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

[B-Large]

Single payer would likely stipulate coverage levels so where's the choice in that? How would it be funded? What does one do when they aren't happy with the service provide by their government?

 

If the government wants to offer Medicare to anyone that wants it at any age and have people pay for that coverage themselves and not create budget deficits in the process, I'm all for it. Let the rest of us that prefer to do it privately do that.

 

Single Payor doesn't mean Government owns the facilities that deliver care- Medicare doesn't pay for something not shown to be proven medicine, people have a choice to pay out of pocket- happen all the time, and its not just Medicare either.

[DC Tom]

Single Payor doesn't mean Government owns the facilities that deliver care-

 

No, but it does mean they ultimately control access.

[B-Man]

No, but it does mean they ultimately control access.

 

 

[B-Large]

No, but it does mean they ultimately control access.

 

There is always a Gatekeeper unless you pay self pay for every service, but you know that- the question is do you want to be dicked around by Aetna where a smaller portion of your healthcare dollar makes it to care delivery, or say your State of residence where a bigger portion of that dollar gets to care? Again, who care who holds the risk pool money in the end, someone is always deciding on your behalf what is best for you, at least from a payment perspective. You might even argue the Red States would be better at better managing Single Payor State-based risk pool that Blue States. Let States fund their own Medicaid, and collect for the general population risk pool- they can let voters decide whow big dedictibles are, and how much they are going to spend annualy on their health system. Really, it put the voters in charge- if they feel the State is spending too much, vote in a budget hacker- of they want to spend more on care, bump up the budget.

[keepthefaith]

There is always a Gatekeeper unless you pay self pay for every service, but you know that- the question is do you want to be dicked around by Aetna where a smaller portion of your healthcare dollar makes it to care delivery, or say your State of residence where a bigger portion of that dollar gets to care? Again, who care who holds the risk pool money in the end, someone is always deciding on your behalf what is best for you, at least from a payment perspective. You might even argue the Red States would be better at better managing Single Payor State-based risk pool that Blue States. Let States fund their own Medicaid, and collect for the general population risk pool- they can let voters decide whow big dedictibles are, and how much they are going to spend annualy on their health system. Really, it put the voters in charge- if they feel the State is spending too much, vote in a budget hacker- of they want to spend more on care, bump up the budget.

 

Agree States should fund (at least the majority) of Medicaid costs and administer their own benefits. Frankly since we have such a political divide in this country we should push more benefits and laws out to the states and let their residents and voters determine such things. As for the risk money holder, I much prefer to have a private insurance company that has to compete for my business and satisfaction as the provider over the government. If I'm unhappy with the service I get from my insurance company, I (or their collective customers) can scream bloody murder and/or take my business elsewhere to get results. If you're unhappy with the government as the gatekeeper, leverage is nil and unfortunately my life experiences with government overwhelmingly support this view.

[B-Large]

Agree States should fund (at least the majority) of Medicaid costs and administer their own benefits. Frankly since we have such a political divide in this country we should push more benefits and laws out to the states and let their residents and voters determine such things. As for the risk money holder, I much prefer to have a private insurance company that has to compete for my business and satisfaction as the provider over the government. If I'm unhappy with the service I get from my insurance company, I (or their collective customers) can scream bloody murder and/or take my business elsewhere to get results. If you're unhappy with the government as the gatekeeper, leverage is nil and unfortunately my life experiences with government overwhelmingly support this view.

 

Providers compete for your business, managed care compaines limit that compeitition- they often chose who you see, not you. Ironically, when you have a consider dispute with an insurance company, you call your State Insurance Commission for a grievence.

[DC Tom]

There is always a Gatekeeper unless you pay self pay for every service, but you know that- the question is do you want to be dicked around by Aetna where a smaller portion of your healthcare dollar makes it to care delivery, or say your State of residence where a bigger portion of that dollar gets to care? Again, who care who holds the risk pool money in the end, someone is always deciding on your behalf what is best for you, at least from a payment perspective. You might even argue the Red States would be better at better managing Single Payor State-based risk pool that Blue States. Let States fund their own Medicaid, and collect for the general population risk pool- they can let voters decide whow big dedictibles are, and how much they are going to spend annualy on their health system. Really, it put the voters in charge- if they feel the State is spending too much, vote in a budget hacker- of they want to spend more on care, bump up the budget.

 

I'd rather be dicked around by Aetna. I can deal with insurers.

 

I work for the federal government, though. I know how !@#$ed up they are.

[jjamie12]

There is always a Gatekeeper unless you pay self pay for every service, but you know that- the question is do you want to be dicked around by Aetna where a smaller portion of your healthcare dollar makes it to care delivery, or say your State of residence where a bigger portion of that dollar gets to care? Again, who care who holds the risk pool money in the end, someone is always deciding on your behalf what is best for you, at least from a payment perspective. You might even argue the Red States would be better at better managing Single Payor State-based risk pool that Blue States. Let States fund their own Medicaid, and collect for the general population risk pool- they can let voters decide whow big dedictibles are, and how much they are going to spend annualy on their health system. Really, it put the voters in charge- if they feel the State is spending too much, vote in a budget hacker- of they want to spend more on care, bump up the budget.

