Althouse: "The Slow-Motion Implosion of ObamaCare."

२ नोव्हेंबर, २०१५

"The Slow-Motion Implosion of ObamaCare."

"I see firsthand in my company why not enough people are signing up and premiums are rising."

१५५ टिप्पण्या:

djf म्हणाले...: I think this guy can look forward to a tax audit, and maybe a Labor Department investigation, as well. And, for good measure, the sudden discovery by the EPA that there is a "wetland" on his property.; २/११/१५, १०:१७ AM
Dan Hossley म्हणाले...: Obamacare is the perfect model of progressive solutions to imaginary problems. They define the problem wrong, their assumptions about peoples behavior are wrong, the solution doesn't work and they carelessly destroy opportunity along the way.

On the other hand, power gets concentrated so that it is easier to milk campaign contributions from the survivors.; २/११/१५, १०:१९ AM
Original Mike म्हणाले...: Inevitable.; २/११/१५, १०:२० AM
rehajm म्हणाले...: It will implode sometime after 2017 when the government loss ratio support is set to expire.; २/११/१५, १०:२२ AM
Deirdre Mundy म्हणाले...: Obamacare is also unsuitable for families. We were told we'd have to pay 1500/month for a 12,500 family deductible. So that's over 30K of payments BEFORE INSURANCE KICKS IN. Basically, we'd need cancer or a preemie to hit that level--they're charging "premium insurance" rates for what's essential catastrophic insurance.

We ended up in a "Medical Sharing Ministry" with a 10K deductible. Still a high-deductible plan, but at about $150/month for out family, it's PRICED like a catastrophic plan.; २/११/१५, १०:२४ AM
Michael K म्हणाले...: Obamacare is just expanded Medicaid and everyone know s how great Medicaid is.

It will collapse of its own weight and I have predicted this all along.

It's a shame that reasonable reform was hijacked by the corrupt governing class.; २/११/१५, १०:२६ AM
Clayton Hennesey म्हणाले...: Obamacare was insurance designed to ensure Obama got elected to two terms. Health care markets operate a little differently.; २/११/१५, १०:२९ AM
rhhardin म्हणाले...: It's imploding in more ways than he spots. It also raises the actual costs by misallocating resources.

It does nothing right.; २/११/१५, १०:२९ AM
rehajm म्हणाले...: What's most disturbing is the growing ranks of people who the administration is taking credit for having public and private insurance but are essentially uninsured economically. A $5,000 deductible with a 30% co-pay is only insurance if you can cover them with personal savings. Most insureds at low and middle income levels are tapped out long before their insurance kicks in.; २/११/१५, १०:३० AM
Sammy Finkelman म्हणाले...: It's more slow motion than many of the critics of Obamacare had implied. But I'v always thought it would be slow motion.

It won't really hit till 2018.; २/११/१५, १०:३१ AM
Richard Dolan म्हणाले...: In truth, it's not that slow. It's only been up and running (so to speak) for two years, and it's already failing badly. When hope-and-change is pitted against arithmetic, the numbers invariably win out. For anyone who can count, it's a result that's hard to miss. Since most consumers can count, especially when they have to pay the tab, only those for whom the cost is irrelevant are likely to stick with it. Hence, it's real impact will be on the expansion of Medicaid, adding to that program's increasingly heavy toll on state and federal budgets.

As WRMead would say, it's another part of the blue social model that is crashing all around us. You're just not likely to read about it in most news outlets.; २/११/१५, १०:३३ AM
Sammy Finkelman म्हणाले...: It was actually designed that way. It comes apart financially only after the 2016 election. The penalty/tax hasn't really kicked on yet.; २/११/१५, १०:३३ AM
Sammy Finkelman म्हणाले...: Some people - but not Obama understood that this wouldn't work. They couldn't stop it, but they could postpone the problem till past the 2012, and 2014 and even 2016 election.; २/११/१५, १०:३६ AM
Original Mike म्हणाले...: When the architect of the plan displayed his lack of understanding of how auto insurance works, well ...; २/११/१५, १०:३८ AM
Michael K म्हणाले...: "designed to ensure Obama got elected to two terms."

Actually, it was designed by insurance industry lobbyists and 25 year old Democrat lawyers for the staff of Pelosi and Reid. Obama and co. concluded that Hillarycare failed because they made enemies of the insurance industry. Hillary is good at that. This time, they decided the insurance companies would be inside the tent pissing out.

None of them have any idea of how insurance or health care works, just as they have no idea how an economy works. Listen to Bernie Sanders for a few minutes.

The French, the Free French while in exile in London during WWII, designed the best health care system in the world. It is still the best and the financial problems it is having now is because of France's crappy economy, not because the system was not designed well.

The US health insurance system was haphazardly set up in WWII with no thought of how it should work. It was OK until Medicare came along in 1965.

The present system that existed until Obama was failing and insurance companies wanted no part of it. That's why they elected to go with short term profits instead of real reform.; २/११/१५, १०:४३ AM
अनामित म्हणाले...: What would really happen if there was a free market for health insurance?; २/११/१५, १०:४७ AM
Bay Area Guy म्हणाले...: It's important to hold the architects of the ObamaCare monstrosity accountable if/when it collapses. The damage they caused to millions of working/middle class families is large. The architects are the Democratic Party. Harry Reid will be in Nevada shadow-boxing his delinquent brother in a retirement home, but Pelosi will still be in Congress. Obama will be on a multi-millionaire book tour.; २/११/१५, १०:४८ AM
Brando म्हणाले...: Obamacare fails to address the major problems with American health care which are:

1) Individuals who are covered by policies and insulated from the costs of their health decisions because premiums are subsidized and their expenses are not closely tied to their decisions (re: doctor visits, drugs to buy and use, lifestyle). Heaping extra subsidies and adding new rules about coverage have only made them more insulated.

2) Lots of people with "coverage" but no meaningful access to health care. What's so great about Medicaid if no doctor will see you, or clinics are overcrowded or too far away? The Medicaid expansion and new ACA enrollees just make this problem worse.

3) The central problem--too much demand and not enough supply. How on earth can subsidizing more people onto plans and driving up demand fix this problem? We can only end up with ever higher prices, or shortages, or some combination of the two.; २/११/१५, १०:४९ AM
Robert Cook म्हणाले...: "Obamacare is the perfect model of progressive solutions to imaginary problems."

Not in the least. It is based on a conservative plan, first proposed by the Heritage Foundation, and implemented in Massachusetts while Romney was governor. Obamneycare has always been primarily a tool to funnel more money to the private insurance companies.

The problem of people not being able to obtain insurance--either because they cannot afford the premiums, or because they are rejected by the insurance companies for having "pre-existing conditions"--is not in the least an "imaginary problem," but a very real and serious problem. If you and your acquaintances are fortunate enough to have insurance coverage...you're fortunate.

"Obamacare is just expanded Medicaid and everyone knows how great Medicaid is."

It is not in the least expanded Medicaid...and what's wrong with Medicaid? The people I have known who had it were very thankful for it.; २/११/१५, १०:५१ AM
MikeR म्हणाले...: The equivalent Obamacare plan to my current private coverage costs more than twice as much. I thought my Maryland Carefirst plan was expensive, with underwriting and stuff, at about $1700/month. The Obamacare plan costs more than $4000/month. I never _heard_ of insurance that expensive. It's insane.; २/११/१५, १०:५१ AM
Michael K म्हणाले...: I guess I should add that Medicare did;t really do the damage. It was a change from the indemnity style health insurance of the 50s and early 60s to a system of "Usual, Customary and Reasonable Fees" that the medical associations promoted and which resulted in the abandonment of the indemnity method. By "indemnity" I mean insurance that paid $250 for an appendectomy. That is very similar to the French system. Doctors could charge more if they were the best in town, but they might not find patients willing to pay more.

Medicare was made mandatory for doctors. We could not charge more than the "allowed amount." This was price fixing and led to efforts to raise the price. UCR resulted.

HMOs came along as a Republican effort at cost control when Nixon was in office. This led to a demand that all services be "insured" which is like auto insurance being expected to pay for oil changes and flat tires.

That's how we got to the "crisis" of the past few years which led to the far worse crisis of Obamacare.; २/११/१५, १०:५३ AM
Sammy Finkelman म्हणाले...: And on top of that $4,000 premium, there's a huge deductible, isn't there? What is he size of the deductible in that plan?; २/११/१५, १०:५५ AM
Michael K म्हणाले...: "what's wrong with Medicaid? The people I have known who had it were very thankful for it."

I have no doubt that those who get welfare are very thankful. But it's still welfare.

