Six Groups of Americans and How They Are Faring - ACA

[Slew Foot]

You stated that prior to the ACA, poor people with cancer and no insurance just died.

I'm asking for evidence of that.

Youre arguing with liberals, youll never win because they read an article on the internet and now they know more about it than you. Never mind that I spent 4 years on the Board of Directors at St Louise and 6 years as a medical CFO, some idiot on the internet with a link to a website knows more than me.

 

[DCal430]

Sorry but hospitals don't spend hundreds of thousands of dollars to treat someone without insurance with out expecting something in return, especially not a religious bases one.

 

[dank69]

Youre arguing with liberals, youll never win because they read an article on the internet and now they know more about it than you. Never mind that I spent 4 years on the Board of Directors at St Louise and 6 years as a medical CFO, some idiot on the internet with a link to a website knows more than me.

You say that as if conservatives wouldn't dream of doing the same thing...like somehow this is a liberal trait.

 

[werepossum]

ACA is a large chunk of people that weren't able to get insurance because of their unhealthiness, that are now able to get insurance even while unhealthy. Congrats, you have an insurance pool of nothing but bad apples that are already sick, all of the time.

This is sure to work well. Much like last year when plenty of the initial ACA plans dropped this year due to... not making jack shit.


All the poor people? Yeah, goodjob convincing some that those $6,500 deductibles in addition to $400 monthly costs are worthwhile. You know they are screwed the moment they actually have a medical issue.

Nothing against already sick/dying/fatasses/mentally ill, but you can't have a pool of largely one-sided and expect a smart outcome while most of the healthy people are in an entirely different pool.

Not necessarily. A lot of the uninsurable are healthy, but have actuarially expensive diseases. Access to health care for them at the non-emergency/non-life-threatening stage may actually save lots of money; it just won't save it for any particular insurer. Case in point, a friend's son presented with stomach bleeding and stomach pain. Having no insurance, he had simply toughed it out as long as possible. When he finally went in hospital, he had stage four cancer. He got treatment, of course, probably a quarter million worth. But had he presented when he first had pain and/or passed blood, he might have been saved, not only at much less cost but preserving his family's quality of life and his own productivity.

I'm with Linux, just bring us single payer. It will be worse in many ways, but single payer is generally adjusted to be good enough for most people most of the time. Most of the people presenting with a sprained shoulder will do fine without an MRI; they are prescribed because the doctor perceives a benefit (to himself as well as to the patient) at no cost. Until we have single payer, we'll just have more and more pain inflicted on the little guy to pressure us into wanting single payer. I see no practical way to reconcile the free market with health care (or at least health insurance) so single payer is inevitable anyway.

 

[rudeguy]

Youre arguing with liberals, youll never win because they read an article on the internet and now they know more about it than you. Never mind that I spent 4 years on the Board of Directors at St Louise and 6 years as a medical CFO, some idiot on the internet with a link to a website knows more than me.

bwahahahaa his reply was perfect.

I ask the questions I do because I don't live in a place where sick people get left in a room to die because they can't pay. I honestly have never heard of it happening first hand but I admit my world is small and I don't deal with terminal cancer on a regular basis.

 

[GarfieldtheCat]

Woosh.


The newly insured are the ones who rack up the most expenses and have the lowest reimbursement rates. Thus making it unprofitable to be seem, thus making the insurance they have, relatively useless.

I don't think you understand what you are saying.

Again, costs have been going up for decades. But if you look at that graph, from about 2008/9 to now, it's pretty flat. right when ACA came about. Oops.

Long term, with the average age of the US getting older, not sure how we can decrease overall costs since more and more people will need some sort of treatment.

 

[GarfieldtheCat]

You stated that prior to the ACA, poor people with cancer and no insurance just died.

I'm asking for evidence of that.

I know I should feed an obvious troll, but here it goes:

Link

Uninsured cancer patients are nearly twice as likely to die within five years as those with private coverage, according to the first national study of its kind and one that sheds light on troubling health care obstacles.

