Ready For the Real Obamacare to be Implemented?

[glenn1]

Honestly healthcare just irritates me. We've known since the early to mid 80's that the costs were growing at an unsustainable rate. There has been periodic talk of fixes but far more grandstanding. Even the ACA its a start but its also far from the solution. I'm tired of partisan hacks spewing out useless or unrealistic points.
We all know:
Costs are too high and rising
Billing is too concealed
Its close to impossible to estimate the cost of medical services
We need to service everyone
Everyone needs to contribute something
Drug companies will over bill & over prescribe whenever possible
Some people won't do preventive care
Some people will be paranoid or selfish with care

Lets get some ideas together to fix the problem. Lets look at what successful healthcare systems do and emulate what works. Lets give a shit about patients experiences.

So what if costs are going up, improved healthcare is a luxury good. Would you prefer the situation from earlier in our history where someone might have spent 1% of their income on healthcare but 95% on food and rent? Spending more money on healthcare is a good thing when the cause is that increasing technology and productivity means we spend less money on other things we value less or are simple consumables.

 

[shira]

How in the FUCK do you expect a TAX to LOWER THE COST of the healthcare industry? What retard mapping to you have in your brain to come up with that kind of logic (lack thereof)?

Please. Do tell.

Gee. It took me 15 seconds of Google to find (for example):

http://www.forbes.com/sites/theapot...ax-could-help-reduce-the-cost-of-health-care/

And we all know how liberal Forbes is.

 

[Nebor]

When I worked in the private sector I was paying around $1000 a month for health insurance for myself, a young, healthy man. I had what might more accurately be described as a Maybach plan than a Cadillac plan. No deductibles, nothing out of pocket, and any provider I wanted. Frankly this tax wouldn't have impacted my choice, but I would be very upset if it impacted my employers choice on whether to offer such plans, effectively forcing me to have crappy insurance just so I was more "equal."

I've been on Tricare for a while, and know plenty of people who go to the VA as well, and let me tell you, those of you rooting for government health care (single payer) are in for a real treat when it actually comes to pass.

 

[Fanatical Meat]

So what if costs are going up, improved healthcare is a luxury good. Would you prefer the situation from earlier in our history where someone might have spent 1% of their income on healthcare but 95% on food and rent? Spending more money on healthcare is a good thing when the cause is that increasing technology and productivity means we spend less money on other things we value less or are simple consumables.

I'd prefer to have all. Good healthcare and good food, plus a roof over my head. I really don't see why this is an unreasonable expectation.


**I'm assuming this is a serious post not sarcasm**

 

[s0me0nesmind1]

Gee. It took me 15 seconds of Google to find (for example):

http://www.forbes.com/sites/theapot...ax-could-help-reduce-the-cost-of-health-care/

And we all know how liberal Forbes is.

Try reading your post before posting it toolbag.

It's a retarded editorial of what "Could" happen - with zero explanation of how the tax could actually lower healthcare costs all around.

The tax will stimulate private-sector innovation

On the bright side, the Cadillac tax could have a positive impact on the pricing of healthcare if employers take into account the long-term effects of their immediate maneuvers to avoid the tax. Rather than scheming to avoid the tax at all costs, employers can accept some portion of increased tax while instituting cost-sharing mechanisms that use consumer shopping and market forces to drive down overall healthcare prices. For example, employers can employ strategies like referenced-based pricing and consolidation of services with specific providers to allow for lower contracted costs. Creative solutions like these will actually decrease the cost of care, not just move money around on the balance sheet.

Translation: Employers will work with insurance companies to take out tidbits of insurance in order to stay below the bottom line of paying the tax - as well as passing on more of the costs of the insurance to the employee. More cash comes out of the employee (middle class) pockets.

Translation: You will get shittier insurance at a higher cost. Enjoy!

How that translates to lower costs of seeing the doc, I'll never know. But then again, I'm not financially retarded like some of you are, so it's hard to see how you get to your conclusions on things :awe:

 

[glenn1]

I'd prefer to have all. Good healthcare and good food, plus a roof over my head. I really don't see why this is an unreasonable expectation.

**I'm assuming this is a serious post not sarcasm**

Healthcare is better now and we are bigger consumers of it, so why is it some surprise that we spend more on it? We spend more on mobile phones now than we did back in the 1970s, should that be cause for concern? Likewise, my healthcare spending was smaller back then because things like MRI's, CAT scans, etc. didn't exist so my quality of treatment wasn't as good - do you prefer that situation because your healthcare spending was some arbitrarily smaller percentage of your income back then?

