Aetna signficantly reducing Obamacare participation

[spacejamz]

surprised this hasn't been mentioned here yet...

They are the 3rd provider (United Health and Humana) to make this decision...

Not a good sign for the ACA.....

http://www.npr.org/sections/health-...major-insurers-in-pulling-back-from-obamacare

Wonder what impact Aetna's merger with Humana being blocked had on this decision though...

 

[glenn1]

We're just getting to the point where there's no more juice to be squeezed from the middle class via health "insurance" that no longer resembles anything like actual insurance. At this point it's just the government and healthcare management companies colluding to strip mine whatever wealth they can from the average worker with a few crumbs being tossed to subsidize the poor. Until eventually like student loans the government gets tired of sharing the goodies with the private sector and takes ownership of the entire extortion racket.

 

[Fanatical Meat]

Excellent Single Payer here we come

 

[hal2kilo]

Excellent Single Payer here we come

Seems to be the only real workable solution. Medicare E here we come.

 

[Bart*Simpson]

Excellent Single Payer here we come

Because it worked so well in Canada and the UK, right? Oh, wait...

http://civitasreview.com/healthcare/father-of-canadian-health-care-admits-its-a-failure/

"Back in the 1960s, (Claude) Castonguay chaired a Canadian government committee studying health reform and recommended that his home province of Quebec — then the largest and most affluent in the country — adopt government-administered health care, covering all citizens through tax levies.

The government followed his advice, leading to his modern-day moniker: "the father of Quebec medicare." Even this title seems modest; Castonguay's work triggered a domino effect across the country, until eventually his ideas were implemented from coast to coast."

Four decades later, as the chairman of a government committee reviewing Quebec health care this year, Castonguay concluded that the system is in "crisis."

"We thought we could resolve the system's problems by rationing services or injecting massive amounts of new money into it," says Castonguay. But now he prescribes a radical overhaul: "We are proposing to give a greater role to the private sector so that people can exercise freedom of choice."

 

[Genx87]

Be nice to just expand Medicare to everybody. I know it will cost people more in taxes. But there is efficiencies involved. There is also people are 100% covered at birth. Providers dont need to worry about people not paying for their services.

 

[interchange]

There are several basic models to do healthcare:
1. socialized medicine (e.g. the UK, where providers are employed by the government)
2. single payer (e.g. Canada, where providers are private but only the government pays on fee-for-service model)
3. employer-provided insurance (e.g. Germany [although it has a public component])
4. cash-based (e.g. Pakistan)

None are necessarily right. It is argued that much of the US waste is because we do all 4 (#1 VA, #2 Medicare/Medicaid, #3/4 obvious).

 

[theeedude]

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

 

[shortylickens]

Aetna fucked me over strongly when Obama care took charge.

Their rates tripled and their coverage went to garbage.
I was so unhappy.

The ACA might have helped insure a handful of poor folks but it stomped all over the middle class.

 

[Fanatical Meat]

Because it worked so well in Canada and the UK, right? Oh, wait...

http://civitasreview.com/healthcare/father-of-canadian-health-care-admits-its-a-failure/

"Back in the 1960s, (Claude) Castonguay chaired a Canadian government committee studying health reform and recommended that his home province of Quebec — then the largest and most affluent in the country — adopt government-administered health care, covering all citizens through tax levies.

The government followed his advice, leading to his modern-day moniker: "the father of Quebec medicare." Even this title seems modest; Castonguay's work triggered a domino effect across the country, until eventually his ideas were implemented from coast to coast."

Four decades later, as the chairman of a government committee reviewing Quebec health care this year, Castonguay concluded that the system is in "crisis."

"We thought we could resolve the system's problems by rationing services or injecting massive amounts of new money into it," says Castonguay. But now he prescribes a radical overhaul: "We are proposing to give a greater role to the private sector so that people can exercise freedom of choice."

It has, we (the US) have the most inefficient and expensive healthcare systems in the world...by far.
The two Canadians I worked with both agreed anything beyond a general check up they'd head home to Canada to have done.
So yes from a consumers perspective that had both options available to them Canada won both times.

 

[BonzaiDuck]

Here's the day's editorial from the LA Times:

http://www.latimes.com/opinion/editorials/la-ed-aetna-obamacare-20160817-snap-story.html

That was the online version, which is abridged. Here's the remainder of it:

Policymakers haven't provided much help, as the partisan split over Obamacare has prevented almost every effort to improve the law. But the biggest factors in the current shakeout appear to have been insurers' setting premiums too low to pay for the care demanded by the newly insured, and many states' inability to persuade enough of the younger, healthier uninsured to sign up.

Those problems should fade as this market matures. Lawmakers could help matters with more aggressive efforts to improve healthcare efficiency, while also providing better safeguards for insurers stuck with unusually expensive customers. In the meantime, it's unfortunate that the number of insurance choices are shrinking in many states' Obamacare exchanges. But that's a predictable result of the major changes the law brought about, not a sign of its failure.

Take it as you choose. I may comment later.

 

[theeedude]

Aetna fucked me over strongly when Obama care took charge.

Their rates tripled and their coverage went to garbage.
I was so unhappy.

