So has Obamacare worked? Has it not? Is it helping or hurting?

[shadow9d9]

I'll just leave these right here...

Southern Illinois Limits Graduate Students' Hours
http://www.insidehighered.com/quicktakes/2013/08/23/southern-illinois-limits-graduate-students-hours

Delta warns ObamaCare will drive $100 million spike in health care costs
http://www.foxnews.com/politics/201...ion-spike-in-health-care-costs/#ixzz2dHhVdaRw

Do you take what corporations say as face value? Where were their excuses for the last 15 years of insane healthcare cost increases?

 

[shadow9d9]

Wait, why are you griping at this person for doing this? That's EXACTLY what tens of thousands of people are going to do under this monstrosity.

Republicans make 0 attempts to change healthcare with 12 years in power. Democrats use Republicans' plan for healthcare after 3+ attempts... Monstrosity!

 

[PrinceofWands]

True - Doctors are notorious for having bad handwriting, sometimes even the pharmacy doesn't understand the chickenscratch written on the prescription.



^^ I agree with hans030390 on this one.

PrinceofWands - I agree with the meat of your statement that healthcare needs massive reform and would benefit greatly from a single payer system or a national universal healthcare system like in Canada, but wouldn't it be more effective to play along with the current system and try to champion the subject of universal healthcare instead?

If you're willing to die to prove true to your moral system, then why not extend your life a few years and champion a cause for the greater good? The world is in sore need of people dedicated to a cause to make this a better place. I applaud the fact that you are willing to stick with your guns to that extent, but I feel that if you really want change, then it's not the most effective way to get change to happen by just dying alone because you don't want to deal with the insurance entities.

Here's what it comes down to for me. Hypocrisy and selfishness.

I watch the arguments unfold every day:

GOP State: We oppose the government spending money.
Govt: Would you like $10,000,000 for flood recovery?
GOP State: *pockets cash so fast the money clip glows amber from friction*
World: So you oppose government spending eh?
GOP State: *hides head in shame*

Now, there's obviously a LOT more to it than that, but the underlying principle applies in personal issues as well:

Person A: Politicians are such crooks, can't trust any of them. I should run for Congress.
Person B: Good idea. Would you like $1,000,000 for campaigning in exchange for hedging votes towards this industry I'm associated with?
Person A: Sure, after all it's for the greater good.

I'm fairly poor, despite a ridiculous mind and skill set. This is because I really don't care about money. If I did, I could almost certainly become embarrassingly wealthy by 'outsmarting' the system in various ways (crime, manipulation, exploitation, etc). However I believe those things are wrong in addition to having no interest in the outcome, so I don't do them.

In the same way, I'm opposed to insurance. If I go ahead and participate in insurance for my own benefit, while trying to oppose the very thing that's saving me, that's nothing but textbook selfishness and hypocrisy.

You CANNOT change a thing by being party to it. Change can ONLY happen from outside...actively resisting the thing while offering alternatives. Otherwise it's not truly change, but the status quo towards a different end.

Honestly, I'm getting too old to worry as much about changing things for the greater good anyway. Even if I believed I could succeed (which I don't), I'm really not sure many people deserve things better anyway. Frankly I kind of like the idea of people suffering for their choices. At this stage I just want to find a way to make it through my final years without being forced to active revolution over my ideals. However, I will NOT sacrifice those ideals in the struggle to maintain them. And yes, I realize the selfishness inherent in this hypocrisy.

 

[First]

I'll just leave these right here...

Southern Illinois Limits Graduate Students' Hours
http://www.insidehighered.com/quicktakes/2013/08/23/southern-illinois-limits-graduate-students-hours

Delta warns ObamaCare will drive $100 million spike in health care costs
http://www.foxnews.com/politics/201...ion-spike-in-health-care-costs/#ixzz2dHhVdaRw

Just pure speculative anecdotal evidence FTL.

