Obamacare, Healthcare, etc.

[Drex]

My work benefits have gone up in price since the year before. I haven't received word about increased coverage or lower price yet...so what do?

Bear in mind that the industry average before the MLR rule came into effect was already around 75% or so. You may just be covered by one of the groups that was already over the 80% ratio and didn't need to change. It shouldn't make too profound an impact one way or the other on anyone covered by their employer: the ones that were way under the 80% line before were typically individual insurers.

[Yugl]

Hmm, this seems disingenuous, that or re-defining expectations. I could have sworn liberals constantly said "Obamacare will bend the cost curve down" or something to that effect, including posters on this board.

Curving costs or reducing the cost is not equivalent to preventing costs from rising. Example:

Would-happen scenario 1: X^3
Would-happen scenario 2: X^2

In both scenarios, the cost inevitably increases, but the amount increases much less with scenario 2.

If you understood that already and are suggesting that people have said Obamacare will produce a race to the floor where the costs gradually reach nothing, I am unaware of such claims.

Edit: Fixed terrible equations.

[Drex]

Curving costs or reducing the cost is not equivalent to preventing costs from rising. Example:

Would-happen scenario 1: X^3
Would-happen scenario 2: X^2

In both scenarios, the cost inevitably increases, but the amount increases much less with scenario 2.

If you understood that already and are suggesting that people have said Obamacare will produce a race to the floor where the costs gradually reach nothing, I am unaware of such claims.

Edit: Fixed terrible equations.

Obamacare was always about insuring the uninsured, never about costs. There's some half-hearted cost controls in place, but I don't think anyone who looks at Massachusetts believes they'll work. That said, there were plenty of people on both sides theorizing how it would lower (or at least slow the rise of) costs because of the increased pool of insured, despite evidence in our one data point that Romneycare accelerated healthcare costs. And since it passed, the CBO is revising their estimates upward significantly on the costs. Widening the base of the pyramid won't make people healthier, smarter, or make the baby boomers younger, which are really the biggest cost pressures we have.

[ringthree]

Obamacare was always about insuring the uninsured, never about costs. There's some half-hearted cost controls in place, but I don't think anyone who looks at Massachusetts believes they'll work. That said, there were plenty of people on both sides theorizing how it would lower (or at least slow the rise of) costs because of the increased pool of insured, despite evidence in our one data point that Romneycare accelerated healthcare costs. And since it passed, the CBO is revising their estimates upward significantly on the costs. Widening the base of the pyramid won't make people healthier, smarter, or make the baby boomers younger, which are really the biggest cost pressures we have.

Do you have a link to the CBO with a revised higher cost estimate? I haven't seen anything from the CBO to indicate anything but cost savings over the next 10 years.

[Drex]

Do you have a link to the CBO with a revised higher cost estimate? I haven't seen anything from the CBO to indicate anything but cost savings over the next 10 years.

No, you're 100% right, their estimate of overall deficit impact is more savings since the 2011 report. It's the expenses that are up, but they are expected to be offset by new taxes passed since 2011, and misc. changes in future economic expectations. My fault for using ambiguous wording.

[archibaldcrane]

Part of Obamacare is a medicaid expansion to cover more poor people with completely subsidized health care, and the bill said that if states didn't expand their programs to cover more people, then the feds would cut all of their medicaid funding. However, the supreme court struck that tiny part down, saying that the feds could only withhold the portion of funding needed for the expansion if states didn't expand.

So, of course, because Republicans want to get rid of Obama no matter what, they are refusing to take billions in federal dollars to expand medicaid, which weakens Obamacare because it creates a loophole in which there's a portion of the upper poor that don't qualify for medicaid OR subsidized insurance.

http://thinkprogress.org/health/2012...red/?mobile=nc

My home state alone (WI) is looking at refusing 4.3 billion in federal medicaid funding, leaving over 200,000 Wisconsin residents without healthcare.

[Dotsudoku]

Is that essentially the same as what Rick Scott planned to do for FL? I wasn't particularly familiar with what it meant to turn down new (optional?) health care legislation.

As far as I can tell, there's virtually no repercussions for these states/governors other than the people who would have otherwise been able to receive newly expanded Medicare not being able to do so after all? The governor can basically say "no thanks", and continue as it was?

I hope I'm misunderstanding.. That's disgusting.

[Tyche]

Well, there's political implications when every other state has 98%+ of their citizens with health care and your state has 85%.

[Dotsudoku]

Based on that chart, it doesn't seem as though too many states are troubled by that.

[Plow]

Well, there's political implications when every other state has 98%+ of their citizens with health care and your state has 85%.

http://www.youtube.com/watch?v=t2Fv097g6m0#t=03m22s

[Yugl]

MD wins again.

[RKenshin]

One question that has always plagued the back of my mind that I've never seen mentioned or found answers to:

What about the money saved by having less unpaid emergency bills? And where exactly in the budget does this money come from anyway (which category? Medicare spending?)? And how big is it?