The ACA might have helped insure a handful of poor folks but it stomped all over the middle class.

I know several middle class families on Obamacare. It's a life-saver for independent contractors and entrepreneurs, especially older ones or those with pre-existing conditions.

 

[SMOGZINN]

Aetna fucked me over strongly when Obama care took charge.

Their rates tripled and their coverage went to garbage.
I was so unhappy.

The ACA might have helped insure a handful of poor folks but it stomped all over the middle class.

The ACA didn't do any of that, Aetna did. Never forget that Aetna is still posting record profits. They made 2.3 billion dollars in profit last year and that was a 17% increase on expected profits.

 

[theeedude]

We need price controls on medications and services. It's getting ridiculous.

 

[Meghan54]

Let me pose this question....again.

When/if single payer health care comes into being in the U.S., what happens to all the money being spent by employers on employees' health ins.? It's seen as a benefit, if not part of your wages, so are the employers going to start giving the money directly to the employees?

I'd think that would go far to taking care of increased taxes to pay for the single payer ins.

 

[Fanatical Meat]

Let me pose this question....again.

When/if single payer health care comes into being in the U.S., what happens to all the money being spent by employers on employees' health ins.? It's seen as a benefit, if not part of your wages, so are the employers going to start giving the money directly to the employees?

I'd think that would go far to taking care of increased taxes to pay for the single payer ins.

I'd assume it would be spent into taxes.

 

[BonzaiDuck]

Someone posted an observation about their Aetna policy tripling, asserting that the ACA shafted the middle-class. Once again, that's an assertion that needs to be proven or disproven statistically.

I have been covered by Blue-Cross/Blue-Shield most of my adult life. I have a circle of friends of the same age. Among all of them except one exception, they've all reported annual premium increases identical in amount to the annual increases they'd experienced over ten years before the ACA. And in my case, there was one year after the ACA when my premiums went down.

The exception among those friends reported a $200/mo increase for himself and his wife combined. They have one of those Cadillac policies which seems to go beyond most expectations of coverage and service.

I wouldn't doubt in the least what the poster reported. It's a statistical observation in a population of observations, and I would probably bet that many AETNA policy-holders got the shaft.

 

[poofyhairguy]

Excellent Single Payer here we come

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).

 

[Mai72]

Could the issue be that there are many more people on government welfare than ever before?

I know it's anecdotal, but I know plenty of people who don't make enough and have dental/health care for free. They take advantage of it too. They get their teeth cleaned a few times a year. They go in for checkups, All on the taxpayer dime.

 

[blankslate]

This is why a public option was necessary and when Obama dropped it (because of pressure from some more conservative democratic members of the House and Senate iirc) I knew it was a bad sign.


______________

 

[Fanatical Meat]

Could the issue be that there are many more people on government welfare than ever before?

I know it's anecdotal, but I know plenty of people who don't make enough and have dental/health care for free. They take advantage of it too. They get their teeth cleaned a few times a year. They go in for checkups, All on the taxpayer dime.

Its still cheaper than ER visits.

 

[Genx87]

We need price controls on medications and services. It's getting ridiculous.

Price controls have never worked. But lets try it one more time. But this time with our health. What could go wrong?

 

[glenn1]

We need price controls on medications and services. It's getting ridiculous.

Only if you agree to price and wage controls on your industry first. Once we chop your salary down to a more reasonable level then we'll talk about price controls on medicines.

 

[glenn1]

Let me pose this question....again.

When/if single payer health care comes into being in the U.S., what happens to all the money being spent by employers on employees' health ins.? It's seen as a benefit, if not part of your wages, so are the employers going to start giving the money directly to the employees?

I'd think that would go far to taking care of increased taxes to pay for the single payer ins.

Why do you think that the people who advocate for single payer actually care about any of that? They want it because they know the middle wage earners (under $100K) will bear most of the burden of paying for the previously uninsured. And that if they decide to 'live their dream' to drop out of the workforce to backpack through Europe or whatever they'll have the knowlege that other, more responsible people will pay for their healthcare needs.

 

[ivwshane]

Anyone find it interesting that Aetna was trying to merge with another company and once the fed blocked their merger they come out saying they are dropping from the ACA?

But the July 5 letter paints an entirely different picture, one where Bertolini says that participating in the marketplaces would be too difficult and costly for the company if it also were in litigation over its merger proposal. This is the key passage:

Our analysis to date makes clear that if the deal were challenged and/or blocked we would need to take immediate actions to mitigate public exchange and ACA small group losses. Specifically, if the DOJ sues to enjoin the transaction, we will immediately take action to reduce our 2017 exchange footprint. We currently plan, as part of our strategy following the acquisition, to expand from 15 states in 2016 to 20 states in 2017. However, if we are in the midst of litigation over the Humana transaction, given the risks described above, we will not be able to expand to the five additional states. In addition, we would also withdraw from at least five additional states where generating a market return would take too long for us to justify, given the costs associated with a potential breakup of the transaction. In other words, instead of expanding to 20 states next year, we would reduce our presence to no more than 10 states.

http://www.vox.com/2016/8/17/12515502/aetna-obamacare-merger