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JuanGuzman

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Posts posted by JuanGuzman

  1. What you're not grasping is that it's a product most people don't want, and no matter what you fix, no matter what you adjust, no matter what law you pass mandating people by it, if it sucks...and everyone knows it sucks...not enough people are going to buy it. It's just the way this country works, and Obama's WH FUBAR'ed that very concept by thinking they could legislate behavior.

     

    I know the polls measure Obamacare as unpopular, part of that is the terrible roll out of the program, and part of that is the negative emphasis the republican's place on it. But I think when you ask American's about individual pieces of the law e.g., should insurers be dis-allowed from denying insurance based pre-existing conditions? you find general support for a lot of ACA principles

     

    I'm of a mind the the polls will change once people see that the law is helpful and the tea party hyperbole is shown to hot air, Obama won the election that was the most important feedback the american people gave, he won a mandate. Sure if you want to repeal the law by all means do it through the elecoral process, elect a president promising to repeal obamacare, elect senators and congressman who will get rid of it etc. But you can't just go ripping up legislation because polls about a program that hasn't even been fully implemented show xx per cent of people are against it etc.

  2.  

    There are few things more fun to watch than a progressive who refuses to admit they screwed up. The roll out wasn't bad enough. He's got to delegate its rescue mission to people who think a guy drinking hot cocoa in a onesie is their target audience.

     

     

    I don't mind admitting the roll out sucked, terrible that the exchange has so many bugs in it when it was launched. ACA is the administration flagship law, the other side just exhausted a lot of political capital shutting down the government in an attempt to repeal it. You should make sure the tech is working relatively well before you go live.

     

    That being said tech failures get fixed, dumb advertising campaigns get replaced. The merits of policy are what matter, and like I said before this is policy is a big improvement on the previous statusquo.

  3. Quoting this anectodal plan shows what a BS's you are. No one here is impressed.0o

     

    I generally agree with you. Anecdotes alone are not very convincing alone. But mainly that was is what I'm hearing from the other side on this anecdotes about plans being cancelled,

     

    Show me anecdotes with data, if you follow most of my posts in this thread they are either looking at big picture data or explaining the theory but once in a while it's nice to post a story about someone saving some money

  4. Lots of People Are Saving Money Thanks to Obamacare

    True story: I’m self-employed, so for several years we’ve been paying out of pocket for a family health insurance plan (me, my wife, my son) from Independence Blue Cross here in Pennsylvania. We have no group to join, no company plan; we effectively buy health insurance at retail cost. Our rates have steadily increased every year, to the point where as of today, we’ve been paying $1500 a month to cover the three of us, for a plan with good coverage (by U.S. standards) and a $500 deductible.

    A few months ago, we got one of those controversial notices that our current plan was being cancelled because it wasn’t compliant with the Affordable Care Act, so we’d have to find a new plan before January. My wife went online, to Healthcare.gov, found a new plan from our same insurer with as good or better coverage — equivalent prescription coverage, same network of doctors and hospitals, same $500 deductible — and our new bill, starting next month, will be $1050 per month. No subsidies or anything like that. We’re just saving over $5000 per year, thanks to Obamacare.

    Link: http://daringfireball.net/linked/2013/12/17/obamacare
  5.  

     

    That the VA works has no bearing on what a mandatory insurance plan with little enforcement will do. I couldn't read the article you linked, but did it mention anything about cost per patient in comparison or just the increased percentage comparison?

     

    I don't think it does, those comparisons are harder because you have to adjust for how sick the average patients are. I realize the fact that VA health care works does not mean that the individual mandate will work. I post it mainly because it combats the generic argument that governments shouldn't be in the health care business. If anything VA care is the most heavy handed government health program out there as they are a provider of health services not just an insurer.

     

    But if you want to see examples of a working individual mandate look at Germany or Massachusetts.

  6. http://tucsoncitizen.com/medicare/2010/06/07/va-health-care-system-rated-highly-in-government-report/

     

    "A recent report by the Congressional Budget Office (CBO) says the VA  (U.S. Department of Veterans Affairs) does a much better job controlling health care costs than the private sector delivery system which is used by Medicare and all private sector insurance plans.