These discussions always bring up the fact that 'tax-payers pay for the uninsured anyway!', but I never hear anything past that. I'm certainly not debating whether it's true, but I am totally confused as to why this always comes up in these discussions but then never comes up in numerical analysis of the potential positives of Obamacare? At least, none that I've seen.

But I would think that eliminating much of the unpaid major emergency room visits/operations/etc through a much larger insurance pool (as opposed to being unpaid in debt/defaults and/or falling on tax-payer dime) would have some sort of a positive, measurable effect? Not only in hospital bottom lines but also tax spending.

Perhaps very minimal, but I'd imagine it's still something positive?

[aurik]

One question that has always plagued the back of my mind that I've never seen mentioned or found answers to:

What about the money saved by having less unpaid emergency bills? And where exactly in the budget does this money come from anyway (which category? Medicare spending?)? And how big is it?

These discussions always bring up the fact that 'tax-payers pay for the uninsured anyway!', but I never hear anything past that. I'm certainly not debating whether it's true, but I am totally confused as to why this always comes up in these discussions but then never comes up in numerical analysis of the potential positives of Obamacare? At least, none that I've seen.

But I would think that eliminating much of the unpaid major emergency room visits/operations/etc through a much larger insurance pool (as opposed to being unpaid in debt/defaults and/or falling on tax-payer dime) would have some sort of a positive, measurable effect? Not only in hospital bottom lines but also tax spending.

Perhaps very minimal, but I'd imagine it's still something positive?

Right now unpaid bills get eaten by the hospital, which means they get passed on to people that need care who are able to pay. I don't think the government pays, or at least not 100%. So that's why healthcare is so damn expensive: it's not that your procedure is actually that costly, but you also partially cover the cost of treating the people who can't afford it. So in essence, the tax-payers aren't paying for the uninsured, or at least not directly. The people who require medical care that are insured and/or wealthy are paying for the uninsured. Which means if you aren't getting sick, you are avoiding it, but otherwise enjoy your $10,000/night hospital beds. When everyone has coverage, then there are no more unpaid bills. The insurance companies can spread the cost of necessary care over the entire population. The cost of a procedure can then go back to the cost to actually perform the procedure. That would be a nice thing to have.

The main benefit of having everyone covered is that people can seek treatment before their condition becomes so grave that they require necessary care. Prophylaxis / preventive medecine is far more cost effective, and far more effective period, meaning a healthier workforce for less money.

[RKenshin]

That's another thing that throws me off, because I keep hearing both arguments. (whether the hospital eats the bill, or tax-payers eat the bill, or it can be both/depends?)

I'm inclined to think that you're correct in that only the hospital foots the bill, but every time I try to find out I still see more people claiming that tax-payers do too. But on the other hand, I have not found anything, anywhere in our budget that indicates it's used for 'assisting with unpaid hospital bills.' Perhaps it's not as direct as that (or well, likely), and more indirect somehow? I guess a hospital writing off their losses as a tax deduction may be what is being referred to?

Found some stuff related to that:
http://www.modernhealthcare.com/arti...gs01/301069983

Err, or not:
http://www.govtrack.us/congress/bills/112/hr5849

Seems that its been proposed in a bill, but not passed. So you can't deduct 'charity care' (care administered to those that can't pay), at least not as a physician (though, don't see anything for hospitals either).

/shrug

[Acturus]

Tax-payers "foot the bill" of uncompensated care because part of the Not-for-profit hospital's requirement in exchange for NFP status is to write off a measure of care as charity or bad debt.

Since a majority of hospitals are NFP in the US, it does bend back on the taxpayer, to an extent. However, part of the argument against NFP hospitals is that they spend too little on charity care.


Also, the cost-control measures that are missing from Obamacare were in several of the original drafts, but were scrapped in favor of getting the law passed. Significant cost control measures were unpopular in the bill debates.

[SwampdonkeyPLD]

"I will cut the cost by up to $2,500 a year." That's what I was thinking of.

[aurik]

The "taxpayers foot the bill anyway" argument stems from the fact that the buck must stop somewhere. Somebody is paying for the care that is provided. The likely victims are the government (ie taxpayers), through tax credits and write-offs and privileged tax status, or the hospital, which must pass the cost on to someone--typically, to folks that have insurance, which eventually trickles down to everyone who has a health insurance plan, which essentially becomes a type of payroll tax (and we all know how much conservatives love their payroll taxes)

Ultimately, the goal should be to improve the efficiency of the system: provide better treatment at the same cost, or the same treatment at a better cost. Preventive medicine accomplishes both of those goals. So how do we get more preventive healthcare? Well, improving access to it is a good start, and one way to do that is to make sure every person has health care insurance so they can feel free to visit the doctor and get a professional opinion without paying $tremendous.

The nice side effect of preventive medicine is that it raises the overall healthiness of your populace, which leads to greater productivity in the workforce, raising GDP, standard of living, happiness, etc, etc, etc...so many positive benefits.

[kuronosan]

So our CEO released a statement basically condemning the ACA and supreme court, chiming that justice Roberts forced the others to accept a law that is unconstitutional by rewriting laws so that it's okay. Anyone else getting things like this?

[Salodin]

You work for who?

[kuronosan]

Yea, no.