**UPDATE** New Obamacare Reality Setting in: 8M in exchanges, 35% are < 35 yrs old

[Sea Ray]

Just because the gov't is helping pay the premium, it doesn't mean the premium's any lower. By your thinking the price of food at Kroger goes down everytime a new person receives food stamps. It doesn't work that way

 

[fskimospy]

Just because the gov't is helping pay the premium, it doesn't mean the premium's any lower. By your thinking the price of food at Kroger goes down everytime a new person receives food stamps. It doesn't work that way

Right, but just because people were paying health care costs through debt, uncompensTed care, and other government subsidies to hospitals instead of through premiums it doesn't mean that total health care costs were any lower. It doesn't work that way either.

 

[Sea Ray]

Right, but just because people were paying health care costs through debt, uncompensTed care, and other government subsidies to hospitals instead of through premiums it doesn't mean that total health care costs were any lower. It doesn't work that way either.

Obamacare won't change that. You'll still have millions showing up at the hospital w/o insurance. This will still leave us far from universal coverage.

I get the sense that you like all the subsidies and increased Medicaid and I'm not totally against it either but why did they have to screw with my insurance in order to do that? Why couldn't they just dole out the money for subsidies/etc and NOT add new requirements for my plan? In so doing they've taken away my freedom to choose the plan of my choice. They've also stepped on the rights of my state to regulate insurance as they see fit

 

[fskimospy]

Obamacare won't change that. You'll still have millions showing up at the hospital w/o insurance. This will still leave us far from universal coverage.

I get the sense that you like all the subsidies and increased Medicaid and I'm not totally against it either but why did they have to screw with my insurance in order to do that? Why couldn't they just dole out the money for subsidies/etc and NOT add new requirements for my plan? In so doing they've taken away my freedom to choose the plan of my choice. They've also stepped on the rights of my state to regulate insurance as they see fit

Obamacare definitely changes that. It doesn't solve the problem 100% as single payer would, but it definitely mitigates those occurrences.

If you don't set a minimum standard for insurance with guaranteed issue then you have people buying what amount to fake insurance policies to comply with the mandate.

 

[Jhhnn]

Just because the gov't is helping pay the premium, it doesn't mean the premium's any lower. By your thinking the price of food at Kroger goes down everytime a new person receives food stamps. It doesn't work that way

The price of food does go down with Ag subsidies, however, which is more along the lines of what the ACA hopes to accomplish.

Food stamps? Other forms of assistance? They exist out of necessity, the necessity created by the Job Creators! increasingly failing to live up to their end of the Social Contract. Prosperity needs to be fairly widespread to achieve a relatively safe, sane & non-revolutionary society, particularly when scarcity has become more of a class warfare contrivance than a reality. Like it or not, some degree of redistribution is a common & necessary feature of all modern democracies.

New Deal policy actually promoted that in a structural way, something that trickle down Reaganomics fails to do. The proof?

The post-WW2 period that conservatives romanticize was actually a lot more socialistic in its own way than the present.

 

[Jaskalas]

The post-WW2 period that conservatives romanticize was actually a lot more socialistic in its own way than the present.

America's great industry provided the post-WW2 era. We've since shipped that overseas, tanking the value of labor. American workers now compete with Chinese slaves.

 

[Sea Ray]

Obamacare definitely changes that. It doesn't solve the problem 100% as single payer would, but it definitely mitigates those occurrences.

If you don't set a minimum standard for insurance with guaranteed issue then you have people buying what amount to fake insurance policies to comply with the mandate.

Obamacare was promised to insure 32 million out of the 50 million who are w/o insurance. Some estimates say that they'll achieve about 9 mill of that this year. That's hardly a dent.

I don't think I had a fake insurance policy. Just because it didn't include kid's dental or substance abuse treatment...It provided very nicely as my wife went through breast cancer. All I want is what I had before. There was nothing wrong with it other than being expensive and Obamacare has made that issue even worse

 

[Sea Ray]

The price of food does go down with Ag subsidies, however, which is more along the lines of what the ACA hopes to accomplish.

Food stamps? Other forms of assistance? They exist out of necessity, the necessity created by the Job Creators! increasingly failing to live up to their end of the Social Contract. Prosperity needs to be fairly widespread to achieve a relatively safe, sane & non-revolutionary society, particularly when scarcity has become more of a class warfare contrivance than a reality. Like it or not, some degree of redistribution is a common & necessary feature of all modern democracies.


The post-WW2 period that conservatives romanticize was actually a lot more socialistic in its own way than the present.

I was comparing Obamacare's subsidies to food stamps; an apt comparison, I'd say. Just because the gov't helps some pay their bills doesn't mean the premium price came down. It just means that some other Americans are helping pay someone else's health care bill

 

[fskimospy]

Obamacare was promised to insure 32 million out of the 50 million who are w/o insurance. Some estimates say that they'll achieve about 9 mill of that this year. That's hardly a dent.

Obamacare was never promised to insure 32 million new people in a single year, I don't think anyone ever said that. I also don't think that covering 20% of all uninsured people in the US in a single year is hardly a dent, that's an enormous accomplishment.

I don't think I had a fake insurance policy. Just because it didn't include kid's dental or substance abuse treatment...It provided very nicely as my wife went through breast cancer. All I want is what I had before. There was nothing wrong with it other than being expensive and Obamacare has made that issue even worse

Well I can't speak for your particular circumstances, but if nothing else you now know that if for whatever reason you lose your health coverage that your wife will not be barred from ever rejoining the individual market. (or at least at non-prohibitive prices with untenable conditions attached)

I know that the average person on the individual market is projected to pay less out of pocket now than they did before. That's also a plus for individuals. As for nationwide health costs and how they compare to outcomes, that's something that we will have to evaluate for years going forward.

