Republicans know they're in trouble once the website problems are solved

[Fern]

Honestly, can someone please explain to me what they think is so damned complicated about delivering insurance and health care under the ACA regimen? It's not rocket science.
-snip-

I think it may end up being far closer to rocket science than you think.

Seems to me that the ACA is the broadest, most far reaching intrusion and disruptive reorganization of an economic segment we've ever seen. That alone is important, but the US govt has no experience, no track record here in HC. So this whole thing is largely based upon untested theory (or "Hope and Change").

Have a look at this link below. The three "R's" are rarely discussed, but the mere fact that these programs exist indicates the level of uncertainty and risks that were recognized when this law was put together. Will they be sufficient to protect in the event things don't go as Washington's theorists hope? IDK, and neither does anyone else.
http://www.google.com/url?sa=t&rct=...ovpPhuSf3XyZTE5Tz8lzuMQ&bvm=bv.55123115,d.dmg

What happens to our HC industry if these safeguards are insufficient? IDK, but am guessing that's where all the doom & gloom predictions come from; why some people claim that ObamaCare was designed to destroy our HC system as we know it.

All-in-all, looks like a pretty big gamble to me.

Obamacare is not only about insuring the uninsured, not close. The 10 Essential Benefits required seem in place to force people to adapt to a desired behavior with regards to use HC. I.e., increased use of HC. Can our HC system meet this increased demand? Will that increased use drive up total costs? Or, will the forced HI payment for these additional services, and higher premium costs, mean less people carry HI?

No, Obamacare is not simply buy HI or pay a fine. It is much closer to rocket science in complexity, maybe even more complex because it's predicated upon the whims of humans and forecasting their behavior has always been difficult.

The website will eventually be fixed. It may be soon, or not. A delay of sorts may be necessary, or not. In any case I think the real test will be in how many enroll and what the demographics of the insured population will be.

Then there's always the 'Law of Unintended Consequences' that seems to invariably plague govt efforts.

I just hope they have a plan "B" and a plan "C" standing by in case things don't work out as hoped.

Fern

 

[Fern]

Originally Posted by raildogg
Or maybe we're all fudged when the website problems are solved? Have you ever thought about people as people rather than Democrats or Republicans?

Look at the ACA without Democrat or Republican color lenses please.

Excellent point. Objectivity above all else. Let's sit back, give the ACA time to mature and let the $$$$ fall where they may.
-snip-

Re: Bolded - That seems no less cavalier than the TEA Partiers willing to bring the US to a financial brink.

Fern

 

[shortylickens]

OP is correct, its free money for the lower class, which has grown by leaps and bounds since Obama stepped into office.

Why would 75% voluntarily give up what the other 25% is being forced to fork over?

 

[EagleKeeper]

I just hope they have a plan "B" and a plan "C" standing by in case things don't work out as hoped.

Fern

Plan B will be: private insurance does not work - the companies can not provide it to people at an affordable cost unless subsidized.

 

[Jhhnn]

Re: Bolded - That seems no less cavalier than the TEA Partiers willing to bring the US to a financial brink.

Fern

I'll take false equivalency for $1000, Alex.

 

[Darwin333]

We'll have to wait and see, won't we? In the meantime, I assume the ERs will be reimbursed for services rendered to the uninsured out of the penalties collected, thus those costs will no longer be passed on to you or me. Feel free to send the ER any extra money you have lying around if you miss that feeling, though.
'(

That is one hellofa assumption and I am very curious how you came to that conclusion?

Do you seriously think that if not required to by law that the Fed or State are just going to "give" hospitals money to cover the cost of uninsured patients? Hell would that even be legal for them to do without passing a new law?

Personally my opinion is, barring the existence of some existing law, the money collected will be spent pretty much the same way as they have always spent "extra" money....

 

[berzerker60]

OP is correct, its free money for the lower class, which has grown by leaps and bounds since Obama stepped into office.

Why would 75% voluntarily give up what the other 25% is being forced to fork over?

Why would Americans allow income tax rates to plummet since WWII for the richest Americans, allowing literally all of the economic growth for the past few decades to go solely to the top 1%? Perhaps because the 'makers vs takers / dependency' framing is childish, facile, and completely misunderstands where the power in American politics actually lies! People act outside their rational economic interests all the time, whether through charity, ignorance, fear, or any number of other reasons. Take, for example, Wisconsin workers allowing their unions to be gutted, and 'right to work' laws in general.

