Blue Cross Blue Shield getting crushed by Obamacare

[Darwin333]

"Quality" is being measured on more than one metric. Cost is one, speed of delivery is another, quality of services yet another. Any overall "best" ranking is going to need to weigh those and other customer satisfaction factors in combination and no single way of ranking the factors will cover every person's wants and needs.

In this discussion, it's obvious Eskimospy is ranking 'accessibility to care' for all as one of his key metrics if not the key metric. SP33d is obviously talking about speed of delivery and the ability to received premium care for those who can afford it. Neither is "wrong" and how to rank those factors is what the whole Obamacare/single payer/free market debate is about.

This is very true and luckily I highly doubt we will ever see the US go to a complete and total single payer model like most countries we are trying to compare to. You will have your basic .gov "insurance" and if you so choose you can purchase higher quality "add on" or Cadillac plans from private insurers. Those with money will always get better coverage but everyone will get the basics.

Personally I think the above is a good idea in general but we would get something like that regardless. The rich have way to much influence and they aren't going to settle with getting the exact same medical service as the plebes.

 

[soundforbjt]

This is very true and luckily I highly doubt we will ever see the US go to a complete and total single payer model like most countries we are trying to compare to. You will have your basic .gov "insurance" and if you so choose you can purchase higher quality "add on" or Cadillac plans from private insurers. Those with money will always get better coverage but everyone will get the basics.

Personally I think the above is a good idea in general but we would get something like that regardless. The rich have way to much influence and they aren't going to settle with getting the exact same medical service as the plebes.

And you'll never get expensive doctors and hospitals to work cheap, they don't want a pay cut.

 

[shortylickens]

Tell that to every other developed nation on Earth that has it.

I will gladly tell you.

They dont have a trillion dollar military.
They borrow our trillion dollar military when they have a problem then turn around criticize us for spending enough on medicine and schools.
They also dont have a government supported monopoly on medicine by a private company.

And they dont keep voting for the same assholes over and over again. Asshole who screw them without lube and then promise to do more if they get reelected.

 

[shortylickens]

And you'll never get expensive doctors and hospitals to work cheap, they don't want a pay cut.

If there was competition they wouldnt have a freakin choice. They'd have to run an efficient business just like every other company in America. Well, I suppose they could accept massive bailouts like some American companies do.
:hmm:

 

[SP33Demon]

Young people are paying the same single payer taxes as anyone else but for services they generally do not use. That is the opposite of an advantage. This is why single payer is disadvantageous for the young.



Under the old US system that you want to return to the old and sick paid vastly higher insurance premiums (if they could get insurance at all). Under a single payer system everyone pays the same regardless of their relative health, meaning a large financial windfall for people who would otherwise be subjected to high premiums.

This isn't hard to understand so I'm not sure why you're having so much trouble grasping it. Also, we do not pay higher taxes than Canadians. US total tax receipts as a percentage of GDP was 26.9% while in Canada it was 32.2%. I don't know where you get this nonsense from.

https://en.wikipedia.org/wiki/List_of_countries_by_tax_revenue_as_percentage_of_GDP

Except everyone has to pay taxes, they don't have a choice so their tax share would be way cheaper than paying a premium in the U.S. as a young person. Hence why it's better for young people to be in Canada, they are paying less overall. Nobody gives a shit if they use it more, it's the bottom line that matters. Both US and Canadians young uns aren't going to use it so you go to the place that's cheaper out of pocket until you have an emergency. Just like with older people. Yes I understand that the sick will get more for what they pay percentage wise. But if either group is sick, then it behooves them to be in the U.S. for lower wait times and they're actually getting their bang for their buck. So non-sick young and old Canadians have it better since they're paying less overall and can hop the border in the even of an immediate surgery. Sick is subjective because of Canadian's shit wait times. 2 months to get an MRI? Awful.

Yeah I ran some numbers and it seems like my taxes would be higher. I also ran some lower calcs and it seems to be the same as the U.S., but once you move into the 150K plus range it really really ramps up. Roughly 11.6% more in total for my wife and I and that's before any deductions. Shit.

 

[SP33Demon]

"Quality" is being measured on more than one metric. Cost is one, speed of delivery is another, quality of services yet another. Any overall "best" ranking is going to need to weigh those and other customer satisfaction factors in combination and no single way of ranking the factors will cover every person's wants and needs.

