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Post 13 Dec 2012, 11:28 am

ray
Which western country model did ACA follow? It seems that it is so convoluted relative to what other countries have.


Yes. And yet still an improvement . At least in that insurance is less expensive, and in a short time, most everyone will have medical insurance.

fate
Also, if you think you can just mandate lower costs without ripple effects, then you don't understand markets


Well, the immediate effect is that insurance companies have returned premiums to people and companies. Those premiums are money that might be spent on other goods and services or used to pay down debt. The effect of that would be a boon to the economy,
Its the first time in the last thirty years or more that insurance costs have gone backwards.
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Post 13 Dec 2012, 11:46 am

geojanes wrote:Nearly every small employer I know got a check back from their health insurance company this year. It was GREAT. My understanding is that ObamaCare limits the profits Aetna and the others can make and if they make too much they have to give back a rebate. Most consumers didn't see it, because it went to the people who pay the premiums: the employers (I didn't say job creators. I wanted to, but passed.)
I think the 'Job Creators' observation is a good one. The premiums are part of the cost of employing people. This is effectively reducing the cost of employing people. Which can only encourage more employment.
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Post 13 Dec 2012, 11:59 am

rickyp wrote:fate
Also, if you think you can just mandate lower costs without ripple effects, then you don't understand markets



Oh, I hadn't even noticed he wrote that. That's funny. The insurance market is so far from a perfect market, the perfect market cannot even be seen from where the insurance market is at. Markets are scripture to people on the right, but they tend to ignore the fact that when they SUCK they aren't any good at being efficient. So, yes, certainly you can mandate lower costs in an inefficient market with the only ripple effect being somebody doesn't make as much money as they had in the past.

If anything the health care debate has brought to the fore, is the fact that there are massive inefficiencies in the system and in many cases these inefficiencies are due to the fact that the market is completely broken (or in insurance's case, lousy on purpose).

Let's be clear, one man's inefficiency is another man's payday. If you're making money because of a broken or opaque market, you don't want to change it because it's easy money! The financial markets were/are prime examples of that. Many years ago, the bond market was brought kicking and screaming into the modern age when they were forced to a public market. Before the public market (which means everyone could see what things cost) the middlemen and dealers made HUGE amounts of money off the backs of both the buyers and the sellers. That's the reason Goldman, Morgan, and the rest don't want public markets for their complex derivative products. How else are they going to make seven figure bonuses for doing something that has almost no value? Get a second job?

DF, you're carrying water for people who really don't need your help, but believe me, they appreciate all your efforts. Let me know if you ever start to feel manipulated. When that starts happening, then you may be on the path to true enlightenment.
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Post 13 Dec 2012, 12:16 pm

danivon wrote:I think the 'Job Creators' observation is a good one. The premiums are part of the cost of employing people. This is effectively reducing the cost of employing people. Which can only encourage more employment.


The only problem with this logic was that my rates went up 25 percent 2011 to 2012. So the rebate only amounted to about 20% of the increase in rates for the year. So you're still paying more for a new employee this year than last. Still, you have the satisfaction of knowing that if they guessed wrong in raising your rates, and they made too much money, they've got to give you a rebate.
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Post 14 Dec 2012, 2:09 pm

geojanes wrote:
rickyp wrote:fate
Also, if you think you can just mandate lower costs without ripple effects, then you don't understand markets



Oh, I hadn't even noticed he wrote that. That's funny. The insurance market is so far from a perfect market, the perfect market cannot even be seen from where the insurance market is at. Markets are scripture to people on the right, but they tend to ignore the fact that when they SUCK they aren't any good at being efficient. So, yes, certainly you can mandate lower costs in an inefficient market with the only ripple effect being somebody doesn't make as much money as they had in the past.


So, a for-profit company has no reason to rein in its costs until the government says so?

On the other hand, it would be unreasonable to expect, oh, I don't know, an across-the-board cut in government spending to squeeze out wasteful spending? And, if that would work, then why would President Obama, budget hawk that he is, not just order it?

If anything the health care debate has brought to the fore, is the fact that there are massive inefficiencies in the system and in many cases these inefficiencies are due to the fact that the market is completely broken (or in insurance's case, lousy on purpose).


And, GOVERNMENT will bring efficiency!

DF, you're carrying water for people who really don't need your help, but believe me, they appreciate all your efforts. Let me know if you ever start to feel manipulated. When that starts happening, then you may be on the path to true enlightenment.


You're carrying water for a corporation that gets to print its own money, has no concept of efficiency, and is all about diminishing your freedom. Let me know if you ever start to feel manipulated. When that starts happening, then you may be on the path to true enlightenment.
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Post 14 Dec 2012, 4:02 pm

fate

And, GOVERNMENT will bring efficiency!


