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

birdog1960 · April 2, 2014

Except costs won't get reined-in and premiums under Obamacaid will continue to rise, eventually pricing most people out. And good luck getting single payer passed.

Not unlike how the Ku Klux Klan was an old Dem idea, eh?

interesting. both those ideas we're born and raised to a large degree in the same states that are now opposing medicaid expansion.

IDBillzFan · April 2, 2014

interesting. both those ideas we're born and raised to a large degree in the same states that are now opposing medicaid expansion. by Democrats.

Fixed.

Edited April 2, 2014 by LABillzFan

birdog1960 · April 2, 2014

Fixed.

hating lincoln and his party for decades after the civil war has nothing to do with being a democrat in spirit. like i said, people of the same ilk and backround can be found spearheading opposition to medicaid expansion. makes perfect sense if you think about it for a minute.

B-Man · April 2, 2014

Las Vegas Unions’ Obamacare Reckoning

Members of Las Vegas’s Culinary Union 226 and Bartenders Union 165 voted to strike last week. As the Las Vegas Review-Journal has reported, if the strike actually occurs, it could cause major problems at several locations along the Strip, becoming “the group’s most significant wage stoppage in Las Vegas in 30 years.”

The issue the union is willing to strike over: health benefits, which have become vastly more expensive since Obamacare took effect. Employers struggling to manage these rising health-care costs have reached an impasse with unions during contract negotiations.

It’s hard not to wallow in schadenfreude, given the unions’ support of the health law’s biggest advocates.

For example, the Culinary Union is the biggest affiliate of UNITE HERE, a union that represents around 400,000 hotel and restaurant workers. That same union, as the Washington Post has reported, “provided a crucial boost to Obama by endorsing him just after his rival Hillary Rodham Clinton had won the New Hampshire Primary.”

Since the health law passed, unions have been betting on an exemption that spares their members from many of Obamacare’s unpleasant side effects. When those unions were subjected to the same bad policies being foisted on the non-organized public, they became vitriolic.

A UNITE HERE report released last month stated that “without smart fixes, the ACA threatens the middle class with higher premiums, loss of hours, and a shift to part-time work and less comprehensive coverage.”

Funny how policy conversions occur when political consequences are felt personally.

The strike vote is the union’s latest attempt to back out of a major bumble. But renegotiated contracts will hardly change Obamacare’s economic equation. The union’s best hope is to bully businesses into paying for Big Labor’s error—and if they succeed, the Las Vegas economy, as well as its tourists, will be once again forced to bear the costs.

.

Edited April 2, 2014 by B-Man

IDBillzFan · April 2, 2014

Las Vegas Unions’ Obamacare Reckoning

I'm sure they'll all change their tune as soon as Obama explains it to them one more time.

Dorkington · April 2, 2014

Except costs won't get reined-in and premiums under Obamacaid will continue to rise, eventually pricing most people out. And good luck getting single payer passed.

Not unlike how the Ku Klux Klan was an old Dem idea, eh?

There's a difference between republican and conservative, and democrat and progressive. Party stances/identities have changed, whereas political ideologies are generally consistent.

I'm not saying that the conservatives bringing up the mandate is some sort of damning thing, but rather they fell out of favor with it, even though they supported it more than supported expansion of medicare. And plus, we're talking Clinton era politics here, not exactly ancient history.

Doc · April 2, 2014

Yes, yes...of course it will improve. After all, look how well it's doing after four freaking years. I'm sure the one thing Obamacare needs is more time. And maybe another speech from Obama since we all know its biggest problem was that it just wasn't explained well enough.

No, like everything else, it needs more of other people's money.

interesting. both those ideas we're born and raised to a large degree in the same states that are now opposing medicaid expansion.

Why do we need to expand Medicaid when Obamacaid will reduce health care costs (which will be passed onto consumers) and save every family $2500?

There's a difference between republican and conservative, and democrat and progressive. Party stances/identities have changed, whereas political ideologies are generally consistent.

I'm not saying that the conservatives bringing up the mandate is some sort of damning thing, but rather they fell out of favor with it, even though they supported it more than supported expansion of medicare. And plus, we're talking Clinton era politics here, not exactly ancient history.

