The Affordable Care Act is Coming Home to Roost

[B-Man]

AP Headlines Obama's 'Health Care Promise' As Year's Top Quote, Truncates What He Actually Said

 

Read more: http://newsbusters.org/#ixzz2nkhQ72qd

 

 

 

 

 

 

Fine print: State can seize your assets to pay for care after you’re forced into Medicaid by Obamacare

 

 

No "free" lunch

 

 

 

 

 

 

Next up for ObamaCare market disruption: small businesses

 

 

[John Adams]

 

promoting competition through online exchanges = efficient

 

 

I'm not going to wade through all 63 pages here but wanted to chime in the HC.gov website and the exchanges.

 

I opened my own firm about 2 months ago and one big concern was figuring out the health care piece. My wife has a job with some benefits so we compared her current benefits vs. what we could get through the exchange. It turns out that the exchange gave us a better plan...with dental--than my wife's job offered--and the healthcare.gov blue cross plan was even cheaper despite her plan being subsidized by her employer.

 

I'm by no means an ACA fan or an Obama lackey but the exchange, if you're looking at health care options, is pretty awesome.

[B-Man]

Cardinal Dolan’s Religious-Liberty Win

 

This has been a fascinating morning. You’d think the news story of the day would be: Cardinal Dolan wins in court against the Obama administration, given the Eastern court in New York yesterday issued a permanent injunction against the Department of Health and Human Services abortion-drug, contraception, sterilization mandate.

 

Wait. Didn’t the president and vice president of the United States tell us the Catholics were all cool with this mandate, that there was no longer a controversy, that their religious liberty had been satisfactorily accommodated? Even before that, didn’t the president of the United States accuse Catholic bishops of bearing false witness in raising conscience concerns about the president’s health-care legislation before it became the “Obamacare” law?

 

That wasn’t true, of course.

 

And where the president has bragged, he has now been slapped down by a court in what’s been a high-profile battle. And yet, it appears a bit muted in the news.

 

Given the amount of coverage the media gave to the “war on women” rhetoric during the presidential campaign, given the way the media often parroted White House talking points while misconstruing the robust case Catholic bishops were in the lead making for religious liberty in the face of the mandate, there should be coverage of a federal court weighing in on Cardinal Dolan’s side of the argument yesterday in Roman Catholic Archdiocese of New York v. Sebelius.

 

I suspect it would be news to most viewers that there was a lawsuit in the first place.

 

 

 

Keep reading this post . . .

[IDBillzFan]

I'm by no means an ACA fan or an Obama lackey but the exchange, if you're looking at health care options, is pretty awesome.

 

There are absolutely values there for some people. The questions that need to be asked include whether your local hospitals are part of the exchange? Are your doctors...especially your wife's OB...part of the exchange? What about your kids' doctors (assuming you have some). Also ,what are your deductibles and cap?

 

They may all be there for you, but we recently announced we would limit coverage only to employees and no longer pay for family's coverage. They could keep their coverage and pay with pre-tax dollars, or look elsewhere. Some went to the exchange and were blown away with how cheap it was, only to find out none of their doctors were available, and the closest hospital part of the plan was too far away. By the time they looked at deductibles and resources, they realized they were getting cut-rate coverage and no access to the doctors and hospitals they've had for the past 15 years.

[JuanGuzman]

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

 

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

[3rdnlng]

I'm not going to wade through all 63 pages here but wanted to chime in the HC.gov website and the exchanges.

 

I opened my own firm about 2 months ago and one big concern was figuring out the health care piece. My wife has a job with some benefits so we compared her current benefits vs. what we could get through the exchange. It turns out that the exchange gave us a better plan...with dental--than my wife's job offered--and the healthcare.gov blue cross plan was even cheaper despite her plan being subsidized by her employer.

 

I'm by no means an ACA fan or an Obama lackey but the exchange, if you're looking at health care options, is pretty awesome.

