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OBAMA/TRUMPCARE MEGATHREAD


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QUOTE (StrangeSox @ Oct 15, 2016 -> 03:30 PM)
We also still have the majority of Americans getting their coverage through non- exchange plans, so while the struggles the exchanges are seeing in some states aren't good, it's not the total destruction of the private health insurance industry.

Yes but the non exchange plans are getting more expensive every single day and covering less and less. It's a joke, actually. And ... despite all this, many industries are daily concocting ways to cut workers, get rid of workers. Why? They don't want to pay for health care for employees so they are cutting, cutting, cutting. It's very sad. Health care indeed is killing Americans.

 

QUOTE (southsider2k5 @ Oct 15, 2016 -> 03:37 PM)
There is the "intent" of the law, and then there is the intent of the law. I have no doubt the government won't be content just controlling insurance, they then will want to control medication distribution and the actual practice of medicine, that they they can control "costs" to save us all.

Probably. And yet so many on here are supporting fully and heavily the big government party over and over.

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  • 2 weeks later...
QUOTE (StrangeSox @ Oct 25, 2016 -> 08:27 AM)
Rates Rise Again For Obamacare Health Plans, But So Do Subsidies

 

Steep rises for plans on the federal exchanges for next year. The underlying issue with both these premium increases and with some insurers pulling out of some markets seems to be that the population that is served by the exchanges need more healthcare than anticipated.

 

So the cost estimates were too low? Get out.

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QUOTE (southsider2k5 @ Oct 25, 2016 -> 10:17 AM)
So the cost estimates were too low? Get out.

 

Health insurers as well underestimated the health care needs of the people who would be using the exchanges.

 

The story here is multi-fold, with the good part being millions of people getting health care they needed but didn't have access to before.

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QUOTE (Ezio Auditore @ Oct 25, 2016 -> 10:20 AM)
That was the point of the public option.

Also worth noting - keeping companies in the exchanges even if they underestimated their costs was the point of the "risk corridor" funds inserted into the original PPACA. Marco Rubio had this stripped out through a clause inserted into an omnibus spending bill.

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QUOTE (StrangeSox @ Oct 25, 2016 -> 10:22 AM)
Health insurers as well underestimated the health care needs of the people who would be using the exchanges.

 

The story here is multi-fold, with the good part being millions of people getting health care they needed but didn't have access to before.

 

And the bad part being millions of people seeing a decline in their quality of health care they had before because they are being excluded or can no longer afford it

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I've long said that the most efficient way to do Obamacare is through a fully national system (not saying I am on board with it cause it will bring down the general quality of care, imo, without the right processes in place and we certainly don't want our nationals healthcare system to turn into the VA system). Doesn't mean that provides the best care, but it is the best way to ensure the most cost effective way (if done right) to provide some bare minimum care to all American's. Otherwise, you have kind of anti-selection and an inability for the insurers to make margins on who goes where (hence why you have large rate increases or people pulling out). That or you just realign and subsidize it in different ways (with others picking up more of the tab). It isn't perfect, but I do believe it is better than what existed prior to Obamacare. I hope we can come up with a better way to do it as a whole, but just repealing it with no real plan is not an option, imo.

 

That said, no matter what we do, whether it is squeeze margins, you push somewhere and it will impact other things. Our costs are out of control so unless you essentially have a government (kind of like with medicare / medicaid) draw the line in the sand about costs associated with widely used procedures, etc., ultimately it is pretty hard to curb costs (and remember, if you do that, profit margins of the companies providing the drugs, etc, might shrink). Very complex issue, one that Obama has improved with, but one that is still and should be a major issue (there is no reason we shouldn't be able to provide high quality medical care to everyone in this country at a price that isn't absurdly unreasonable and growing at rates much larger than inflation).

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I got prescribed a drug for bad cholesterol counts and it was 15 bucks. I asked the pharm person what it costs if I have no insurance. It's 235 bucks. Cmon, folks. Our country is a joke. No medical product should cost the uninsured 235 bucks. The supply was for a month. If we can't get our costs together, then I'm in favor of a government run system. I know plenty of people without insurance. Think of the costs of drugs!!!

 

Obamacare is a disaster. If the Republicans were to win, they'd repeal it. Then what would we have? Something similarly bad I'm sure. We're all afraid a government run plan would be as disastrous as VA hospital situatiion. We've got to do something. TONS OF PEOPLE have no insurance.

 

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QUOTE (greg775 @ Oct 25, 2016 -> 06:34 PM)
I got prescribed a drug for bad cholesterol counts and it was 15 bucks. I asked the pharm person what it costs if I have no insurance. It's 235 bucks. Cmon, folks. Our country is a joke. No medical product should cost the uninsured 235 bucks. The supply was for a month. If we can't get our costs together, then I'm in favor of a government run system. I know plenty of people without insurance. Think of the costs of drugs!!!

