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Topic: Key Mandates Of Obamacare Unchanged, Free Market Health Care Under Attack< Next Oldest | Next Newest >
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PostIcon Posted on: Nov. 30 2012, 8:25 am  Skip to the next post in this topic. Ignore posts   QUOTE

Despite efforts to undermine key parts of Obamacare by the insurance industry and medical providers, the law has essentially remained unchanged.

One of the most hated provisions, the insurance exchanges, has been rejected by 15 states but exchanges will be created and run for those states by the federal government. Making shopping and comparing insurance policies and the fine print exclusions more transparent to consumers is viewed as government intrusion by many in America. America has a long tradition of "buyer beware" where fine print exclusions to what is covered by health insurance are buried in lengthy legal wording of policies of hundreds of pages. Excluding insurance coverage of many expensive medical treatments, such as organ transplants, back pain, etc, can result in much more profits for the insurance company.

Also, despite intensive lobbying, a number of  basic benefits, including hospitalizations, emergency care, newborn and maternity care, prescription drugs, etc, will have to be covered in order for the insurance policy to be marketed as "health insurance". Opponents point out that these requirements undermine free markets and the freedom of insurance companies to offer less expensive coverage to consumers who do not desire to pay for example, a policy that covers cancer treatment.

These attacks on free markets and capitalism will depress the profits of the health insurance industry and result in pay cuts for insurance company CEO's and executives.

Administration Affirms Key Mandates Of Affordable Care Act
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PostIcon Posted on: Nov. 30 2012, 9:48 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

"What this means is that beginning in October next year, families and small-business owners everywhere will be able to shop for affordable, quality health coverage," Health and Human Services Secretary Kathleen Sebelius said

Unless of course, they are offered a heath care package by their employer. For those individuals (about 60% of individuals under 65), they cannot shop for coverage within the exchange, have little choice in quality of coverage, and costs are no more affordable than prior to the ACA. The reform simply ignores a large percentage of the population (if not the vast majority).
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PostIcon Posted on: Nov. 30 2012, 11:36 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Wishing for a magic wand that will "fix" everything is sweet, but not very effective at addressing issues in the real world.

The legislation addressed accessibility, taking a run at solving the affordable access challenge faced by 35 million or so Americans.

Oh and anyone who for a moment doesn't understand that the tens and tens of billions in medical bills the uninsured run up every year and do not, can not pay, DO impact the "vast majority" of the percentage of the population who DO have medical insurance coverage is terminally naive. Or worse. Operational costs get covered, one way or another from where ever there's a source of money: that means US.

Extensive challenges in the realm of healthcare remain, well Duh, quality, efficiency, overall cost and adequacy of resources to name a few. None, none, of that at all means the Obamacare effort wasn't necessary or worthwhile to accomplish.
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PostIcon Posted on: Nov. 30 2012, 11:55 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

"Wishing for a magic wand that "fix" everything is sweet, but not very effective at addressing issues in the real world."

-It is bad legislation in it’s own right, and much worse, will prevent any meaningful & necessary Health Care reform that would be effective in addressing the issues facing the majority of Americans here in the real world.

"The legislation addressed accessibility, taking a run at solving the affordable access challenge faced by 35 million or so Americans."

-At the expense of the remaining 300 million

"Oh and anyone who for a moment doesn't understand that the tens and tens of billions in medical bills the uninsured run up every year DO impact the "vast majority" of the percentage of the population who DO have medical insurance coverage is terminally naive. Or worse. Operational costs get covered, one way or another from where ever there's a source of money: that means US."

-How did the legislation really change any of that? The money is still being pulled from the same place (US). It is just on the front end, rather than the back.
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PostIcon Posted on: Nov. 30 2012, 12:10 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

How does the legislation "prevent any meaningful & necessary Health Care reform"?  It's not like the Supreme Court ruling on the Bush election.  It's a law.  Laws are reformed and massaged every day.  That's a little Chicken Little-ish, don't you think?

Yes, the costs still fall on us, but the front end is a lot cheaper than the back.  Usually is.

It's not a perfect piece of legislation.  But the beauty of this country is that we continue to strive to be better.  And our Constitution allows for that.  But if you think that you can tell the future and understand both the good and bad parts as if it were shown to you in a magic hat, good on ya.  But I think the rest of us will see what those failures and accomplishments actually are, address them accordingly, and not condemn the unknown because of how it makes us feel.

As a person who has spent the vast majority of his life working for small companies and being unable to afford anything other than catastrophic care insurance, I look forward to having options that weren't available to me before.  Clearly you don't have that concern and probably never have.

(Frankly, I think the "35 million uninsured" number is ridiculously understated.)


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PostIcon Posted on: Nov. 30 2012, 12:15 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(markinOhio @ Nov. 30 2012, 8:55 am)
QUOTE
-How did the legislation really change any of that? The money is still being pulled from the same place (US). It is just on the front end, rather than the back.

