The Affordable Care Act II - Because Mr. Obama Loves You All

[DC Tom]

 

I think that's the end game. They know that anyone participating in ACA from the insurer & provider side will either go bankrupt or stop accepting it, which will lead to the inevitable nationalization of healthcare for all. Like it's hard to predict this Trojan Horse.

 

Yeah...but it's an awfully expensive way to go about it. Spending a trillion-plus to drive the entire industry to the point where it has to be bailed out and federalized for another two-plus trillion?

 

Sad thing is that it's so transparent.

[B-Man]

 

 

 

 

11th Non-Profit Obamacare Co-Op Closes........................Arizona latest to close, New York closing earlier than planned.

 

 

Last we reported, eight non-profit co-ops created by the Affordable Care Act announced they were closing. Two weeks later, that number is now eleven.

 

State and federal regulators have suspended Arizona’s Meritus Health Partners and Meritus Health Mutual Partners. Like the ten non-profit tax-payer funded co-op closures before, regulators cited financial troubles as the reason for the co-op closure.

The Washington Examiner reported:

 

State regulators have suspended the company that operates as Meritus Health Partners and Meritus Health Mutual Partners to ability to sell or renew plans to Obamacare customers for 2016. The federal government kicked the co-op out from offering plans on the Obamacare marketplaces.

The Arizona Department of Insurance had issued an order of supervision against the company, requiring that the insurer no longer offer plans after the end of the year.

 

Meritus did not choose to accept the order of supervision. The company’s CEO said that the order “really caught us by surprise,” according to a report in the Arizona Republic. CEO Tom Zumtobel said that he couldn’t get feedback from state regulators on what they needed to do, according to the Republic’s report.

The reason appears to be linked to financial woes, which have doomed the other 10 co-ops. Meritus received $93 million in federal start-up and solvency loans but has yet to make a profit and has lost more than $78 million since it started, the department said.

The decision on Friday comes two days before open enrollment kicks off for Obamacare. It means that all of Meritus’ customers will need to find a new plan.

 

 

More than 50,000 Arizonan’s will lose their health insurance policy as a result.

 

 

 

[keepthefaith]

Our healthcare system will never be government owned or run, at the very most we might see a single national risk pool payment system. I think what will eventually be comfortable with is tax deducted premium for catastrophic care, and a combination of deductibles and health spending accounts that are tax free that will be used for meds, annual exams, ED visits, outpatient specialist visits, etc.

 

However, a switch like this will require nuking an entire economic industry, is private medical insurance, and I'm not sure how will that will go. I think there are mountains to gain by getting rid of third party payors, one of the biggest items is getting a true price for a service that is consistent across the industry.

Looking at the drag queen in your avatar and seeing a reference to ED in your post just doesn't sit well.

[drinkTHEkoolaid]

 

Yeah...but it's an awfully expensive way to go about it. Spending a trillion-plus to drive the entire industry to the point where it has to be bailed out and federalized for another two-plus trillion?

 

Sad thing is that it's so transparent.

Something about being too big to fail.... I think I've heard that somewhere before.

[B-Large]

Looking at the drag queen in your avatar and seeing a reference to ED in your post just doesn't sit well.

 

Too close to home?

[B-Man]

How long can Democrats ignore Obamacare's toxic effects on their party's viability?

https://www.commentarymagazine.com/politics-ideas/matt-bevin-obamacare-local/ …

ObamaCare Loses Big In Kentucky

Obamacare Is Dead

By Kevin Williamson

It doesn’t work because it couldn’t work

. Regardless of whether there is a President Cruz or a President Rubio in January 2017, regardless of the existence or size of a Republican majority in Congress, the so-called Patient Protection and Affordable Care Act (ACA) has failed. The grand vision of an efficient pseudo-market in health insurance under enlightened federal management — the heart of Obamacare — is not coming to pass. Obamacare, meaning the operating model that undergirded the law that Congress passed and President Barack Obama signed with great fanfare — is dead, and it will not be revived. What remains is fitful chaos.