 

[Doppel]

I'm reading a lot about people getting sticker shock on plans and being unwilling to pay for a new plan. One approach is thus to go without insurance and just quickly sign up for it if one is sick, taking advantage of the removal of the prexisting conditions things.

Question: is there a maximum time insurance can make people wait when they sign up? e.g. 30 days? Surely it's not so simply as just paying the small penalty for no insurance and then calling up blue cross in the amberlamps and getting insurance?

--

The more I read about this stuff the more certain I am the US needs to kick out private insurance on its ass and do a single payor system. The overhead insurance is adding to this is just patently INSANE. It's not efficient, it's asinine. That I can't even do a regular trip to the doctor without handing over insurance is indicative of how idiotic it is. It's like getting insurance for groceries, even though you know you always will buy them, so now you pay some middle man on every purchase (so, it's like your credit card, except if it charged a 30% rate on purchases).

 

[Fern]

I'll take false equivalency for $1000, Alex.

You'd be better off thinking through the financial implication of a large scale interruption to our HC system. It won't just effect HI companies, not close.

Fern

 

[werepossum]

This canard has been soundly refuted. Rather than derail this thread proving yet again that this is just another baseless claim that keeps being repeated like a tired joke, I invite you to do a little googling.

I did a little Googling and saw nothing to refute that claim. Millions of Americans are receiving cancellation notices. In fact, the CBO's own best estimates were that three to five million Americans each year, into the 2020s would lose health insurance due to the ACA. That is by design, for the ACA mandates better coverage than some people have and clearly not all those employers can or will provide much more expensive health insurance. Even Bachman's claim that 30 million Americans would lose health insurance due to the ACA was not debunked by CNN's FactCheck; they merely pointed out that that was the worst case CBO estimate of 14 million by 2019 and three to five million a year afterward. This was to be offset (at least partially and hopefully more than fully) by those purchasing private health insurance through the exchanges, but the exchanges are (A) not working and (B) priced much higher than most people dreamed. We now have conservatively two to three million Americans who will lose their health insurance within the year - most on January 1 due to the nature of policies - and many of those simply cannot buy health insurance on the exchanges. The administration is now promising to have the portal fixed by the end of November, but people will need to be signed up no later than December 15 to insure continuity of coverage. That's two weeks to enroll the two to three million Americans losing their health insurance because of the ACA PLUS those millions who did not have health insurance before the ACA.

Worse, the front end portal is far from the only problem, or even the most serious one. The ACA uses a non-standard version of the 834 form. Worse, our system allows every participating insurer to use their own variant of the 834 form. Where the portal works, it spits out 834s with a very high error rate, not unexpected when a buggy front end is feeding many similar but not identical back ends. Currently this is not a big problem because the front end is so screwed up, insurers are receiving only a few dozen applications each day and can correct the errors with phone calls or emails and get the person correctly insured. Now fast forward to the end of November. The new front end comes on line, it largely works, and millions of Americans realize that they need to get on the stick and get insured. Now each insurer is getting literally thousands of 834 forms every day, still with the same very high error rates. There aren't enough IT people in either the government or the insurers to fix this by December 15 - or January 1, either.

This is the biggest cluster fuck for the American people that I've seen in my lifetime. Some of the better insurance companies recognize this and are offering early renewals to allow policies to remain in force through December 2014, but that's a big risk; they could easily end up being punished for doing so and thereby circumventing the ACA. Others are not taking that chance, and their customers are merely SOL. And still others are dropping out of certain states and so cannot continue those policies as they have already shut down those offices.

My links.
http://www.cbo.gov/sites/default/files/cbofiles/attachments/03-15-ACA_and_Insurance_2.pdf

http://thecoloradoobserver.com/2013...loradans-losing-their-health-insurance-plans/

http://politicalticker.blogs.cnn.co...ir-employer-health-insurance-under-obamacare/

http://healthpolicyandmarket.blogspot.com/

http://healthpolicyandmarket.blogspot.com/2013/10/just-what-is-834-transaction-why-is-it.html

 

[compuwiz1]

I'm reading a lot about people getting sticker shock on plans and being unwilling to pay for a new plan. One approach is thus to go without insurance and just quickly sign up for it if one is sick, taking advantage of the removal of the prexisting conditions things.