The collapse of national borders will probably be the end of the welfare state.; २/११/१५, १०:५६ AM
CWJ म्हणाले...: Sammy F,

What's your situation? Goodness knows that it has not been slow motion for the individual health insurance buyer. Nothing slow motion about losing your coverage to Obamacare mandates, and being grandfathered was hardly better. Last year I commented about the 40% increase in our premium for our grandfathered plan. This year's increase is 25%; a compounded 75% increase for the same coverage.; २/११/१५, १०:५८ AM
traditionalguy म्हणाले...: ObamaCare was carefully designed to fail the year Obama left office. And then cometh Single Payer.; २/११/१५, १०:५८ AM
Skeptical Voter म्हणाले...: Obama, Pelosi and Reid--a trifecta of economic ignoranmuses. Except that Reid knows how to feather his own nest; Pelosi married a pile of dough; and Obama is the favorite donee of wealthy liberals. So they've got theirs Jack--tough about you though.; २/११/१५, १०:५९ AM
MikeR म्हणाले...: Sammy, I'll have to check if I still have the paperwork. It was the same as my current plan - non-trivial, which is why I called it the "equivalent".
I didn't get too far; I saw that premium and dropped the idea real fast. I had thought my current plan was painfully expensive, but now I see it was really a great deal! :); २/११/१५, १०:५९ AM
Curious George म्हणाले...: Crazy Joe was right about something finally, this IS a big fucking deal.; २/११/१५, ११:०० AM
Lewis Wetzel म्हणाले...: From the article:
"Supporters credit ObamaCare with helping nine million uninsured Americans find coverage in 2014."
This because they mandated coverage. If you mandated every adult to buy a cell phone, the number of people owning cell phones would increase. This is tautological.; २/११/१५, ११:०१ AM
dreams म्हणाले...: "Obama, Pelosi and Reid--a trifecta of economic ignoranmuses. Except that Reid knows how to feather his own nest; Pelosi married a pile of dough; and Obama is the favorite donee of wealthy liberals. So they've got theirs Jack--tough about you though."

The liberal Dems do know how to game the system and lets not forget all those democrat government workers.; २/११/१५, ११:०२ AM
MikeR म्हणाले...: Got it! (copied off pdf): "
BluePreferred HSA Compatible (Bronze) Bronze plan - $4,000
BPHMM5C, Prescription Drug RXCMMA5R
Member pays:
In-network...Deductible Indiv/Family $4000/$8000
Out-of-network...Deductible Indiv/Family $5000/$10000

There is also an HMO Bronze plan that is only $3,000 for the premium.; २/११/१५, ११:०७ AM
Michael K म्हणाले...: " If you mandated every adult to buy a cell phone, the number of people owning cell phones would increase. This is tautological."

Not if they don't buy them. The increase is almost all Medicaid.

Last year’s changes in health insurance enrollment are of particular interest, as 2014 was the year in which key provisions of the Affordable Care Act (ACA, or Obamacare) took effect—most notably, the offering of subsidies for coverage purchased through the new government exchanges and the ACA’s Medicaid expansion. Analysis of enrollment data for private health insurance plans and public programs finds that 9.25 million more Americans had health insurance coverage at the end of 2014 than at the end of 2013.[1] However, the data (see Figure 1) also show that the ACA’s Medicaid expansion was responsible for almost all of the net increase in coverage.

You know who is paying for that ? We are,.; २/११/१५, ११:११ AM
BarrySanders20 म्हणाले...: The real beauty of Obamacare is that expanding coverage, which is all we have done at this point, is the easy part.

The hard part is that pesky first word in the title: Affordable. The pressures on providers to reduce cost will be intense. This is the only way the scheme would ever work, since the vast majority of the costs are at the provider level, as it should be. The providers are the ones doing the actual work of providing medical services and should be paid for it. But health care got so expensive -- too many tests, too many procedures, all billed individually as fee-for-service, that something had to be done. Obamacare is something, so Obama reasoned it had to be done.

Rationing is the logical result. Force too many people into a system that cannot handle the load and some, though insured, will simply not get care, or will have to wait, and give up, etc. It's the VA and Canada. It will work for some, mostly healthy, but not others, mostly sick.

We need to be able to control the chronic diseases like obesity and diabetes, when possible before they start, to get control of the costs. Like it or not, lifestyle has a lot to do with how much health care a person consumes. If we can avaoid teh avoidable, it would allow room for the truly unexpected and unavoidable medical conditions to receive proper attention.; २/११/१५, ११:१५ AM
Dear corrupt left, go F yourselves म्हणाले...: The top 8 big insurance companies still like it. They give big bucks to the Clintons and are expecting a good CEO payoff after she kicks ObamaCare into HillaryCare - or - what her followers like to call "Single Payer."; २/११/१५, ११:१६ AM
Jane the Actuary म्हणाले...: Here's the deal: those "co-ops"? There's nothing magical about them. They're just mutual insurance companies that got their seed money from the government. The operate the same way as any other mutual insurance company would, with the same regulatory requirements, but with the assumption that their newness means some enthusiasm for delivering innovative plan designs and actually focusing on price rather than plowing revenues into monster reserves and/or reinvestments, and with executives with lower pay based on a public service ideal.

http://www.patheos.com/blogs/janetheactuary/2015/10/money-doesnt-grow-on-trees-and-other-healthcare-co-op-surprises.html; २/११/१५, ११:१९ AM
अनामित म्हणाले...: It is not in the least expanded Medicaid...and what's wrong with Medicaid? The people I have known who had it were very thankful for it.

97% of the people who theoretically gained health care via the Obamacare law did it as part of the Medicaid expansion.

Getting a Doc to take you and actually provide care is another issue, so it's still the ER.

Add in the fact that this new Medicaid expansion is demonstrably unsustainable for the states...

yet some Governors are still trying to get the Free Fed money and bankrupt their states. Virginia, I'm talking about you...; २/११/१५, ११:२० AM
Dear corrupt left, go F yourselves म्हणाले...: Robert Cook - Explain to the class why NOT ONE single solitary member of the GOP voted for ObamaCare?

It's not the same idea or plan as the Heritage Foundation.; २/११/१५, ११:२१ AM
TrespassersW म्हणाले...: ObamaCare is imploding? Who could have predicted that?

Besides purblind partisan hacks, that is.; २/११/१५, ११:२३ AM
Dear corrupt left, go F yourselves म्हणाले...: ही टिप्पणी लेखकाना हलविली आहे.; २/११/१५, ११:२३ AM
Brando म्हणाले...: "The top 8 big insurance companies still like it. They give big bucks to the Clintons and are expecting a good CEO payoff after she kicks ObamaCare into HillaryCare - or - what her followers like to call "Single Payer.""

Predictions aren't my strong suit, but I'd say if Hillary got in the White House and the Dems took back Congress (a long shot on the latter) we'd probably see bigger ACA subsidies, more rules, and perhaps a tax on private plans to help pay for it all. Over the long run, the biggest threat to the system is more providers dropping out if they can't break even, and the government assuming an ever-growing financial responsibility. Quality of care will gradually erode until we start seeing richer Americans stick with concierge medicine or, once that gets taxed out of existence, going overses for care. I could see some companies setting up hospitals in foreign countries or even on ocean liners to provide care outside the reach of the system.; २/११/१५, ११:२३ AM
Dear corrupt left, go F yourselves म्हणाले...: Single payer is the next false promise of "free"

When will you learn, leftists, nothing is free. Ever.; २/११/१५, ११:२४ AM
Charlie म्हणाले...: Jonathan Gruber could not be reached for comment.; २/११/१५, ११:२५ AM
Dear corrupt left, go F yourselves म्हणाले...: The left were expecting hoards of young people to sign up. Young people are not interested in signing up, and they haven't. They want someone else to sign up, not them. Even though these same young people LOVE the idea of free healthcare, they have no clue that they must pay first, in order for it to be "free".; २/११/१५, ११:२५ AM
Brando म्हणाले...: "The left were expecting hoards of young people to sign up. The Young people are not interested in actually signing up and joining the collective fun. Even though these same young people LOVE the idea of free healthcare, they have no clue that they must pay first, in order for it to be "free"."

I'm guessing the ones who love it and are signing up for it are the lower income and less healthy young people, while the truly young and healthy who make too much money for subsidies but don't have coverage through employers are just staying out of it. There's just not enough incentive for a relatively healthy person to pay very high nonsubsidized premiums for coverage they're unlikely to use.; २/११/१५, ११:२६ AM
jr565 म्हणाले...: And this is somehow news? there were people talking about the problems with it when it was being imposed. I mean, implemented. I hate to say I told you so, but I did. Actually I don't hate saying that at all.
(you by the way is not Althouse, but a collective you describing those for Obamacare. As far as I know, Althouse was not actually in favor of it); २/११/१५, ११:३० AM
Paul म्हणाले...: Well you voted for the POS so tough luck.

Votes have consequences.; २/११/१५, ११:३१ AM
jr565 म्हणाले...: But lets remember, it will bend the cost curve down. And you will be able to keep your doctors. And they had to pass it for us to know what's in it.; २/११/१५, ११:३२ AM
jr565 म्हणाले...: In other news, when you max out your credit cards and are in deep debt, you credit score sucks. Who'd have thunk it?; २/११/१५, ११:३२ AM
Todd म्हणाले...: AprilApple said...
The left were expecting hoards of young people to sign up. The Young people are not interested in actually signing up and joining the collective fun. Even though these same young people LOVE the idea of free healthcare, they have no clue that they must pay first, in order for it to be "free".

