Ready For the Real Obamacare to be Implemented?

[sportage]

All Obamacare has really done is little.
Pooled together the same old insurance for profit providers so that people could get insurance outside of employment, if needed.
Plus, enabled a few common sense regulations like removing caps and pre-existing denial.
Which sounds great on paper, except we all know insurance companies will re-coop that increased cost with raising rates. After all, this is still an insurance for profit system we all live in.

I find it so amusing when some people think or actually believe this is any wheres near a government healthcare system. Or universal healthcare system.
Not anything even close to.

Oh, and that penalty tax for people that refuse to carry health insurance.
Which makes sense, since we have the very same system for our automobile insurance.
And the health of the human body is more important than your SUV or Prius. No?

I sat up, eyes wide open, when Trump mentioned that universal healthcare works very well in other countries.
Can you imagine, a republican president for universal healthcare?
That definitely beats Obamacare, FYI.
And if an Obamacare repeal is in the future, universal healthcare would be a great and acceptable replacement, realistically speaking of replacement options.

People are justly worried that any universal government type of national healthcare would operate like the IRS or most other dysfunctional government agencies.
The challenge for the next president and congress would be to merge a newly formed government program with the current private insurance program.
Allow the private companies to function but no longer independent.
Place them under a highly government regulated system where the private providers still provide the care, but all the costs are strictly controlled and costs set by the government.
And a tax system set in place where everyone pays for their universal health insurance.
The government could control drug costs and profits as well.

Yep! It would be a major change to our healthcare system, but the profit thing would be eliminated. And every US citizen would be 100% covered, services as well as medications.
It could be done. All it needs is a very smart president, congress, and some old fashion American will power. The same will power that won us WWII.

 

[Jeff7]

Not really, since no one is really paying $23,000 for an MRI. Insurance companies are paying less than 10% of that I'd guess.

But yeah, they're making good money off the machines, paying "technicians" to operate them 24 hours a day in a lot of places.

Still, 25 years ago an MRI would be science fiction magic. Most people complaining about the cost of an MRI have absolutely no idea how it works, or what it really does. To me, it's like complaining about how expensive it is to put a satellite in orbit or how expensive overnight shipping at FedEx costs.

And you have a computer that's capable of many millions upon millions of calculations per second, possibly with more than a billion vacuum tube equivalents in it that are able to operate beyond 1GHz, and not require a dedicated nuclear power plant to run it. Science fiction magic.
No one should ever complain that even something like a Pentium 133MHz with MMX is too slow.


Technology integrates and becomes the norm. Yes, it's impressive that a bunch of atomic clocks several thousand miles away can be used to determine your location to within a dozen or so feet, but it's still darn inconvenient when your $100 handheld GPS receiver loses its location inside a complicated system of tunnels or overpasses.

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.

You've also got to keep the shareholders happy, and maintain the high performance of the healthcare sector of the stock market. Sure seems like a lot of people are expecting a good return on investment there.

 

[dmcowen674]

Originally Posted by dmcowen674
You honestly believe $23,000 is an acceptable price for an MRI scan?

I honestly believe this had nothing to do with Obamacare and more to do with you having been taken to the cleaners....

I didn't say it had anything to do with Obamacare.

The system was a scam and broken before Obamacare and still a scam and broken after Obamacare.

 

[Nebor]

Did you not read the part that my wife and I are paying $46,000 for 2 MRI's because not in Insurance network?

I did, but I know you to be both a liar and an idiot, so I'd recommend you try to pay them off in gallons of milk that you procure via manipulating the milk exchange rate market, you loon.

 

[dmcowen674]

I did, but I know you to be both a liar and an idiot, so I'd recommend you try to pay them off in gallons of milk that you procure via manipulating the milk exchange rate market, you loon.

and you are welcome to come here and see the bills for yourself but you won't because you are chickenshit.

 

[Meghan54]

debi and I both had to get an MRI after Motorcycle crash.

It was $23,000 for each MRI and not covered by Insurance since the ambulance brought us to Hospital not in network.