Question: is there a maximum time insurance can make people wait when they sign up? e.g. 30 days? Surely it's not so simply as just paying the small penalty for no insurance and then calling up blue cross in the amberlamps and getting insurance?

--

The more I read about this stuff the more certain I am the US needs to kick out private insurance on its ass and do a single payor system. The overhead insurance is adding to this is just patently INSANE. It's not efficient, it's asinine. That I can't even do a regular trip to the doctor without handing over insurance is indicative of how idiotic it is. It's like getting insurance for groceries, even though you know you always will buy them, so now you pay some middle man on every purchase (so, it's like your credit card, except if it charged a 30% rate on purchases).

The flaw in your logic and many other's is this; What happens when you have a single payer that dictates how much doctors can charge for service and pretty soon the doctors say "fuck it, it's no longer worth it for me to do this"? You take the incentive out of something and there goes the ambition to do it. A far thinner number of providers means further travel and delays to get care. That will increase deaths.

 

[werepossum]

Plan B will be: private insurance does not work - the companies can not provide it to people at an affordable cost unless subsidized.

I believe that was Plan A, although I'd like to believe that Obama and the Dems never envisioned quite this level of pain and fail.

Ironically, single payer will be brought to you by the same people who can't make a functioning web site with $600+ million and three years.

 

[boomerang]

The flaw in your logic and many other's is this; What happens when you have a single payer that dictates how much doctors can charge for service and pretty soon the doctors say "fuck it, it's no longer worth it for me to do this"? You take the incentive out of something and there goes the ambition to do it. A far thinner number of providers means further travel and delays to get care. That will increase deaths.

You just described the Medicare program.

Also, the .gov can't even get a website working and they're going to be in charge of a single payer system?

Here's the root of the problem IMO and this is something Republicans were saying until they finally got tired of nobody in DC listening. This program is too enormous, too extensive and too far reaching to be implemented at once. There should have been far, far smaller bills that nibbled away at it piece by piece. The other option was to let the states implement their own programs and let the cream rise to the top. We are totally fucked right now-totally. We can't go forward and we can't go back. This law is so massive and far-reaching that we'd better hope that we realize we're going over the cliff about 5,000 miles before we reach said cliff or we'll never be able to stop in time. I think we're 4,500 miles away right now.

On a secondary note, a single payer system will throw how many hundreds of thousands of people out of work? You don't do that at the snap of a finger. At least a .gov that operates in a sane manner doesn't.

On a somewhat related note, anyone else notice that those that have the least faith in a higher power have unwavering faith in our government? I ask that from the perspective of an atheist that respects the beliefs of others.

 

[werepossum]

Just so we're all clear about whether or not millions of Americans losing their health insurance is true or a soundly refuted canard: http://investigations.nbcnews.com/_...ns-could-not-keep-their-health-insurance?lite

It appears that I wildly underestimated the number of Americans affected. 50 to 75 percent of 14 million Americans is 7 to 10.5 million Americans just out of the individual policy insured, to say nothing of those already uninsured and those whose employer-provided health insurance has been canceled.

tl/dr: The Obamacare regulations themselves estimate that "50 to 75 percent” of Americans' individual market policies will be dropped initially, with another “40 to 67 percent” losing grandfathered status every year.

President Obama repeatedly assured Americans that after the Affordable Care Act became law, people who liked their health insurance would be able to keep it. But millions of Americans are getting or are about to get cancellation letters for their health insurance under Obamacare, say experts, and the Obama administration has known that for at least three years.

Four sources deeply involved in the Affordable Care Act tell NBC NEWS that 50 to 75 percent of the 14 million consumers who buy their insurance individually can expect to receive a “cancellation” letter or the equivalent over the next year because their existing policies don’t meet the standards mandated by the new health care law. One expert predicts that number could reach as high as 80 percent. And all say that many of those forced to buy pricier new policies will experience “sticker shock.”