How puzzling?

11/2/15, 11:23 AM

Don't forget that thanks to big brother government, many of these "special snowflakes" have HUGE Ed bills, have low paying jobs (when they can get them at all), and little to no prospects. If the economy were not so bad, the ACA may well have been able to soak up enough young payers to smooth out the curve but... Well, they voted in droves for "hope and change". I "hope" they like the "change"...; २/११/१५, ११:३४ AM
jr565 म्हणाले...: ""what's wrong with Medicaid? The people I have known who had it were very thankful for it."

Well one reason it sucks is that the govt doesn't really re-imburse doctors adequately for Medicaid/medicaire patients. And so, many of them are no longer taking medicaire/Medicaid patients.; २/११/१५, ११:३६ AM
Michael K म्हणाले...: all billed individually as fee-for-service, that something had to be done

"Fee for service" is called The Market in other industries.

The French system, which I have written about for years, is fee for service with a fixed subsidy. The FFS option allows some elasticity. The contract rates are too low and doctors are dropping out or retiring. England is seeing most young doctors fleeing the NHS.

Some of that is housing cost in England where the English are self segregating into the southeast. Housing prices there are astronomical. I say "English" as opposed to "British" as the British are increasingly foreign in birth and/or culture.

If we stay on this path, we will see most primary care delivered by "lesser licensed practitioners." These are PAs and NPs right now but they will get tired of Medicaid. Then, who knows ?; २/११/१५, ११:३७ AM
Rusty म्हणाले...: Told ya.; २/११/१५, ११:३८ AM
dreams म्हणाले...: "Single payer is the next false promise of "free""

Single payer has always been their goal.; २/११/१५, ११:३९ AM
Dear corrupt left, go F yourselves म्हणाले...: "--It's the law of the land!"

Maddow and Clinton insist. Stop questioning it and love it, rubes.; २/११/१५, ११:४१ AM
SteveR म्हणाले...: I was put into a position where I was able to witness, first hand, the ACA start up/ implementation as a family that needed exactly what the program was supposed to provide.

After thirty years or various employer provided plans of varying degrees pf quality and cost, I felt most people I have dealt with were sincere about being helpful but the truth is, its not very good, to be generous.

I think the politics of it, speak for themselves. I saw what was really in it, before you passed it.; २/११/१५, ११:५१ AM
Kevin म्हणाले...: ObamaCare was always intended to collapse - thus forcing the adoption of single-payer health care, which was the idea all along.

After all, "you never let a crisis go to waste".; २/११/१५, ११:५४ AM
Michael म्हणाले...: Kevin
"ObamaCare was always intended to collapse - thus forcing the adoption of single-payer health care, which was the idea all along."

It would be a different world if we were ruled by people smart enough to operate like this. No, sadly, they actually thought it would work.; २/११/१५, १२:०० PM
Fernandinande म्हणाले...: "Whatever" -- Jonathan Gruber; २/११/१५, १२:०१ PM
SDN म्हणाले...: "Robert Cook - Explain to the class why NOT ONE single solitary member of the GOP voted for ObamaCare?"

Because he's a Democrat, and pathological liar is a condition of membership.; २/११/१५, १२:०३ PM
Bob Ellison म्हणाले...: Obamacare killed my insurance policy. I keep telling people that, and the story gets old. Obamacare killed my insurance policy. This happened. It happened to several million people. Obama is a lying asshole.; २/११/१५, १२:०५ PM
Dear corrupt left, go F yourselves म्हणाले...: Anyone who reads Mother Jones or Huffington Post is fed bullcrap and if you buy it, you eat bullcrap. willingly. I suggest you stop.; २/११/१५, १२:०५ PM
damikesc म्हणाले...: The problem is that the supporters never seem to follow up after their "win" to see what happened.

Is it the "law"? Sure. I'm not sure why the Left finds it being "the law" so compelling since plenty of other things that are "the law" they don't give two shits about, but whatever.

Has this helped much of anybody? No. And, even worse, the critics who predicted that it's inevitably enter a death spiral were all laughed and mocked...and, as usual with Obama's idiotic policies, were correct.

It is not in the least expanded Medicaid...and what's wrong with Medicaid? The people I have known who had it were very thankful for it.

Per the Rainmakers, make them all beggars because they're easier to please.; २/११/१५, १२:०५ PM
tim maguire म्हणाले...: ही टिप्पणी लेखकाना हलविली आहे.; २/११/१५, १२:०७ PM
Dear corrupt left, go F yourselves म्हणाले...: The implosion is because of Romney and the Heritage Foundation... certainly NOT the Gruber's and the Pelosi staffers who wrote it. Oh... no no no...

Leftists will forever feed you crap because that's all they ingest.

I also love how Obama is now whining about how he won't accept anything passed on party line vote. Hypocrite.; २/११/१५, १२:१४ PM
Sammy Finkelman म्हणाले...: Michael K:

"Fee for service" is called The Market in other industries.

No, "Fee for service" is called "cost-plus" in other industries. There is no market. Prices are not rational.

And another problem is what is being paid for. Telephone consultations - at east to get the results of tests, or, possibly, to renew prescriptions, are not paid for. There should be a lot more telephone consultations and longer actual visits when they happen.

The big problem is that, not only are resources (certainly without insurance) not equal, but you cannot equalize money available, because different amounts of money are needed for different people.

I think this is semi-solvable, but the way things have been done since the 1960s is all wrong. It leads to higher prices, and when governments eventually try to stop prices from rising and cost controls are put in, rationing and deterioration of the quality of medical care.

The problem actually is, as Rush Limbaugh put it, insurance (third party payments) Prices don't matter to anybody. Right now the only constraint is the time of the patients, or, worse, artificial rules.

Prices have got to matter, to the point where medical providers advertise price and nobody needs to do any kind of special research, and yet, when something needs to be done, or more doctors needs to be consulted for proper diagnosis, it's got to be possible for nearly everyone at least to do so.; २/११/१५, १२:१५ PM
Dear corrupt left, go F yourselves म्हणाले...: If Gruber were an R - the hack press would still be all over his a$$. Instead, where did he go? *crickets*; २/११/१५, १२:१६ PM
Sammy Finkelman म्हणाले...: Explain to the class why NOT ONE single solitary member of the GOP voted for ObamaCare?

Because it was bad legislation, and there was no attempt to win a single Republican over with special provisions. It was the Democratic Party that was partisan, not the Republican Party. It's the party where some members dissented that was partisan, because no party votes 100% in lockstep.; २/११/१५, १२:१७ PM
Matt Sablan म्हणाले...: "It's not the same idea or plan as the Heritage Foundation."

-- It is based on it like the Disney Three Musketeers movies are based on the books. There are some general big picture things that are the same, but a lot of the details are drastically different. But the point isn't to actually try and bring Republicans/conservatives in. If it was, they'd have ASKED for MODERN conservatives/Republicans' opinions.

The point is to confuse people and lie to the public in an attempt to, once again, indulge in a cheap shot on The Political Other while trying to work up a good five minute hate.; २/११/१५, १२:१८ PM
Sammy Finkelman म्हणाले...: What's wrong with Medicaid

The terms to get it, and the penalty for making money and having savings, including scary $15,000 bills sent to debt collection agencies to people who make the mistake of going back to work without cancelling their Medicaid, and the deteriorating quality of care oweing to cost cutting measures.; २/११/१५, १२:२१ PM
tim maguire म्हणाले...: tim maguire said...
AprilApple said...Robert Cook - Explain to the class why NOT ONE single solitary member of the GOP voted for ObamaCare?

Because it's imploding. That's how Mr. Cook figures it can't possibly be a liberal plan. Liberal plans don't fail.

Never mind, I copied the wrong post. This makes no sense. I intended to respond to the claim that Obamacare is a conservative plan.; २/११/१५, १२:२३ PM
Rick म्हणाले...: Robert Cook said...
"Obamacare is the perfect model of progressive solutions to imaginary problems."

Obamneycare has always been primarily a tool to funnel more money to the private insurance companies.

Yes which is why it fits the progressive vision.

It is based on a conservative plan, first proposed by the Heritage Foundation, and implemented in Massachusetts while Romney was governor.

So one conservative proposed it while the left supported and implemented it and Cook claims this makes it "conservative". This seems much like the NYT definition of "bipartisan" whereby 200 Democrats and one Republican supporter is "bipartisan" when it's useful to the political left.

