Aetna signficantly reducing Obamacare participation

[Fanatical Meat]

Bart, I don't wish this upon anyone but at one time I was like you. Completely against Socialized medicine, that changed rapidly after getting a long term care condition. Anyone who believes their insurance is great either hasn't had to use it much or hasn't cost your insurer much because once you do it becomes a constant battle of what's covered, where its covered and enormous bills that are sent in "error". These are all things insurers do to either squeeze more out of you or make you so tired of dealing with them you change insurers.

 

[Fanatical Meat]

Meanwhile, an epi-pen is $600/2 in US and $200/2 in Canada.

Want a shock look up MRI costs US vs anywhere else on the planet.

 

[poofyhairguy]

1. You are assuming your government can't handle it. Fair statement, BUT, you already have government employees sitting around with nothing to do but you want to pay even more to private contractors.

The government doesn't have the capacity to administer every healthcare claim in the country. Single payer who mean hiring thousands (maybe tens of thousands) of bureaucrats to do the job. I don't know where you feel we have this excess capacity. If an old person calls Medicare with a question they are on hold for an hour to get an answer.

Don't provide alcohol to someone with alcohol problems.

To me it's more like don't set an alcoholic (a power hungry federal government) next to an open bottle (the massive growth in government single payer would allow) and not expect him to take a drink.

2. You are assuming every grandma gets multiple hip replacements. Show me proof that is the case in Canada, France, Taiwan, or any other modern democracy. Actually, show me proof that healthcare is "more expensive" per capita than the US of A.

I can't, what I talk about is a uniquely American problem.

We set the expectations for decades that patients are "healthcare consumers," and in that relationship the "customer is always right." In such a system a hypochondriac can bankrupt you, and already 25% of US healthcare visits are believed to have no identifiable medical cause. Other countries don't have to deal with that because the patient expectation is "take what you are given and be happy." Single payer works if the patients don't demand you waste money on them, but as a culture we aren't ready for that.

In our current system the hypochondriac consumers of healthcare DO raise our costs, I believe such people are part of the reason our system is so expensive overall. Well that and we demand the hospital do everything it can to keep grandma alive another day even if it costs tens of thousands of dollars in real costs to get that extra day, because he consumer is always right dammit. But there is a limit in our system because the "evil" insurance companies will drop you if you cost too much, so Mr Consumer doesn't always get his way.

What terrifies me about American single payer is you then take away that limit, you take away the bad guy. If any politician tries to do the responsible thing and pass laws or appoint people that tell grandma/the hypochondriac no then they will be replaced by a politician telling the people they can have anything they want because the Chinese will just buy a little more debt. If we started in single payer system day one our expectations would be in line with cost savings, but as it is I don't see a way to go to single payer and not have the healthcare budget grow 50% even after "efficiencies" of insurance profits being taken out.

It's kinda how I feel about guns. American would be a safer place today if we never allowed personal firearms, but we did and now there are like 100 million guns in America. From this point forward we can't take those guns away without starting a second civil war so as a result we basically have to live with mass shootings without a policy solution. So my personal solution is to own a gun. We have to live in the real world with practical solutions, otherwise we get another failed policy like Obamacare.

I would love a single payer system in theory but I don't see how America gets there in actuality without going bankrupt. The only system that will work for us IMHO is a two tier healthcare system- a crappy free one for poor people (who often don't vote) and a nice one for people with jobs and old rich people with money who have most of the political power. Then the hypochondriacs either have to pay per visit to curb their demand, or they deal with the doctor that had to get the government job because he is so incompetent he can't afford malpractice insurance for free. At least that is my theory, maybe there is no fix that will work for us greedy fat Americans.

 

[agent00f]

I don't know why that is the default conclusion. It is much more likely that we live with a broken Obamacare system for a few decades that slowly unwinds into disaster. Disaster should rarely be celebrated.

Obama had one of the strongest political mandates since Reagan and even he couldn't do any better than Obamacare, and just getting Obamacare broke his political momentum (his plans to fix social security or immigration afterwards were shot by the Obamacare implementation). I don't see Hillary getting a bigger political mandate, she might not even have the gift of a Democratic Congress. Plus even if the Democrats do win Congress she might want a different legacy than Obama (whose legacy is tied to Obamacare).

Honestly I don't see why so many people want a US single payer setup so badly. Such a system would quickly push our healthcare system in a direction of inequality only seen in third world countries. The good doctors will go cash only, so the rich will still get the best healthcare (and will be the only ones to get it). The middle class can access those top tier doctors today via a (non exchange) health insurance plan, but once every service/test pays Medicaid reimbursement rates many doctors will opt of out taking whatever the government plan is. Already we have a third of doctors not taking Medicaid, I don't see how the average person's health care improves when that number is 40%+ for a single payer plan. Especially when the only doctor we can get under the single payer plan is the guy who is the reason malpractice insurance exists and the wait time to see him is measured in months because of the backlog.

