law change fails to live up to the big and frequent promises for most people, the scoreboard won't read in your favor. What we're watching now is the game being played.

 

No, the fun part will be Conservatives trying to explain how to replace it. They can't! They cannot have any plan that allows poor people to be covered. Too many haters in the base

 

 

 

More at link:

 

 

but (of course) since they published it on the Heritage Foundation blog, you could always just dismiss it on those grounds....................lol

 

Hello??? Consumers have to be able to afford the health insurance you ding dong. They are not buying breakfast cereal. You realize that a lot of poor whites would be ruined by a market based health care system without government assistance

[Koko78]

President Obama has gone to Hawaii on vacation, but he can’t escape the wave of disaster that is inundating his party as a result of Obamacare.

 

 

.

 

The cartoon artist misspelled BUSH.

[keepthefaith]

No, the fun part will be Conservatives trying to explain how to replace it. They can't! They cannot have any plan that allows poor people to be covered. Too many haters in the base

 

 

 

Hello??? Consumers have to be able to afford the health insurance you ding dong. They are not buying breakfast cereal. You realize that a lot of poor whites would be ruined by a market based health care system without government assistance

 

We've had a medical coverage plan for poor people for decades called Medicaid. We didn't need the ACA to cover poor people. It was already being done. Depends on how you define "poor". The government has had such a definition and it's the same I believe for all skin colors. You can debate where to draw the line on "poor" and also how to pay for it.

[3rdnlng]

We've had a medical coverage plan for poor people for decades called Medicaid. We didn't need the ACA to cover poor people. It was already being done. Depends on how you define "poor". The government has had such a definition and it's the same I believe for all skin colors. You can debate where to draw the line on "poor" and also how to pay for it.

 

My question is why that reptile even had to mention race?

[DC Tom]

My question is why that reptile even had to mention race?

 

'Cause he's got nothing else at this point.

[Tiberius]

 

 

We've had a medical coverage plan for poor people for decades called Medicaid. We didn't need the ACA to cover poor people. It was already being done. Depends on how you define "poor". The government has had such a definition and it's the same I believe for all skin colors. You can debate where to draw the line on "poor" and also how to pay for it.

 

That's just not true. For so many reasons. Your point about where to draw the line is great, because the fact that many people won't be cut off from medical coverage keeps them from crossing the line to poverty cause insurance companies can't cut people off anymore. Can the GOP really just say it's ok to cut people off? The Tea Party will say hell yes, please, let's let them die, please! But that's part of the reason why the tea party is so unpopular

 

 

 

My question is why that reptile even had to mention race?

 

 

 

My question is why that reptile even had to mention race?

For what? Are you talking about B and his white power message board he had a link to?

[3rdnlng]

That's just not true. For so many reasons. Your point about where to draw the line is great, because the fact that many people won't be cut off from medical coverage keeps them from crossing the line to poverty cause insurance companies can't cut people off anymore. Can the GOP really just say it's ok to cut people off? The Tea Party will say hell yes, please, let's let them die, please! But that's part of the reason why the tea party is so unpopular

 

 

 

For what? Are you talking about B and his white power message board he had a link to?

 

Just stop. You've used up all of your ammo, thrown the gun and are now running in cement. Find a new cause.

[IDBillzFan]

The government has had such a definition and it's the same I believe for all skin colors.

 

I think we all know that progressives need to specify "poor whites" because they know no one has done more damage to the prospects of poor blacks in this country than the efforts and policies of the half-white guy sitting in the WH.

[B-Man]

SHOCKER: Massachusetts, the model for Obamacare, has highest health costs in the United States.

 

 

 

 

Howard Dean: Administration won't be blamed if people can't see their doctor

 

http://www.washingtontimes.com/blog/inside-politics/2013/dec/29/dean-administration-wont-be-blamed-if-people-cant-/

 

Good luck with that.................

 

 

 

 

 

The Washington Times reports Missouri bill would gut Obamacare Next month, the Missouri Senate will consider a bill which would effectively cripple the implementation of the Affordable Care Act within the state.

 

Following the lead of South Carolina, where lawmakers are fast-tracking House Bill 3101 in 2014, and Georgia, where HB707 was recently introduced by Rep. Jason Spencer, Missouri State Senator John T. Lamping (R-24) pre-filed Senate Bill 546 (SB546) to update the Health Care Freedom Act passed by Missouri voters in 2010. It passed that year with more than 70% support.

 

SB546 would ban Missouri from taking any action that would “compel, directly or indirectly, any person, employer, or health care provider to participate in any health care system.” That means the state would be banned by law from operating a health care exchange for the federal government.

[IDBillzFan]

Howard Dean: Administration won't be blamed if people can't see their doctor

 

http://www.washingto...f-people-cant-/

 

“Remember, this is the insurance industry that’s running this...,” said former Vermont Gov. Howard Dean during an interview on “Fox News Sunday.

Yeah. That's right. Obamacare is being run by the insurance industry. :lol:

 

He's like the gatorman of progressive talk show guests.

[boyst]

I was thinking about Bush today. I saw the illustration above with Obama and the ACA wave. At first I thought, wow it must suck. The guy can't even have a vacation without this stuff beating him down and taking him out to sea. It reminds me of Bush and and the way he got ate up in the press just to go take some time away from the office as everyone would say he is clearly not doing his job.

 

Well, the only reason Obama needs to reap what he has sewn is that he was so beyond arrogant. That he let the whole shut down happen and then throw it on the GOP was a punk move because he knew his system was not even ready yet. If he was the politician and smart man they said he would have played the game and let the 'Tea Party' win the round only to steal the thunder next Fall when it will matter.

[keepthefaith]

That's just not true. For so many reasons. Your point about where to draw the line is great, because the fact that many people won't be cut off from medical coverage keeps them from crossing the line to poverty cause insurance companies can't cut people off anymore. Can the GOP really just say it's ok to cut people off? The Tea Party will say hell yes, please, let's let them die, please! But that's part of the reason why the tea party is so unpopular

 

 

The Tea Party has never had a platform of letting people die. The Tea Party simply believes more in the virtues or personal responsibility and more fiscally responsible government. Fixing the pre-existing condition obstacle could have been done to protect the sliver of the population that effected without negatively revamping the whole system.

 

You simply believe (if I read your various posts correctly) that our federal government should provide all of the basic needs for able-minded and able-bodied people (food, clothing, shelter, education and health care) if they cannot afford it themselves with no limits on the duration of benefits. You simply want to make working optional for people. You want to make it so that people can quit high school, have babies (married or not), make little or no effort to support themselves and as a birth right be guaranteed a basic minimum lifestyle paid for by the most productive taxpayers or financed through borrowing by our Treasury department.

[Koko78]

The Tea Party has never had a platform of letting people die. The Tea Party simply believes more in the virtues or personal responsibility and more fiscally responsible government. Fixing the pre-existing condition obstacle could have been done to protect the sliver of the population that effected without negatively revamping the whole system.

 

You simply believe (if I read your various posts correctly) that our federal government should provide all of the basic needs for able-minded and able-bodied people (food, clothing, shelter, education and health care) if they cannot afford it themselves with no limits on the duration of benefits. You simply want to make working optional for people. You want to make it so that people can quit high school, have babies (married or not), make little or no effort to support themselves and as a birth right be guaranteed a basic minimum lifestyle paid for by the most productive taxpayers or financed through borrowing by our Treasury department.

 

Why not? It worked so well everywhere else that it has been done.