In this discussion, it's obvious Eskimospy is ranking 'accessibility to care' for all as one of his key metrics if not the key metric. SP33d is obviously talking about speed of delivery and the ability to received premium care for those who can afford it. Neither is "wrong" and how to rank those factors is what the whole Obamacare/single payer/free market debate is about.

Yep, agree.

 

[SP33Demon]

I will gladly tell you.

They dont have a trillion dollar military.
They borrow our trillion dollar military when they have a problem then turn around criticize us for spending enough on medicine and schools.
They also dont have a government supported monopoly on medicine by a private company.

And they dont keep voting for the same assholes over and over again. Asshole who screw them without lube and then promise to do more if they get reelected.

Shorty on the Trump train?

 

[werepossum]

Lots of hate against insurance companies, and I get the frustration, but a healthy insurance industry is vital for our society. People need a way to insure themselves and their assets, and the insurance companies have to have a way to assign and price risk.

Was the health insurance industry screwed up before the ACA? Absolutely. But the blame rests at all of our feet, not just greedy Wall Street. For instance why do we insist that our employers (who have absolutely nothing to do with our health insurance, nor do they specialize in health insurance unless you happen to work in the industry) provide our coverage? It makes no sense.

Well said, sir. Although arguably, single payer also solves some problems better than does the ACA.

Such concern for insurance company profits. Touching.

Um, the Blues are not-for-profits. Even the ones forced to organize as for-profits due to onerous state regulatory burdens aim for 0% profit.

Obamacare is to collapse the market and force you to face the obvious.
You cannot maintain current policy... and you cannot go back.
The only way forward is single payer. Is it not?

I agree, that is the long game.

 

[Rakehellion]

Company is struggling because their industry is outmoded: "Poor corporations!"

Person struggling to make ends meet: "You should have found a better job"


Maybe the corporation should have just found a better job. :awe:

 

[werepossum]

I will gladly tell you.

They dont have a trillion dollar military.
They borrow our trillion dollar military when they have a problem then turn around criticize us for spending enough on medicine and schools.
They also dont have a government supported monopoly on medicine by a private company.

And they dont keep voting for the same assholes over and over again. Asshole who screw them without lube and then promise to do more if they get reelected.

Exactly, and well said.

The USA becoming a European-style socialist economy means ceding policing of the world to Red China; we simply can't afford both a huge, constantly deployed military and socialist-level giveaways. In the long run though I'm not sure it makes much difference. How long can we keep being the world's lone superpower on money we borrow from China?

 

[werepossum]

Except everyone has to pay taxes, they don't have a choice so their tax share would be way cheaper than paying a premium in the U.S. as a young person. Hence why it's better for young people to be in Canada, they are paying less overall. Nobody gives a shit if they use it more, it's the bottom line that matters. Both US and Canadians young uns aren't going to use it so you go to the place that's cheaper out of pocket until you have an emergency. Just like with older people. Yes I understand that the sick will get more for what they pay percentage wise. But if either group is sick, then it behooves them to be in the U.S. for lower wait times and they're actually getting their bang for their buck. So non-sick young and old Canadians have it better since they're paying less overall and can hop the border in the even of an immediate surgery. Sick is subjective because of Canadian's shit wait times. 2 months to get an MRI? Awful.

Yeah I ran some numbers and it seems like my taxes would be higher. I also ran some lower calcs and it seems to be the same as the U.S., but once you move into the 150K plus range it really really ramps up. Roughly 11.6% more in total for my wife and I and that's before any deductions. Shit.

Well reasoned, sir. Of course, it's not all one way. Two months wait for an MRI would sound pretty good if one is without health insurance and cannot get an MRI at all because one's problem is not (yet) life-threatening.

 

[fskimospy]

Exactly, and well said.

The USA becoming a European-style socialist economy means ceding policing of the world to Red China; we simply can't afford both a huge, constantly deployed military and socialist-level giveaways. In the long run though I'm not sure it makes much difference.