While Romneycare was enacted while Romney was governor it was written by the left controlled legislature which had veto proof majorities in both houses. So while Cook pretends he's not a Democrat his constant reiterating of Democrat propaganda shows that's a distinction of convenience.; २/११/१५, १२:२८ PM
cubanbob म्हणाले...: As noted above by others Obamacare is a disaster of the first order. it solves nothing and makes almost everyone else worse off.
My little tale of woe: as an employer I provide all of my employees an HMO that is 100% employer paid for (the employee only). And even with that the only coverage I could get that is affordable (barely) for me is a $600 a month per employee plan with a $5,000 deductible and a 20% coinsurance. Mind you I'm paying 100% of the premium and yet for some my employees the deductible and coinsurance makes it essentially unaffordable. Indeed some of the single mothers that work for me opted out and went straight to Medicaid. So where exactly does the taxpayer save money? Where do the privately insured save money? Everything the Democrats said would happen was a lie. And yet this country is on the verge of electing as president the mother of this disaster. Before Obama-Democrat care I was offering my employees a 100% employer paid HMO with a $1,000 deductible at a cost to me of $514.00 a month. Frankly if rates go any higher and the coverages worsen I will be better off not offering health insurance since what is the point of offering a benefit the employee can't benefit from? Obama-Democrat care is so stupid I can't even give them what I was paying per month per employee for health insurance next year without triggering a huge tax hassle for myself and the employee if don't renew the plan and opted to give the the cash instead so they can buy whatever crap insurance is available on the federal exchange. Only Democrats and leftists are capable of such cosmic level stupidity. No ordinary person is capable of being that stupid.; २/११/१५, १२:३२ PM
Big Mike म्हणाले...: And so, many of them are no longer taking Medicare/Medicaid patients.

All too true. I've retired and my doctor only continues to see me because I'm a longtime patient. He'll retire soon and I am not looking forward to finding a good doctor who takes Medicare. The problem is that the electronic patient records mandate is expensive in practice, and the Medicare rates were already pretty low to begin with. Making it more expensive to do business while lowering reimbursements is not a way to make doctors embrace new Medicare patients. Even Cookie should be able to work that out.

If the US ever sufficiently loses its sanity to embrace single payer my prediction is that a large contingent of the best doctors will enter into concierge plans, charging high fixed annual fees for participants and thus rationing the best medical care for wealthy people only. Congress will go along because (1) the Congressmen will themselves participate in the concierge plans and (2) their donors will want to participate in concierge plans.; २/११/१५, १२:३२ PM
Curious George म्हणाले...: "Robert Cook said...

It is not in the least expanded Medicaid...and what's wrong with Medicaid? The people I have known who had it were very thankful for it."

Recipients of free shit like it? Imagine that. But my experience is that they feel entitled. It sucks for taxpayers and health providers.; २/११/१५, १२:३५ PM
Sammy Finkelman म्हणाले...: Re: Obamacare -> Single Payer.

Years ago, Obama in a radio interview, talked about first doing something moderate and then going to single payer, but he assumed that what happened first would work. He assumed the problem was political. (or maybe it is this)

https://www.youtube.com/watch?v=fpAyan1fXCE

http://www.politifact.com/truth-o-meter/statements/2009/jul/16/barack-obama/obama-statements-single-payer-have-changed-bit/

Yes, Obama [in 2003] did support single-payer, but Duffett said Obama also talked about the need to be strategic and work within political limitations, which he attributed to Obama's background as a community organizer.

Obamacare is not workable because the premiums are too high, and the deductibles too high (one or the other might be high, but not both!) and the networks too narrow, and the people who devised it are too dumb or stubborn to realize this. Nobody will buy it voluntarily, and the penalty is too low to force people.

Medical care is no more affordable now than college tuition, or, to a considerable degree, housing, all three which have had their costs inflated overthe past several decades, albeit by different means. (Housing is the only one of these where it often government policy to make it more expensive)

The unaffordability of the Obamacare premiums is disguised by subsidies and by delaying any kind of reconciliation of accounts, but the disguise will eventually give way.; २/११/१५, १२:३६ PM
Brando म्हणाले...: I don't really care if the ACA was originally a "conservative" plan or came from the Heritage Foundation--it's not as though bad ideas cannot come from the right. Whether it came from a right wing think tank, or sprang from the head of Cronos, it's a terrible plan that combines the worst aspects of big government nanny-statism with the worst aspects of crony capitalism, and it is worsening many of the original problems it was intended to solve. The only reason anyone supports it now is if they're getting subsidized (though subsidized premiums don't equal better access to health care) or if they have some political stake in its perceived success.

I don't think it'll ever get fixed, though. There will never be enough political support for a single overhaul, because the law's critics have different reasons for opposing it, and no one wants to stick their neck out to do this piecemeal. We may be stuck with this mess for a long time.; २/११/१५, १२:३८ PM
hawkeyedjb म्हणाले...: " It is based on a conservative plan, first proposed by the Heritage Foundation..."

This is the made-up talking point that allows Democrats and lefties to gasp in astonishment that Republicans and conservatives would reject their very own plan. Probably the sole aspect of any plan favored by Heritage that might be found in Obamacare would be the individual mandate - not a Heritage invention, of course, and their version relied on incentives rather than penalties. The core of Heritage's discussion was about the use of vouchers to replace both Medicare and Medicaid; it looks like that central idea somehow was left out of Obamacare. And of course there was no employer mandate to subsidize health insurance - no Republican or conservative plan ever required more than simply offering group insurance, and none had any calculations regarding percentages of income or full-time status. Most conservative plans attempted to break the link between employment and insurance, which is an admirable goal and one that Obamacare ignores - indeed, one could argue that we missed a once-in-a-lifetime opportunity to sever insurance and employment completely. Democrats seemed obsessed with beating employers into submission instead of getting them out of the insurance business.

Even smart lefties (my brother is one) parrot the absurd lie that "Obamacare was written by Republicans!" You'd think they would have been more proud of it.; २/११/१५, १२:४० PM
Brando म्हणाले...: "Nobody will buy it voluntarily, and the penalty is too low to force people."

I'm wondering if Hillary's IRS might raise the penalty (unless only Congress can do that, though maybe they won't care) to a very high level. At that point maybe even John Roberts will decide it is no longer a "tax"!; २/११/१५, १२:४१ PM
Dear corrupt left, go F yourselves म्हणाले...: We need to get back to a free-market system and health savings accounts. It will never be perfect. Got that. It will never be perfect. The left want to kill all free markets, and then lie and say single payer = more competition.; २/११/१५, १२:४४ PM
Deirdre Mundy म्हणाले...: Big Mike-- except concierge care isn't always expensive.

There's a NP group in our area that offers a family plan at $70/month. That gives you all check-ups, shots, primary care visits and in-office tests, stitches and Xrays.

It's totally affordable, and apparently the not having to deal with insurance or EMR requirements makes it a good deal for them, too.

Basically, between that and the catastrophic coverage, we have most things covered.; २/११/१५, १२:४४ PM
lgv म्हणाले...: Yo, cubanbob. I'm paying an average of $700 per employee for a PPO. My rate varies by age. Older employees cost me almost $1000 per month. There is no logical reason to provide health coverage as an employer if you don't have to. I'm stupid for doing it.

Excellent care, low cost, timely service. Choose any two.

If you want affordable health care, then single payer is the solution. Abolish all private health insurance. Cap health expenditures to $5k a year per person. There you go. Cost problem solved. Granted, people may miss all those services they used to get, but don't or have to wait a year for, buy hey, the cost is contained and everyone is covered. I don't think Americans would like that. Unlike those who only know single payer, we know what access to care is like.

Canadians would be very upset if we got a system just like theirs. They couldn't come here for certain services.; २/११/१५, १२:५१ PM
Michael K म्हणाले...: "Whether it came from a right wing think tank"

Yes, the Heritage myth gets more play as Obamacare is imploding. The original idea was the :free riders" were a big problem. It was eventually decided that the free rider was not a big cost driver. Heritage dropped the proposal before Massachusetts adopted their employer mandate. Remember that Mass is a very left wing state with lots of big medical centers in Boston. One serious problem Boston has alway had is the number of nonprofit entities in Boston that don't pay property tax.

McCain had a pretty decent reform plan in 2008 but he, like so much of his campaign, could not explain it.

I'm just glad I'm retired. I encourage medical students to consider the military which will pay their tuition but they still take out huge loans that they will not be able to repay.; २/११/१५, १२:५८ PM
Michael K म्हणाले...: "the cost is contained and everyone is covered."

And the population problem, if any, is solved. Die young.

Canadians are not that dumb. Private clinics are growing all across Canada. Their supreme court told them a couple of years ago they could not ban private practice.; २/११/१५, १२:५९ PM
Michael म्हणाले...: I believe we will find an acute shortage of doctors in the very near future. I was shocked to learn that a friend who is a surgeon received what I consider a pittance for performing hip replacements. I frankly am not certain I want to be operated on by someone who is paid so little for something so important.; २/११/१५, १:१० PM
Larry J म्हणाले...: "Single payer is the next false promise of "free"

So, we let the government screw things up royally, and the result of that is to give them even more control over health care? Imagine having an idiot relative who fancies himself as a handyman. You hire him to do some work around your house and he screws up every single job. You decide to have a new house built and he wants to be your contractor? Would you let him, given his track record of failure?

Look at the US government ran health care programs that have existed for a long time, such as military health care, VA health care, Bureau of Indian Affairs health care, etc. How many of them are models of success? Based on that track record of failure, we're supposed to let the same people run health care for everyone? Wouldn't that be stuck on stupid?; २/११/१५, १:२३ PM
Michael K म्हणाले...: The doctor shortage is almost here. In Britain, it is there now.