Link

In 2002, the Institute of Medicine (IOM) estimated that 18,000 Americans died in 2000 because they were uninsured. Since then,
the number of uninsured has grown. Based on the IOM’s methodology and subsequent Census Bureau estimates of insurance
coverage, 137,000 people died from 2000 through 2006 because they lacked health insurance, including 22,000 people in 2006.

Less then 2 minutes using google.....maybe you should start using it yourself?

 

[Jhhnn]

Not necessarily. A lot of the uninsurable are healthy, but have actuarially expensive diseases. Access to health care for them at the non-emergency/non-life-threatening stage may actually save lots of money; it just won't save it for any particular insurer. Case in point, a friend's son presented with stomach bleeding and stomach pain. Having no insurance, he had simply toughed it out as long as possible. When he finally went in hospital, he had stage four cancer. He got treatment, of course, probably a quarter million worth. But had he presented when he first had pain and/or passed blood, he might have been saved, not only at much less cost but preserving his family's quality of life and his own productivity.

That applies in a very broad sense-

http://news.harvard.edu/gazette/sto...s-annually-linked-to-lack-of-health-coverage/

I'm with Linux, just bring us single payer. It will be worse in many ways, but single payer is generally adjusted to be good enough for most people most of the time. Most of the people presenting with a sprained shoulder will do fine without an MRI; they are prescribed because the doctor perceives a benefit (to himself as well as to the patient) at no cost. Until we have single payer, we'll just have more and more pain inflicted on the little guy to pressure us into wanting single payer. I see no practical way to reconcile the free market with health care (or at least health insurance) so single payer is inevitable anyway.

Single payer simply won't happen anytime RSN, so we shouldn't pretend it might. That's merely distraction from working to make the ACA better. It's what we have, & likely what we'll have for the foreseeable future unless Repubs succeed in tearing it down to replace it with... what, exactly? Free market healthcare insurance?

I can't really see that as a viable model.

 

[highland145]

I don't think you understand what you are saying.

Again, costs have been going up for decades. But if you look at that graph, from about 2008/9 to now, it's pretty flat. right when ACA came about. Oops.

Long term, with the average age of the US getting older, not sure how we can decrease overall costs since more and more people will need some sort of treatment.

The fact sheet from the site that graph came from.

 

[werepossum]

Sorry but hospitals don't spend hundreds of thousands of dollars to treat someone without insurance with out expecting something in return, especially not a religious bases one.

Sorry, but you know not what not what you speak. Hospitals (and doctors) do that very thing on a daily basis. My doctor for instance spends more than a month a year in Africa giving free care, and a huge part of almost any hospital's emergency room and admissions occur with the foreknowledge that any payment is extremely unlikely. This is part of the price for being a hospital or health care provider.

That applies in a very broad sense-

http://news.harvard.edu/gazette/sto...s-annually-linked-to-lack-of-health-coverage/



Single payer simply won't happen anytime RSN, so we shouldn't pretend it might. That's merely distraction from working to make the ACA better. It's what we have, & likely what we'll have for the foreseeable future unless Repubs succeed in tearing it down to replace it with... what, exactly? Free market healthcare insurance?

I can't really see that as a viable model.

That Harvard article makes sense. The uninsured get emergency care and care for life threatening conditions, but they have problems getting non-essential care. Some small portion of non-essential care will detect potentially life-threatening conditions in early stages, so whatever percentage that is, the non-insured are more likely to miss until the condition is advanced. Advanced conditions like cancer or sarcoidosis or heart disease have much worse outcomes statistically if caught later as opposed to earlier. They'll still get the treatment, but more often at a time when it's more expensive and less effective. That is essentially what happened to my friend's son; he waited until it was too late.

I'm not absolutely sure he could have been saved - some diseases such as pancreatic cancer are almost never caught early enough to have a really good prognosis, and his was so metastasized that the doctors could not tell where it began. But statistically, some people without health insurance are absolutely going to die when they would not with the same condition with health insurance.

 

[piasabird]

What is the use of having insurance if you go to the doctor and he prescribes Insulin and you find out it costs $200?

 

[Victorian Gray]

Please show some examples.

Just because you say something doesn't make it true.