I don't really think that's the case at all. Canada spent 1% of GDP on their military in 2014 and we spent 3.5% of GDP on it. While 2.5% of GDP is a lot of money in nominal terms, it's not like that 2.5% of GDP is what is preventing us from instituting a European style welfare state. It's a political choice on our part.

http://data.worldbank.org/indicator/MS.MIL.XPND.GD.ZS

How long can we keep being the world's lone superpower on money we borrow from China?

Indefinitely, really. By the way, China has been a net seller of treasuries for awhile now and it's total supply of them has dropped by about 15%. So basically we aren't borrowing money from China anymore.

 

[fskimospy]

Except everyone has to pay taxes, they don't have a choice so their tax share would be way cheaper than paying a premium in the U.S. as a young person. Hence why it's better for young people to be in Canada, they are paying less overall. Nobody gives a shit if they use it more, it's the bottom line that matters. Both US and Canadians young uns aren't going to use it so you go to the place that's cheaper out of pocket until you have an emergency. Just like with older people. Yes I understand that the sick will get more for what they pay percentage wise. But if either group is sick, then it behooves them to be in the U.S. for lower wait times and they're actually getting their bang for their buck. So non-sick young and old Canadians have it better since they're paying less overall and can hop the border in the even of an immediate surgery. Sick is subjective because of Canadian's shit wait times. 2 months to get an MRI? Awful.

Now you're comparing across countries which doesn't make any sense. You said single payer is better for young people, period. This is demonstrably false. It's really simple if you think about it: old and sick people cost the health care system more money than young and healthy people. If everyone is paying the same price then math dictates that if old and sick people are paying less than they cost someone else must be paying more than they cost. There's no getting around it.

Yeah I ran some numbers and it seems like my taxes would be higher. I also ran some lower calcs and it seems to be the same as the U.S., but once you move into the 150K plus range it really really ramps up. Roughly 11.6% more in total for my wife and I and that's before any deductions. Shit.

Taxes on certain people in the US may be higher than their Canadian counterparts but overall we pay considerably lower taxes than Canadians do.

 

[Sonikku]

And you'll never get expensive doctors and hospitals to work cheap, they don't want a pay cut.

If I could get away with charging $500 for a pill of Tylenol I too wouldn't necessarily want an end to the gravy train. But that kind of behavior is not sustainable and something has to give.

 

[slag]

I skipped everything after the first page. I work on the technical side for a Blue plan and have worked many hours to accommodate Obama care and the changing rules that seemed to come in all the time. Know what? We rolled with the punches, adjusted our business plan instead of selling mainly to businesses to selling to businesses and individuals, established a presence on the local exchange, and are doing ok. It has taken a lot of adjustment and coding of new applications to adjust to the changing times, but if you don't change and stay flexible, yeah, you're gonna have a hard time.

Another large insurance provider pulled out of the state due to whatever spin they want to put on it, but in the end, they couldn't compete and their costs per member were probably too high to be successful in the market (from what I've heard).

 

[werepossum]

I don't really think that's the case at all. Canada spent 1% of GDP on their military in 2014 and we spent 3.5% of GDP on it. While 2.5% of GDP is a lot of money in nominal terms, it's not like that 2.5% of GDP is what is preventing us from instituting a European style welfare state. It's a political choice on our part.

http://data.worldbank.org/indicator/MS.MIL.XPND.GD.ZS

Indefinitely, really. By the way, China has been a net seller of treasuries for awhile now and it's total supply of them has dropped by about 15%. So basically we aren't borrowing money from China anymore.

Well, if you are correct and we can borrow as much money as we want to spend over any practical period of time, and then borrow more money to pay the interest, then I suppose we can have both. Perhaps you wonder why no other nation does that? Surely France or Germany or Great Britain would love to have a world class military in addition to their rich social spending?

 

[Slew Foot]

Um, the Blues are not-for-profits. Even the ones forced to organize as for-profits due to onerous state regulatory burdens aim for 0% profit.

Lol, Not for profit. The NFL is not for profit too. That just means any money left over at the end of the year gets rolled into C suite bonuses.

