Can someone explain ObamaCare to me?

[Dino1]

I know I sound really stupid, but I really did research this on my own and did not understand what I read/heard. Can someone explain to me how ObamaCare would help me retire at 62 (rather than 65 when Medicare kicks in)? I do not understand this stuff about state pools, etc. Is it less expensive than my COBRA plan would be or continuation of my corporate insurance (which I cannot afford in retirment)? Medical coverage for my wife and I at age 62 to 65 is a major stumbling block to my retiring at 62. Thank you very much for sharing you expertise. I know I sound dumb.

 

[Bestwifeever]

Here is a thread that is still active. There are some links within some of the posts that may answer your question.

http://www.early-retirement.org/forums/f38/patient-protection-and-affordable-care-act-61961.html

 

[Animorph]

The main benefit to ER's is that you are guaranteed coverage at reasonable price (perhaps subsidized). Currently COBRA only lasts 18 months. State insurance pools are expensive (one post today mentioned TX sets rates at 2x normal rates). Private insurance can be a good deal, but they can reject you for pre-existing conditions. I believe the rejection rate is something like 30% for older folks, so it's kind of a crap shoot.

I have no reason to believe the coverage under the new law would cost any less than COBRA, but if you can't afford that you may qualify for the subsidy. There is a thread or two here discussing the subsidy.

 

[haha]

Obamacare will be important for some ERs for a while. But our entire health finance system is due to hit the wall, likely within 10 years. IMO, after that everything will change.

As a nation, we will be looking at trains of crises. Reasonable non-corrupt leadership will get us through, but does anyone see any of that on the horizon?

Much more likely in my opinion is all rats abandoning ship with as much loot as they can steal, and leaving the rest of us to burn.

Over and over we keep expecting people to behave differently from how they naturally behave. Although there are excellent examples of this, such as the Marshall Plan, and the founding of our country, it's always a reach to assume that we will get more than a bit of this, over a limited time only.

So get what you can while you can from O-Care.

Ha

 

[Zero_Footprint]

Here a bullet list of the major parts and the years they kick in. The significant part is at the top in yellow. Below that are comments, some helpful, some not.

"Obamacare" explained very well. via reddit.com

 

[MichaelB]

Obamacare will be important for some ERs for a while. But our entire health finance system is due to hit the wall, likely within 10 years. IMO, after that everything will change.

As a nation, we will be looking at trains of crises. Reasonable non-corrupt leadership will get us through, but does anyone see any of that on the horizon?

Much more likely in my opinion is all rats abandoning ship with as much loot as they can steal, and leaving the rest of us to burn.

Over and over we keep expecting people to behave differently from how they naturally behave. Although there are excellent examples of this, such as the Marshall Plan, and the founding of our country, it's always a reach to assume that we will get more than a bit of this, over a limited time only.

So get what you can while you can from O-Care.

Ha

Maybe I'm naive, but I think the PPACA is a positive step and it makes subsequent improves easier to design and implement. Many other countries get it right, so there's no reason we can't.

 

[haha]

Maybe I'm naive, but I think the PPACA is a positive step and it makes subsequent improves easier to design and implement. Many other countries get it right, so there's no reason we can't.

This is certainly a valid attitude. I hope you are right, but I don't see it.

And the other countries you refer to did make good sytems, and likely the Scandinavian countries and perhaps Germany can afford theirs. But most of Europe, and Japan, can actually afford very little at this point. And the US system is 2x the cost of the average of the 3 next most expensive ones.

And the US can afford very little of all the things it is doing. People on this board are (rightly) quick to condemn our citizens who borrow to spend for things they cannot afford. Shouldn't the same tests be applied to our beloved Uncle Sam?

Ha

 

[MichaelB]

This is certainly a valid attitude. I hope you are right, but I don't see it.

And the other countries you refer to did make good sytems, and likely the Scandinavian countries and perhaps Germany can afford theirs. But most of Europe, and Japan, can actually afford very little at this point. And the US system is 2x the cost of the average of the 3 next most expensive ones.

And the US can afford very little of all the things it is doing. People on this board are (rightly) quick to condemn our citizens who borrow to spend for things they cannot afford. Shouldn't the same tests be applyied to our beloved Uncle Sam?