 

Obamacare is a disaster. If the Republicans were to win, they'd repeal it. Then what would we have? Something similarly bad I'm sure. We're all afraid a government run plan would be as disastrous as VA hospital situatiion. We've got to do something. TONS OF PEOPLE have no insurance.

Technically, more people have insurance now with Obamacare than before (so more people would have some form of coverage). I agree that there are disasters and major issues with it. To me you either go single payer or you don't. That is the only way it can truly work successfully. Whether as a country we are ready to do that while still having the right standards in place to ensure we have high quality care, incentives for innovation in the medical industry (as well as incentives for doctors to go through all it takes to be a doctor). Not an easy solution.

 

The interesting thing is once you turn 65, everyone in this country is all for a single payer model (i.e., medicare / medicaid). prior to that, burn in hell if you want to socialize medicine. What gives?

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QUOTE (Chisoxfn @ Oct 26, 2016 -> 10:49 AM)
Technically, more people have insurance now with Obamacare than before (so more people would have some form of coverage). I agree that there are disasters and major issues with it. To me you either go single payer or you don't. That is the only way it can truly work successfully. Whether as a country we are ready to do that while still having the right standards in place to ensure we have high quality care, incentives for innovation in the medical industry (as well as incentives for doctors to go through all it takes to be a doctor). Not an easy solution.

 

The interesting thing is once you turn 65, everyone in this country is all for a single payer model (i.e., medicare / medicaid). prior to that, burn in hell if you want to socialize medicine. What gives?

 

Some sort of bias towards believing we need to care for the elderly but no one else?

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QUOTE (Chisoxfn @ Oct 26, 2016 -> 09:49 AM)
Technically, more people have insurance now with Obamacare than before (so more people would have some form of coverage). I agree that there are disasters and major issues with it. To me you either go single payer or you don't. That is the only way it can truly work successfully. Whether as a country we are ready to do that while still having the right standards in place to ensure we have high quality care, incentives for innovation in the medical industry (as well as incentives for doctors to go through all it takes to be a doctor). Not an easy solution.

 

The interesting thing is once you turn 65, everyone in this country is all for a single payer model (i.e., medicare / medicaid). prior to that, burn in hell if you want to socialize medicine. What gives?

 

The problem is that it's difficult to vote against your interest. If you have good, employer provided insurance, or if you are generally healthy, you didn't see the issue with the pre-Obamacare system. Catastrophe policies were cheap - even if you didn't really get much coverage. So unless you had a pre-existing condition, or your employer didn't provide coverage, there was no reason to see the problem with the system.

 

I am struggling with how to vote on a measure in CO this year that would turn the state to single payor - no premiums to insurance companies, no deductibles for the vast amount of care. The measure will be funded by (1) the State would move off the exchange and under ACA would receive the amount paid to CO residents in ACA subsidies as federal funding; and (2) a 10% payroll tax - 2/3 of which is paid by the employer and the remaining 1/3 paid by the employee.

 

I'm generally very in favor of single payor. But here's the problem: my employer covers the cost of my insurance premiums entirely. It's a really, really great benefit for me and I consider that in my total compensation package. I'm relatively healthy (knocks on wood), so my total annual expenditure on healthcare is practically nill.

 

A vote for single payor in CO means higher taxes for me without the corresponding benefit so long as I stay healthy. If I paid insurance premiums, this would be an easy decision because I'd basically be trading those premiums for a deductible free insurance policy. Under ordinary circumstances, I'm absolutely the voter that the amendment would hit, but a vote against my pocket book is a tougher sell. So the dilemma is do I vote for the societal good, or do I vote my own selfish gain?

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QUOTE (illinilaw08 @ Oct 26, 2016 -> 11:44 AM)
The problem is that it's difficult to vote against your interest. If you have good, employer provided insurance, or if you are generally healthy, you didn't see the issue with the pre-Obamacare system. Catastrophe policies were cheap - even if you didn't really get much coverage. So unless you had a pre-existing condition, or your employer didn't provide coverage, there was no reason to see the problem with the system.

 

I am struggling with how to vote on a measure in CO this year that would turn the state to single payor - no premiums to insurance companies, no deductibles for the vast amount of care. The measure will be funded by (1) the State would move off the exchange and under ACA would receive the amount paid to CO residents in ACA subsidies as federal funding; and (2) a 10% payroll tax - 2/3 of which is paid by the employer and the remaining 1/3 paid by the employee.

 

I'm generally very in favor of single payor. But here's the problem: my employer covers the cost of my insurance premiums entirely. It's a really, really great benefit for me and I consider that in my total compensation package. I'm relatively healthy (knocks on wood), so my total annual expenditure on healthcare is practically nill.