 

[Grooveriding]

Your system is a ramped down version of our Medicare but with worse wait times according to studies comparing the two systems. Like:
https://www.fraserinstitute.org/sites/default/files/effect-of-wait-times-on-mortality-in-canada.pdf


and


http://www.forbes.com/sites/theapot...sal-health-care-is-the-goal-dont-copy-canada/

2 months for an MRI? hahahahaha. I can get same day MRI's at SIX major hospitals in the DC Area that are within an hour's drive. Fuck your 2 month wait, and when I need surgery I'm going to Johns Hopkins (top three in the world - notice how they're all American too), not your shitty little Canadian hospital where I'll be waitlisted and possibly die before getting treatment in time. You get what you pay for, and that's why you're paid less than in the U.S. - you have chosen to accept mediocrity in a mediocre system with shitty wait times that kill your own people. No offense. :biggrin:

Anytime you want to step your game up, feel free to move to the U.S. and actually get paid for what you claim you're worth.

I mentioned exactly this in my post. If you present as emergent you will receive whatever diagnostic necessary immediately. I also even highlighted that in the US you can receive diagnostics more readily for non-emergent presentations, one of the few pros I'd give to their system. Although, you can do the same here, as there are private diagnostics available, if you want a same day MR, CT, US etc., because you have a sore leg from carrying groceries, you're free to go pay for one out of pocket if you'd rather not wait. I doubt you actually read and absorbed my post though, you are immune to any reality that contravenes the beliefs you need to hold.

Take your google-fu and look up numbers on how many die in the US from not having care, or insufficient care. How much more money is spent in the US per capita on healthcare than anywhere else with a lower standard of delivered care per capita than other first world nations.

You are unable to even absorb information or have intelligent discourse without throwing out insults. There isn't even a discourse to be had on the merits of my accomplishments. If I wanted to be in the US, with my education and in my field, I could be landed there in a year. In your obtuse reality I'm sure you believe that a doctor anywhere but in the US just didn't make the grade and had to resort to working elsewhere. This is how broken your faculties for logic are.

 

[fskimospy]

Well, if you are correct and we can borrow as much money as we want to spend over any practical period of time, and then borrow more money to pay the interest, then I suppose we can have both. Perhaps you wonder why no other nation does that? Surely France or Germany or Great Britain would love to have a world class military in addition to their rich social spending?

Well in 2014 numbers that would involve an increase in military spending for France and the UK of just over 1% of GDP to match our proportional spending. Are you really trying to say that France and UK are incapable of doing that if they wanted to? That seems far fetched to me.

We don't have a strong welfare state because we choose not to, not because we are incapable of providing one.

 

[werepossum]

I skipped everything after the first page. I work on the technical side for a Blue plan and have worked many hours to accommodate Obama care and the changing rules that seemed to come in all the time. Know what? We rolled with the punches, adjusted our business plan instead of selling mainly to businesses to selling to businesses and individuals, established a presence on the local exchange, and are doing ok. It has taken a lot of adjustment and coding of new applications to adjust to the changing times, but if you don't change and stay flexible, yeah, you're gonna have a hard time.

Another large insurance provider pulled out of the state due to whatever spin they want to put on it, but in the end, they couldn't compete and their costs per member were probably too high to be successful in the market (from what I've heard).

Thanks for the input. Seems to me that success under Obamacare is largely determined by how quickly the insurance company can adapt its business model and actuarial tables to the new reality, no?

 

[slag]

Lol, Not for profit. The NFL is not for profit too. That just means any money left over at the end of the year gets rolled into C suite bonuses.

It goes into a reserve in case of catastrophic issues. Plans have to have money stores for contingencies lasting months or years of people not being able to pay their premiums. There is a max upper limit you are supposed to have though, and if there are additional monies, usually it goes into infrastructure spending such as servers, network, fault tolerance, clustering services, etc, however, additional monies is a rarity due to the market regulating itself under the state and federal regulations that already exist. There is still competition that occurs and as with any free market system, if you charge too much, you won't get the people signing up for your services.

 

[SP33Demon]

Now you're comparing across countries which doesn't make any sense. You said single payer is better for young people, period. This is demonstrably false. It's really simple if you think about it: old and sick people cost the health care system more money than young and healthy people. If everyone is paying the same price then math dictates that if old and sick people are paying less than they cost someone else must be paying more than they cost. There's no getting around it.



Taxes on certain people in the US may be higher than their Canadian counterparts but overall we pay considerably lower taxes than Canadians do.