     

    The CBO estimates that the VA’s health care cost per enrollee grew by only 1.7 % from 1999 to 2005, which amounts to 0.3% annually. Medicare’s costs grew 29.4 % per capita over that same period, or 4.4 % per year.  In the private sector insurance market (employer and individual plans) premiums increased by more than 70% during this period.

     

    The CBO report also says that the VA scores better than the private sector when it comes to patient/customer satisfaction. In 2005, the VA achieved a satisfaction score of 83 out of 100 for inpatient care and 80 out of 100 for outpatient care.  The same survey showed private-sector providers of got 73 for inpatient care and 75 for outpatient care."

     

     

    I know that VA had trouble dealing with the influx of veterans after Iraq and Afghanistan but to 3rdning comments this form of government health care has performed well in terms of cost control

  7. Every single example of "efficiency" you posted, for starters.

     

    see this is my problem with you DC Tom, I ask you to explain how it was incorrect and you don't, or are unable to. Just another vague assertion that my examples don't fit your criteria.

     

    I listed reforms that will achieve cost savings or deliver better services. I argue that they are efficient. Explain to me how they are not? Demonstrate a modicum of usefulness and make an argument please

  8. I think you're an idiot for many reasons, going back to your earlier posts on this board.

     

    I just highlight this one because I thought you might understand how it demonstrates your idiocy. Clearly I gave you far too much credit.

     

    Haha well lets just end this debate in true message board form, by both calling each other an idiot. You're the idiot!

     

    Anyway like I said many times over I'm interested in watching Obamacare evolve over the next few years and seeing who was right and wrong. I'll check back in here to either face the music or to crow about the improvement in the U.S. health care system thanks to the Affordable Care Act.

  9. He's on a playoff team now in Cincinnati.....Where was the pressure in Buffalo??

     

    Yeh we will see how he performs. I think being a NFL punter is a high pressure job regardless of record, it comes from knowing that you have non-guaranteed contract and can be cut at anytime for under performance. As a fan god knows I am quick to pile on the punter if he screws up because its so easy to evaluate his performance.

     

    Basically one job is too punt far without allowing a return.

  10. Just to be clear, you're playing the "But it's a conservative plan!" card while simultaneously whining that other people won't argue with you on merit?

     

    I can't possibly imagine why anyone would believe you're an idiot.

     

     

    haha thats all you got? You think I'm idiot cause i correctly stated that some of the Obamacare principles evolved from the Heritage Plan. Note that I was responding to a guy who linked to heritage piece about administrative costs it was and topical and I referred to it as an an FYI.

  11. I'll give you a hint.

     

    While there's no reason for you have read ALL 63 pages of this thread,

     

    this (at least) the tenth time someone has tried to play the Obamacare = Heritage/Conservative silliness.

     

     

    What is the argument regarding the heritage proposal of an individual mandate about anyway? Personally it doesn't make a lick of difference to me if some of the policies in the ACA were from Heritage Institute or not, I was just pointing it out for interest.

     

     

    "[N]either the federal government nor any state requires all households to protect themselves from the potentially catastrophic costs of a serious accident or illness. Under the Heritage plan, there would be such a requirement...

    Society does feel a moral obligation to insure that its citizens do not suffer from the unavailability of health care. But on the other hand, each household has the obligation, to the extent it is able, to avoid placing demands on society by protecting itself...

    A mandate on households certainly would force those with adequate means to obtain insurance protection.

    Here is link: http://healthcarereform.procon.org/sourcefiles/1989_assuring_affordable_health_care_for_all_americans.pdf check out page 6

     

    Anyway again just a point of interest

     

    What matters is the actual policy on how it affects health markets. But please enlighten me on this issue

  12. If you were at ALL capable of understanding why you're retarded, you'd have figured out why already. But here's a BIG hint:

    If you were at ALL capable of understanding why you're retarded, you'd have figured out why already. But here's a BIG hint:

    You're a freakin' idiot.

     

    Neither of you seem capable of making actual arguments. Just your typical Ad Hominem logical fallacies out of your mouths.

  13. JuanGuzman:

     

    Medicare administrative costs, as outlined in your argument are intentionally not demonstrated as as apples to apples comparison so as to distort the actual metrics.