 

A vote for single payor in CO means higher taxes for me without the corresponding benefit so long as I stay healthy. If I paid insurance premiums, this would be an easy decision because I'd basically be trading those premiums for a deductible free insurance policy. Under ordinary circumstances, I'm absolutely the voter that the amendment would hit, but a vote against my pocket book is a tougher sell. So the dilemma is do I vote for the societal good, or do I vote my own selfish gain?

 

I honestly think I would vote against that measure. Remember that Vermont tried this. THere is a huge benefit to this being done on federal level with ability to handle debt more effectively than at state level. You have larger customer base, more diversification to negotiate (read: dictate) rates to providers, and again, for states that are older (fortunately not colorado anymore) they would be bankrupted by that.

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That's what Bill Clinton was talking about when he called our current system "crazy," right? Like if you were starting from scratch, no one would ever set out to design the current system we have with employer-provided health insurance being the primary vehicle for coverage for everyone not in retirement age, a whole separate system for people 65+ that's just fully socialized, patchwork medicaid and SCHIP programs, etc. etc.

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QUOTE (LittleHurt05 @ Nov 8, 2016 -> 03:03 PM)
"Your plan has been discontinued. We will automatically enroll you in this new plan that has a much higher deductible and costs 33% more." Every November, a kick to the nuts. Hopefully Clinton Care will save the day.

Ha, you' get to be uninsured now.

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  • 5 weeks later...

 

U.S. life expectancy declines for the first time since 1993

 

For the first time in more than two decades, life expectancy for Americans declined last year — a troubling development linked to a panoply of worsening health problems in the United States.

 

Rising fatalities from heart disease and stroke, diabetes, drug overdoses, accidents and other conditions caused the lower life expectancy revealed in a report released Thursday by the National Center for Health Statistics. In all, death rates rose for eight of the top 10 leading causes of death.

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I'm one of those people who has had their premiums more than double in the last few years. It was steady before the ACA. Didn't lose my plan so I'm grandfathered into a plan with a low ass deductible. It's weird feeling lucky that I'm only getting really screwed instead of super screwed. But I'm not getting screwed remotely close to the level the poor or sick were before the ACA. It still hurts though cuz I work my butt off. And the poor are poorer because of the ACA but they have insurance. But it's not like the super poor are happy now, working way less but having insurance. It's a really tough situation all around.

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QUOTE (Jerksticks @ Dec 9, 2016 -> 01:40 AM)
I'm one of those people who has had their premiums more than double in the last few years. It was steady before the ACA. Didn't lose my plan so I'm grandfathered into a plan with a low ass deductible. It's weird feeling lucky that I'm only getting really screwed instead of super screwed. But I'm not getting screwed remotely close to the level the poor or sick were before the ACA. It still hurts though cuz I work my butt off. And the poor are poorer because of the ACA but they have insurance. But it's not like the super poor are happy now, working way less but having insurance. It's a really tough situation all around.

 

The poorest of the 20 million people who have gained coverage, roughly 7-8 million people, have gained it through the Medicaid expansion and aren't impacted by insurance premiums.

 

The sick, or those with pre-existing conditions, got zero coverage before and now have coverage. The reason we've been seeing premiums rise as much as they have is that insurance companies didn't anticipate how poor the level of health for people just getting insurance would be.

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QUOTE (StrangeSox @ Dec 9, 2016 -> 10:23 AM)
The poorest of the 20 million people who have gained coverage, roughly 7-8 million people, have gained it through the Medicaid expansion and aren't impacted by insurance premiums.

 

The sick, or those with pre-existing conditions, got zero coverage before and now have coverage. The reason we've been seeing premiums rise as much as they have is that insurance companies didn't anticipate how poor the level of health for people just getting insurance would be.

I continue to find this incorrect.

 

Premiums have actually risen, even counting this year, more slowly than they did during the Bush years. This year has partially caught up with the projections, but health care costs have been increasing at >>5% per year since before I existed.

 

I read statements like the previous one "My insurance premiums were steady" as generally how it works overall - not everyone's costs went up 5% a year. During boom years it would be taken up by businesses so that they didn't lose employees. Not every state goes up at the same time - one state will do a 20% hike one year because there's regulatory approval steps they'd have to take to make smaller jumps happen and those have costs.

 

If your premium was steady, then that's because something else was taking up the cost increases for a couple years and the jump now is it getting passed on to you. Overall health spending is still below what you'd have projected before the PPACA passed, even considering how much care that population needed. That's the classic blaming of everything in the industry on Obamacare when that's just how the industry operated. I understand it - the ACA could have been a more expansive program and done a better job of this, but then it wouldn't have been passed and tens of thousands of extra people would be dead. When we kick the poors back into uninsurance where they belong, costs will still keep going up at that same rate and you'll still go 3 years with steady costs then your company will renegotiate a contract and you'll take a huge hit.

 

At least the only ones kicked to the curb will be the poors, but they don't deserve to live anyway.

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