The ACA is complicated legislation and I certainly don't claim to be an expert in it.
I do know that one of the basic goals is to have more people insured and offer more options for treatment such as private medical doctors and clinics for non-emergent health issues.  

Currently, the uninsured have essentially no options other than using the local emergency rooms for the healthcare needs.  This is by far the most expensive option for treatment.  Also, it gums up the emergency rooms with non-emergent patients which in turn has a negative impact on those who need the ER for more serious injuries or illnesses.

I work in fire/ems and we see the impact of this on literally a daily basis.  It is called "ER Saturation".  For example: We respond to a heart attack patient in critical condition and we can't take them to the nearest ER because they are closed due to "ER Saturation".  It's not uncommon for the next nearest ER to also be down to Saturation.  This leads to much longer transports to distant hospitals for those who truly need the services of a hospital ER - ASAP.  

You may not like all aspects of the ACA but please don't kid yourself - the current system is BROKEN.
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PostIcon Posted on: Nov. 30 2012, 1:01 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(markinOhio @ Nov. 30 2012, 8:55 am)
QUOTE
"Wishing for a magic wand that "fix" everything is sweet, but not very effective at addressing issues in the real world."

-It is bad legislation in it’s own right, and much worse, will prevent any meaningful & necessary Health Care reform that would be effective in addressing the issues facing the majority of Americans here in the real world.

"The legislation addressed accessibility, taking a run at solving the affordable access challenge faced by 35 million or so Americans."

-At the expense of the remaining 300 million

"Oh and anyone who for a moment doesn't understand that the tens and tens of billions in medical bills the uninsured run up every year DO impact the "vast majority" of the percentage of the population who DO have medical insurance coverage is terminally naive. Or worse. Operational costs get covered, one way or another from where ever there's a source of money: that means US."

-How did the legislation really change any of that? The money is still being pulled from the same place (US). It is just on the front end, rather than the back.

It's enactment doesn't block future improvements, that's just fatasy alongside Death Panels and plug pulling.

The personal responsibility mandate (to use the Heritage Foundation's terminology) means they pay for themselves, not "us", then for the smaller portion that do require affordability assistance even within the more cost effective (as Republicans argued previously) exchanges then that cost support is still balancable against the very expensive crisis care the uninsured consume not to mention the lost national productivity.

How did the legislation change the challenge of the uninsured running up medical bills the insured would then pay for through cost transference (as operational bills must get paid or the facility shuts down)? Well, by opening up a further 35 million people to having health insurance coverage. Rather than, you know, not. The entire function of insurance being a spreading of the risk and expense burden as widely as possible, the PACA bills do exactly that. The bill isn't anything approaching a single payer like you seem to think. "The money is still being pulled from the same place (US).", No actually it's mostly not. Private individuals are purchasing private health insurance coverage. The numbers that I've seen are out of the 35 million perhaps 7 million will be eligible for some sort of assistance and what with the costs associated with people remaining uninsured being well established I see that as an effective effort as well.

Opposition of ObamaCare on the assumption it's some sort of federal single payer system, basically Medicare for everyone, is entirely inaccurate.
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PostIcon Posted on: Nov. 30 2012, 2:25 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Before the ACA health care reform was at least discussed, now the only discussion is defending/attacking the ACA. Any new legislation now must be contorted around the ACA.

Almost 70% of the population is below 400% FPL. Yet, only 20% of the 35 Million uninsured will not only NOT get assistance, but help to offset costs? Why were these apparently affluent individuals choosing not to have health coverage? The cost transference is still there, and will continue to fall on those with employer sponsored health care, and ultimately the taxpayer. It has NOT and will NOT reduced health care costs for the majority of Americans, and in fact has contributed (OK, only slightly thus far) to the price increases.

Finally, I’m not criticizing ACA because I think that it is a single payer system, I’m criticizing it because it is NOT a single payer system, and is not meaningful positive reform from the majority of Americans.
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PostIcon Posted on: Nov. 30 2012, 2:38 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

" the only discussion is defending/attacking the ACA"

Well get right out there and write Boehner a very strongly worded letter then. If he got over it, along with his minions, maybe the discussion would move forward past this done deal? Many other Congressional Republicans have said that very thing, but the TEAs don't seem to be capable of letting Boehner go on this and he's a key player.

Well "meaningful positive" is your value judgement. I disagree. OTOH I'm not all that enamored by single payer: our military is "single payer" and that wonderful system has produced gems like the one third of a billion dollar aircraft, the F-22.... which is too expensive to actually ever have chanced using. Changing the logo on the overly large and getting larger treatment checks isn't a solution, it's rearranging the deck chairs on the Titianic. Look at the Kaiser chart: eliminate private health insurance and may 6% of the costs disappear. That's a rounding error. Cost control lays elsewhere. Time to deal with that elsewhere.
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PostIcon Posted on: Nov. 30 2012, 3:16 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(markinOhio @ Nov. 30 2012, 11:25 am)
QUOTE
Before the ACA health care reform was at least discussed, now the only discussion is defending/attacking the ACA. Any new legislation now must be contorted around the ACA.