 

A brief refresher: The fundamental problem with ACA is that under it, insurance ceases to be insurance. Insurance is a prospective financial product, one that exploits the mathematical predictability of certain life events among very large groups of people — out of 1 million 40-to-60-year-old Americans, x percent will get in car wrecks every year, and y percent will be diagnosed with chronic renal failure — which allows actuaries and the insurance companies that employ them to calculate premiums based on risk, thus funding the reimbursement of certain expenses incurred by the insurance pool’s members. Insurance is, by its very nature, always forward-looking, considering events that have yet to come to pass but that may be expected and, to a reasonable extent, predicted with some level of specificity. Under ACA, insurance is retrospective. ACA mandates that insurance companies cover pre-existing conditions, meaning events that already have happened, which renders the basic mathematical architecture of insurance — the calculation of risk among large pools of people — pointless.

{snip}

Many of Obamacare’s failures came fast and early. Strike one: “If you like your doctor, you can keep your doctor.” Strike two: Obamacare will save “the average family $2,500 a year on their premiums.” Strike three: Obamacare will add “not one dime” to the deficit.

We all knew that was coming, just as we knew that people would respond to the very strong incentives not to buy insurance by not buying insurance.

Obamacare’s partisans were confronted with the economic facts long before the law was even passed, and their answer was: “Never mind the economics, we’re the good guys, and you want poor people to die.” Democrats argued that Republicans literally wanted to kill poor people, that their plan was for the poor to “die quickly.” This is a habitual mode of discourse among progressives: Reality doesn’t matter; only the purity of Democrats’ motives matters. Obamacare is what it is: Another damned five-year plan based on wishful thinking and very little else.

The fact is that Obamacare has fallen apart without Republicans’ dismantling it. Almost all of its basic promises have failed, it is an economic shambles, and it is a political mess: Unsurprisingly, people still don’t like it. Less than a third of Americans support the individual mandate, three-fourths oppose Obamacare’s tax on high-end health-care programs, and more voters oppose the law categorically than support it.

Read more at: http://www.nationalreview.com/article/426550/obamacare-failures

.

[OCinBuffalo]

I think there are mountains to gain by getting rid of third party payors, one of the biggest items is getting a true price for a service that is consistent across the industry.

Health care stops reeling and tailspinning, and starts to get fixed, the same day that the "health care experts", as well as the rank and file administrators, as well as every health care professional from the Cheif Cardiac Surgeon down to the lowliest of CNAs, who just got here yesterday, realizes that:

 

 

There never was, is, or will be a truce price for service that is consistent across the industry.

 

EDIT: I had a whole explanation here. But...if you can't figure out why the above is emprically true, then...there's little hope.

Edited November 5, 2015 by OCinBuffalo

[DC Tom]

Health care stops reeling and tailspinning, and starts to get fixed, the same day that the "health care experts", as well as the rank and file administrators, as well as every health care professional from the Cheif Cardiac Surgeon down to the lowliest of CNAs, who just got here yesterday, realizes that:

 

 

There never was, is, or will be a truce price for service that is consistent across the industry.

 

EDIT: I had a whole explanation here. But...if you can't figure out why the above is emprically true, then...there's little hope.

 

It's less that I can't figure it out, and more that I can think of a whole shitpot full of reasons why that could be so.

[TakeYouToTasker]

 

It's less that I can't figure it out, and more that I can think of a whole shitpot full of reasons why that could be so.

It's the exact same list of reasons that there is no one true cost of a hotel room.

[B-Man]

UNEXPECTEDLY!

 

Cost Of Cheapest ObamaCare Plans Is Soaring.

 

Good news! You’re now required to buy health insurance that you can’t afford! Also, the deductibles are huge. . . .

 

 

 

 

 

 

NOPE. STICK IT TO ‘EM AND THEIR UNION PALS.

 

Reid, Pelosi pushing for repeal of ObamaCare’s ‘Cadillac tax.’

 

You guys rammed it through on an abusive party-line vote, using “reconciliation” inappropriately to keep Scott Brown from stopping you.

[DC Tom]

 

NOPE. STICK IT TO ‘EM AND THEIR UNION PALS.

 

Reid, Pelosi pushing for repeal of ObamaCare’s ‘Cadillac tax.’

 

You guys rammed it through on an abusive party-line vote, using “reconciliation” inappropriately to keep Scott Brown from stopping you.