 

[Nebor]

Healthcare is better now and we are bigger consumers of it, so why is it some surprise that we spend more on it? We spend more on mobile phones now than we did back in the 1970s, should that be cause for concern? Likewise, my healthcare spending was smaller back then because things like MRI's, CAT scans, etc. didn't exist so my quality of treatment wasn't as good - do you prefer that situation because your healthcare spending was some arbitrarily smaller percentage of your income back then?

Yeah, but we're talking about Obamacare: the government taking money from people and using it to buy healthcare for other people. Let's keep the argument to reality and not some sort of theoretical situation where the government takes money from people and uses it to buy cell phones for other people. What would you even call that? Obamacells? Obamamobiles?

 

[Fanatical Meat]

Healthcare is better now and we are bigger consumers of it, so why is it some surprise that we spend more on it? We spend more on mobile phones now than we did back in the 1970s, should that be cause for concern? Likewise, my healthcare spending was smaller back then because things like MRI's, CAT scans, etc. didn't exist so my quality of treatment wasn't as good - do you prefer that situation because your healthcare spending was some arbitrarily smaller percentage of your income back then?

Want to explain why MRI's are substantially more expensive here than almost anywhere else on the Planet or does America have the only MRI machines & operators?

 

[shira]

Try reading your post before posting it toolbag.

It's a retarded editorial of what "Could" happen - with zero explanation of how the tax could actually lower healthcare costs all around.



Translation: Employers will work with insurance companies to take out tidbits of insurance in order to stay below the bottom line of paying the tax - as well as passing on more of the costs of the insurance to the employee. More cash comes out of the employee (middle class) pockets.

Translation: You will get shittier insurance at a higher cost. Enjoy!

How that translates to lower costs of seeing the doc, I'll never know. But then again, I'm not financially retarded like some of you are, so it's hard to see how you get to your conclusions on things :awe:

I agree with what's bolded. But clearly you're MUCH smarter than legions of health care analysts, who recommended the provisions of the Cadillac Tax as one way to lower costs. After all, you were able to read just two paragraphs in that article and you can already see the huge flaw in the design. Wow!

 

[Meghan54]

If 26% of Americans are hit but the average hit is a couple hundred bucks or less, it's not exactly a catastrophe. If 26% of Americans are hit but the average hit is a couple grand, then we'll see this delayed yet again and probably reduced and/or phased in so that people don't take the hit (financial or a drop in coverage) all in one year.

I see where you got the 26% number, but that's not what the linked article in the OP said.

The article "estimated that 26 percent of all employers would face the tax in at least one of their plans during its first year", that's 26% of employers have at least one plan, out of more than one, that will be subject to the tax....on plans that cost well above the average for those plans. That doesn't mean 26% of Americans with employer sponsored health plans will be hit with the tax.

Since we're using the Kaiser Foundation as the source, they also put the average cost of a employer provided health care plan for single persons at ~$6K/year and $~17K for a family plan, far below the cost threshold for the tax (~$10K for singles, $24K for families.)

http://kff.org/report-section/ehbs-2014-section-one-cost-of-health-insurance/


In fact, if you browse through the slides on that page, slide #7 states less than 4% of Americans with single coverage pay $9K/year or more.....4%. Slide #8 shows that 6% of Americans with family coverage pay over $24K/year. Those numbers are well below your claim that 26% of Americans will be subject to the tax this year.

 

[s0me0nesmind1]

I agree with what's bolded. But clearly you're MUCH smarter than legions of health care analysts, who recommended the provisions of the Cadillac Tax as one way to lower costs. After all, you were able to read just two paragraphs in that article and you can already see the huge flaw in the design. Wow!

And as we can all tell, you clearly didn't read your own article that you linked. You just looked at the headline saw "Reduce the cost" and assumed it would provide what you were looking for.

In reality it's an editorial from a complete one-sided moron with no actual facts or logic on how the tax would translate to lower health care costs. But feel free to find it yourself... So far I've read the article and you clearly have not.

 

[cabri]

Gee. It took me 15 seconds of Google to find (for example):

http://www.forbes.com/sites/theapot...ax-could-help-reduce-the-cost-of-health-care/

And we all know how liberal Forbes is.

From your linked article

On the bright side, the Cadillac tax could have a positive impact on the pricing of healthcare if employers take into account the long-term effects of their immediate maneuvers to avoid the tax. Rather than scheming to avoid the tax at all costs, employers can accept some portion of increased tax while instituting cost-sharing mechanisms that use consumer shopping and market forces to drive down overall healthcare prices. For example, employers can employ strategies like referenced-based pricing and consolidation of services with specific providers to allow for lower contracted costs. Creative solutions like these will actually decrease the cost of care, not just move money around on the balance sheet.