Total bill was $63,500 and all not covered by Insurance.

I'm curious, what/how much did your insurance pay? Every ins. policy I've had since 1980 has granted the same coverage in-network for ER visits as out-of-network ER visits. Granted, diagnostics done out-of-network aren't paid as fully as in-network, typically requiring a higher patient responsible percentage of the diagnostic's cost, but it does pay something. I can't even find a policy that outright refuses to cover any diagnostics done out-of-network, esp. in an accident scenario.

 

[glenn1]

You honestly believe $23,000 is an acceptable price for an MRI scan?

I'm not talking about the price of one procedure for one customer or anything that granual. The point I'm addressing the idea that just because spending is increasing on healthcare, that fact by itself is prima facie evidence that healthcare is "broken". That we're spending less money as a percentage of income on staples like food, rent, etc. and more money (again, as a percentage of income) on discretionary spending like education, leisure, and yes improved medical care is a good thing.

 

[werepossum]

And if American health-care costs were half what they actually are, like the are in most other first-world countries, that would be more realistic. But American health-care costs are already too great, and growing too fast (even though the rate of increase since the ACA went into effect has slowed down). More and more Americans are unable to "pull their own" health care weight. So your statement isn't remotely a solution. The Cadillac Tax is a part of the long-term solution.

My statement was my ideological preference and admitting that it isn't a practical solution. I tried to use small words . . .

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.

We'll see. I would think the 26% of employers affected would be large employers though, which would argue for larger numbers. My own company is unaffected since we were forced to step down to a cheaper plan - although if/when the bureaucrats decide that our HSAs must be crushed they may get us in another way.

Welcome to the 1%.

And, uhh, get over yourself. Few political promises deliver at the level of 98-99%.

That promise was a lie to 100% of the private sector, although maybe not to government workers.

 

[Jhhnn]

That promise was a lie to 100% of the private sector, although maybe not to government workers.

Lemme see... who to believe... internet Obama haters or Kaiser...

I'm not seeing this as a difficult choice.

 

[Fanatical Meat]

Interesting HC stories site. US usually looses but not always.

http://www.pluralofanecdote.com/#

 

[Fanatical Meat]

I'm not talking about the price of one procedure for one customer or anything that granual. The point I'm addressing the idea that just because spending is increasing on healthcare, that fact by itself is prima facie evidence that healthcare is "broken". That we're spending less money as a percentage of income on staples like food, rent, etc. and more money (again, as a percentage of income) on discretionary spending like education, leisure, and yes improved medical care is a good thing.

Glenn we both know there are many inefficiencies that make costs in the US higher than anywhere else if the extra charges were a small percent more and all that was going to research that's fine. What we have is large to enormous over charging and a tiny fraction of those charges going to research.
I'll accept the vague overview point that better medical is a good thing.

 

[shira]

Well, predicting the apocalypse is a tricky business. It's just like with libertarians and hyper-inflation or evangelicals with Revelations. Soon we'll have a healthcare apocalypse. So what if they're wrong over and over again? The predictions can always be renewed.

Trust them. They only have to get it right once, right? :biggrin:

And the really irritating part is that most of what would pass for the "health-care apocalypse" was proceeding quite nicely long before the ACA took effect. But with the ACA now the law of the land, ANY negative health care statistics are going to be blamed on the ACA by righties.

 

[shira]

Interesting HC stories site. US usually looses but not always.

http://www.pluralofanecdote.com/#

But to be fair, I'll bet we can easily find exactly opposite examples from the same two systems.

What's important is statistical data: What are the median wait times for various health-care scenarios in the US and in Canada? (And in various European countries, for that matter.)

 

[fskimospy]

Did you not read the part that my wife and I are paying $46,000 for 2 MRI's because not in Insurance network?

If you actually pay $46,000 for them (or anywhere even remotely close to that) you are a fool.

 

[Fanatical Meat]

^^I know I don't believe all the stories are verified and many of the US free visits are at tax payers expense plus some stories are over a decade old. Simply an interesting site to see what come up.