If you consider medical systems around the world, that's true. Of course, you probably discount the experience anywhere else...
But hey, , even if you consider the US system. (Even though congress has legislated against allowing Medicare to really bargain as effectively as they could
Medicare Has Controlled Costs Better Than Private Insurance
.
According to CMS, for common benefits, Medicare spending rose by an average of 4.3 percent each year between 1997 and 2009, while private insurance premiums grew at a rate of 6.5 percent per year. (See Table 13)
According to a calculation by the National Academy for Social Insurance, if spending on Medicare rose at the same rate as private insurance premiums during that period, Medicare would have cost an additional $114 billion (or 31.7 percent).


http://healthaffairs.org/blog/2011/09/2 ... insurance/

Fate
So, a for-profit company has no reason to rein in its costs until the government says so?


If the costs are simply passed onto the consumer. No. And that's the basic problem in the US medical system. There is an absence of market forces, The market is inelastic.
In that case, regulation or a change in the market is the only alternative to the kind of runaway medical inflation the US has experienced.
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Post 15 Dec 2012, 6:46 am

Doctor Fate wrote:So, a for-profit company has no reason to rein in its costs until the government says so?

On the other hand, it would be unreasonable to expect, oh, I don't know, an across-the-board cut in government spending to squeeze out wasteful spending? And, if that would work, then why would President Obama, budget hawk that he is, not just order it?

If anything the health care debate has brought to the fore, is the fact that there are massive inefficiencies in the system and in many cases these inefficiencies are due to the fact that the market is completely broken (or in insurance's case, lousy on purpose).


And, GOVERNMENT will bring efficiency!


ABSOLUTELY! You're getting it now. Government isn't good at much, but it is good at creating rules so that people play fair. With an insurance industry regulated by 50 different states and a broken market it had to be near impossible to facilitate a fair market. So what they did was limit the profit insurance companies could make. Simple, probably not ideal because it may increase costs because an increase in cost would mean more absolute profit, but it does eliminate the immediate incentive to gouge the consumer.

I know this is against the Tea Party Republican Good Book, but there is no reason for private enterprise to lower prices if they don't have to. The ONLY reason private for-profit corporations lower prices is if they think someone else will lower prices and take business from them. That equation only works in a functioning market.

Insurance is different than other goods. They are a middle man between the provider and the consumer and the more they screw either side the more money they make. The fact that they've been enshrined at the center of ObamaCare still makes me roll my eyes, but if that's how it's done, then thank goodness they're regulated.
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Post 15 Dec 2012, 10:43 am

rickyp wrote:fate

And, GOVERNMENT will bring efficiency!


If you consider medical systems around the world, that's true. Of course, you probably discount the experience anywhere else...


Dude, we've gone round and round on this. Why CANNOT you grasp what I say without making stuff up?

1. Some countries have efficient methods of socialized medicine.
2. The socialists, er, Democrats, did not propose one of those plans. They cobbled together a hodge-podge of regulations, rules, taxes, and lobbyist-approved measures. No one can possibly know if it will work because no system like it exists anywhere.
3. The United States government is almost universally revered for its ability to waste money. How many examples do you want? Here is just the surface. http://www.cnn.com/2012/10/15/politics/ ... index.html

Medicare Has Controlled Costs Better Than Private Insurance
.
According to CMS, for common benefits, Medicare spending rose by an average of 4.3 percent each year between 1997 and 2009, while private insurance premiums grew at a rate of 6.5 percent per year. (See Table 13)
According to a calculation by the National Academy for Social Insurance, if spending on Medicare rose at the same rate as private insurance premiums during that period, Medicare would have cost an additional $114 billion (or 31.7 percent).


http://healthaffairs.org/blog/2011/09/2 ... insurance/

This is an op-ed.

Personally, having just had my father killed, in part, due to medicare "efficiency," I find your lack of compassion and understanding pretty galling. You have no idea how convoluted and ridiculous the system is.

Fate
So, a for-profit company has no reason to rein in its costs until the government says so?


If the costs are simply passed onto the consumer. No.


Hmm, let's see . . . why would they do this?

Lack of competition?

As in MA, the government sets ridiculous standards, reducing the number of companies willing to do business here, so guess what happens? Insurance rates skyrocket.

You love to post that "markets have failed." We never have tried a free market in health insurance. Congress forbade it by outlawing selling insurance across State lines.

And that's the basic problem in the US medical system. There is an absence of market forces, The market is inelastic.


So, there are two choices: 1) trust the government; 2) open up competition.

I prefer the second option.

You, being socialistic, prefer the first.

The US chose neither.
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Post 15 Dec 2012, 10:50 am

geojanes wrote:
Doctor Fate wrote:So, a for-profit company has no reason to rein in its costs until the government says so?

On the other hand, it would be unreasonable to expect, oh, I don't know, an across-the-board cut in government spending to squeeze out wasteful spending? And, if that would work, then why would President Obama, budget hawk that he is, not just order it?

If anything the health care debate has brought to the fore, is the fact that there are massive inefficiencies in the system and in many cases these inefficiencies are due to the fact that the market is completely broken (or in insurance's case, lousy on purpose).


And, GOVERNMENT will bring efficiency!


ABSOLUTELY! You're getting it now. Government isn't good at much, but it is good at creating rules so that people play fair.


This from the man who rails against unfair taxation (government, I think, sets up those rules) and unfair profits made in the derivative markets (ditto).