Oh, well it was discussed.  And exactly how many people did that discussion insure*?  (My guess is somewhere between 50 million and -50 million, with the most likely number falling in the middle of that range.)  

QUOTE
It has NOT and will NOT reduced health care costs for the majority of Americans, and in fact has contributed (OK, only slightly thus far) to the price increases.

If only the CBO and organizations like the Kaiser Family Foundation had your wisdom and expertise, they would not fall into the grievous error of concluding the opposite.

Snark aside: what on earth is your basis for this opinion?

QUOTE
Finally, I’m not criticizing ACA because I think that it is a single payer system, I’m criticizing it because it is NOT a single payer system, and is not meaningful positive reform from the majority of Americans.

In other words, the PPACA is deficient compared to a system that was not politically possible, is not politically possible, and will not be politically possible at any time in the foreseeable future.  Gosh, that makes all kinds of sense. No, really--I mean that.




*Sam Spade: Ten thousand? We were talking about a lot more money than this.
Kasper Gutman: Yes, sir, we were, but this is genuine coin of the realm. With a dollar of this, you can buy ten dollars of talk.


If anything, this understates the rate of exchange.


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PostIcon Posted on: Nov. 30 2012, 7:11 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

If only the CBO and organizations like the Kaiser Family Foundation had your wisdom and expertise, they would not fall into the grievous error of concluding the opposite.

Ok, where is the report indicating that it will reduce Health Insurance cost for those with Employer sponsored health coverage (the vast majority of Americans)? The only thing that I have read from the CBO indicated that about 1% of the increase for 2012 could be attributed to the ACA. But, please provide the report! I'm eager to be wrong.
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PostIcon Posted on: Nov. 30 2012, 7:39 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(markinOhio @ Nov. 30 2012, 4:11 pm)
QUOTE
If only the CBO and organizations like the Kaiser Family Foundation had your wisdom and expertise, they would not fall into the grievous error of concluding the opposite.

Ok, where is the report indicating that it will reduce Health Insurance cost for those with Employer sponsored health coverage (the vast majority of Americans)? The only thing that I have read from the CBO indicated that about 1% of the increase for 2012 could be attributed to the ACA. But, please provide the report! I'm eager to be wrong.

What you said is that it "will NOT reduced [sic] health care costs" for most people.  Again, is there some basis for that projection?

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PostIcon Posted on: Dec. 01 2012, 7:24 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

TehipiteTom
QUOTE
What you said is that it "will NOT reduced [sic] health care costs" for most people.  Again, is there some basis for that projection?


The 2000-plus pages of Obamacare do not ignore the high cost of health care - and in fact set up the framework to fund more medical training, etc that will lead to long term shifts in the supply/demand curve. But this article outlines the more immediate effect of the "David Clause":

"David Clause" in Obamacare Ready to Slay the Healthcare Cost Beast

From the article:

QUOTE
In Health Insurance’s $4.4B Bunker Buster I outlined a clause in Obamacare that most health insurance companies are asleep at the wheel in their response. It is both a threat and an opportunity to traditional health insurance companies. Previously, I have called this new model “concierge medicine for the masses.” Officially, it is called Direct Primary Care (DPC). In the Marcus Welby/Steve Jobs Solution to the Medicaid-driven State & County Budget Crisis the scale of impact on healthcare costs of little-noticed clause (Section 1301 (a)(3)) was detailed.

In my study of disruptive innovation in healthcare, I haven’t seen anything come close to DPC in its positive impact on what healthcare wonks call the “Triple Aim” (improved patient experience, health of the population and per capita costs). .......


The “David” Clause Ready to Slay Goliath

What looks like a very minor part of Obamacare may prove to be the most important clause to slaying the healthcare cost giant that has crushed family, business and government budgets. When IBM conducted its global study of its $2 billion of healthcare spend, the conclusion was strikingly simple. Greater access to primary care (which is what DPC is all about) led to healthier employees and family members. In turn, that led to cost savings. This is why IBM has unleashed the “Primary Care Spring” that has led 50% of the 100 biggest companies in America to adopt a primary care centric system and have been joined by the Office of Personnel Management at the federal level.

The healthcare cost “Goliath” will be slayed by the “David” clause in Obamacare. The “Davids” have been organizations such as Iora Health, MedLion and Qliance. They are now being joined by many more organizations ranging from publicly held DaVita to small practices such as Total Access Physicians.
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PostIcon Posted on: Dec. 01 2012, 2:42 pm Skip to the previous post in this topic.  Ignore posts   QUOTE

Bass

Hadn't read that. Interesting article.
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