Ha

I think our problem is not one of affordability but willingness to pay. The same holds true for Europe as a whole, but not necessarily each country. Changing our health care system, to make it more affordable, is critical. Like you, I'm not confident this will happen, but I am certain we have the capability and resources.

 

[packrat44]

This is certainly a valid attitude. I hope you are right, but I don't see it.

And the other countries you refer to did make good sytems, and likely the Scandinavian countries and perhaps Germany can afford theirs. But most of Europe, and Japan, can actually afford very little at this point. And the US system is 2x the cost of the average of the 3 next most expensive ones.

And the US can afford very little of all the things it is doing. People on this board are (rightly) quick to condemn our citizens who borrow to spend for things they cannot afford. Shouldn't the same tests be applyied to our beloved Uncle Sam?

Ha

+1.

 

[travelover]

I think our problem is not one of affordability but willingness to pay. The same holds true for Europe as a whole, but not necessarily each country. Changing our health care system, to make it more affordable, is critical. Like you, I'm not confident this will happen, but I am certain we have the capability and resources.

I'm a strong believer in equilibrium. When the costs are no longer bearable, there will be lower cost work-arounds that will evolve to fill the need.

 

[samclem]

I'm a strong believer in equilibrium. When the costs are no longer bearable, there will be lower cost work-arounds that will evolve to fill the need.

Some systems aren't stable, they don't tend toward equilibrium. If everyone were paying for their own health care (or pizza), I'd agree with your reasoning--spending slows or stops, and competition brings good answers when people have reached the limit of what they want to spend. But if, say, 51% of the people can force 49% of the people to pay for everyone's health care (or pizza), how will the feedback system work?

"Democracy is two lions and a lamb voting on what to have for dinner." Anon

 

[donheff]

I'm a strong believer in equilibrium. When the costs are no longer bearable, there will be lower cost work-arounds that will evolve to fill the need.

+1 The health care cost curve is on such a steep curve that, as others have said, it is unsustainable. I agree with MichaelB that Obamacare will ultimately prove to ease the transition IF it survives. Back to the OP's question, the biggest ER issues in the law as it stands are guaranteed coverage and lifting of annual and lifetime caps. That removes one of the greatest uncertainties facing ERs. What is left is a requirement to make sure we can fund what will continue to be expensive insurance.

 

[travelover]

Some systems aren't stable, they don't tend toward equilibrium. .........

Samclem, I think we are looking at different time lines. Long term, equilibrium is always established. Like Warren says, trees don't grow to the sky.

 

[MichaelB]

I'm a strong believer in equilibrium. When the costs are no longer bearable, there will be lower cost work-arounds that will evolve to fill the need.

That makes sense. It would be nice if we were more proactive in this and not wait until we have no choice.

The thought that health care will break the bank reminds me of my college years, just after OPEC had raised the price of petroleum in the early 70s. A prominent economist was invited to give a lecture which I attended. Over an hour he very carefully and rationally showed how, at that new price, OPEC members would accumulate all the money in the world within a decade, and the global economy would collapse.

I suspect we may be seeing the peak of healthcare costs in the US now, and from this point they may stabilize, and possibly decline a bit.

 

[M Paquette]

Samclem, I think we are looking at different time lines. Long term, equilibrium is always established. Like Warren says, trees don't grow to the sky.

Heh! I went through the exercise a while back with someone who thought medical insurance and health care costs could keep rising by double digit percentages "forever". It gets absurd pretty quickly. Absent Medicare, I wound up with an insurance premium over $300,000 a year in 30 years. Long before that, though, medical spending exceeded the GDP in the US, which was silly.

The old gag of picking some data points and then scribing a line rising to infinity doesn't match the real world.

 

[brewer12345]

The old gag of picking some data points and then scribing a line rising to infinity doesn't match the real world.

A couple years ago I was actually requested to do this by my boss in something for widespread distribution in my organization. He could not understand why this was not a valid approach to "forecasting" and got upset with me when I finally flatly refused to do it.