None of this should come as a shock to the Obama administration. The law states that policies in effect as of March 23, 2010 will be “grandfathered,” meaning consumers can keep those policies even though they don’t meet requirements of the new health care law. But the Department of Health and Human Services then wrote regulations that narrowed that provision, by saying that if any part of a policy was significantly changed since that date -- the deductible, co-pay, or benefits, for example -- the policy would not be grandfathered.

Buried in Obamacare regulations from July 2010 is an estimate that because of normal turnover in the individual insurance market, “40 to 67 percent” of customers will not be able to keep their policy. And because many policies will have been changed since the key date, “the percentage of individual market policies losing grandfather status in a given year exceeds the 40 to 67 percent range.”

That means the administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans, even if they liked them.
Yet President Obama, who had promised in 2009, “if you like your health plan, you will be able to keep your health plan,” was still saying in 2012, “If [you] already have health insurance, you will keep your health insurance.”

“This says that when they made the promise, they knew half the people in this market outright couldn’t keep what they had and then they wrote the rules so that others couldn’t make it either,” said Robert Laszewski, of Health Policy and Strategy Associates, a consultant who works for health industry firms. Laszewski estimates that 80 percent of those in the individual market will not be able to keep their current policies and will have to buy insurance that meets requirements of the new law, which generally requires a richer package of benefits than most policies today.

The White House does not dispute that many in the individual market will lose their current coverage, but argues they will be offered better coverage in its place, and that many will get tax subsidies that would offset any increased costs. “One of the main goals of the law is to ensure that people have insurance they can rely on – that doesn’t discriminate or charge more based on pre-existing conditions. The consumers who are getting notices are in plans that do not provide all these protections – but in the vast majority of cases, those same insurers will automatically shift their enrollees to a plan that provides new consumer protections and, for nearly half of individual market enrollees, discounts through premium tax credits,” said White House spokesperson Jessica Santillo.
SNIP

 

[michal1980]

Just so we're all clear about whether or not millions of Americans losing their health insurance is true or a soundly refuted canard: http://investigations.nbcnews.com/_...ns-could-not-keep-their-health-insurance?lite

It appears that I wildly underestimated the number of Americans affected. 50 to 75 percent of 14 million Americans is 7 to 10.5 million Americans just out of the individual policy insured, to say nothing of those already uninsured and those whose employer-provided health insurance has been canceled.

tl/dr: The Obamacare regulations themselves estimate that "50 to 75 percent” of Americans' individual market policies will be dropped initially, with another “40 to 67 percent” losing grandfathered status every year.

but the only problem is the website :-/

 

[compuwiz1]

but the only problem is the website :-/

Riiight. Like a bad comedian......it's already bombed.

 

[dank69]

I think it may end up being far closer to rocket science than you think.

Seems to me that the ACA is the broadest, most far reaching intrusion and disruptive reorganization of an economic segment we've ever seen. That alone is important, but the US govt has no experience, no track record here in HC. So this whole thing is largely based upon untested theory (or "Hope and Change").

Have a look at this link below. The three "R's" are rarely discussed, but the mere fact that these programs exist indicates the level of uncertainty and risks that were recognized when this law was put together. Will they be sufficient to protect in the event things don't go as Washington's theorists hope? IDK, and neither does anyone else.
http://www.google.com/url?sa=t&rct=...ovpPhuSf3XyZTE5Tz8lzuMQ&bvm=bv.55123115,d.dmg

What happens to our HC industry if these safeguards are insufficient? IDK, but am guessing that's where all the doom & gloom predictions come from; why some people claim that ObamaCare was designed to destroy our HC system as we know it.

All-in-all, looks like a pretty big gamble to me.

Obamacare is not only about insuring the uninsured, not close. The 10 Essential Benefits required seem in place to force people to adapt to a desired behavior with regards to use HC. I.e., increased use of HC. Can our HC system meet this increased demand? Will that increased use drive up total costs? Or, will the forced HI payment for these additional services, and higher premium costs, mean less people carry HI?

No, Obamacare is not simply buy HI or pay a fine. It is much closer to rocket science in complexity, maybe even more complex because it's predicated upon the whims of humans and forecasting their behavior has always been difficult.