Seems like the best case scenario practically is the exchanges die from lack of use and we just roll back into a sort of pre-Obamacare system (with the worst parts like pre-existing conditions being fixed by Obamacare).

All the other first world countries with reasonable healthcare costs implement price controls of some sort.

We can talk about the nature of the medical econ market, but that's an unimpeachable practical reality.

 

[Jhhnn]

More good news on Obongocare:

http://blogs.wsj.com/cfo/2016/08/16/fed-survey-obamacare-causing-companies-to-cut-jobs/

(Federal Reserve) Survey: Obamacare Causing Companies to Cut Jobs

Just spreading the FUD like the WSJ, huh? It's a survey of executives having nothing to back it up other than thin air. Well, the air is actually pretty thick with the aroma of bullshit.

From the article-

The percentage of companies predicting job cuts is similar to prior surveys on the Affordable Care Act conducted in 2015 and 2014

Funny how employment went up the whole time, huh?

What does it mean, Mr Wizard?

It means there's no difference in the exchanges between Aetna pulling out & Aetna being allowed to merge with Humana. It means that Aetna & Humana will still complete in the group insurance market that cover a helluva lot more Americans than the exchanges. It means that the execs got all pissy when their chance to make a killing off the merger went bye-bye.

 

[poofyhairguy]

All the other first world countries with reasonable healthcare costs implement price controls of some sort.

We can talk about the nature of the medical econ market, but that's an unimpeachable practical reality.

And the most effective method so far to stop mass shootings was Australia's 1996 Gun Confiscation, but neither policies are a reality with our current US political system.

I don't trust insurance companies beyond that I trust them to put profits first and control healthcare expenditures to control profits. I can't trust the government side to do that much, it is estimated 10% of Medicare spending is fraud. It's a rock and a hard place.

 

[agent00f]

And the most effective method so far to stop mass shootings was Australia's 1996 Gun Confiscation, but neither policies are a reality with our current US political system.

I don't trust insurance companies beyond that I trust them to put profits first and control healthcare expenditures to control profits. I can't trust the government side to do that much, it is estimated 10% of Medicare spending is fraud. It's a rock and a hard place.

The US spends double for similar results so 10% is a drop in the bucket. Switzerland is an example with private providers and publicly set prices.

 

[poofyhairguy]

Fair enough, I will look into their system more.

 

[s0me0nesmind1]

Everyone underestimated it. Hell Obamacare was sold on the premise of "we will trick the young people into buying insurance that most of them don't need to subsidize the old sick people." And then everyone was surprised when the young people didn't fall for the trick!

People will always do what it is their self interest. Young people who don't need health care avoid it. Insurance companies who want profits will avoid pools with a lot of sick people. Doctors will avoid payers that don't compensate them as well. The entire system is based on denying basic economic realities and then we get pissed at people for acting in their own self interest. The best system would be one that pushes people into optimal solutions via economics instead of the other way around.

I actually heard after Aetna pulled out of their districts that some areas in Arizona (IIRC) will actually have 0 exchanges as it currently stands.... So essentially, they must have healthcare or they will pay a tax penalty... but they can't get any since it's not offered. It's going to be an interesting 2 years.

Not that I give a shit. As much as I have a lifetime condition of taking a medication for epilepsy, either myself or my spouse will always be employed with insurance - so meh. Either way I hope it crashes and burns and amongst the rubble a solu

 

[dmcowen674]

Want a shock look up MRI costs US vs anywhere else on the planet.

Yep, when had my Motorcycle accident got charged $23,000 for MRI. Insurance would not cover because was brought to a Hospital not in Network of course. I was out cold, how do you check if a Hospital is on Network when you are unconscious?

 

[WackyDan]

Well, we gave the private insurance solution a chance, moving on to single payer. Keep expanding Medicaid.

Have you ever been on Medicaid? It is a shit show. ***yes, I know first hand.

 

[openwheel]

Fact is other countries with single payer are getting better care while paying less. My new born baby needed to see dermatologist but was told the wait is 7 weeks, so my new born baby was sent to urgent care with some yahoo mis-diagnosed her condition. No one truly cares except for: INSURANCE INSURANCE INSURANCE so they can file the claims. What a bizarre health care system. At least Obama care is mandating everyone should be covered. I have been tired of paying for dead beats not paying insurance and medical bills. Since the introduction of Obamacare, my employer has offered more variety of choices and I am paying less overall. A step in the right direction but the insurance companies need to go.