The individual mandate was proposed by the Heritage Foundation some 20 years before Obamacaid was even a thought. I doubt more than a handful of then-current Repubs had ever even heard about it. And there's a difference between having a good idea, and implementing it successfully. Just wait until the news breaks of the premium hikes coming for 2015.

birdog1960 · April 3, 2014

Why do we need to expand Medicaid when Obamacaid will reduce health care costs (which will be passed onto consumers) and save every family $2500?

we need it to insure the millions of poor or near poor uninsured and stop people from standing in line to get care in tents from volunteers and med students like they do here in appalachia. we need to stop acting and looking to anyone with any interest, like a 3rd world country to a 6th of our population or so. we need it cuz it's the right, moral and ethical thing to do. we need it cuz health care is supposed to be about caring for people, not about making the most bucks. if that doesn't convince you. we need it to stop cost shifting by health care systems trying to stay afloat while medicare cuts aren't being offset by medicaid payments for currently uninsured patients.

Dorkington · April 3, 2014

No, like everything else, it needs more of other people's money.

Why do we need to expand Medicaid when Obamacaid will reduce health care costs (which will be passed onto consumers) and save every family $2500?

The individual mandate was proposed by the Heritage Foundation some 20 years before Obamacaid was even a thought. I doubt more than a handful of then-current Repubs had ever even heard about it. And there's a difference between having a good idea, and implementing it successfully. Just wait until the news breaks of the premium hikes coming for 2015.

Rates are going to forever increase simply because they can. When something is relatively mandatory and is a for profit service, it's basically free reign to hike until the breaking point. ACA or not, that will not change.

IDBillzFan · April 3, 2014

we need it to insure the millions of poor or near poor uninsured and stop people from standing in line to get care in tents from volunteers and med students like they do here in appalachia. we need to stop acting and looking to anyone with any interest, like a 3rd world country to a 6th of our population or so. we need it cuz it's the right, moral and ethical thing to do. we need it cuz health care is supposed to be about caring for people, not about making the most bucks. if that doesn't convince you. we need it to stop cost shifting by health care systems trying to stay afloat while medicare cuts aren't being offset by medicaid payments for currently uninsured patients.

You didn't need trillions of taxpayer dollars wasted and a job-killing nobody-likes-it monstrous abortion of a law that screws millions of other people to do that.

Well, progressives do. But smart people don't.

Doc · April 3, 2014

we need it to insure the millions of poor or near poor uninsured and stop people from standing in line to get care in tents from volunteers and med students like they do here in appalachia. we need to stop acting and looking to anyone with any interest, like a 3rd world country to a 6th of our population or so. we need it cuz it's the right, moral and ethical thing to do. we need it cuz health care is supposed to be about caring for people, not about making the most bucks. if that doesn't convince you. we need it to stop cost shifting by health care systems trying to stay afloat while medicare cuts aren't being offset by medicaid payments for currently uninsured patients.

The Oregon study found that Medicaid had no significant effects on health outcomes versus being uninsured. RomneyCare has shown that ER rates don't change and in fact worsen. And there are no cost reducers in Obamacaid, except to squeeze just 15% (i.e. us) of the equation. So ultimately it's going to bust. And again, no one will vote for single payer and put the entire system into the government's hands, when they can't run even the post office efficiently and botched Obamacaid.

Whether you choose to believe it or not, medical care IS a commodity and you can't give everyone everything, much less save everyone, much less from themselves. And if you want to get into what is right, moral, ethical, etc., there are a lot of behaviors that people engage in which aren't right, moral, ethical, etc., which lead to them getting and staying sick and/or poor.

Rates are going to forever increase simply because they can. When something is relatively mandatory and is a for profit service, it's basically free reign to hike until the breaking point. ACA or not, that will not change.

So they were going to increase before, and are still going to increase after. Again what was the point? To insure 868K people while kicking off more than that?

3rdnlng · April 3, 2014

http://www.conservative-daily.com/2014/03/31/obamacare-navigators-sign-up-illegal-aliens-to-pad-numbers/

The Patient Protection and Affordable Care Act (aka Obamacare) explicitly says that the coverage cannot be offered to illegal aliens. That didn’t stop Oregon from illegally signing over 4000 illegal aliens up for Medicaid. Oregon’s healthcare site has been so riddled with problems that the state has resorted to processing applications by hand. So, this wasn’t a computer glitch… these were more than 4000 instances where an “Obamacare Navigator” manually gave these illegal immigrants the Obamacare stamp of approval.

That’s just one state, and it is the state that has had the most problems rolling out the health law. God only knows how many illegal aliens have signed up for FREE healthcare across the country. Now, we all know that Obamacare isn’t free. There’s no such thing as a free lunch. But for illegal immigrants who skirt the system and don’t pay any taxes into this… They are getting this healthcare for free and on YOUR dime!

