Obamacare

[youbet]

The lack of cost reduction is a red herring, because that never has been part of the this initiative.

Although cost control and reduction was an important talking point in selling the initiative.

 

[MichaelB]

Although cost control and reduction was an important talking point in selling the initiative.

While implementation of the PPACA may lead to cost control, I don't recall it being part of the discussion. Cost reduction was never part of the proposed or approved legislation, or part of the process, AFAIK.

 

[youbet]

While implementation of the PPACA may lead to cost control, I don't recall it being part of the discussion. Cost reduction was never part of the proposed or approved legislation, or part of the process, AFAIK.

It was part of the discussion, an important selling point. If nothing else, the fact that our health care cost per person was high while our outcome effectivity was not, was repeated again and again calling for change and the establishment of a "reformed" system.

I'm not against Obamacare. I just think it's been over promised, especially on cost control.

 

[MichaelB]

It was part of the discussion, an important selling point. If nothing else, the fact that our health care cost per person was high while our outcome effectivity was not, was repeated again and again calling for change and the establishment of a "reformed" system.

I'm not against Obamacare. I just think it's been over promised, especially on cost control.

Do you have a source? I am familiar with election campaign rhetoric about health care costs but not the legislation. My recollection is very much a discussion about breadth and reach of coverage, insurance options, and the mandate.

 

[youbet]

Exactly.

Health care cost reduction was an important part of campaign rhetoric. Then legislation was proposed and passed which will likely not be effective in bringing about cost reductions.

 

[Mulligan]

Exactly.

Health care reduction was an important part of campaign rhetoric. Then legislation was proposed which will likely not be effective in bringing about cost reductions.

That is exactly the interpretation I have perceived during the process.

 

[MichaelB]

Let's acknowledge that agreement (it's not often) and get the conversation back to the PPACA. Implementation issues, coverage, roll out, etc.

ETA: If it wasn't clear, let's keep election rhetoric out of the thread.

 

[youbet]

Let's acknowledge that agreement (it's not often) and get the conversation back to the PPACA. Implementation issues, coverage, roll out, etc.

ETA: If it wasn't clear, let's keep election rhetoric out of the thread.

OK, I'm glad you agree. And I have no problem not discussing election rhetoric. I only mentioned it since you pushed for a source.

But, the cost vs effectiveness of health care in the USA and the need for reform and improvement has been discussed extensively here on the ER forum. Are you suggesting that will no longer be allowed? Or, are you just saying not on this thread which should be focused only on the existing Obamacare program staus quo?

 

[MichaelB]

OK, I'm glad you agree. And I have no problem not discussing election rhetoric. I only mentioned it since you pushed for a source.

But, the cost vs effectiveness of health care in the USA and the need for reform and improvement has been discussed extensively here on the ER forum. Are you suggesting that will no longer be allowed? Or, are you just saying not on this thread which should be focused only on the existing Obamacare program staus quo?

If you want to talk healthcare reform please do so, in a separate thread. All I'm trying to do is keep this thread on topic.

 

[travelover]

Exactly.

Health care cost reduction was an important part of campaign rhetoric. Then legislation was proposed and passed which will likely not be effective in bringing about cost reductions.

Wasn't the single payer option, which was dropped prior to passage of the ACA, supposed to force rates for services down, as it does for Medicare?

 

[youbet]

Shhhhhhh......... PM me to discuss this. (See above.) Or let's reopen one of the earlier threads where health care cost in the USA vs rest of world were being discussed.

 

[travelover]

Shhhhhhh......... PM me to discuss this. (See above.) Or let's reopen one of the earlier threads where health care cost in the USA vs rest of world were being discussed.

We can meet in the bathroom and pass notes under the stall partition.

 

[bUU]

I had a big long message with citations of the actual 2008 presidential campaign messages regarding ACA typed in, starting with the 2008 Democratic Party platform statement, and then I got to this...

Let's acknowledge that agreement (it's not often) and get the conversation back to the PPACA. Implementation issues, coverage, roll out, etc. ETA: If it wasn't clear, let's keep election rhetoric out of the thread.

I suppose folks interested can do the research themselves. Focusing on what ACA actually is, we cannot lose sight of the fact that healthcare is now going to be more affordable for those who were struggling to be able to afford healthcare previously. That's a very important objective that has been achieved, and Americans should feel quite proud of at least that (admittedly partial) accomplishment.