 

[Animorph]

A couple years ago I was actually requested to do this by my boss in something for widespread distribution in my organization. He could not understand why this was not a valid approach to "forecasting" and got upset with me when I finally flatly refused to do it.

Kind of like those house prices that were going to keep going up forever.

 

[Texas Proud]

A couple years ago I was actually requested to do this by my boss in something for widespread distribution in my organization. He could not understand why this was not a valid approach to "forecasting" and got upset with me when I finally flatly refused to do it.

We are getting off topic... but hey....

A long time ago (before internet), a bank where I worked was wanting to start a phone loan system... the bankers who put the proposal together had this high growth path...

I was asked to review it and pointed out that in 2 years they had the phone loan system making more loans than what was being made by all banks from all sources... they also forgot to amortize the loans, so the outstanding balance was increasing at an accelerated rate...


Even with these errors, they went ahead with the proposal... within 3 months the people who put it together were let go... my projections (which were not presented) were much closer to actual than theirs...

 

[samclem]

Samclem, I think we are looking at different time lines. Long term, equilibrium is always established. Like Warren says, trees don't grow to the sky.

Yes. I suppose after the vote and suppertime the "lion and sheep" system has reached equilibrium.

More to the immediate point, it's easy to see how prices reach a point of equilibrium in a "pure" market where the individual is spending their own resources. If the individual is able to spend someone else's resources, it's less clear how prices are to be constrained.
This isn't a knock on PPACA specifically, we have much the same problem with our present health care delivery "system." But we're deliberately broadening the customer base by quite a bit and changing the incentives. I'm interested in hearing exactly what is supposed to limit the amount we spend on medical care as a nation. I assume it will now become the federal budgeting process (through establishment of subsidy levels and administrative caps on what will be paid for procedures). And if, for argument's sake, 50% of the voters are paying zero FIT but receiving these services, I'm just not seeing an effective brake on the growth of this spending.

Again--not a criticism of PPACA, just an inquiry into the new homeostatic mechanism we can expect.

 

[travelover]

Yes. I suppose after the vote and suppertime the "lion and sheep" system has reached equilibrium. ..........

Yes, sometimes it takes some wild swings of the pendulum before equilibrium is achieved - look at Greece and now Spain. Sheep carcasses all over the place.

 

[FinanceDude]

This is certainly a valid attitude. I hope you are right, but I don't see it.

And the other countries you refer to did make good sytems, and likely the Scandinavian countries and perhaps Germany can afford theirs. But most of Europe, and Japan, can actually afford very little at this point. And the US system is 2x the cost of the average of the 3 next most expensive ones.
Ha

I have little doubt US doctors are the highest paid in the world. That may have something to do with high health care costs. A local GP I know moved here from Egypt, he told me he was capped at $40,000 a year, and he was a specialist in neurology. I doubt an American neurologist makes $40,000 a year..........

 

[Animorph]

I have little doubt US doctors are the highest paid in the world. That may have something to do with high health care costs. A local GP I know moved here from Egypt, he told me he was capped at $40,000 a year, and he was a specialist in neurology. I doubt an American neurologist makes $40,000 a year..........

He may also have had a much less costly education, perhaps government subsidized. U.S. docs certainly paid enough up front, time and money or loans, to get where they are. Some docs, primary care in particular, are not doing all that well compared to that investment. And there's probably a reason why the med schools are so expensive. I suppose if we squeeze the doctors pay enough, the system will eventually figure out how to train them less expensively, but we might do better with a more systemic approach.

 

[FinanceDude]

He may also have had a much less costly education, perhaps government subsidized. U.S. docs certainly paid enough up front, time and money or loans, to get where they are. Some docs, primary care in particular, are not doing all that well compared to that investment. And there's probably a reason why the med schools are so expensive. I suppose if we squeeze the doctors pay enough, the system will eventually figure out how to train them less expensively, but we might do better with a more systemic approach.

I am merely stating that the US has been a hotbed for highly skilled foreign doctors to move to. I can't blame them for doing that. It has been a huge positive for our medical system, provided the foreign doctors can pass the medical boards, which not all have been able to do.......

 

[obgyn65]

Here is the link for seniors : Seniors and the Affordable Care Act ? Fact Sheets | HealthCare.gov