 

Do you think the premiums will stay the same once they have to account for the actual numbers of the young and healthy who sign up?

[DC Tom]

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:

http://www.businessw...rance-companies

 

New England Journal of Medicine:

 

http://www.nejm.org/...56/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

 

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.

 

 

 

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

http://www.newrepubl...-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/s...rageEffects.pdf

 

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

 

 

 

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

 

You're truly retarded.

[IDBillzFan]

So word is a Microsoft person is going to start running healthcare.gov, and that naturally leads to this:

 

[JuanGuzman]

You're truly retarded.

 

why?

[keepthefaith]

I'm not going to wade through all 63 pages here but wanted to chime in the HC.gov website and the exchanges.

 

I opened my own firm about 2 months ago and one big concern was figuring out the health care piece. My wife has a job with some benefits so we compared her current benefits vs. what we could get through the exchange. It turns out that the exchange gave us a better plan...with dental--than my wife's job offered--and the healthcare.gov blue cross plan was even cheaper despite her plan being subsidized by her employer.

 

I'm by no means an ACA fan or an Obama lackey but the exchange, if you're looking at health care options, is pretty awesome.

 

You might do better on the exchange because you are pooled differently than your wife's company and therefore rated better. Hate to rain on the Obamacare exchange parade but before Obamnacare became law and also in more recent years, you could buy all kinds of individual and family health plans online at places like ehealthinsurance.com through very good providers and for some people here, what they could get on their own was less expensive than what we could provide through the company for comparable coverage. We have a couple high risk folks here who make it more expensive for everyone else.

 

 

 

I give you examples of obamacare inititiatives to lower costs such as expansion of medicaid

 

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.

 

 

 

Apples, oranges and bananas. Medicaid coverage is less coverage than most private plans and makes available far fewer doctors and specialists. Like many things in life, you get what you pay for. This is not hard for you to understand, right?

[JuanGuzman]

 

Apples, oranges and bananas. Medicaid coverage is less coverage than most private plans and makes available far fewer doctors and specialists. Like many things in life, you get what you pay for. This is not hard for you to understand, right?

 

I'll accept that. I'm just pointing out that medicaid has done a good job of controlling per-capita costs

[TakeYouToTasker]

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 Medicare's 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 administrative costs per patient 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 wish to read the work of Robert Book: http://www.heritage.org/research/reports/2009/06/medicare-administrative-costs-are-higher-not-lower-than-for-private-insurance

Edited December 17, 2013 by TakeYouToTasker

[TheMadCap]

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.

 

 

I agree, the elimination of Pre-existing conditions as a disqualifier for insurance is a good thing, as is allowing some people to remain on parent's insurance until 26 can be a good thing. Tell me why it took a 2600 page law to do that? This law is too far overreaching and tries to do all things to all people, as ususally happens when Big Gov gets involved. If we wanted insurance companies to require preventative care in a plan, we could have done it and the above things and not changed the entire insurance system.

 

and the verdict is VERY much up still out on whether anything available to someone like me would be "Affordable". Everything I've seen on Healthcare.gov is so overpriced I'd never be able to afford it. This is why I am skeptical of the whole thing. If the plans were about what I am paying now or maybe a little more...

Edited December 17, 2013 by TheMadCap

[GG]

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.

 

Never mind that there isn't a business in the world that can survive with 2% G&A costs.

[JuanGuzman]

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 Edited December 17, 2013 by JuanGuzman

[TakeYouToTasker]

 

 

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:

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

 

link: http://healthcareref...sourceID=004182

Medicare does advertise, however. Those costs are associated with the DHHS budget.

Edited December 17, 2013 by TakeYouToTasker

[DC Tom]

why?

 

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:

 

 

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

[Alaska Darin]

I'll accept that. I'm just pointing out that medicaid has done a good job of controlling per-capita costs

You're a freakin' idiot.

[IDBillzFan]

From Barack Obama's twitter account.

 

This is beyond embarrassing now.

 

[JuanGuzman]

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.