We need to attack the cost of healthcare at its source: level of use and initial pricing of services. Simply adding another tax that will indeed raise money but will not change cost is just biding time. Employers have an opportunity here to be pioneers. While the Cadillac tax may change some with revised legislation, it is an idea that has stuck and it addresses a problem that needs solving. This is an opportunity for innovation and change in the private market that can truly impact healthcare behavior and habits.

The first paragraph has two critical words that I have bolded.

The second also, is what could be a disclaimer.

After reading the article, it is an opinion piece and also lays out potential scenarios; it does not claim that the tax will lower health care.
It shows three ways that it can make things worse.

Those potential scenarios are based on an employer making choices that line up with the intentions of the ACA/Cadillac tax.

They are hoping that the tax on employers will cause a change to social policy.

 

[shira]

I see where you got the 26% number, but that's not what the linked article in the OP said.

The article "estimated that 26 percent of all employers would face the tax in at least one of their plans during its first year", that's 26% of employers have at least one plan, out of more than one, that will be subject to the tax....on plans that cost well above the average for those plans. That doesn't mean 26% of Americans with employer sponsored health plans will be hit with the tax.

Since we're using the Kaiser Foundation as the source, they also put the average cost of a employer provided health care plan for single persons at ~$6K/year and $~17K for a family plan, far below the cost threshold for the tax (~$10K for singles, $24K for families.)

http://kff.org/report-section/ehbs-2014-section-one-cost-of-health-insurance/

I think the family threshold is $27,500 when the provisions go into effect in 2018.

 

[shira]

From your linked article



The first paragraph has two critical words that I have bolded.

The second also, is what could be a disclaimer.

After reading the article, it is an opinion piece and also lays out potential scenarios; it does not claim that the tax will lower health care.
It shows three ways that it can make things worse.

Those potential scenarios are based on an employer making choices that line up with the intentions of the ACA/Cadillac tax.

They are hoping that the tax on employers will cause a change to social policy.

That is exactly right. No one knows for sure. Kind of like when you get treatment for a disease and hope that the treatment works for you.

Our country has to start somewhere in attempting to control health care costs. The pre-ACA status-quo was insanely bad. The ACA world is better but still far from perfect. Many additional changes in our health care system are needed, and most of them will be painful. So citing the "pain" associated with a change as THE definitive consideration without also considering the potential benefits is like having appendicitis and deciding to forego having your appendix removed because you know you'll feel some discomfort afterward.

 

[Jhhnn]

It's why (as the article states) most companies are making a move and a push towards getting employee's to choose HSA compatible plans. Basically shit coverage, but an HSA investment account that the employer gives a contribution to.

It's a way to avoid the tax through a shit coverage, but giving money for the actual costs of healthcare. Though the article says they are considering finding a way to tax that as well.

I didn't get that out of the article at all. I got that FSA's would be the first to go.

It's the standard doom & gloom prediction, anyway. Given that there's a considerable delta between the max allowed ($27,500) & what family health insurance actually costs in most places then that difference can still go towards FSA's & is still pre-tax money.

 

[s0me0nesmind1]

I didn't get that out of the article at all. I got that FSA's would be the first to go.

It's the standard doom & gloom prediction, anyway. Given that there's a considerable delta between the max allowed ($27,500) & what family health insurance actually costs in most places then that difference can still go towards FSA's & is still pre-tax money.

Look towards the bottom of the article:

— Treasury is also trying to figure what do about a different kind of workplace arrangement called a "health savings account."

A growing number of workers have high-deductible health insurance that comes with tax-sheltered health savings accounts, or HSAs, that they and their employer can contribute to.

But if an employee has his or her contribution deducted from their paycheck, it could potentially trigger the tax.

Officials say they're considering options.

 

[glenn1]

Want to explain why MRI's are substantially more expensive here than almost anywhere else on the Planet or does America have the only MRI machines & operators?

Primarily it's due to price controls. Which would directly impact the incomes of and reduce the numbers of people who work in the medical field if implemented here. If that's your goal then have at, but I don't think that's a winning campaign strategy not to mention goes directly against the Keynesian fetishes of those who implemented Obamacare in the first place.

 

[s0me0nesmind1]

Primarily it's due to price controls. Which would directly impact the incomes of and reduce the numbers of people who work in the medical field if implemented here. If that's your goal then have at, but I don't think that's a winning campaign strategy not to mention goes directly against the Keynesian fetishes of those who implemented Obamacare in the first place.

I think a lot of it is due to the ol' "We trust the doctor, do as he says". A doctor can tell you to go get an MRI - and he doesn't have to say how much it's going to cost you. Yet the moment you agree you are on the hook for something that costs a shitload.