It gets even worse than that. The Obama administration has figured out that illegal aliens and their families have been signing up for Obamacare. What did the regime do? It promised these illegals that no matter what, their inputted information wouldn’t be used to deport them or their families. Essentially, the government has received thousands of notarized admissions of guilt; illegal aliens admitting on a federal form that they are in the country illegally. Instead of upholding the law and sending these criminals back to whatever country they came from, Barack Obama is turning a blind eye while simultaneously giving them health insurance they DON’T DESERVE!

This is your tax dollars at work. You can rest assured that your tax money is now being deliberately funneled to provide entitlements to illegal aliens! I don’t know why I was so shocked when I heard that, but I was. This past January, the GOP offered an amendment to a bill that would have closed a tax loophole abused by illegal aliens to the tune of over $4 BILLION every year, but the Democrats refused to touch it.

Why? Well, the last thing the Democrats want is to punish their key voting-block. They need these illegal aliens to be out in force voting on Election Day…

boyst · April 3, 2014

here's a prediction: medicaid expansion will happen in all but the most backward states within the next few years. why? because health care systems are pressuring their senators and congressmen to get it done. the partial offset for decreased medicare payments for them is increased medicaid payments for the previously uninsured. that's not happening even in many of the poorest states that desperately need those healthcare jobs and dollars (yup, that map again - the southeastern states are all nonadopters). in effect, the uninsured that would be eligible for medicaid are being used as pawns by the cons. so what else is new? but once that happens, game over.

why should a state have to "expand" to some thing it does not want?

Why should a state be forced to comply with something that does not work, would not work, would not serve, does not want, does not need, etc?

At what point is that state or community allowed to say shove it to the government above it? If Tennessee can fund its own program with their own money, their own system, staff and all entities why can't they? And what happens if they play hardball?

Well, we have been down this road before. It didn't end well. A civil war and Northern invasion and aggression that ceased the power of the state. In today's age that would not be possible but we have seen what the Gov would do: shut down all funding to the state, shut down all Fed offices, close all Fed land and have a big **** fest beating their chest.

The Federal Gov is way too powerful and that scares the crap out of me. I can't believe it doesn't you, at least any more, ya know since probably 2008?

boyst · April 3, 2014

yup. people that get 3x's what they pay in to medicare back as benefits aren't gonna like it much when costs begin to get reigned in. people playing the health care lottery choosing to go uninsured and really only putting the healthcare systems at risk cuz they have no where near the assets to cover a catastrophic illness aren't gonna like it when they're made to be responsible. and some people don't like it because many of the benefits (especially the medicaid expansion) haven't been fully implemented. add to that outright propaganda against it (every new or old problem in healthcare is blamed on the aca) and an outright war against it by the cons and the results you cited are hardly surprising. they will improve.

so what is my relief for being extremely healthy, practicing a safe lifestyle, and not smoking, doing drugs, driving a motorcycle, etc going to do for me?

It'd be cool if the whole system worked fairly, but it doesn't. Ya know, if yandrive a motorcycle you pay more. If you are fat you pay more. If disease runs in your family you pay more.

Wait a minute... The death panels don't want me to bring down the system because I need $4000/month low blood pressure pills, insulin, sponge baths, a new lung and am disabled from my weight.

There's a difference between republican and conservative, and democrat and progressive. Party stances/identities have changed, whereas political ideologies are generally consistent.

I'm not saying that the conservatives bringing up the mandate is some sort of damning thing, but rather they fell out of favor with it, even though they supported it more than supported expansion of medicare. And plus, we're talking Clinton era politics here, not exactly ancient history.

yeah, well if they've changed why haven't they?

Helping you out here. Think us white folk should get a shirt ready for "yes we can?". How about the women get one for Hilrod?

I know more Baptist, pro life, anti-gay Democrats that are male and over 45 then into Baptist, pro life anti gay Republicans. I know more women that are pro choice, Christian, anti gay Democrats then I do pro life, Christian and gay friendly Democrats

Welcome to the Old South.

Keukasmallies · April 3, 2014

we need it to insure the millions of poor or near poor uninsured and stop people from standing in line to get care in tents from volunteers and med students like they do here in appalachia. we need to stop acting and looking to anyone with any interest, like a 3rd world country to a 6th of our population or so. we need it cuz it's the right, moral and ethical thing to do. we need it cuz health care is supposed to be about caring for people, not about making the most bucks. if that doesn't convince you. we need it to stop cost shifting by health care systems trying to stay afloat while medicare cuts aren't being offset by medicaid payments for currently uninsured patients.