Would any of these count?

https://www.google.ca/search?q=aca+...=palemoon&gws_rd=cr&ei=eaPrVJTvMc70oAS6-oLYDg

 

[Mxylplyx]

The major cost containment mechanism of the ACA went away with the public option, which I firmly believe was a trojan horse to single payer, which I have absolutely no problem with. The answer to fixing our healthcare system is already here in the form of Medicare. Expand eligibility to cover everyone, and then the government has a giant lever to ratchet down costs. The private insurance racket can die on the vine as it's a useless money sink that adds no actual value to the system.

 

[Matt1970]

Maybe you can explain this-

https://www.google.com/search?q=ACA+exchange+satisfaction&ie=utf-8&oe=utf-8

This just in, free shit hugely popular amongst those receiving the free shit. Seeing as how the ACA effects everyone, lets more than just those on the exchanges.

http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html

 

[Fern]

How many of these newly insured are due to Obamacare, and how many are due to the fact that more people are working?

Outside of generic grouping to paint Obamacare as some godsend. I hardly see any real groups in this fluff piece.

This link has a chart showing the number of uninsured nonelderly: http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/

Other than a uptick of the % uninsured during the worse years of the recession nothing has significantly changed with regard to coverage.

The OP's linked fluff piece is contradicted by other sites who claim a (super) majority of the 13.4 million were composed of (1) people whose employer discontinued coverage and so they switched over to individually purchased HI plans through the exchange and (2) increase in Medicaid enrollment.

The link below shows that more people are putting off medical care due to higher costs, higher deductibles etc: http://www.gallup.com/poll/179774/cost-barrier-americans-medical-care.aspx

Other than a (likely) small population of people with preexisting conditions who may be able to afford coverage now not much has appeared to change other than higher deductibles and co-pays; less coverage for more.

In any case it's too early to tell and constant cheer leading has become old.

Fern

 

[Fern]

In fact, the actual cost of care has increased while the reimbursement has decreased, leading to many smaller hospitals and offices shutting down. You may have insurance, but youll have no where to use it.

Yes. I'm hearing this exact thing from physicians.

It's my belief that Obamacare has a lot of moving parts that most are unfamiliar with. We don't need 3,000 of new law and 100,000's of pages of new govt regulations to achieve what we know about Obamacare.

I spoke with an oncologists a couple of weeks ago, and they use a lot of expensive medicine, and he claims Medicare only reimburses 80% of the medicine's cost. This is significant when his private practice uses in excess of $1 million of this medication. I.e., he's 'eating' $200K annually.

Now, under the new govt regulations hospitals get (IIRC) a 40% discount on the cost of those medications. Consequently, many doctors are abandoning their private practice and joining up with hospitals.

I suspect that this is intentional. Single payer has always raised the question of what to do about all the many private practices. The answer appears to be slowly run them out of business while nobody is looking. A 'frog in the pot' sort of thing.

Fern

 

[GarfieldtheCat]

Yes. I'm hearing this exact thing from physicians.

It's my belief that Obamacare has a lot of moving parts that most are unfamiliar with. We don't need 3,000 of new law and 100,000's of pages of new govt regulations to achieve what we know about Obamacare.

I spoke with an oncologists a couple of weeks ago, and they use a lot of expensive medicine, and he claims Medicare only reimburses 80% of the medicine's cost. This is significant when his private practice uses in excess of $1 million of this medication. I.e., he's 'eating' $200K annually.

Now, under the new govt regulations hospitals get (IIRC) a 40% discount on the cost of those medications. Consequently, many doctors are abandoning their private practice and joining up with hospitals.

I suspect that this is intentional. Single payer has always raised the question of what to do about all the many private practices. The answer appears to be slowly run them out of business while nobody is looking. A 'frog in the pot' sort of thing.

Fern

And again, Medicare has been reducing payments for over a decade. Is there a point?

Healthcare costs are up? Gee, no kidding.....happens every year, even before the ACA.

Reimbursements going down? Gee, no kidding....happens every year, even before the ACA.

How this is news is shocking. I now MD's that stopped treating Medicare/Medicaid over a decade ago...you wanna blame Obama for that too?

Thanks Obama! He's been screwing up medicare since 2000! Amazing.