I still don't know WTF I am getting charged for from the hospital. I lost count on how many times they tried to sell my wife epidural while she insisted she didn't need it.

 

[Londo_Jowo]

Want a shock look up MRI costs US vs anywhere else on the planet.

The copay cost for the MRI on my shoulder was $75, didn't cause any shock at all. The copay for my shoulder surgery didn't shock me either. I had hit the max out of pocket of $2,000 and didn't have to pay a penny out of the $30,000.

 

[highland145]

The copay cost for the MRI on my shoulder was $75, didn't cause any shock at all. The copay for my shoulder surgery didn't shock me either. I had hit the max out of pocket of $2,000 and didn't have to pay a penny out of the $30,000.

Become self employed. I was billed $3300 for a CT scan in January. YMMV The upside is it was negative.

 

[Pens1566]

More good news on Obongocare:

http://blogs.wsj.com/cfo/2016/08/16/fed-survey-obamacare-causing-companies-to-cut-jobs/

(Federal Reserve) Survey: Obamacare Causing Companies to Cut Jobs

Your webs are starting to show ...

 

[Fanatical Meat]

The copay cost for the MRI on my shoulder was $75, didn't cause any shock at all. The copay for my shoulder surgery didn't shock me either. I had hit the max out of pocket of $2,000 and didn't have to pay a penny out of the $30,000.

Now compare your costs and your insurers cost for a similar procedure anywhere else in the world.

 

[boomerang]

Obamacare is a disaster. Why?

• It is based around lies told repeatedly by Obama
• It was passed in a totally partisan manner in the dead of night
• It does not address real problems, it is based in perceptions
• It was passed for political reasons, not as a means to improve healthcare

How can it be fixed?

Not by Republicans because nothing they come up with will be satisfactory to Democrats. Not by Democrats because any fix may draw attention to the failures and shortcomings of the legislation.

But early next year we will have a regime change. If it's Hillary, she will double down. No fixes, just more spending, more entitlement aspects and more lies. Lots of lies. Congress will go along with anything she suggests because more "free" stuff for the masses means more votes. That's something both parties can be comfortable with. There's road ahead for that can to be kicked down.

If it's Trump, Congress will chicken out and there will be more spending, more entitlement aspects and more votes will be forthcoming. That road will still be before them and the can will still travel down it.

 

[Fanatical Meat]

Boomer Trump has already outlined a plan that sounds very similar to ACA. He changed a couple of tax things and ability to buy insurance across state lines, which no state or insurer will be able to comply with and stay competitive.
However I agree ACA was passed too quickly and one side wants failure at all costs and the other side won't admit any failures instead of working to make it better.

 

[glenn1]

Boomer Trump has already outlined a plan that sounds very similar to ACA. He changed a couple of tax things and ability to buy insurance across state lines, which no state or insurer will be able to comply with and stay competitive.
However I agree ACA was passed too quickly and one side wants failure at all costs and the other side won't admit any failures instead of working to make it better.

Because Obamacare is fundamentally a failure as a concept. It was an attempt to include two things that basically work at cross-purposes - a new entitlement to give "free" healthcare to the uninsured, *AND* at the same time improve health insurance for the great mass of middle class employed who would pay for the first. Obamacare can't be "fixed" until the Democrats who champion the law decide which of those two approaches they actually care about and act accordingly.

Personally I don't think most voters give much of a damn about reducing the amount of uninsured, as least when compared to their desire to see their issues with health insurance fixed. If you can do the first at reasonable cost then sure, but otherwise that's probably one of their lowest priorities. Yeah, sorry that you Fanatical Meat might have been bankrupted by that long-term condition you mentioned but that still doesn't mean I should feel any obligation to sacrifice myself or pay higher health insurance rates as a charity function to help you. I like most don't want my healthcare screwed with even though the prior system was a stupid mess initiated by stupid choices decades ago. No one in their right fvckign mind would link healthcare provision to one's employment but that's what policymakers did during WW2 and then allowed the mistake to continue and get worse. Obamacare does nothing to fix that. Giving 'universal healthcare' doesn't really fix it either, it just shifts where I would remit the payments to. I'm not going to get better care from Uncle Sam and have zero recourse if they screw me over (unlike a health insurance plan) plus privacy is a bigger concern so there's no way I'd want a "universal healthcare" system.

 

[Subyman]

In IL I used to be blue cross blue shield. They hiked their rates so high last year that it was obvious they didn't want my business. Then I went to United and have been happy but now they are leaving. Ugh! I wish I could buy into Medicaid and be done with it. Having to switch providers every year is ridiculous.