I get solicitations for doctor jobs every day. I was a general surgeon. I get job offers a couple of times a week for good salaries. When I was in training, general surgery was a high status specialty. It was challenging and rewarding. Now, the "lifestyle specialties" are the rage. Some of this is the feminization of medicine with 60% of medical students women. They work fewer hours than we did but male doctors do too these days.

I talked to a female general surgeon in San Francisco a few years ago. She did not know a general surgeon in San Francisco under the age of 50. The medical schools probably have faculty members but they are in very restricted practice settings. They are not doing ruptured aneurysms at midnight like I was.

Primary care now is almost all by Nurse Practitioners and Physician Assistants. That's OK until you get a complex case.

I work a few hours a week examining military recruits. They should be healthy teenagers and early 20s kids who think they want a military career. I find pathology almost every week. Often it's just a hernia but last year I found a kid with cancer spread to his lymph nodes in his neck. I've found breast lumps in young women.

The enemy of primary care is the representativeness heuristic. Every cold is just a cold, until one isn't.; २/११/१५, १:५२ PM
Brando म्हणाले...: "We need to get back to a free-market system and health savings accounts. It will never be perfect. Got that. It will never be perfect. The left want to kill all free markets, and then lie and say single payer = more competition."

The situation I'd prefer would be individualized accounts and a baseline level of catastrophic coverage. I'm fine with a program that reimburses health providers when they get stuck with uncovered people in extreme circumstances, though we would still have the problem of rationing out those costs and how to increase supply of health services to meet the demand. We should also deregulate health care to enable cheaper services provided for those who want some level of care but cannot afford higher priced care.; २/११/१५, १:५२ PM
Dear corrupt left, go F yourselves म्हणाले...: Socialized government run single payer is wonderful if you never get sick. *fingers crossed* The NHS in Britain is pure suck if you DO get ill. Wait in line for crap care then die. You're expendable. shhhhh - that's secret information our hack press and hack press propaganda satellites like Huffington, Vox and Blu Mother will never let out.; २/११/१५, १:५८ PM
Gabriel म्हणाले...: It wouldn't matter if every single Republican in Congress voted for Obamacare: the question of whether Obamacare is working as promised is totally irrelevant to that.

The only reason to say that Obamacare was originally proposed by conservatives, which is a lie, is to attempt to discredit any opposition to it.

Surprised to hear such a partisan lie from Cook; I thought he was a principled socialist with no interest in supporting Democrats when they get things wrong. Well, live and learn.; २/११/१५, २:०३ PM
rehajm म्हणाले...: AprilApple said...
We need to get back to a free-market system and health savings accounts. It will never be perfect. Got that. It will never be perfect.

It would be close enough to perfect that nobody would care.; २/११/१५, २:०४ PM
MaxedOutMama म्हणाले...: What good is a plan with a $5,500 deductible for most workers in the restaurant industry???

They wouldn't be buying insurance for themselves - they would be buying insurance for the hospital if they have an acute emergency. They can't afford other types of care - they cannot afford what they have to pay before the insurance kicks in. And nowadays most providers except the ones that legally have to take you want cash up front.

If you made $25,000 a year in 2015, and you were single without children, your federal tax was about $1,750. Your FICA was about $1910, leaving you about $21,340. Your state tax would usually run between 4-6%. Say 4%, leaving you $20,340 to live on. If you pay for that insurance, that brings it down to about $19,200 after taxes and insurance.

So if you get ill, you are supposed to pay $5,500 before your insurance kicks in? That's about 28% of your actual money income, leaving you $13,700 a year, or $1,141 a month to pay for food, transportation, rent and utilities. God help you if you have loans.

The reality is that the insurance offered is not meaningful for most of the employees. It won't change the care they receive. They are paying for nothing, so they don't pay for it.

The "crappy" insurance plans which were popular in many low-paying industries were more useful than this, because they didn't have high deductibles and so the employees had a chance of using them.; २/११/१५, २:१४ PM
Lewis Wetzel म्हणाले...: It is problematic to make major policy changes with a bare plurality of votes. It could be argued that Obamacare didn't even rise to the level of "bare plurality." The problem occurs because every major change in policy produces winners and losers. If a bare plurality approves of the change, the pro-change forces have created a large class of losers with no stake in the success of the policy. Indeed the losers may have a large stake in defeating it. It is Obama's preference for strong-arming the opponents of his policy proposals that has created so much division in this country, and has led to record opposition party gains at the state level and in the US congress.
This is poli-sci 101, and is yet another reason to believe that Obama is not very bright.; २/११/१५, २:१७ PM
Brando म्हणाले...: "This is poli-sci 101, and is yet another reason to believe that Obama is not very bright."

His team assumed for some reason that people would sign up in such large numbers that the "losers" under the plans would be losing little enough that they wouldn't notice it, and the "winners" would somehow create lower health care costs because of this idea that if you have general coverage you aren't running up big hospital bills by going to the hospital for basic care or for major problems that could have been prevented by going to a primary care physician earlier. They became convinced by their own press releases, so to speak, and bought into the wishful thinking that couldn't hold up once it was clear that for young, healthy people there is a very low monthly amount that they would be willing to pay for health coverage (particularly if the coverage wasn't too great or had a high deductable). If say you wouldn't mind paying $50 a month for peace of mind, you might balk at paying $300 a month for something you have a very low chance of using.

Part of the problem with political bubbles is people cherrypicking the facts and opinions they read and listen to, and surrounding themselves with those who already generally agree, so they never adequately consider what might happen if their assumptions go wrong.; २/११/१५, २:२९ PM
Sammy Finkelman म्हणाले...: Apparently, anyone who commented on the White house website about anything is getting a reminder to buy health insurance. The message says you can visit healthcare.gov.

Do they not realize that that only applies in 34 states, and not many of the biggest ones?

That came Sunday night. This was followed by another e-mail from "Michelle Obama" about how she is going to Qatar to speak at a global education conference. Qatar! Subsidizer of al Jazeera! This is all because she's for educating girls. (How about the girls prevented from attending school in China because they were born outside the birth quota? (This is actually officially not supposed to happen); २/११/१५, २:४८ PM
Todd म्हणाले...: Larry J said...
"Single payer is the next false promise of "free"

So, we let the government screw things up royally, and the result of that is to give them even more control over health care? Imagine having an idiot relative who fancies himself as a handyman. You hire him to do some work around your house and he screws up every single job. You decide to have a new house built and he wants to be your contractor? Would you let him, given his track record of failure?

Look at the US government ran health care programs that have existed for a long time, such as military health care, VA health care, Bureau of Indian Affairs health care, etc. How many of them are models of success? Based on that track record of failure, we're supposed to let the same people run health care for everyone? Wouldn't that be stuck on stupid?

11/2/15, 1:23 PM

Your analogy does not go far enough. It should actually be:

Your idiot relative comes over and [with some strong arm goons] demands that you let him fix your toilet, screws it up, charges you too much and comes back 3 months later demanding you let him fix your roof at an even higher price.

You have NO choice. Government is the things we choose to do to each other "at the point of a gun", for your own good.; २/११/१५, २:४९ PM
Beloved Commenter AReasonableMan म्हणाले...: Now playing, Obamacare as the Fabulous Invalid. Always dying but never dead.; २/११/१५, २:४९ PM
Lewis Wetzel म्हणाले...: Sammy Finkelstein wrote:
"This was followed by another e-mail from "Michelle Obama" about how she is going to Qatar to speak at a global education conference. Qatar! Subsidizer of al Jazeera! This is all because she's for educating girls. (How about the girls prevented from attending school in China because they were born outside the birth quota? (This is actually officially not supposed to happen)"

The international elites (aka the UN and international NGO's) are much more concerned about "gender parity education" than they are concerned terrorism. For some reason they do not see this as cultural imperialism.; २/११/१५, ३:०१ PM
Theranter म्हणाले...: "by another e-mail from "Michelle Obama" about how she is going to Qatar to speak at a global education conference. Qatar! Subsidizer of al Jazeera! This is all because she's for educating girls." I guess clockboy isn't invited then.; २/११/१५, ३:०८ PM
khesanh0802 म्हणाले...: @ Michael K I thought your statement: "The collapse of national borders will probably be the end of the welfare state." was a real thought provoker. You, I assume, are talking about all national borders as is happening in Europe now as well. When the paid outnumber the ability of the payers there will be no choice.; २/११/१५, ३:०८ PM
Todd म्हणाले...: Terry said...

The international elites (aka the UN and international NGO's) are much more concerned about "gender parity education" than they are concerned terrorism. For some reason they do not see this as cultural imperialism.

11/2/15, 3:01 PM

Nor do they seem so interested in the fact that the education parity they are champion directly leads to the deaths of a good number of these girls. They also don't seem to get so worked up over that genital mutilation stuff either.