You can't fire the government. You can fire Aetna.

[Chef Jim]

I work for the federal government, though. I know how !@#$ed up they are.

 

No ****, they hired you.

[keepthefaith]

You can't fire the government. You can fire Aetna.

 

Exactly and government culture isn't exactly conducive to "customer satisfaction". All industries have a culture and the government services culture (at least what we see from the public point of view) is not one known for common sense, responsiveness and quality of service.

[Chef Jim]

You can't fire the government. You can fire Aetna.

 

How do I fire Aetna if it's the carrier that my employer offers? I can't. That's why one of the reforms I wanted to see was disconnecting health insurance from your employer.

[Doc]

Exactly and government culture isn't exactly conducive to "customer satisfaction". All industries have a culture and the government services culture (at least what we see from the public point of view) is not one known for common sense, responsiveness and quality of service.

Or cost efficiency.

[B-Man]

JAMES TARANTO: ObamaCare’s Missing 3.2 Million: A mixed verdict from the Rand Corp.

 

The Rand study suggests that ObamaCare’s greatest incentive effect–a function of both the mandate tax and the unattractiveness of individual plans–is to nudge employees to opt in to workplace plans. As for the incentives on employers, they go in both directions. But the law’s main disincentive for ESI–the so-called Cadillac tax on expensive plans–doesn’t take effect until 2018.

 

As for the individual marketplace, its viability is questionable even if the administration’s overall enrollment figures turn out not to be wildly inflated. Because of price controls–a k a the ban on considering “pre-existing conditions” and limits on accounting for age in setting premiums–the exchanges depend on enrolling a substantial proportion of young, healthy people paying inflated premiums.

 

Preliminary data showed early enrollments skewing much older than the administration had hoped

. And while no data are collected on enrollees’ health status, a new study shows, as the New York Times reports, that “people who signed up early for insurance through the new marketplaces were more likely to be prescribed drugs to treat pain, depression and H.I.V.”

 

 

Not a good demographic to insure.

 

 

 

 

 

 

 

 

OUCH: Two New Studies Raise Red Flags On ObamaCare.

 

“Before we get to these studies, though, we should recognize why we need outside organizations to validate White House claims in the first place. The Department of Health and Human Services still has no way to quantify important data about those consumers signing up for health insurance through state and federal exchanges. More than six months after the initial rollout of Obamacare — and four years after the ACA’s passage — the systems designed by HHS still cannot determine basic and critical information about enrollments such as whether a premium payment has been made. Without a premium payment, a sign-up in the web portal does not mean coverage has been extended.”

 

 

.

[jjamie12]

How do I fire Aetna if it's the carrier that my employer offers? I can't. That's why one of the reforms I wanted to see was disconnecting health insurance from your employer.

Your employer forces you to take health benefits from them?

 

You may not like the alternative you can find elsewhere, but you CAN get rid of AETNA. Additionally, if AETNA is not providing your employer with the types of benefits that they expect then your employer can fire AETNA. They or you cannot get rid of the government.

 

I definitely agree with you about severing the link between jobs and health insurance.

Edited April 10, 2014 by jjamie12

[B-Large]

Your employer forces you to take health benefits from them?

 

You may not like the alternative you can find elsewhere, but you CAN get rid of AETNA. Additionally, if AETNA is not providing your employer with the types of benefits that they expect then your employer can fire AETNA. They or you cannot get rid of the government.

 

I definitely agree with you about severing the link between jobs and health insurance.

 

prior to HCR, if he didn't take Aetna, what choice did he have? Maybe he could buy individual coverage through BC/BS, but if he had a prexisiting, forget about it.

 

I don't get where some stand on decoupling insurance from employment. When Nancy P suggested people no longer had to stay at a job because they could buy individual coverage, Conservatives freaked out that these people would now just live on the dole. But now its agreed that not being stuck at a job for just health insurance is a good thing? Am I missing something?

[OCinBuffalo]

There is always a Gatekeeper unless you pay self pay for every service, but you know that- the question is do you want to be dicked around by Aetna where a smaller portion of your healthcare dollar makes it to care delivery, or say your State of residence where a bigger portion of that dollar gets to care?

What in the sam hell makes you think that would be true? I have already delivered to this thread multiple examples of how this is utter BS in every way. I know Medicare cold. It's a lie. They cook the books, and then make the bolded claims about administrative costs. It's utter crap that comes from The West Wing.

 

Either you are obtuse...or...what I suspect is more likely, you want Single Payer because that way, you don't ever have to worry about competition, or REAL cost cutting, or being held accountable for bad management decisions ever again.