I have worked with two dual citizenship people from Canada they each had similar opinions wait times here are a bit shorter but costs are definitely higher. Care was the same. They both scheduled primary care doctor visits for when they were in Canada.
I also knew a guy that traveled to Europe for work frequently. One trip he cut his hand & arm pretty deep opening a box(?) while being careless with a knife. He bled on the carpet and didn't want to explain an stained carpet fee to work so he called the front desk for some cleaning supplies. Cleaner showed up and demanded he head to the hospital. I was told he was bandaged immediately then they said you need this wound closed up. He was concerned about cost, what happened was he had to pay for an emergency filing fee, he said that was a few dollars then a guy who was in med school closed the wound with I think the glue stuff, he was issued an antibiotic the cost for that was around $20.
I doubt there is any emergency room where that would happen in the US and when you think about it how much should 20 minutes if an interns time plus some basic medical supplies cost $30 sounds pretty accurate to me.

**this was a long time ago I'm pretty sure he was in England although he went to Germany & Denmark often. I can't remember the country.

 

[cabri]

debi and I both had to get an MRI after Motorcycle crash.

It was $23,000 for each MRI and not covered by Insurance since the ambulance brought us to Hospital not in network.

Total bill was $63,500 and all not covered by Insurance.

Did you question the hospital and insurance company?

Not being in network might cause an adjustment on price; but that is usually for voluntary services.

Mis-coding of procedures can also cause a kickout by an insurance company.
Given your propensity for exaggeration; I am sure that you can post up documentation identifying the bill, hospital and insurance company

 

[cabri]

^^I know I don't believe all the stories are verified and many of the US free visits are at tax payers expense plus some stories are over a decade old. Simply an interesting site to see what come up.

I have worked with two dual citizenship people from Canada they each had similar opinions wait times here are a bit shorter but costs are definitely higher. Care was the same. They both scheduled primary care doctor visits for when they were in Canada.
I also knew a guy that traveled to Europe for work frequently. One trip he cut his hand & arm pretty deep opening a box(?) while being careless with a knife. He bled on the carpet and didn't want to explain an stained carpet fee to work so he called the front desk for some cleaning supplies. Cleaner showed up and demanded he head to the hospital. I was told he was bandaged immediately then they said you need this wound closed up. He was concerned about cost, what happened was he had to pay for an emergency filing fee, he said that was a few dollars then a guy who was in med school closed the wound with I think the glue stuff, he was issued an antibiotic the cost for that was around $20.
I doubt there is any emergency room where that would happen in the US and when you think about it how much should 20 minutes if an interns time plus some basic medical supplies cost $30 sounds pretty accurate to me.

**this was a long time ago I'm pretty sure he was in England although he went to Germany & Denmark often. I can't remember the country.

In 2011, i had a wound that was sutured by an Urgent Care. $100
A week later after they cleaned it, it started bleeding the next evening (suture loosened up)
Hotel front desk called for ambulance - I could not drive and staunch the bleeding.
$800 ride and $3500 ER charge to suture the bleeder.

Yet if the UC had been opened, at max it would have been another $100.

At hospital - 1 hours, 4-5 staff working on me at one point or another and 4 hours in recovery room area

 

[Fanatical Meat]

In 2011, i had a wound that was sutured by an Urgent Care. $100
A week later after they cleaned it, it started bleeding the next evening (suture loosened up)
Hotel front desk called for ambulance - I could not drive and staunch the bleeding.
$800 ride and $3500 ER charge to suture the bleeder.

Yet if the UC had been opened, at max it would have been another $100.

At hospital - 1 hours, 4-5 staff working on me at one point or another and 4 hours in recovery room area

Sounds reasonable 35 times the cost at a hospital. I can't fathom why we tolerate this. Imagine if that was your wireless provider. You switch to a new company and they don't disclose the cost or even give you a warning about the cost. You are expecting something more than $100 and it ends up being $3500. The new company falls back on you have better coverage its worth the extra cost!

You're lucky the ambulance was only $800 in my area if someone gets in an ambulance its a guaranteed $2500.