The feminists are rather mute on those subjects as well. I guess they don't have the time what with all of that "yes means yes" legislation to shove through. Go figure...; २/११/१५, ३:०८ PM
eric म्हणाले...: This thread sort of reminds me of how our society is run now.

Republican: What's the problem?
Democrat: Too many people don't have health care. We need to fix this, now.
Republican: Ok, let's fix this. How about...
Democrat: Don't worry your evil, racist, mysoginist little heads, we will take care of this without your help.
Republican: But we actually have some good ideas, and doctors who have dealt with this, and some suggestions....
Democrat: Buzz off creeps, we got this.

Later....

Republican: Um, your plan isn't working so great. You went and did it yourself and now its all messed up. Let's fix this, shall we?
Democrat: Our plan? The gall! We just took all of your ideas and ran with it, this should be called your plan. It is your plan!
Republican: Ok, fine, whatever. Let's just fix it. We have some ideas....
Democrats: You racists hate the poor. And your wars and your gun rights, shut up!
Republican: Yes, I know, but we need to fix health care, let's work together and fix it.
Democrat: Why are you still talking!? Shut up! You had your chance and you ruined healthcare. You're going to take awayba woman's right to choose. You're going to round up millions of illegals?! As if!
Republican: Ummmm, what? Can we just stay focused on health care a moment? I think private accounts will work. Dr. Ben Carson has a good idea we would like to discuss further.
Democrat: Black Lives Matter! Stop the campus rapes!

And on and on it goes.; २/११/१५, ३:१४ PM
Gabriel म्हणाले...: @A Reasonable Man:Now playing, Obamacare as the Fabulous Invalid. Always dying but never dead.

Way to move those goal posts. What happened to "if you like your doctor you can keep your doctor" and "the average family will save $2500" and "21 million people will be enrolled in 2016"? Now it's "it's not dead yet".

You would need more than four downs to get to the old goalposts from where you put the new ones...; २/११/१५, ३:१५ PM
Lewis Wetzel म्हणाले...: "Nor do they seem so interested in the fact that the education parity they are champion directly leads to the deaths of a good number of these girls."
In Bloodlands: Europe Between Hitler and Stalin, historian Timothy Snyder viewed the Nazi conquests of Eastern Europe as an extreme case of colonization. The Nazis moved in, eradicated the local population, and made the newly conquered land a German province. Snyder is a Lefty, though, so he had a harder time describing what Stalin did to the Soviet people, which was similar to what the Germans had done to their conquered populations. Finally he settled on the term "internal colonization", which can't be right. You can't colonize yourself.
Snyder puts his finger on the source of the Soviet genocide earlier in the book, where he says the Soviet leadership had declared war on the Soviet people.; २/११/१५, ३:२१ PM
Brando म्हणाले...: "Now playing, Obamacare as the Fabulous Invalid. Always dying but never dead."

Define "dead". As long as it's still on the books and causing trouble to the economy, the health care sector and the lives of most Americans, I guess you could stay it's "alive" much like a bad tumor. But as noted above I don't see it getting repealed any time soon.; २/११/१५, ३:२१ PM
khesanh0802 म्हणाले...: My wife has a 46% increase in premium on her BC/BS this year - over 100% since the inception of Obamacare. Deductible increase of 20%. Total annual potential cash outlay before ANY insurance reimbursement: $15,620. Her penalty payments will be $0. All right students; what should she do?; २/११/१५, ३:३० PM
I Callahan म्हणाले...: Now playing : ARM comes into the thread, completely ignores EVERY valid piece of discussion in the thread, post and link, but leaves a steaming pile on his way out.

Never gets old!; २/११/१५, ३:५९ PM
Michael K म्हणाले...: "The situation I'd prefer would be individualized accounts and a baseline level of catastrophic coverage."

That would be cheap and the education of the public is the most useful feature of Obamacare.

They are finding out how expensive "free care" is.

Next we need to educate them about paying cash for routine care. The HMOs screwed that up by promising free well baby care. The sky high deductible is teaching them about that.

Doctors who are under contract CANNOT charge less than the insurance "ALLOWED" amount or they will be fired/fined. Therefore many are dropping all insurance. That allows reduced overhead. If you don't bill insurance, your office expense is half. If you have quit insurance you can charge half for routine visits. That is what is happening with cash care. "Concierge Care" is a term invented by the NY Times to make it sound expensive,

It's a painful education but maybe it will do some good.

"I thought your statement: "The collapse of national borders will probably be the end of the welfare state." was a real thought provoker."

Europe is learning the hard way. Now, we need to think about our own borders. Prop 187 in California passed with 63% of the vote. The CA Supreme Court threw it out.; २/११/१५, ३:५९ PM
virgil xenophon म्हणाले...: With Obamacare collapsing for all the reasons described, I want to be in one of two classes of people: (a) Those selling flood insurance to the inhabitants of every island in the Caribbean when they sink under the weight of every physician east of the Mississippi relocating their practice to escape the feds, or, (b) to have the ability to pass on every act of sale on all property within 50 miles south of the Rio Grande from the Gulf Coast to the Pacific as every physician west of the Mississippi relocates to do the same..; २/११/१५, ४:०४ PM
Achilles म्हणाले...: AReasonableMan said...
"Now playing, Obamacare as the Fabulous Invalid. Always dying but never dead."

That is the problem. We wish it would die. It is terrible legislation written and supported by terrible people. But it remains killing old preferred plans. It remains lowering quality of care and increasing cost. Meanwhile it enriches the largest insurance companies as they gobble up the smaller struggling insurers ans the industry consolidates.

That is ok though because the insurance industry donates large amounts of money to democrats.; २/११/१५, ४:०६ PM
Michael म्हणाले...: Michael K

I wonder if shifting the insurance hassle from doctor to patient will not only reduce the cost for doctors but make plain to the patient the colossal pain in the ass insurance companies can be. It could be the beginning of a rebellion and very dangerous to the socialists. Rather like having workers receive their gross income and then having to write the government checks every month. They would howl.; २/११/१५, ४:०९ PM
Achilles म्हणाले...: Michael K said...
"The situation I'd prefer would be individualized accounts and a baseline level of catastrophic coverage."

Strip down medicare/medicaid. Take the money from those taxes and set a universal cap of $100,000 in medical care a year per person. If you go over $100,000 in a calendar year the government covers the rest. Take the rest of the money and set up an emergency care system the deals with acute issues.

Deregulate insurance and allow people to purchase across state lines. Insurance companies will have limited risk because of the cap so rates can come down and smaller companies can exist. Put a 1% excise tax on insurers over a certain size. Treat all medical procedures like Lasik and and cosmetic surgery are treated now.

We wont need medical savings accounts because we need to switch to a flat tax.; २/११/१५, ४:१५ PM
damikesc म्हणाले...: Now playing, Obamacare as the Fabulous Invalid. Always dying but never dead.

Welcome to, basically, every government program. Ever.

Obamacare is like a slow-moving but untreatable cancer. It is going to kill healthcare in this country, but hey --- you stuck it to conservatives, so go you!

When the paid outnumber the ability of the payers there will be no choice.

It's worse in Europe. When the payers have ZERO desire or any sense of obligation to support the paid, it falls apart.

Do you think Mohammad is going to be any desire to support Gunter in his old age? No. He'll just kill him.

Europe is committing suicide because the Left did a bang up job killing off Western culture. And nature does so abhor a vacuum...; २/११/१५, ४:२२ PM
Lewis Wetzel म्हणाले...: Now playing : ARM comes into the thread, completely ignores EVERY valid piece of discussion in the thread, post and link, but leaves a steaming pile on his way out.
The 'Bush lied and people died!' debate technique.; २/११/१५, ४:३१ PM
Michael K म्हणाले...: " If you go over $100,000 in a calendar year the government covers the rest."

The French system is pretty good for the routine stuff. You go to the doctor and pay FIRST. You swipe a card and then you get a check from the plan a couple weeks later for a fixed amount based on what the service was. The doctor can charge more if they think they can collect it. Hospitals do the same thing only there they get 1/3 up front. The rest of it is here and the link to the next part is at the top of that post.

The pure high deductible you describe is fine but the cap is too high. If you have a cap of $15,000, it would cover almost all illnesses. There are cash model hospitals appearing, too. They are mostly specialty like Orthopedics.

The "pre-existing condition" group numbers about 250,000 people. That's not enough to destroy the system for 85% of the population.; २/११/१५, ४:३५ PM
Rusty म्हणाले...: Terry said...
Now playing : ARM comes into the thread, completely ignores EVERY valid piece of discussion in the thread, post and link, but leaves a steaming pile on his way out.
The 'Bush lied and people died!' debate technique.

At this point it's all he's got.
He backed this thing to the hilt even when it was pointed out to him that the economics made no sense at all.
So.
Win!!; २/११/१५, ४:४६ PM
Michael K म्हणाले...: "He backed this thing to the hilt even when it was pointed out to him that the economics made no sense at all.
So.
Win!!"

No, everybody loses when the government is this incompetent. Look at Europe for our future.; २/११/१५, ४:५६ PM
Bay Area Guy म्हणाले...: Europe is committing suicide because the Left did a bang up job killing off Western culture. And nature does so abhor a vacuum...