The website will eventually be fixed. It may be soon, or not. A delay of sorts may be necessary, or not. In any case I think the real test will be in how many enroll and what the demographics of the insured population will be.

Then there's always the 'Law of Unintended Consequences' that seems to invariably plague govt efforts.

I just hope they have a plan "B" and a plan "C" standing by in case things don't work out as hoped.

Fern

No track record in HC? Now we're pretending Medicare/Medicaid don't exist?

 

[dank69]

I read...you should try it.

I read that Ben Franklin said 90% of statistics found on the internet are made up. That doesn't make it true.

 

[Matt1970]

Just so we're all clear about whether or not millions of Americans losing their health insurance is true or a soundly refuted canard: http://investigations.nbcnews.com/_...ns-could-not-keep-their-health-insurance?lite

It appears that I wildly underestimated the number of Americans affected. 50 to 75 percent of 14 million Americans is 7 to 10.5 million Americans just out of the individual policy insured, to say nothing of those already uninsured and those whose employer-provided health insurance has been canceled.

tl/dr: The Obamacare regulations themselves estimate that "50 to 75 percent” of Americans' individual market policies will be dropped initially, with another “40 to 67 percent” losing grandfathered status every year.

So when President Obama promised in 2009 that “if you like your health plan, you will be able to keep your health plan,” really meant that you may not be able to keep it, but if you do get dropped, you will like this new plan better. So basically, like the ACA itself, trust us, we know what you want more than you do.

 

[werepossum]

So when President Obama promised in 2009 that “if you like your health plan, you will be able to keep your health plan,” really meant that you may not be able to keep it, but if you do get dropped, you will like this new plan better. So basically, like the ACA itself, trust us, we know what you want more than you do.

Pretty much, although I'd have phrased it differently. "If you like your health plan, you will be able to keep your health plan" means "Fuck you serf, you will do as I say and like it."

He's a politician - if his lips are moving, he's lying. The American people require it.

 

[Matt1970]

That looks like Karl Rove and every other conservative right up until election night was over in 2012. Conservative solution? Keep on keepin' on.

Weak, real weak.

 

[werepossum]

You just described the Medicare program.

Also, the .gov can't even get a website working and they're going to be in charge of a single payer system?

Here's the root of the problem IMO and this is something Republicans were saying until they finally got tired of nobody in DC listening. This program is too enormous, too extensive and too far reaching to be implemented at once. There should have been far, far smaller bills that nibbled away at it piece by piece. The other option was to let the states implement their own programs and let the cream rise to the top. We are totally fucked right now-totally. We can't go forward and we can't go back. This law is so massive and far-reaching that we'd better hope that we realize we're going over the cliff about 5,000 miles before we reach said cliff or we'll never be able to stop in time. I think we're 4,500 miles away right now.

On a secondary note, a single payer system will throw how many hundreds of thousands of people out of work? You don't do that at the snap of a finger. At least a .gov that operates in a sane manner doesn't.

On a somewhat related note, anyone else notice that those that have the least faith in a higher power have unwavering faith in our government? I ask that from the perspective of an atheist that respects the beliefs of others.

A lot of people have replaced G-d with Government. G-d may reward you in the afterlife, but demands a lot of self-control and self-denial. Government will reward you now and demands virtually nothing that G-d does not also demand.

 

[Matt1970]

Pretty much, although I'd have phrased it differently. "If you like your health plan, you will be able to keep your health plan" means "Fuck you serf, you will do as I say and like it."

He's a politician - if his lips are moving, he's lying. The American people require it.

This is true. A lot of people attribute Bush Senior's loss to him saying read my lips, one promise broken. I miss those days when a lie cost you something. Now it's "He's a liar, but he's our liar"

 

[werepossum]

I read that Ben Franklin said 90% of statistics found on the internet are made up. That doesn't make it true.

Not true. Ben Franklin said "90% of statistics found on the internet WILL BE made up, once Algore creates it."

See, the little double quotey things are how you tell it's the real quote.

 

[werepossum]

This is true. A lot of people attribute Bush Senior's loss to him saying read my lips, one promise broken. I miss those days when a lie cost you something. Now it's "He's a liar, but he's our liar"

Yeah, I miss those days too. Nowadays Nixon would be a hero to half the nation.