     

    Consider:

     

    1) Many of Medicares costs are administered by external government agencies, and reflect in those agencies budgets, rather than the Medicare budget. The IRS collects the taxes that funds the program, the SSA collects the premiums paid by the beneficiaries, and the DHHS handles the accounting, auditing, and other business functions.

     

    2) Because of the particular risk pool being dealt with by medicare (ie. the old and the sick) costs for treatments are higher. This drives up the denominator of the administratice costs per partient significantly. I'll quote directly from Forbes:

     

    "If two patients cost $30 each to manage, but the first requires $100 of health expenditures and the second, much sicker patient requires $1,000, the first patient’s insurance will have an administrative-cost ratio of 30%, but the second’s will have a ratio of only 3%. This hardly means the second patient’s insurance is more efficient — administratively, the patients are identical. Instead, the more favorable figure is produced by the second patient’s more severe illness."

     

    You may which to read the work of Robert Book: http://www.heritage....ivate-insurance

     

    Thanks. I'll have to review the article before I can comment in full but in principle the logic to your argument does make sense, I wonder if its addressed in the NEJM paper. I'll note though that one wau medicaid and medicare can hold down costs by not doing any advertising.

     

    This is from the CBO:

    According to a recent analysis, administrative costs for

    private health insurance totaled $90 billion in 2006 (see

    Table 3-1), of which about $24 billion was for marketing

    and related costs,

    link: http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/99xx/doc9924/12-18-keyissues.pdf re: page 69

     

     

    Just an FYI it was the Heritage Institute that first proposed the Individual Mandate... many of the ideas in the ACA come from conservative ideas in the past

     

    The concept of the individual health insurance mandate is considered to have originated in 1989 at the conservative Heritage Foundation.
    link: http://healthcareref...sourceID=004182
  14. What? I'm just going after the boiler plate 4% vs. 20% argument, that Juan didn't even get right. That argument is predicated on the assumption that you never run into somebody like me.

     

    Bad assumption. I now have access to terrabytes of data. All of which says the same thing:

     

     

    You guys know where the "Medicare administrative costs are 4%, private insurance are 20%" comes from?

     

    The West Wing. Yes, TV show "data". And, it's 4%, not 2%, and there's a reason WHY.

     

    Haha oh man, I'm supposed to believe the internet commentator ranting about his access to terrabytes of data. Yes it's all a conspiracy. Look the reality is people with sharpminds, advanced degrees have had their work peer reviewed and come to the same results about administrative costs.

     

    Bllomberg Business Week:

    More than 20 years ago, two Harvard professors published an article in the prestigious New England Journal of Medicine showing that health-care administration cost somewhere between 19 percent and 24 percent of total spending on health care and that this administrative burden helped explain why health care costs so much in the U.S. compared, for instance, with Canada or the United Kingdom. An update of that analysis more than a decade later, after the diffusion of managed care and the widespread adoption of computerization, found that administration constituted some 30 percent of U.S. health-care costs and that the share of the health-care labor force comprising administrative (as opposed to care delivery) workers had grown 50 percent to constitute more than one of every four health-sector employees
    http://www.businessweek.com/articles/2013-04-10/the-reason-health-care-is-so-expensive-insurance-companies

     

    New England Journal of Medicine:

     

    The average U.S. physician spends 43 minutes a day interacting with health plans about payment, dealing with formularies, and obtaining authorizations for procedures.1 In addition, physicians' offices must hire coders, who spend their days translating clinical records into billing forms and submitting and monitoring reimbursements. The amount of time and money spent on administrative tasks is one of the most frustrating aspects of modern medicine.

    Indeed, for the system as a whole, administrative tasks are extremely costly. According to the Institute of Medicine (IOM), the United States spends $361 billion annually on health care administration2 — more than twice our total spending on heart disease and three times our spending on cancer. Also according to the IOM, fully half of these expenditures are unnecessary.

    What can be done to reduce these costs? Though some argue that a single-payer system would eliminate many administrative expenses, that solution seems unlikely to be embraced in the United States. Nevertheless, administrative expenses are one area of health care in which large savings might be realized particularly rapidly

    http://www.nejm.org/doi/full/10.1056/NEJMp1209711

     

    I give you OECD data showing U.S. isn't getting very much bang for their buck in terms life expectancy and per-capita health spending... and you respond with blinding ignorance, nothing to see here folks.