This is worthy of a thread all to itself. My thought is that Europe was so traumatized by WWII and its aftermath (75 million killed), that it put its entire emphasis on avoiding WWIII, and, made the conscious decision to run away from Christianity, capitalism, the military, and any form of nationalism, which it mistakenly believed were the root causes of that devastating war.

And, now, slowly, except for Poland & Russia (ironically), we see an atheistic, socialist continent throwing down their arms, and welcoming in the Muslim invaders, er, I mean, refugees. Pathetic.; २/११/१५, ५:२० PM
Francisco D म्हणाले...: Michael K,

I am usually in complete agreement with you. However, you might be a bit off in estimating that 50% of medical charges are due to the cost of billing, dealing with insurance, etc. In my Psychology Clinic (associated with a large hospital system) we only give a 40% discount for people who pay cash at time of service. Hence, we are only 80% in agreement.

Of course, with the advent of ICD-!0 codes, medical practitioners have a LOT more coding to do than poor Ph.D. psychologists like me. Our number of MH codes went up by about 20%. MD codes went up by close to 200%.You may be right after all.

Addendum: Obamacare will make me retire in two years. I might otherwise worked several more years (part-time) and provided quality service that will now be provided by Psy.D.'s with little experience, relatively low ability and relatively high grad school loans. They are the equivalent of ARNPs and PAs.; २/११/१५, ५:२१ PM
Rusty म्हणाले...: Michael K said...
"He backed this thing to the hilt even when it was pointed out to him that the economics made no sense at all.
So.
Win!!"

No, everybody loses when the government is this incompetent. Look at Europe for our future.

It matters not a wit to them. For them it IS a win. Everything that destroys individual choice, for them, is a win.; २/११/१५, ५:२७ PM
David म्हणाले...: All of this happening in less than a year is not "slow motion."; २/११/१५, ५:३८ PM
Michael K म्हणाले...: "However, you might be a bit off in estimating that 50% of medical charges are due to the cost of billing, dealing with insurance, etc."

It varies a lot by the type of practice. In my surgical practice, we had about 30% overhead but most of our charges were "big ticket" items. Most of our office care wasn't even charged. We never charged postops and we never charged post op cancer patients although I saw them annually forever.

General practice was about 80% over head but insurance was about half of that. Maybe less, depending on the type of practice. Two women docs in our area started a cash walking precise 40 years ago. They had x-ray and a small lab. They did fine for years and each took off about 3 months a year. I think they both eventually retired. Alms everybody I know uses Urgent Care as primary doctors now.

I don't know how they handle insurance. I had to buy a new $30,000 computer billing system about 1987 to handle all the managed care. I had 287 contracts with managed care outfits. We couldn't do it manually because they all had different requirements/. I was once fined $500 for sending a patient to the "wrong lab" for a $16 culture. I refused to see that HMO's members in that office anymore.

It was what the English call a "Mare's nest." Now, of course, most doctors are on salary and a billing office which employs about one staffer for each doctor in a 60 person group does all the "back office " stuff. I ran a practice that grossed about $200,000 a month with two full time employees and one part time who came in for office hours.

I am so glad I'm retired. I work a couple of days a week as a federal contractor.; २/११/१५, ५:५२ PM
Michael K म्हणाले...: "Cash walk-in practice..."; २/११/१५, ५:५३ PM
Lewis Wetzel म्हणाले...: The problem Obama faced in passing Obamacare was that 57% of the American people were happy with the plan that they had and only 39% were not happy with their plan (http://www.gallup.com/poll/102934/majority-americans-satisfied-their-own-healthcare.aspx). There was no crisis of health care in 2009. What there was was an economic crisis. The engine of employmeny -- small business -- was hit hard by the collapse in consumer spending that occurred in 2008. It's hard to convince a majority that they need to risk what they have for a government promise -- hence the lie "If you like the plan you have, you can keep it. If you like the doctor you have, you can keep your doctor, too. The only change you’ll see are falling costs as our reforms take hold." https://www.whitehouse.gov/the-press-office/weekly-address-president-obama-outlines-goals-health-care-reform
He had to convince the 85% that liked their plan that Obamacare wouldn't affect them. So he lied. And our wonderful media, the watchdog of democracy, never called him on it.

Powerline is running this Obama interview quote:

And this is where conceptions of government can get us in trouble. Whenever I hear people saying that our problems would be solved without government, I always want to tell them you need to go to some other countries where there really is no government, where the roads are never repaired, where nobody has facilitated electricity going everywhere even where it’s not economical, where the postal system doesn’t work, or kids don’t have access to basic primary education. That’s the logical conclusion if, in fact, you think that government is the enemy.

And that, too, is a running strain in our democracy. That’s sort of in our DNA. We’re suspicious of government as a tool of oppression. And that skepticism is healthy, but it can also be paralyzing when we’re trying to do big things together.

What fucking planet is this guy from?; २/११/१५, ६:१८ PM
Michael K म्हणाले...: "What fucking planet is this guy from?"

Chicago. Next question.; २/११/१५, ७:११ PM
Bob Loblaw म्हणाले...: what's wrong with Medicaid? The people I have known who had it were very thankful for it.

Where I live, a suburban area flush with doctors, the closest doctor I know of who accepts medicaid patients is forty minutes away. If you want an appointment, first available is usually something like two weeks away. For a lot of things, by two weeks you're either going to have recovered on your own or you'll have gone to the ER. What's the point?

The feds are not going to be able to square the financial circle by shorting doctors, and the more they try the more pointless medicaid will be.; २/११/१५, ७:२१ PM
Skeptical Voter म्हणाले...: When Obama became President some little village on Mars lost its idiot. That's the planet he's from.; २/११/१५, ७:२५ PM
Hagar म्हणाले...: In post-WWII Norway, when the Labor Party was indeed socialist and riding high, the medical system was like social security in that a percentage was deducted from all working people's paycheck. Then when you had a medical problem that called for a doctor's attention, you went to the doctor for traetment, the doctor billed you, you paid his bill, and he signed it paid. You then took it to the SS office and they would reimburse you for 2/3 of the amount, and that was it.
There obviously had to be more to it for serious diseases, etc., but this is what I remember from what ailed me, which was usually being bandaged up from some injury or other.

This worked quite well for a small country with a homogenous population and everybody knowing everybody elses business, which kept down the cheating.

And since it did cost something, and Norway then was a poor country, we did not go to the doctor unless we needed to, and there was no drugstores with OTC medications. Just the apothecary for real prescriptions. (and chemicals for making fireworks, of course.)

No chicken soup either, but lots of codliver oil. Ugh!; २/११/१५, ८:२६ PM
Dear corrupt left, go F yourselves म्हणाले...: Obama: 'If you are against a government take over of your healthcare, you must be against road repairs.'; २/११/१५, ८:२८ PM
Hagar म्हणाले...: There of course have been lots of changes since, but about a year ago, I read that the Norwegian government had decided that centralizing medical treatment and other social services had not worked out well, and they were working on sending as much authority and function as possible back to the local communities.

It seems like even the communists are doing that these days, while America is still centralizing all power it can in Washington, D.C.; २/११/१५, ८:३४ PM
Moneyrunner म्हणाले...: A few years ago my primary care physician switched to a concierge service. After a day or two of consideration I realized that his fee was reasonable, I could see him as frequently as I wanted and there was no waiting. I have been very happy with this service.

The cost of medical insurance for a family of four and the deductible make ObamaCare insurance financially unaffordable for a family I'm close to. They are a middle income family who's employer does not provide company-paid medical insurance. One work-around has been the development of health care co-ops where members pay a modest monthly fee and pay for each other's medical expenses. These kinds of organizations are unregulated and if a member contracted a very expensive medical situation such as cancer the organization would be bankrupt. But this is the response of individuals to the disaster that ObamaCare has been to medical care coverage.; २/११/१५, ८:३५ PM
Sammy Finkelman म्हणाले...: khesanh0802 said... 11/2/15, 3:30 PM

My wife has a 46% increase in premium on her BC/BS this year - over 100% since the inception of Obamacare. Deductible increase of 20%. Total annual potential cash outlay before ANY insurance reimbursement: $15,620. Her penalty payments will be $0. All right students; what should she do?

Buy some non-qualifying catastrophic (or even non-catastrophic) insurance, if you can find it.; २/११/१५, ८:४० PM
Moneyrunner म्हणाले...: I'm not sure if the health care co-ops are working outside the law; whether they are illegal under ObamaCare. They strike me as a type of medical underground economy.

Under socialism, there is a great deal of underground financial activity. I recall my father telling me about running his small business in the Netherlands. They had wage controls, limiting the amount he could pay his employees. In order to keep them happy he paid them the "official" wage plus cash under the table.