 

 

"Obamacare is the law of the land. It has been for four years...why don't they get a life and figure out something else they want to mess with?"

 

-Harry Reid.

[B-Large]

Health care stops reeling and tailspinning, and starts to get fixed, the same day that the "health care experts", as well as the rank and file administrators, as well as every health care professional from the Cheif Cardiac Surgeon down to the lowliest of CNAs, who just got here yesterday, realizes that:

 

 

There never was, is, or will be a truce price for service that is consistent across the industry.

 

EDIT: I had a whole explanation here. But...if you can't figure out why the above is emprically true, then...there's little hope.

 

My point was getting a price is extremely difficult from a medical provider, not that the cost of a service would be the same at all providers. It would be nice to be able to get a price from different providers to compare.

[B-Man]

High Deductibles Force Many to Opt Out of Obamacare

 

As ObamaCare co-ops close and people lose ObamaCare subsidies while getting hit with sky-rocketing premiums, the New York Times has noticed that the deductibles associated with ObamaCare make the plans useless to many people.

 

The NYT reports:

Obama administration officials, urging people to sign up for health insurance under the Affordable Care Act, have trumpeted the low premiums available on the law’s new marketplaces.

But for many consumers, the

sticker shock is coming not on the front end, when they purchase the plans, but on the back end when they get sick: sky-high deductibles that are leaving some newly insured feeling nearly as vulnerable as they were before they had coverage.

“The deductible, $3,000 a year, makes it impossible to actually go to the doctor,” said David R. Reines, 60, of Jefferson Township, N.J., a former hardware salesman with chronic knee pain. “We have insurance, but can’t afford to use it.”

 

 

While we’ve been told that ObamaCare will slow the increase in the cost of health insurance, we can now see that the slowed increase is due to the decrease in the number of people who can afford to see a doctor. Because of the high deductibles, many people are choosing not to purchase health insurance at all.

 

Those who choose not to carry health insurance will be receiving a nifty letter from the IRS about their “shared responsibility” payment. Even with that figured in, many consumers feel they are better off without health insurance because, in the words of Josie Gibb, “it’s really just a catastrophic policy.”

 

(more…)

 

 

 

Thank goodness the New York Times is publicizing this.........if only we had known beforehand.....

[DC Tom]

High Deductibles Force Many to Opt Out of Obamacare

 

As ObamaCare co-ops close and people lose ObamaCare subsidies while getting hit with sky-rocketing premiums, the New York Times has noticed that the deductibles associated with ObamaCare make the plans useless to many people.

 

The NYT reports:

Obama administration officials, urging people to sign up for health insurance under the Affordable Care Act, have trumpeted the low premiums available on the law’s new marketplaces.

But for many consumers, the

sticker shock is coming not on the front end, when they purchase the plans, but on the back end when they get sick: sky-high deductibles that are leaving some newly insured feeling nearly as vulnerable as they were before they had coverage.

“The deductible, $3,000 a year, makes it impossible to actually go to the doctor,” said David R. Reines, 60, of Jefferson Township, N.J., a former hardware salesman with chronic knee pain. “We have insurance, but can’t afford to use it.”

 

 

 

 

While we’ve been told that ObamaCare will slow the increase in the cost of health insurance, we can now see that the slowed increase is due to the decrease in the number of people who can afford to see a doctor. Because of the high deductibles, many people are choosing not to purchase health insurance at all.

 

Those who choose not to carry health insurance will be receiving a nifty letter from the IRS about their “shared responsibility” payment. Even with that figured in, many consumers feel they are better off without health insurance because, in the words of Josie Gibb, “it’s really just a catastrophic policy.”

 

(more…)

 

 

 

Thank goodness the New York Times is publicizing this.........if only we had known beforehand.....

 

"Shared Responsibility Payment?" What Ministry of Truth Newspeak bull **** is that?

[Doc]

"Shared Responsibility Payment?" What Ministry of Truth Newspeak bull **** is that?

 

It the term Barry's and Val's focus groups liked best.

[OCinBuffalo]

 

Health care stops reeling and tailspinning, and starts to get fixed, the same day that the "health care experts", as well as the rank and file administrators, as well as every health care professional from the Cheif Cardiac Surgeon down to the lowliest of CNAs, who just got here yesterday, realizes that:

 

 

There never was, is, or will be a truce price for service that is consistent across the industry.