This law will be a fiscal disaster. The costs will skyrocket to the point where we will either have to reduce our military to the Coast Guard (only) or get rid of Obamacare. No matter how wonderful you think it is now, it will simply grow and grow and grow--that's what entitlements do.

If you think the government that gave you $600 toilet seats, has put 47 million people on welfare, and can't seem to function on its most basic duties (like a budget) is going to introduce efficiency into medical insurance, well, good for you. Say hi to the Mad Hatter for me.
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Post 15 Dec 2012, 11:36 am

I don't love anything about ObamaCare now (well, that rebate from the insurance company was a pretty big like.) Putting insurance companies at the center of health care is like putting the fox in charge of the hen house. No matter how well you muzzle the fox, he's going to figure out how to get his chicken. But our system is already a complete fiscal disaster. Will Obamacare make it worse? Maybe. Will it make it better? Maybe. But it's not doing the same old thing, which has been and would have certainly continued the complete disaster we currently have. If it doesn't work, then we will change it, but the next change should be easier than the last one.
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Post 15 Dec 2012, 12:03 pm

geojanes wrote:I don't love anything about ObamaCare now (well, that rebate from the insurance company was a pretty big like.) Putting insurance companies at the center of health care is like putting the fox in charge of the hen house. No matter how well you muzzle the fox, he's going to figure out how to get his chicken. But our system is already a complete fiscal disaster. Will Obamacare make it worse? Maybe. Will it make it better? Maybe. But it's not doing the same old thing, which has been and would have certainly continued the complete disaster we currently have. If it doesn't work, then we will change it, but the next change should be easier than the last one.


It will be like putting new clothes on Frankenstein's monster.

Sure, there will be tweaks to Obamacare. The problems, however, will be harder to fix than to identify. A Rube Goldberg contraption has been created. When you raise this lever, what happens to that one? We don't know.

It will be non-stop adjustments and surprise after surprise.

In their haste to circumvent the election of Scott Brown, the Democrats cobbled together a most ill-thought out plan. Now, they will defend its necessity, only offering to tinker with it when problems become too obvious to ignore.
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Post 29 Mar 2013, 2:19 pm

Obamacare is a winner!

The President said if you like your doctor, you can keep him . . . Nyet!

The President said costs would go down . . . Nyet!

A study commissioned by the State of California says that the new federal health care law will drive up individual insurance premiums, but that subsidies will offset most of the increase for low-income people.

The study, issued Thursday in the midst of a growing national debate over the impact of the law, is significant because California is far ahead of most states in setting up a competitive marketplace, or exchange, where people can buy insurance this fall.

Premiums could increase by an average of 30 percent for higher-income people in California who are now insured and do not qualify for federal insurance subsidies, the study said.
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Post 30 Mar 2013, 6:47 am

That's very interesting. Thanks.

If you mandate certain services, and increase the demand for those services, and add additional regulation and tax to those providing those services, it would make sense that costs would increase.
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Post 03 Apr 2013, 1:45 pm

Joe Klein is beginning to see what is as blindingly obvious as the Sun:

Let me try to understand this: The key incentive for small businesses to support Obamacare was that they would be able to shop for the best deals in health care super-stores—called exchanges. The Administration has had 3 years to set up these exchanges. It has failed to do so.

This is a really bad sign. There will be those who argue that it’s not the Administration’s fault. It’s the fault of the 33 states that have refused to set up their own exchanges. Nonsense. Where was the contingency planning? There certainly are models, after all—the federal government’s own health benefits plan (FEHBP) operates markets that exist in all 50 states. So does Medicare Advantage. But now, the Obama Administration has announced that it won’t have the exchanges ready in time, that small businesses will be offered one choice for the time being—for a year, at least. No doubt, small business owners will be skeptical of the Obama Administration’s belief in the efficacy of the market system to produce lower prices through competition. That was supposed to be the point of this plan.

Certainly, the Republicans who have stood in the way of these exchanges—their own idea, by the way, born in the conservative Heritage Foundation—deserve a great deal of the “credit” for the debacle. But we are now seeing weekly examples of this Administration’s inability to govern.


. . . the Administration is incompetent.

This law is unworkable.

That's not a good combination.
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Post 03 Apr 2013, 1:50 pm

Haha, and THIS will CUT costs:

Tens of thousands of health care professionals, union workers and community activists hired as "navigators" to help Americans choose Obamacare options starting Oct. 1 could earn $20 an hour or more, according to new regulations issued Wednesday.

The 63-page rule covering navigators, drawn up by the Centers for Medicare & Medicaid Services, also said the government will provide free translators for those not fluent in English -- no matter what their native language is.

"The proposed requirements would also include that such entities and individuals provide consumers with information and assistance in the consumer's preferred language, at no cost to the consumer, which would include oral interpretation of non-English languages and the translation of written documents in non-English languages when necessary to ensure meaningful access," said the regulations.

The rules also addressed conflict of interest and other potential issues that navigators could face as the public's first stop on the Obamacare trail.

It is still not clear how many navigators will be required. California, however, provides a hint. It wants 21,000.