Somehow people make do. The current American economy is a tribute to the fact that no matter how hard the government tries to stifle economic activity, the flower of freedom manages to sprout through a crack in the cement of government control.; २/११/१५, ८:४६ PM
Michael K म्हणाले...: There is a new type of life insurance that lets you take some of the value for health crises. There will be other innovative evasions,. The health insurers were always negative on heath insurance but other companies with other focus will step in if they are not outlawed.; २/११/१५, १०:३५ PM
Paul म्हणाले...: And notice folks... Congress and the administration are EXEMPT from Obamacare.

You were real suckers voting for him.

Live with it stupes.; २/११/१५, १०:४८ PM
Big Mike म्हणाले...: People were always going to opt out because their Obamacare, by law, requires them to pay for things they will never need -- men and post-menopausal women paying for birth control so Sandra Flake could get favorable attention from Congress and the press, for instance. (Sorry, I meant Fluke. Flake merely describes her personality.) Still, requiring someone who can afford tuition at Georgetown Law ($55,255 per year) to pay for their own birth control pills ($50 per month) seems reasonable to me.; २/११/१५, ११:१० PM
Bruce Hayden म्हणाले...: Mike - i have been using the "Flake" for years. She earned it.; २/११/१५, ११:४८ PM
Achilles म्हणाले...: Eric said...
"what's wrong with Medicaid? The people I have known who had it were very thankful for it.

Where I live, a suburban area flush with doctors, the closest doctor I know of who accepts medicaid patients is forty minutes away. If you want an appointment, first available is usually something like two weeks away. For a lot of things, by two weeks you're either going to have recovered on your own or you'll have gone to the ER. What's the point?"

Medicaid wait time is only 2 weeks? That's better than the VA...; ३/११/१५, १२:०३ AM
Bruce Hayden म्हणाले...: It will be interesting. We continue to see why cutting the Republicans out of the process was so fateful, when t comes to BamaCare. It was designed to fail (by ignoring basic economics). And that pretty much guaranteed that the Republicans would retake the House at the earliest chance after PACCA enactment, which made tweaking the program almost impossible, esp while Obama is President. This is his signature legislatin, and he is vain enough and suborn enough that there will be no compromises as long as he has the power to prevent such.

And, no, there will not be a single payer system n this country until the Dems can retake both houses of Congress, while maintaining their control f the Presidency. Voting for it would be suicdal politically for almost any Republican, and the GOP is likely to lose the House until they have held rhe Presidency again for better than one term. Or, until the Dems can give all the illegals the vote through executive action. This may have been the preferred solution for a lot of Dems, but is anathema for Republicans, who are very likely going to retain the House for at least much of the next decade.; ३/११/१५, १२:०७ AM
Guildofcannonballs म्हणाले...: "I have no doubt that those who get welfare are very thankful."

OMG.

I have a bunch of doubt saying your statement is 99% wrong, yet as youtube or google can show anyone, after short time of receiving their entitled amount human nature, God Bless Her heart, demands bitching for more and more and more from the bad/evil rich who took yours.

The less you earn, the more you feel justified taking when compared to evil people like doctors performing surgery instead of giving a pill, reducing costs, or somebody who, like, oh you know, drives or uses or, GOD FORBID, produces *trigger warning* oil.; ३/११/१५, १२:१५ AM
Guildofcannonballs म्हणाले...: Diagnosis: Human

Cure: Faith in God's Providence, or for any reason excluding that as a last resort, Nature's Creator as paradigmed by the Constitution, including the recognition power doesn't corrupt of necessity but unfortunately for everyone involved save society's (blingful) bottom-dwellers allows easily the averaging of the pedestrianism of cruel desposts' actions with visions of Che's effective-because-so-grisly murders and Stalin's Knowing Deaths and Mao's Great Philosophy Near-Genocide in their heads, along with their Halo to Heaven for caring so Goddamned fucking much about their stupid subjects they had to spend so much time controlling, or thanklessly attempting to.; ३/११/१५, १२:३९ AM
Guildofcannonballs म्हणाले...: If details matter, then using terms like "no" or "very" should mean something other than what I take them to mean, which is the use that the modern man can't fathom, without the hyperbole I just used, because the word fathom is never used at all anymore by anyone ever.

I believe an entity other-than-me wrote the above, so I ain't not be using me no damn self-refuting examples, Sir.

(editor says Your Welcome); ३/११/१५, १:०० AM
BN म्हणाले...: I used to be so lucid. But then I read all these comments.

Now... not so much.

So all I can say is... oh hell... what's the use?; ३/११/१५, १:०८ AM
exhelodrvr1 म्हणाले...: You voted for him, when it was blindingly obvious that this was very likely to happen.; ३/११/१५, १:२५ AM
Guildofcannonballs म्हणाले...: The people very grateful for the welfare state, those whom take liberty in order to benefit themselves, are paid along with abortion doctors using tax dollars spent because, as so wisely put before gun shots in a gangster rap album from my youth, "I can."

Trumps subverting this well-known motivator with something more powerful, demonstrating money, in more ways than one I'm talking here for those of you dull, is a key.

You people here ain't opening no doors soon anytime though, as it should be. Ignorance is many things including bliss of course. It's deadly and ignorant to promote also. I could, most likely will, consider ignorance as infinite given another three seconds.

Confirmed.; ३/११/१५, १:३५ AM
damikesc म्हणाले...: And, now, slowly, except for Poland & Russia (ironically), we see an atheistic, socialist continent throwing down their arms, and welcoming in the Muslim invaders, er, I mean, refugees. Pathetic.

And the "elites" cannot explain WHY the citizenry should go along (because this is not something the people want. The government wants it). It's just "BIGOTRY!!" yelled at critics. And when "respectable" parties ignore popular will, well, "non-respectable parties" will pick up the slack happily.

People forget that a lot of these horrendous regimes that did so much destruction and genocide --- initially had popular support because the government in power ignored the citizenry.; ३/११/१५, ६:५३ AM
Robert Cook म्हणाले...: "Robert Cook - Explain to the class why NOT ONE single solitary member of the GOP voted for ObamaCare?"

Because it was Obama promoting it. If a Republican president had promoted a similar scheme, you can be certain the Republicans would have voted for it.

(Do not infer, by the way, that I support Obama or Obamneycare...I don't. I believe we should be exploring some form of single-payer health system, cutting the insurance companies out altogether. As I stated, Obamneycare is just a scheme to funnel more money to the insurance companies.); ३/११/१५, ७:१९ AM
Robert Cook म्हणाले...: "That would be cheap and the education of the public is the most useful feature of Obamacare.

"They are finding out how expensive 'free care' is."

Who ever said Obamneycare would be "free care?" That whole premise of it is the government requiring people to buy insurance from private companies.; ३/११/१५, ७:२२ AM
Guest videos म्हणाले...: ही टिप्पणी लेखकाना हलविली आहे.; ३/११/१५, ७:३६ AM
khesanh0802 म्हणाले...: @Sammy Winkleman Cheapest catastrophic policy I could find in Mn was $600.00. There really is no truly "catastrophic" insurance available here.; ३/११/१५, ९:१४ AM
khesanh0802 म्हणाले...: @ Robert Cook Both ObamaCare and RomneyCare were sold on the premise that it would save individuals money. This made sense to some of the people. If not "free' then cheaper - which made sense - but it turned out it was a lie and those selling knew it all along. Even the insurance companies, who thought they were going to make a killing, are turning out to be wrong and they have all these actuaries! You can not legislate a change in human nature, although some will never stop trying.; ३/११/१५, ९:२१ AM
Lewis Wetzel म्हणाले...: "Because it was Obama promoting it."
Utter bullshit. Your evidence for this is . . . exactly nothing. This is a thing that was created in your mind, Cook.
How many Republicans voted for Obama?
"According to a Wall Street Journal/NBC News poll this month, 5% of respondents who identify themselves as Republicans say they plan to vote for Sen. Obama in November, compared with 74% for Sen. McCain."
http://www.wsj.com/articles/SB122442243992348037#printMode
That's called a citation, Cook.; ३/११/१५, १०:०६ AM
Anthony म्हणाले...: Doesn't matter. 98% of the news media won't really report on it. As far as they're concerned, it's working! After all, 10 million people now have insurance that didn't before! Isn't that wonderful?!

Besides, OCare wasn't ever intended to fix anything or even work. It's sole purpose was to get something to pass while they had the votes. Saying "They didn't understand insurance markets" or whatever is beside the point; they didn't care because they weren't trying to make it work or do anything besides getting the Fed's paws on the health care industry.; ३/११/१५, ११:३५ AM
damikesc म्हणाले...: (Do not infer, by the way, that I support Obama or Obamneycare...I don't. I believe we should be exploring some form of single-payer health system, cutting the insurance companies out altogether. As I stated, Obamneycare is just a scheme to funnel more money to the insurance companies.)

Single payer would be amazing, I bet.

Wait...we already have one MAJOR single payer system.

The VA.

Man, I bet they got their shit together.; ३/११/१५, २:३५ PM
Diogenes of Sinope म्हणाले...: All that matters is they had good socialist, intentions.; ३/११/१५, ७:४४ PM
Rusty म्हणाले...: Everything is markets; ४/११/१५, ६:०० AM