 

[Fern]

And again, Medicare has been reducing payments for over a decade. Is there a point?
-snip-

Yes, there is a point. And that was my point.

In some cases reduction in Medicare reimbursement amount have made sense. E.g., some surgical eye procedures can be done soo much more efficiently and quickly that reducing the reimbursement actually makes some sense.

But reducing it to below break-even for necessary prescriptions? That's questionable. More so when the govt turns around and arranges for (only) those officially connected with a hospital to get it at a steep discount.

I suspect that this is not by accident.

Fern

 

[Jhhnn]

Yes, there is a point. And that was my point.

In some cases reduction in Medicare reimbursement amount have made sense. E.g., some surgical eye procedures can be done soo much more efficiently and quickly that reducing the reimbursement actually makes some sense.

But reducing it to below break-even for necessary prescriptions? That's questionable. More so when the govt turns around and arranges for (only) those officially connected with a hospital to get it at a steep discount.

I suspect that this is not by accident.

Fern

That's something you have merely alleged wrt prescriptions w/o proof of any kind. Makes for the beginnings of a nice conspiracy theory, huh?

 

[pcgeek11]

Hate to break up the Obama-hate, but you do realize that costs have been increasing, and reimbursement decreasing for many years, way before the ACA was suggested, let alone enacted.

Please let us know how the ACA affected costs back in the 1960's please.

No one said that it did effect the 60's. The ACA was supposed to fix this. It didn't even slow it down. Look at your chart.

 

[pcgeek11]

He won't,.. because he can't. None of them can.

https://www.google.com/search?q=ACA...utf-8&oe=utf-8#q=ACA+exchange+dissatisfaction

You can find google links that say anything.

 

[GarfieldtheCat]

No one said that it did effect the 60's. The ACA was supposed to fix this. It didn't even slow it down. Look at your chart.

Vision fail? Did you notice the flat line in the graph? Did you notice that it is centered around right now, starting about 2008/9 with the ACA?

LOL....fail. Anything else you would like to be wrong about?

But again, long term, with the patient population getting older, even if we cut costs, the older population will continue to need more care driving the overall costs up. It would take really large cuts in reimbursement to offset the larger amount of healthcare that will be provided for probably the next 20 years or so.

Look at the baby boomers:

And look at the age breakdown of the US:

Baby boomers are in their 50's to late 60's. They will continue to get older and need more healthcare. Until this bubble passes (to be blunt, when they all die) it will be hard to reduce overall healthcare costs. Same concept as the problems with Social Security, there is a bubble of people all retiring and thus drawing more money from SS.

 

[pcgeek11]

Vision fail? Did you notice the flat line in the graph? Did you notice that it is centered around right now, starting about 2008/9 with the ACA?

LOL....fail. Anything else you would like to be wrong about?

Don't you know how to read a graph? Draw a straight line through the data points and that will show you the trend which along with the Projected is still upwards at the same rate.

You can't nit pick one little data point or two.

 

[fskimospy]

Don't you know how to read a graph? Draw a straight line through the data points and that will show you the trend which along with the Projected is still upwards at the same rate.

You can't nit pick one little data point or two.

When trying to assess the effects of the ACA it makes no sense to draw a trend line that includes 50 years without the ACA and 5 with it.

If you were going to draw trend lines at all (and I would say that five years is too little) you would want to do before and after, which would make him right.

 

[OverVolt]

And again, Medicare has been reducing payments for over a decade. Is there a point?

Healthcare costs are up? Gee, no kidding.....happens every year, even before the ACA.

Reimbursements going down? Gee, no kidding....happens every year, even before the ACA.

How this is news is shocking. I now MD's that stopped treating Medicare/Medicaid over a decade ago...you wanna blame Obama for that too?

Thanks Obama! He's been screwing up medicare since 2000! Amazing.

Just the fact you bring up your argument like this means you don't understand what the effects of the ACA have been in the here and now in 2015 thus far. There is a big trend where people who have no idea WTF they are talking about are the ones cheerleading for the ACA.

And yea the ACA has made the doctor shortage worse. Just one example is many small private practices can't afford to upgrade to electronic health records which is mandatory. None of the systems work very well.