Comparing across countries has to be done when talking about how Canadians can choose and we cannot. You also just repeated yourself for the third time about how the young folk have to pay for the poor who use it more. No shit, that's why United threatened to pull out of the US exchange, there weren't enough young folk signing up. However, what I'm telling you is the out of pocket cost is all I care about. And non-sick kids and elderly canadians will pay less OOP than americans, even factoring in taxes. Hypothetically they have it better than we do since they can jump borders for superior treatment in emergencies. We are stuck paying higher and higher premiums for better care of course but we don't always use it. Hypothethically if we're young and in shape then Canada's going to be cheaper.

 

[slag]

Thanks for the input. Seems to me that success under Obamacare is largely determined by how quickly the insurance company can adapt its business model and actuarial tables to the new reality, no?

I think that's a lot of it. The ACA didn't just appear overnight. Insurance companies had ample notice of what was coming and started formulating strategies and think tanks on how to adapt to this changing market. ACA is just another set of rules insurance companies have to follow. Those with a low overhead per insurer (I don't know the actual term), are in a better position to offer services at a cheaper rate than other competing plans. Makes sense, right?

Larger established corporations with older employees sometimes are like a sleeping giant and it takes a big stick to poke and prod them and make them wake up and change. The ACA was that stick. Those that woke up and saw the writing on the wall were ahead of the game from the beginning, but it's still a catch-up game as there changes that seem to come in all the time, both internally and from other entities and rates are adjusted all the time to find the sweet spot that benefits both the consumer and the plans.

 

[fskimospy]

Comparing across countries has to be done when talking about how Canadians can choose and we cannot. You also just repeated yourself for the third time about how the young folk have to pay for the poor who use it more. No shit, that's why United threatened to pull out of the US exchange, there weren't enough young folk signing up. However, what I'm telling you is the out of pocket cost is all I care about. And non-sick kids and elderly canadians will pay less OOP than americans, even factoring in taxes. Hypothetically they have it better than we do since they can jump borders for superior treatment in emergencies. We are stuck paying higher and higher premiums for better care of course but we don't always use it. Hypothethically if we're young and in shape then Canada's going to be cheaper.

You said this:

If you are young and don't need ever get sick, then single payer is best

That is a false statement.

If you want to say young people in Canada have it better than young people in the US that's fine. That's also a debatable point, but it could possibly be correct. Saying that if you're young and healthy single payer is best is simply wrong, however. If you are young and healthy then the US's old system was the best.

 

[SP33Demon]

I mentioned exactly this in my post. If you present as emergent you will receive whatever diagnostic necessary immediately. I also even highlighted that in the US you can receive diagnostics more readily for non-emergent presentations, one of the few pros I'd give to their system. Although, you can do the same here, as there are private diagnostics available, if you want a same day MR, CT, US etc., because you have a sore leg from carrying groceries, you're free to go pay for one out of pocket if you'd rather not wait. I doubt you actually read and absorbed my post though, you are immune to any reality that contravenes the beliefs you need to hold.

Take your google-fu and look up numbers on how many die in the US from not having care, or insufficient care. How much more money is spent in the US per capita on healthcare than anywhere else with a lower standard of delivered care per capita than other first world nations.

You are unable to even absorb information or have intelligent discourse without throwing out insults. There isn't even a discourse to be had on the merits of my accomplishments. If I wanted to be in the US, with my education and in my field, I could be landed there in a year. In your obtuse reality I'm sure you believe that a doctor anywhere but in the US just didn't make the grade and had to resort to working elsewhere. This is how broken your faculties for logic are.

So people are going to have to pay OOP for an MRI if they want it same day? No, just no. That's horseshit. Not waiting 2 months for an MRI. Thanks for confirming.

Americans on waitlists - I can't find anything unless it's about the VA.
http://dailycaller.com/2015/07/14/a...7000-long-waitlist-have-died-without-va-care/
So more people dying on a single payer waitlist. Great.

A new leaked document from the Department of Veterans Affairs indicates 238,657 veterans have died while waiting for health care appointments.

Yes, I'm sure you'd "land here in a year". So what's stopping you? You'd make more here and pay less in taxes. Either you're slow or you're lying or you have no balls to tell your family you want to move. Take control, you may like it here depending on the place (e.g. don't move to Detroit MI!).