Given that those things are true, why not tell the truth about the increased premium costs involved, the sacrifices such as higher co-pays and deductibles, the need to close some insurance programs and open new ones with coverages that many neither want nor need, the need to change doctors in some cases? Why taint the good and moral things you mentioned with deceit, obfuscation, political rhetoric, and strong arm tactics, etc.? I think I know why: It's because the effort is spearheaded by government at several levels. Government doesn't do private enterprise very well and is often too stupid to know it. Edited April 3, 2014 by Keukasmallies

birdog1960 · April 3, 2014

The Oregon study found that Medicaid had no significant effects on health outcomes versus being uninsured. RomneyCare has shown that ER rates don't change and in fact worsen. And there are no cost reducers in Obamacaid, except to squeeze just 15% (i.e. us) of the equation. So ultimately it's going to bust. And again, no one will vote for single payer and put the entire system into the government's hands, when they can't run even the post office efficiently and botched Obamacaid.

Whether you choose to believe it or not, medical care IS a commodity and you can't give everyone everything, much less save everyone, much less from themselves. And if you want to get into what is right, moral, ethical, etc., there are a lot of behaviors that people engage in which aren't right, moral, ethical, etc., which lead to them getting and staying sick and/or poor.

the oregon study, published in nejm, followed less than 6000 pt's for an average of 17 insured months. how many statin studies over how long of study periods we're needed before proof of the benefit of statins was shown (a much simpler question)? go back and look at that data and tell me with a straight face that this small, short study definitively answers the questions it posed. hell, in many offices it would be a 3-4 month wait to get an appointment after getting insurance, making the study period roughly 1 year. and even in that time, the financial impact of catastrophic events was completely mitigated for the newly insured. this is not a small matter. it means hospitals and doctors got paid for the catastrophic care they provided those pts. without it, many of the patients would have likely gone into bankruptcy and the providers would receive pennies on the dollar.

no shite, medical care is a commodity. so is food. should we let people starve rather than provide food assistance? i don't know of a single patient or person for that matter that hasn't done something stupid that might have caused themselves harm. and in frequent cases, that involves repeated and continuous infractions. i don't see how that changes the ethical and moral response to suffering. can everyone get everything in regards to care? no, but basic care can be delivered as it is in many seemingly more advanced nations then us.

i might have asked you this before but it bears repeating: did you write down thoughts like these in the "why i want to be a doctor" section of your med school applications or did you just lie and color yourself a humanist?

Edited April 3, 2014 by birdog1960

B-Man · April 3, 2014

The ACA: Still Falling Short :A realistic assessment of Obamacare shows it is not delivering what was promised.

By James C. Capretta

The Obamacare open-enrollment season (supposedly) closed yesterday, so it is good time to step back and assess where things stand with the law and its first-year implementation.

Interestingly, Obamacare remains something of a Rorschach test for journalists and health-policy analysts. Looking at the same set of facts, two observers can reach very different conclusions.

For instance, Noam Levey of the Los Angeles Times writes that Obamacare “has spurred the largest expansion in health coverage in America in half a century.”

Meanwhile, health consultant Howard J. Peterson, writing at the Philadelphia Inquirer news site, says “the first four years of Obamacare has led to solving about 10 percent of the problem of uninsured citizens.” He expects no further improvement in the coming years.

So which is it? Is Obamacare on track to be a historic achievement? Or is it falling well short of the lofty goals set for it by the administration?

{snip}

At its heart, Obamacare was a large-scale redistribution program. It provides large new subsidies to lower-income households and to those with previously expensive insurance due to risk rating of their premiums. These subsidies are paid for by raising premiums on many millions of previously insured households, raising taxes significantly, and cutting Medicare.

The end result will be a reduction in the uninsured of some magnitude, that’s for sure. But it was never going to be hard to reduce the uninsured if that was all that concerned policymakers. Massive public subsidies and expansion of free public-insurance programs can expand insurance enrollment, so long as others were willing to pay for it.

But that wasn’t what was promised. Americans were told that reform would lower costs for everyone, and that no one would lose the policies they previously held and liked. People are dissatisfied with Obamacare because they’ve realized the law will never deliver on these promises. Indeed, just yesterday it was announced that health-care costs rose at the fastest pace in a decade in the last three months of 2013. Most Americans are seeing no benefit whatsoever from Obamacare, and in fact are paying much more than they ever have before.

In its first year, Obamacare did not completely collapse from lack of support or interest. That’s true. But that’s not the same thing as saying the law is out of the political woods and on track to be broadly accepted by the American people. Far from it.

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