"Doc, my arm hurts"
"Better get an MRI on it"

I'm not saying doctors are screwed up, but they are VERY quick to tell you to get an expensive procedure when the chances of it showing anything are VERY slim.

 

[Nebor]

I think a lot of it is due to the ol' "We trust the doctor, do as he says". A doctor can tell you to go get an MRI - and he doesn't have to say how much it's going to cost you. Yet the moment you agree you are on the hook for something that costs a shitload.

"Doc, my arm hurts"
"Better get an MRI on it"

I'm not saying doctors are screwed up, but they are VERY quick to tell you to get an expensive procedure when the chances of it showing anything are VERY slim.

But the cost of the MRI does impact it's usage. Most people can get an MRI within a day or so of a doctor ordering it. Lower the cost of the MRI to zero, as it was in my case in San Antonio earlier this year, and even with 8 machines running 24/7 at 3 clinics (not exaggerating, my eventual appointment was at 2:30am) it took 4 weeks to get me in with two torn tendons in my rotator cuff.

 

[glenn1]

I think a lot of it is due to the ol' "We trust the doctor, do as he says". A doctor can tell you to go get an MRI - and he doesn't have to say how much it's going to cost you. Yet the moment you agree you are on the hook for something that costs a shitload.

"Doc, my arm hurts"
"Better get an MRI on it"

I'm not saying doctors are screwed up, but they are VERY quick to tell you to get an expensive procedure when the chances of it showing anything are VERY slim.

That speaks to the demand side of the equation but supply is also high in the U.S.

I'm also baffled because the left thinks that high costs in healthcare is an issue willing to float the idea of price and wage controls to address, but when it's exploding costs on primary education then they want to throw more money at the problem and raise teacher salaries yet again. Same problem but they approach it with diametrically opposite "solutions". One might begin to think there were politically motivated reasons for that.

 

[cliftonite]

But the cost of the MRI does impact it's usage. Most people can get an MRI within a day or so of a doctor ordering it. Lower the cost of the MRI to zero, as it was in my case in San Antonio earlier this year, and even with 8 machines running 24/7 at 3 clinics (not exaggerating, my eventual appointment was at 2:30am) it took 4 weeks to get me in with two torn tendons in my rotator cuff.

Was able to get an MRI in NJ within 2 days in NJ.

 

[shira]

I think a lot of it is due to the ol' "We trust the doctor, do as he says". A doctor can tell you to go get an MRI - and he doesn't have to say how much it's going to cost you. Yet the moment you agree you are on the hook for something that costs a shitload.

"Doc, my arm hurts"
"Better get an MRI on it"

I'm not saying doctors are screwed up, but they are VERY quick to tell you to get an expensive procedure when the chances of it showing anything are VERY slim.

Most expensive procedures these days already need to be medically justified by insurance companies. A physician can't just send you for an MRI for any old reason. There's almost always a hierarchy of tests/procedures: least expensive first, then more expensive later.

But there also needs to be more/easier price transparency. For example, hospital "Chargemasters" (= "CDMs") should be required by law to be made available on easily-searchable public websites. And the typical, total costs associated with various hospital procedures (for example, $125,000 for bypass surgery) should similarly be made public.

 

[Jhhnn]

Look towards the bottom of the article:

I already did. That doesn't say employers are moving in that direction as you claimed.

 

[Jhhnn]

I see where you got the 26% number, but that's not what the linked article in the OP said.

The article "estimated that 26 percent of all employers would face the tax in at least one of their plans during its first year", that's 26% of employers have at least one plan, out of more than one, that will be subject to the tax....on plans that cost well above the average for those plans. That doesn't mean 26% of Americans with employer sponsored health plans will be hit with the tax.

Since we're using the Kaiser Foundation as the source, they also put the average cost of a employer provided health care plan for single persons at ~$6K/year and $~17K for a family plan, far below the cost threshold for the tax (~$10K for singles, $24K for families.)

http://kff.org/report-section/ehbs-2014-section-one-cost-of-health-insurance/


In fact, if you browse through the slides on that page, slide #7 states less than 4% of Americans with single coverage pay $9K/year or more.....4%. Slide #8 shows that 6% of Americans with family coverage pay over $24K/year. Those numbers are well below your claim that 26% of Americans will be subject to the tax this year.

Facts don't matter when Righties take off on a Chicken Little rant. You know that. They already believe & nothing can change it.

 

[Cozarkian]

I'm not saying doctors are screwed up, but they are VERY quick to tell you to get an expensive procedure when the chances of it showing anything are VERY slim.

To be fair, that is because people are VERY quick to sue a doctor if they happen to be in the group of people who have a serious condition for which there is an ANY chance that an MRI would lead to a successful diagnosis and an MRI was not recommended.