But here's some for you, if you care:

Howard Schultz: Obamacare Doesn’t Worry Starbucks

Companies Doing Right by Their Employees Ahead of Obamacare's Implementation

San Francisco Fed study: Obamacare not to blame for the rise in part-time work

 

[vi edit]

This. Big Data and Analytics + EMR could provide huge benefits to the health industry, which in turn will hopefully be passed on to the patients.

That's where the industry is heading. Traditionally inpatient stays were cashcows for healthcare organizations. That's where you could charge for rooms, diagnostic testing, physician bills, ect. The higher the census the more money they raked in. That's changing. Fast. Hospitals are getting highly scrutinized on core measures - pnuemonia rates, infections, MI's, bounce backs, ect. CMS (Medicare) is holding hospitals accountable for these various measurements and if you don't meet the standards you don't get paid. The revenue streams are drying up.

In turn, you are seeing ambulatory visits more than triple over the last 10 years. The problem there is that reimbursement is even lower. Many doctors offices are struggling to meet staffing demands due to numbers of visits, yet can't hire more staff because the extra volume doesn't equate to extra income.

Healthcare systems are entering agreements with the government (ACO's) where population health management is coming into play. That's where analytics and highly functional EMR's come into use. A health care organization that has a collection of accute care inpatient facilities, outpatient labs, owned physician offices, specialties, ect will have all of their patient encounters dumped into a singular EMR database.

The health care organization will then identifiy key population groups - diabetics, heart failure, kidney failure, women's health, ect and then start mining data for patients that either fit risk profiles for these areas or are already under management of them. They will assign these populations to care teams and these teams will in turn reach out to patients in these populations to either get them in for preventative care, review current meds and evaluate approriateness, help offer alternative treatment plans/assistance, ect. The entire goal is to start identifying risk groups and preventing expensive (and no longer good paying) hospital visits. In turn, there are assessment reviews with the feds to monitor how effective these plans are. The more effective you are the more you are paid. It's a big shift from looking at reimbursement at the patient level. This is large groups of people (one I'm aware of is 25,000 people) and getting paid based on reduction of costs at that high of a level.

It's been happening for a while, but it will continue - stand alone hospitals will not survive. Small health care groups will not survive. The shift will be to very large organizations where all control of patient data goes back to a central source where it can be mined and analyed.

And the other commonality is a single EMR vendor that can share data between systems for better continuation of care and for better reporting back to the feds and the various accrediting agencies. A lot of this has been happening for years, but structured and more adopted EMR systems make this a lot easier.

This shift towards outcomes is already rolling down the hill and the sustainability of healthcare practice for weaker organziations is going to be greatly strained.

 

[Hayabusa Rider]

Republicans make 0 attempts to change healthcare with 12 years in power. Democrats use Republicans' plan for healthcare after 3+ attempts... Monstrosity!

Hillary wants her plan. Reps come up with a dumb distraction. Democrats embrace dumb. This is somehow good.

 

[sunzt]

Hillary wants her plan. Reps come up with a dumb distraction. Democrats embrace dumb. This is somehow good.

This is politics.

Dems: We can't get through single payer so lets do the GOP plan since they're sure to embrace their own plan!
GOP: LPOIFEWHP(#A(*U#@_(*$U(*#@H$#OIHRA#)(PJF#P(WFMNWPFEWPOIJF
Dems: .... it's your plan ....
GOP: )(W#UR_)U#@R(JHF_#W*U(*#H(IN#FKJ#HNF(*H@(*#U$(#

 

[palehorse]

Do you take what corporations say as face value? Where were their excuses for the last 15 years of insane healthcare cost increases?

Did you read the article? The numbers that the Delta CEO quoted in his letter to Obama appear to be quite realistic. Could he be lying or slightly exaggerating? I guess, but why would he do so in a private letter to Obama? He knows the numbers would be intensely scrutinized, so lying about them would be a waste of time.