I do believe that ACA could have a positive impact toward reducing the cost of healthcare overall, in that it is revealing the costs of healthcare previously hidden from view: The costs of inadequate health care and lack of access to healthcare on the part of those who were struggling to be able to afford healthcare previously. Unfortunately, our society is very much money-fixated, these days, and converting these human costs into dollars that can be counted might help put pressure on the government to take positive action toward reducing excess cost within each provision of service and within each bottle of medication.

 

[Mulligan]

I had a big long message with citations of the actual 2008 presidential campaign messages regarding ACA typed in, starting with the 2008 Democratic Party platform statement, and then I got to this...

I suppose folks interested can do the research themselves. Focusing on what ACA actually is, we cannot lose sight of the fact that healthcare is now going to be more affordable for those who were struggling to be able to afford healthcare previously. That's a very important objective that has been achieved, and Americans should feel quite proud of at least that (admittedly partial) accomplishment.

I do believe that ACA could have a positive impact toward reducing the cost of healthcare overall, in that it is revealing the costs of healthcare previously hidden from view: The costs of inadequate health care and lack of access to healthcare on the part of those who were struggling to be able to afford healthcare previously. Unfortunately, our society is very much money-fixated, these days, and converting these human costs into dollars that can be counted might help put pressure on the government to take positive action toward reducing excess cost within each provision of service and within each bottle of medication.

I certainly hope your last paragraph comes to fruition, and your first paragraph I do not dispute either...it's just for every push side, their is the pull side, and I am fixing to be on it. If the Kaiser quotes are anywhere near accurate, I could face over a 500% increase in my monthly individual premium. Then the "struggling to pay" shoe is then slipped on my foot. I am not trying to get too worked up yet, and see some hard numbers first. But as they say...the waiting is the hardest part..

I have a friend just this week, emailed me this week. He has had both his kids on his group plan. One just got employed and will be receiving
employer sponsored health benefits. So he was going to put his other one on an individual policy and save money. He asked me if he should go with the $35 ( $3500 deduct) or $55 plan ($2500 deduct). I laughed at him and said neither. It will only be good for the rest of the year and then he would be dumped into the exchange and pay a significantly higher premium. I said you will probably be better off keeping him on your group plan even though you aren't getting the 2 for 1 discount anymore. He was shocked! He knew about Obamacare, but never really understood what it was until he got a first hand lesson. This does not mean I am necessarily against this, and I hope it accomplishes what you do, but there does stand to be people who may lose more than you think. And yes, that could be me, so maybe that is why I am concerned, as 500%-600% increase would probably concern many people.

 

[pb4uski]

..... If the Kaiser quotes are anywhere near accurate, I could face over a 500% increase in my monthly individual premium. .......This does not mean I am necessarily against this, and I hope it accomplishes what you do, but there does stand to be people who may lose more than you think. And yes, that could be me, so maybe that is why I am concerned, as 500%-600% increase would probably concern many people.

IIRC Mulligan you have a screaming deal on health insurance currently which is why you may be facing a large increase. I don't think a 500% increase would be typical at all based on what I have seen thus far.

Vermont was the first state that insurers have submitted proposed 2014 rates under Obamacare. The 2014 proposed rates for similar coverage to what I currently have are ~20% more than what I am currently paying and are actually less than what my COBRA from megacorp would have been.

I think there are a lot of chicken littles running around that Obamacare is going to mean the end of the world as we know it. I think there will definitely be some challenges but I don't think the reality will be as bad as the hype in most cases (and I'm not a fan of Obamacare to begin with).

 

[travelover]

IIRC ............
I think there are a lot of chicken littles running around that Obamacare is going to mean the end of the world as we know it. I think there will definitely be some challenges but I don't think the reality will be as bad as the hype in most cases (and I'm not a fan of Obamacare to begin with).

+1. Any change is opposed by those benefiting from the status quo.

 

[samclem]

+1. Any change is opposed by those benefiting from the status quo.

When I read Mulligan's post and others like it I come to believe a lot of people didn't realize how much they were benefiting from the status quo. And, as you say, as that realization becomes more clear they will oppose the change.

Maybe they thought that if they had insurance they liked they would be able to keep it.

 

[ziggy29]

When I read Mulligan's post and others like it I come to believe a lot of people didn't realize how much they were benefiting from the status quo. And, as you say, as that realization becomes more clear they will oppose the change.

Then again, things change. I thought I was going to be one who would be better off with the status quo for a while.