 

EDIT: I had a whole explanation here. But...if you can't figure out why the above is emprically true, then...there's little hope.

 

My point was getting a price is extremely difficult from a medical provider, not that the cost of a service would be the same at all providers. It would be nice to be able to get a price from different providers to compare.

 

Here's an example of why I write long sometimes. I knew he was going to say this. But, I cut out what would have addressed this last time...so that some of you could learn the lesson: depending on topic, I'm going to write the same number of words no matter what: it's just a matter of whether they go into 1 post or 10, and, I have nothing to do with that decision. B-large is the reason I now have to write what is below. So blame him.

 

 

 

A price to compare...is based on cost.

 

The bottom line is: you can't walk into a heart surgeon and say "how much for quadruple bypass...but I don't want the full package, just give me the bypass and only 1 unit of blood". You can't actually attach a price tag to an entire health care procedure, from admit to discharge. It's difficult to have that price expectation be met one time, never mind every time.

 

Thus, even if we did what you are proposing, and make the price/procedure clear as a bell? Based on our data? 95% of the time that price will be inaccurate. Surprisingly, ~65% of the time, our data suggests a lower price(cost) than would be set, but, they'd charge it anyway, in an effort the defray the over-priced ~45%.

 

This is the eternal evil of packaging together a set of unique tasks, calling them: a procedure, and slapping a flat price on top of them. If you've costed 1 patient getting an MRI? You've costed 1 patient, and that's it. You CANNOT apply that cost to all patients in broad scale. Certainly you can't do it in an effort to get a "straight price". What's the variable cost for a 24 year-old vs. an 80 year-old? Gotcha! What if that 80 year-old has full mobility, but the 24 year-old is a parapalegic? See? NOBODY knows the cost ahead of time. What if the 80 year-old is mobile as hell, but ***** the MRI? What if the 24 year old does?

 

No. No. No. Fing No. Top-down financial allocation is doing it wrong. Nobdy drinks 2.3 cartons of milk. And what exactly is the price for that? Can we give the .7 to somebody else?

 

What we can do, and what we are doing, is looking at cost properly in health care. We look at every attribute of each individual task. Soon providers won't be talking about how they've kept their price/procedure low...because that is pointless: the price for a routine surgery...can suddenly balloon if they find something else, or, if they have unforeseen complications == unplanned work == unplanned cost == unplanned price.

 

Rather, they will be able to demonstrate how they've kept their costs low, and managed them properly. They will be able to show responsiveness to cost spinning out of control in acute situations, as well as a constant cutting of cost over time. They can do this by showing consistent improvement not only in effectiveness but also in cost of each task. It's legos. We use task legos, with inderminate cost/time/measurement/materials and build them into procedures for the final cost.

 

This...and only this...is how we accomplish the goal, and I know this, because I'm doing it.

Edited November 17, 2015 by OCinBuffalo

[4merper4mer]

Here's an example of why I write long sometimes.

 

 

Least realistic word ever typed in this forum.

[Nanker]

The government knows best. The government ALWAYS knows what's best - especially concerning healthcare. Because... well, they're the government after all. They're smart and lots of them have read the classics. PLUS, these guys live in Europe. They must also be rich. I can't afford to live in Europe - can you? Europeans are also inherently smarter than Americans. Or so we've been told. Most of them can speak a couple of languages - like Mitt Romney, and unlike our President - much to his chagrin.

[GG]

When "good" intentions try to trump economics.

 

UnitedHealth Group Inc. said it expects major losses on its business through the Affordable Care Act’s exchanges and will consider withdrawing from them, in the most prominent signal so far of health insurers’ struggles with the health law’s marketplaces.

The disclosure by the biggest U.S. health insurer, which had just last month sounded optimistic notes about the segment’s prospects, will sharply boost worries about the sustainability of the law’s signature marketplaces, amid signs that many insurers’ losses on the business continue to mount.

 

[B-Man]

Obamacare’s Bait and Switch Has Left Consumers Scrambling in 2016

 

 

 

“We have insurance, but can’t afford to use it,” thanks to a $3,000 deductible on top of his premiums."

 

 

 

Fundamentally transformed!