What do the future increasing costs to employers, as a result of Obamacare, have to do with the higher rates prior to the existence of Obamacare?

I don't recall seeing hours cut to below 30 prior to the passage of ACA, and the annual premium increases of 5-7% prior to ACA are something we'll only be able to dream about in the very near future when premium increases ranging from 20 to 200% will become the norm.

 

[ZaneNBK]

Arkansas just sent out letters to CHIP plan members (like me) telling us the program is gone as of Jan 1st and to go to http://arhealthconnector.org to find a new plan. Of course that site doesn't list plans until October 1st. They're even advertising the site on the radio here now and it's basically unusable at the moment. Way to go AR government!

So my $260/mo plan with $1000 deductible and $1000 OOP max (after deductible) will likely be replaced by something worse that costs more. Oh well, hopefully the new plan will actually have prescription coverage, that kinda sucked on my old plan.

 

[First]

I don't recall seeing hours cut to below 30 prior to the passage of ACA,

Then you aren't reading the studies carefully enough.

“Before the law was passed, most large employers already faced [Internal Revenue Service ] rules that prevented them from denying available health benefits to full-time workers. These rules gave employers an incentive to create part-time jobs to avoid rising health benefit costs,” the paper says.

It goes on to say: “Moreover, recent research suggests that the ultimate increase in the incidence of part-time work when the ACA provisions are fully implemented is likely to be small, on the order of a 1 to 2 percentage point increase or less. This is consistent with the example of Hawaii, where part-time work increased only slightly in the two decades following enforcement of the state’s employer health-care mandate.”

and the annual premium increases of 5-7% prior to ACA are something we'll only be able to dream about in the very near future when premium increases ranging from 20 to 200% will become the norm.

Annual healthcare increases since passage of ACA has been just 3%. FYI.

 

[First]

Annnnd more

Employers See Obamacare Options For Part-Time Workers, COBRA Purchasers

 

[Zaap]

Republicans make 0 attempts to change healthcare with 12 years in power. Democrats use Republicans' plan for healthcare after 3+ attempts... Monstrosity!

More R vs. D stupidity. So jumping off a cliff is a bad idea if a R suggest it, but if a D takes up the charge, you'd be the first one to jump? Got it.

 

[First]

More R vs. D stupidity. So jumping off a cliff is a bad idea if a R suggest it, but if a D takes up the charge, you'd be the first one to jump? Got it.

There's nothing stupid about it; we've already seen what insurance with a mandate (MA) and without a mandate (NY) looks like; the former is far less expensive than the later.

 

[Zaap]

The stupid part you're not understanding is that all people have to do to ignore your so-called 'mandate' is simply pay a fine- then jump onboard when they have full blown medical problems at taxpayer expense. Like I said, tens of thousands (maybe even millions) will do just that, so why jump on some guy who's admitting it?

 

[First]

The stupid part you're not understanding is that all people have to do to ignore your so-called 'mandate' is simply pay a fine- then jump onboard when they have full blown medical problems at taxpayer expense. Like I said, tens of thousands (maybe even millions) will do just that, so why jump on some guy who's admitting it?

Huh? I don't think you understand how ACA fines work. While some younger people will in fact pay the fine the first year, it gets considerably and ridiculously expensive after that to pay fines, and makes far more sense to just buy insurance on the exchanges. This has already been shown to be the case in MA; people avoided the fines and bought insurance instead. The fines also act as a way to fund the law, so even if people don't sign up, it's money in the bank. Get it?

 

[Hayabusa Rider]

There's nothing stupid about it; we've already seen what insurance with a mandate (MA) and without a mandate (NY) looks like; the former is far less expensive than the later.

Huh.

NY more than MA?

Oh that 3% was 4% for family and 5% for individuals last year. The estimates for after it takes full effect. You can call up the unions and tell them that their coverage won't change and premiums won't go up more than 3% if you like.

 

[First]

Huh.

NY more than MA?