I don't really blame it on Obamacare because it has really helped my family especially my mom who has pre-existing conditions. But I wish the market would settle down so we can get consistent coverage.

 

[Fanatical Meat]

Because Obamacare is fundamentally a failure as a concept. It was an attempt to include two things that basically work at cross-purposes - a new entitlement to give "free" healthcare to the uninsured, *AND* at the same time improve health insurance for the great mass of middle class employed who would pay for the first. Obamacare can't be "fixed" until the Democrats who champion the law decide which of those two approaches they actually care about and act accordingly.

Personally I don't think most voters give much of a damn about reducing the amount of uninsured, as least when compared to their desire to see their issues with health insurance fixed. If you can do the first at reasonable cost then sure, but otherwise that's probably one of their lowest priorities. Yeah, sorry that you Fanatical Meat might have been bankrupted by that long-term condition you mentioned but that still doesn't mean I should feel any obligation to sacrifice myself or pay higher health insurance rates as a charity function to help you. I like most don't want my healthcare screwed with even though the prior system was a stupid mess initiated by stupid choices decades ago. No one in their right fvckign mind would link healthcare provision to one's employment but that's what policymakers did during WW2 and then allowed the mistake to continue and get worse. Obamacare does nothing to fix that. Giving 'universal healthcare' doesn't really fix it either, it just shifts where I would remit the payments to. I'm not going to get better care from Uncle Sam and have zero recourse if they screw me over (unlike a health insurance plan) plus privacy is a bigger concern so there's no way I'd want a "universal healthcare" system.

No offense taken I do have to say isn't the whole point of insurance to cover you in a disaster? Why is it OK to think its the insurers decision to dump you or make life so miserable that you leave.
Ps you have no right if your insurer decides to screw you. You do have the court route but have fun filing a suit against a multi billion dollar company, good luck finding a competent lawyer to take the case off its anything difficult.

 

[glenn1]

No offense taken I do have to say isn't the whole point of insurance to cover you in a disaster? Why is it OK to think its the insurers decision to dump you or make life so miserable that you leave.
Ps you have no right if your insurer decides to screw you. You do have the court route but have fun filing a suit against a multi billion dollar company, good luck finding a competent lawyer to take the case off its anything difficult.

If disasters were what it covered then it really would be insurance. But instead insurance pays for almost every conceivable medical service, including the routine and recurring. And Obamacare added more, such as the mandate to cover contraception 100%. Now you can make the argument that doing so is good public policy (and I would tend to agree) but again you've further bastardized "health insurance" into something that's more like a prepaid medical services account. Or one of those "all-inclusive" vacation resorts where you pay for every possible service they could conceivably offer, including those you have no interest in. Again, that's fine for those who consider that type of pricing arrangement to be the one they like, but I don't want to be forced into it myself.

What Obamacare should have been was (A) taxpayer provided vouchers to procure universal true catastrophic insurance (e.g. high deductible, $10-20k or above?), (B) expanded use of Health Savings Accounts to account for the smaller health events (e.g. acute illnesses, non-life threatening urgent care, etc) and routine goods and services like medications and wellness checks, and finally (C) free clinics to provide medical services for the poor and indigent.

 

[Dulanic]

It isn't even just the health insurance companies... its the WHOLE heathcare industry, I'm sorry there is ZERO reason that a medication like modafinil which is GENERIC should cost $33+ a pill in the US ($6000 for 90 days supply) and yet it can be gotten elsewhere for $1 or $2. All because Cephalon sued the shit out of companies using invalid patents and bribed them will millions to stop others from making a generic. The whole pharma industry is screwed up beyond belief.

Obamacare didn't cause any of this, but it didn't fix it either. Until we can get these insane prices under control, nothing can change.

 

[Phynaz]

Yep, when had my Motorcycle accident got charged $23,000 for MRI. Insurance would not cover because was brought to a Hospital not in Network of course. I was out cold, how do you check if a Hospital is on Network when you are unconscious?

Bullshit.

Medical insurance doesn't cover accidents, your motorcycle insurance does.

 

[SMOGZINN]

But instead insurance pays for almost every conceivable medical service, including the routine and recurring.

The problem is that the medical industry has priced itself so that even routine and recurring medical services are disasters to most people. When paying cash routine doctor visits can run $300+ dollars, and another hundred or so for the medication. That might not be too much money for you or I, but for many, maybe even most, Americans they have to go into debt to pay it. Get into even simple surgical procedures and you run $10k+, and amount many Americans will never be able to pay off.