 

[cabri]

Sounds reasonable 35 times the cost at a hospital. I can't fathom why we tolerate this. Imagine if that was your wireless provider. You switch to a new company and they don't disclose the cost or even give you a warning about the cost. You are expecting something more than $100 and it ends up being $3500. The new company falls back on you have better coverage its worth the extra cost!

You're lucky the ambulance was only $800 in my area if someone gets in an ambulance its a guaranteed $2500.

And the darn "Silver Level" insurance ended up only being a discount negotiator for a $300/month. 20% off
Dropped them the next day

And they would not cover ambulatory. :thumbsdown: (not life critical)

 

[WackyDan]

Really? Let's do some math. You have to pay taxes on $2700/yr that you didn't previously. If you income is anywhere in the bottom 90%, <~$120K, you probably don't pay 12% in federal taxes. At 12%, that's $324/year.

That's supposed to be a ball breaker?

Typical. Eat the rich right Jhhnn? But I'm not rich and the hit is higher than $324.

Why they reduced something that was engineered to reduce out of pocket medical expenses to begin with is still beyond me. That is ok by you though eh?

 

[fskimospy]

Well, predicting the apocalypse is a tricky business. It's just like with libertarians and hyper-inflation or evangelicals with Revelations. Soon we'll have a healthcare apocalypse. So what if they're wrong over and over again? The predictions can always be renewed.

Trust them. They only have to get it right once, right? :biggrin:

That's the silliest part. There have been, and are bound to be more, significant problems with health reform this large. They aren't insurmountable (or haven't been so far), but they are real problems. People who oppose the ACA look at these and say "LOOK I TOLD YOU SO", while ignoring the fact that overall the legislation has met or exceeded basically every benchmark at its enactment.

If people who support the ACA can be honest enough to admit flaws in it, it would sure be nice for opponents of the ACA to be honest enough to admit its successes. I've seen little evidence that they are interested in doing that.

 

[Jhhnn]

Typical. Eat the rich right Jhhnn? But I'm not rich and the hit is higher than $324.

Why they reduced something that was engineered to reduce out of pocket medical expenses to begin with is still beyond me. That is ok by you though eh?

Just because you say so, right?

If you're making enough money so that the marginal tax rate takes a big bite out of $2700 then the extra obviously isn't some great burden to whine piteously about.

Perspective. Get some.

 

[Zorba]

Really? Let's do some math. You have to pay taxes on $2700/yr that you didn't previously. If you income is anywhere in the bottom 90%, <~$120K, you probably don't pay 12% in federal taxes. At 12%, that's $324/year.

That's supposed to be a ball breaker?

Except, that is not how taxes work. FSA reduce the last dollar tax, so the $2700 is taxed at the marginal rate, so at 120K that is 25%. Plus assume 6% for state taxes. It also reduces FICA tax at 7.65%. So it is an extra $1043/yr. Not exactly nothing, almost as much as I pay for full coverage on two cars.

I don't really have a problem with the concept of the Cadillac tax. But including FSA and HSA contributions in the calculation of the limits is BS and will hurt people that need their insurance more than anyone else. Not to mention that the 40% tax would be higher than almost anyone saved by using the HSA and FSA in the first place.

 

[Zorba]

Just because you say so, right?

If you're making enough money so that the marginal tax rate takes a big bite out of $2700 then the extra obviously isn't some great burden to whine piteously about.

Perspective. Get some.

In every state I've lived the top marginal rate kicks in at a very low income. So lets look at someone making 30K a year. Lets just assume they pay no federal income tax, they will still save the 6% on state and 7.65% on FICA. So that would still be $369/yr, which is a big deal to someone making 30K a year. But yeah, fuck those rich people who use their FSAs.

BTW: I support ACA and think it has been a big success, and for the most part I am fine with the FSA changes. But it is completely disingenuous to claim it doesn't impact middle class people in a noticeable way.

 

[Dannar26]

Except for the military; they can't ever give them enough money.

They die for us. Seems fair.

What do inner city thugs do for us, other than give democrats votes?