Don't see any context there WRT benefits or coverage, so pretty pointless what the premiums are without that info.

Oh that 3% was 4% for family and 5% for individuals last year. The estimates for after it takes full effect. You can call up the unions and tell them that their coverage won't change and premiums won't go up more than 3% if you like.

I didn't say it applied to everyone. Also, I was talking healthcare, as in healthcare costs, not premiums.

 

[Hayabusa Rider]

Don't see any context there WRT benefits or coverage, so pretty pointless what the premiums are without that info.



I didn't say it applied to everyone. Also, I was talking healthcare, as in healthcare costs, not premiums.

So MA made people pay more for cheaper service?

 

[First]

So MA made people pay more for cheaper service?

Huh?

 

[palehorse]

I didn't say it applied to everyone. Also, I was talking healthcare, as in healthcare costs, not premiums.

I was speaking of premiums. Some individuals and families can expect an increase of 20 to 200% in the next year or two if they hope to purchase coverage from the exchanges that is comparable to the plans they've had for the last decade.

 

[sactoking]

The stupid part you're not understanding is that all people have to do to ignore your so-called 'mandate' is simply pay a fine- then jump onboard when they have full blown medical problems at taxpayer expense. Like I said, tens of thousands (maybe even millions) will do just that, so why jump on some guy who's admitting it?

Except for the fact that you can only purchase during open enrollment or you have to wait until next year. While that may work for some long-term conditions that don't require immediate attention anything that requires treatment soon (emergent care, HIV, cancer, etc.) will not be eligible.

 

[Zorkorist]

Except for the fact that you can only purchase during open enrollment or you have to wait until next year. While that may work for some long-term conditions that don't require immediate attention anything that requires treatment soon (emergent care, HIV, cancer, etc.) will not be eligible.

At that point they will just fall on Society, ie., Medicaid, to pay.

There's no difference in who is PAYING for medical care, under ObamaCare (we the people are paying) the only difference is who is PROFITING from medical care.

It's socialism... pure and simple.

-John

 

[umbrella39]

Have you talked to very many doctors about EMRs?

The doctors I spoke to hate it. The doctors spend more time entering into the EMR system then caring for patients.

Clinics and hospitals do not want to hire someone full time to enter information for the doctor, so the doctor is left to enter their own information.

The more time the doctor spends entering information into EMRs, the less time they have to see pts.

And its debatable if EMRs even improve care.

I work in the field and electronic medical records have made our jobs astronomically easier and faster. Their PA's do most of their docs order entry anyway. Nurses and therapists still have protocol to enter orders for the docs in EMRs When a doc actually does bother to put their own orders in it is just as fast if not faster than it used to be when they would grab the chart and write it down and a HUC would have to enter it for them. Not buying your anecdotes. EMR's don't improve care if a doc is still a slacker and a shitty doc to begin with.

 

[umbrella39]

Regardless of how it impacts our health care it's a dismal failure in that utterly destroyed the last vestiges of freedom by mandating participation in private enterprise.

Since I refuse to take part in the insurance industry, the law will be of ZERO benefit to me. In fact, it will eventually put me in prison for life, or on the streets to die, since I will neither obtain insurance nor pay the fine. Providing my coming lawsuit fails of course.

I wish we could turn people like you away. I really do.

 

[Hayabusa Rider]

I work in the field and electronic medical records have made our jobs astronomically easier and faster. Their PA's do most of their docs order entry anyway. Nurses and therapists still have protocol to enter orders for the docs in EMRs When a doc actually does bother to put their own orders in it is just as fast if not faster than it used to be when they would grab the chart and write it down and a HUC would have to enter it for them. Not buying your anecdotes. EMR's don't improve care if a doc is still a slacker and a shitty doc to begin with.

Out of curiousity how many established practices have you converted? I'm all for much more than EMRs, but converting roomfuls of records to digital isn't easy. Necessary, but not easy.