 

Yes, if everything was Medicare, all you have to do is go to your hospital association, who goes to their lobbyists(and with the magic word "consolidation", now you have the biggest lobbyist firms in DC working for you) and demand 10% " payment adjustments" from Congress. Otherwise known as arbitrarily jacking up your rates every year.

 

All you want to do is run the game you say the insurance companies run. Pathetic.

 

This solves all sorts of problems for you, doesn't it? Now, you've got your nurses' demands for raises covered. Now? You don't have to compete for doctors, since they have no place else to go, because they are going to get the same thing down the street, and now, you don't actually have to manage anything.

 

You don't have to manage, because, whether you make good management calls or bad ones, you always have Mommy Hospital Welfare to come give you your 10+% increase every year, and that means: there are never consequences for your bad decisions.

 

Why don't you just come right out and admit this is about self-interest for you, and drop the pretense that you are being objective/a real problem solver?

 

Do you really think you are fooling anyone here with this? How long have you been here? It's not like the BB.com politics board got shut down yesterday.

Again, who care who holds the risk pool money in the end, someone is always deciding on your behalf what is best for you, at least from a payment perspective. You might even argue the Red States would be better at better managing Single Payor State-based risk pool that Blue States. Let States fund their own Medicaid, and collect for the general population risk pool- they can let voters decide whow big dedictibles are, and how much they are going to spend annualy on their health system. Really, it put the voters in charge- if they feel the State is spending too much, vote in a budget hacker- of they want to spend more on care, bump up the budget.

Yeah right, and said budget hacker isn't going to want to face you, and the rest of the budget panderer candidate's cronies, in elections, when they run "budget hacker wants to throw cancer patients into the street" commericals 10x a day. Using the milions of $ that you give panderer's campaign, which you can easily afford, because the rest of the panderers you give some of your yearly windfall to, always vote to give you that windfall...every year.

 

 

Again I ask: do you really think you are fooling anyone with this BS?

 

Perhaps you are simply an umitigated moron, and don't realize that your argument simply boils down to setting up the biggest crony/cyclical scam in history?

[keepthefaith]

Or cost efficiency.

 

Can't believe I left that out.

[jjamie12]

prior to HCR, if he didn't take Aetna, what choice did he have? Maybe he could buy individual coverage through BC/BS, but if he had a prexisiting, forget about it.

 

I don't get where some stand on decoupling insurance from employment. When Nancy P suggested people no longer had to stay at a job because they could buy individual coverage, Conservatives freaked out that these people would now just live on the dole. But now its agreed that not being stuck at a job for just health insurance is a good thing? Am I missing something?

 

Yes. The biggest thing you're missing (theoretically), is that employers are getting a tax break by offering benefits. If the IRS would, instead, offer the tax break to people instead of employers, then employers would just pay people more (by the value of the benefits) and we would be free to shop for our own health insurance with the extra money that the employers pay us. In theory. I'm sure someone knows more than I do about it, but that is the general thought behind it.

[keepthefaith]

I don't get where some stand on decoupling insurance from employment. When Nancy P suggested people no longer had to stay at a job because they could buy individual coverage, Conservatives freaked out that these people would now just live on the dole. But now its agreed that not being stuck at a job for just health insurance is a good thing? Am I missing something?

 

One of the problems with health care is that it has been free or near free for most. Most are covered by Medicaid or Medicare or private insurance paid by their employer. Due to this we've become lousy users of health insurance and health care and a bunch of whiners that don't want to pay for anything. The population will make better decisions if they have skin in the game with each person making their own choice of coverage and usage and paying their own premiums. Can't tell you how many neighbors of mine and people that work here that run off the to doctor or ER every time they or their kids get a runny nose and sometimes that results in ridiculous tests and prescriptions being ordered for them. Drives up everyone's insurance cost, but these people don't care because they don't have to pay. If they paid the premiums or paid for their doc visits, they'd become better consumers. That and I find it ridiculous as en employer that we select the plan(s) that our employees choose from. I can assure that we don't make the best choices for everyone in that process.

Edited April 10, 2014 by keepthefaith

[IDBillzFan]

JAMES TARANTO: ObamaCare’s Missing 3.2 Million: A mixed verdict from the Rand Corp.

 

You know what's really funny and telling? Right after Obama came out and announced they hit 7.1M, there were a number of Obama knob-gobblers in the media who were running articles (Eugene Robinson, The Hill, etc) how the GOP really miscalculated the success of ACA and how the discussion is over and everyone needs to get behind the law because America is really on board with it.

 

And as it was happening, you knew...you just KNEW the WH was making stuff up, and that the usual knob-gobblers were right in his tailwind to trumpet his victory...and that any moment reports would come out explaining how the person who blatantly lied to pass the law was also lying about the enrollment numbers, too.

 

And then out comes the Rand report, Obama is still a liar and America still hates Obamacare and the only thing left are progressives trying to explain how trillions wasted was somehow okay because, y'know, SHUT UP BUSHCHENEYRUMMYCRUZTEABAGGERBACHMAN!!!

Edited April 10, 2014 by LABillzFan