Then I got laid off. Instead of having a $140K household income in 2014, it's likely to be in the $30-35K range unless I get bored and start w*rking again. Needless to say, the prospect of paying the full unsubsidized price of health insurance suddenly became a nightmare scenario. Frankly, regardless of my opinions, pros and cons, about PPACA and how it's implemented, but the bottom line is now that I've been laid off it's about to save our butts in a big way.

My wife's group insurance through her church body normally requires participation in the health insurance plan (at $960 per month, paid by the church but would result in reduced salary if we needed it) if you don't have other qualifying group coverage. But for 2014 they have already announced we could use the exchange instead of their plan. At our income level, the exchanges will probably result in a cost of 1/4, maybe 1/3, of what the church group plan would cost in '14.

 

[travelover]

When I read Mulligan's post and others like it I come to believe a lot of people didn't realize how much they were benefiting from the status quo. And, as you say, as that realization becomes more clear they will oppose the change.

Maybe they thought that if they had insurance they liked they would be able to keep it.

It is bigger than that. Right now some people are making a ton of money in the medical / pharmaceutical industry. They have lobbyists that are paid to fan the Chicken Little fires to prevent any real cost cutting reform going forward. IMHO.

 

[samclem]

It is bigger than that. Right now some people are making a ton of money in the medical / pharmaceutical industry. They have lobbyists that are paid to fan the Chicken Little fires to prevent any real cost cutting reform going forward. IMHO.

Remember when those lobbyists were on the other side of the debate, fanning the flames pretty hard for the "change." It's a good business to be in, apparently--as long at there are rents, there will be rent-seekers.

 

[travelover]

.......as long at there are rents, there will be rent-seekers.

Amen to that.

 

[Mulligan]

When I read Mulligan's post and others like it I come to believe a lot of people didn't realize how much they were benefiting from the status quo. And, as you say, as that realization becomes more clear they will oppose the change.

Maybe they thought that if they had insurance they liked they would be able to keep it.

That was what I was lead to believe since the President said it himself... Like I said, I am not trying to say I am against it or anything. And I need to control myself (not that it would change anything).....But when I punch in the estimator and it shows I would go from under $100 to near $600, that is a startling increase. Especially since I thought I could keep my policy, and then I read must grandfathered plans will not survive the guidelines, and BCBS is silent on the matter. Either unwilling or unable yet to provide clarification on their intentions with their grandfathered plans. I certainly find it hard to believe no one else would be concerned about facing that much on an increase. I guess I am an outlier on insurance costs, but it is all I have been used to.

 

[gbstack]

Then again, things change. I thought I was going to be one who would be better off with the status quo for a while.

Then I got laid off. Instead of having a $140K household income in 2014, it's likely to be in the $30-35K range unless I get bored and start w*rking again. Needless to say, the prospect of paying the full unsubsidized price of health insurance suddenly became a nightmare scenario. Frankly, regardless of my opinions, pros and cons, about PPACA and how it's implemented, but the bottom line is now that I've been laid off it's about to save our butts in a big way.

My wife's group insurance through her church body normally requires participation in the health insurance plan (at $960 per month, paid by the church but would result in reduced salary if we needed it) if you don't have other qualifying group coverage. But for 2014 they have already announced we could use the exchange instead of their plan. At our income level, the exchanges will probably result in a cost of 1/4, maybe 1/3, of what the church group plan would cost in '14.

Has it been determined we will be able to enter our projected 2014 income or will they use the 2012 tax return?

 

[travelover]

.......... I certainly find it hard to believe no one else would be concerned about facing that much on an increase. I guess I am an outlier on insurance costs, but it is all I have been used to.

I think that you have a valid concern and I would certainly feel the same way. I may end up be affected similarly, I don't know yet.

That said, we can push forward and make real health care reform work or sit on the sidelines and gloat at every misstep and falter. America always muddles through and we will again.

 

[Texas Proud]

One of the things that a lot of people forget about this plan is that for a good number of people it will be a big burden...

I read an article yesterday (someone else might be able to find it), but IIRC, they said that about 1/3 of the people who have insurance now do not go to the doctor or do not take their medication as prescribed because of the costs....

IOW, if you still do not have money to pay for your copays and drugs, having insurance does not help that much for most normal things....



I still wonder how much this will really help the people who were previously uninsured..... as opposed to just a wealth transfer of $1 trillion over 10 years....