     

    I give you examples of obamacare inititiatives to lower costs such as expansion of medicaid 092113krugman2-blog480.png

     

    And you barely blink "oh yeh sure they doing a way better job keeping costs low but what about outcomes" keep in mind that these people can't afford insurance in the private market because insurance companies can't get an appropriate risk pool because of information assymetry e.g., the patient knows more about their health status than the insurance does. They now have access to preventative treatment.

     

     

    I should also mention that I am a transplant patient, so I do have quite a bit of personal experience with all types of health insurance, both good and bad. In 2015 when my plan gets cancelled because my employer cannot afford to splurge out an extra 40% off the top for the same coverage, our cost WILL go up, and our coverage WILL go down. It is ridiculous and beyond comprehension that anyone would argue it would not. It HAS to, it's designed to do that. This is why that law is ****...

     

    what if you lost your job? thanks to Obamacare you will no longer be denied insurance because of pre-existing condition. Or what if you wanted to work as a consultant because the hours and pay was better. well than you'd be pretty happy to be able to get affordable insurance as a private individual.

     

    honestly none of you have the ability to argue effective salient points on this issue (you've been swallowed whole by asinine talking points". nor is there insterest in getting to the bottom of U.S. health challenges. you just throw crap at the wall and see what sticks.... "Cadillac Health Plans are efficient" haha

    The story is about Obamacare's "Cadillac Tax," which isn't really a tax so much as a convoluted attempt to undo an existing tax break. To simplify things a bit, the government today doesn't treat employer health insurance as taxable income. That makes a dollar of insurance worth more than a dollar of wages, giving both employers and employees incentive to load up on insurance
    http://www.newrepublic.com/article/113323/obamacare-cadillac-tax-conservatives-should-love-it

     

    Conservative should love this, it's a repeal of government subsidy for insurance that cause people to over consume health services, Unions are filled with cadillac plans and I say get rid of em.

     

    Or you "insert anecdote about so-so losing their insurance because of obamacare" even though the net effect on insurance rolls is positive. By 2017 the CBO expects to the number of uninsured to be reduced by 27 million people http://www.cbo.gov/sites/default/files/cbofiles/attachments/43900_ACAInsuranceCoverageEffects.pdf

     

    or you say you are going to do something and don't

     

    here I was warming up to crush each bullet....

     

    Why don't you actually do it OCinBuffalo.. crush each bullet point instead of patting your fellow idealogues on the back for making non-sensical points

     

    Obamacare ain't perfect but its way better than the status quo...

    1) more people will be able to get health insurance

    2) per-capita spending on health care will slow because of the efficiency cost control measures in the act

    3) productivity will increase as people can finally move from job to job, from employed to self employed without worrying whether they can get insurance

    4) U.S. Health Outcomes will improve

  15. None of those are measures of efficiency, merely cost-cutting measures.

     

    Do you know what "efficiency" means?

     

    Starting to question your intelligence if you don't think the ACA measures i listed are efficient.

    Getting the same drugs for less money = efficient

    promoting competition through online exchanges = efficient

    reducing hospital re-admissions through incentives for better treatment = efficient

    reducing the number of cadillac plans that inefficiently use health resources = efficient

    Access Preventative Care that lowers life time spending health and improves outcomes = Efficient

    reducing administrative fees = Efficient

     

    ect the list goes on.... cutting costs and maintaining or in this case improving service is a textbook definition of improved efficiency.

     

    Anyway, it's clear most people have made up their mind in this room. (at least those commentating). I doubt I can convince anyone support Affordable Care Act, and I don't think I'll be convinced by anyone that ACA is worse than the status quo.

     

    The awesome thing is we are going to have the next half decade to see who was right and who was wrong. I look forward to it

  16. You've got me cornered. I can not find a single link that proves 50 million people were uninsured before Obamacare was passed.

     

    Here it is:

    The United States Census Bureau annually reports statistics on the uninsured. The current Census Bureau report states that the number of Americans living uninsured declined to 48.6 million in 2011 from 49.9 million in 2010. In in 2009 there were 50.7 million people in the US (16.7% of the population) who were without health insurance. link: http://www.census.gov/newsroom/releases/archives/income_wealth/cb11-157.html

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