As for what constitutes a fake policy, my only point was that if you don't set a floor to what is covered there will be a race to the bottom and you end up with worthless policies. We can certainly have a discussion of exactly what should be in a policy, but I hope you see why the feds needed to set some standards.

 

[fskimospy]

I was comparing Obamacare's subsidies to food stamps; an apt comparison, I'd say. Just because the gov't helps some pay their bills doesn't mean the premium price came down. It just means that some other Americans are helping pay someone else's health care bill

Again though, premiums are only one part of health care spending and the ACA dramatically shifted how overall health spending is distributed. If the total cost to you in year 1 was $1,000 in premiums and $1,000 in expenses and then the next year it was $2,000 in premiums and $0 in expenses, saying your premiums doubled is pretty meaningless. Similarly, lots of health spending was accounted for in other ways as opposed to premiums before and that has changed.

With all that in mind, don't you think that looking at total yearly costs spent on health care would be a better way of doing it?

 

[Sea Ray]

What's considered non prohibitive prices? I don't see any limits for health insurance premiums for people making over $78K/yr.

I doubt that the avg person on the individual market will pay less than but Obamacare folks might tout that if they figure in subsidies and added people to Medicaid.

There's no trick to adding 9 mill people to the insurance rolls. Just pass out more goodies. I doubt they'll come anywhere near their promise of 32 mill. The lion's share will get their insurance this year. If they're not insured after this year, only a few will join thereafter.

I'd like to see more people get insured because the premiums on the x-change have come down.

 

[Sea Ray]

Again though, premiums are only one part of health care spending and the ACA dramatically shifted how overall health spending is distributed. If the total cost to you in year 1 was $1,000 in premiums and $1,000 in expenses and then the next year it was $2,000 in premiums and $0 in expenses, saying your premiums doubled is pretty meaningless. Similarly, lots of health spending was accounted for in other ways as opposed to premiums before and that has changed.

With all that in mind, don't you think that looking at total yearly costs spent on health care would be a better way of doing it?

Definitely. With these newer higher deductibles I expect costs to increase a great deal. Hope I'm wrong.

Does it make you nervous that the feds are now determining your health care? That's what state agencies used to do. IF a Republican ever gets in charge, they'll likely change these parameters to meet their political best interests. They may drop birth control and add Viagra with the explanation that Viagra actually treats a non working physical condition. We the people become political footballs.

 

[fskimospy]

What's considered non prohibitive prices? I don't see any limits for health insurance premiums for people making over $78K/yr.

I would like to know what percentage of people making $78k/year+ are shopping on the individual market for health care. My guess is not many. Regardless, what exactly would be a non-prohibitive price is something else we could talk about! I know that for me I basically can't get individual insurance at any price, so without the ACA I'm simply fucked if I lose my job.

I doubt that the avg person on the individual market will pay less than but Obamacare folks might tout that if they figure in subsidies and added people to Medicaid.

Again, of course you would include subsidies. Remember, total health spending is what matters. If you aren't including the subsidies then you are just adding up all the costs of the law without looking if they are accounted for elsewhere. That's cherry picking your data points, a big analytic no-no.

There's no trick to adding 9 mill people to the insurance rolls. Just pass out more goodies. I doubt they'll come anywhere near their promise of 32 mill. The lion's share will get their insurance this year. If they're not insured after this year, only a few will join thereafter.

I'd like to see more people get insured because the premiums on the x-change have come down.

Well the CBO and other actuaries disagree with you. Don't you think they probably have a more informed opinion about this?

 

[fskimospy]

Definitely. With these newer higher deductibles I expect costs to increase a great deal. Hope I'm wrong.

Again, I couldn't speak to your personal circumstances. For most people on the individual market their costs will likely decrease.

Does it make you nervous that the feds are now determining your health care? That's what state agencies used to do. IF a Republican ever gets in charge, they'll likely change these parameters to meet their political best interests. They may drop birth control and add Viagra with the explanation that Viagra actually treats a non working physical condition. We the people become political footballs.

Nah. First, state organizations are frequently far less accountable than federal ones and their decisions are often scrutinized much less closely. Second, radical change of federally mandated coverage mostly comes through the institutional bureaucracy and not as the result of some political wind change. Sure they might monkey around the edges, but overall it should stay about the same. Third, if they decide to monkey with it too seriously I imagine they will pay a stiff political price, which is how the system is supposed to work.

 

[michal1980]

That would be a very different problem. Additionally, the conclusions of that sample size of one run contrary to some real actuarial analysis of cost changes over time.



There are actually several states listed in the very survey you cite where rates have gone down quite a bit.

Regardless, yes I'm referring to subsidies and the fact that we should be focusing on total health care costs. Before the ACA in many cases this care was still taking place, just happening through ruinous debt, being picked up by third parties like government, uncompensated care to hospitals, etc. All of those costs were real and remain. This law is (among many other things) an attempt to shift away from that model.

That's why I think focusing on a change in premiums between two time periods where those premiums covered very different things without accounting for all the other changes that happened is a bad idea. I understand why people want to do that for political reasons, but that doesn't make it better.

Just so you know, I'm in the same boat as you. I have a personal history of cancer and I thank my lucky stars every day for this law.

How exactly have the cost been shifted?

Before Obamacare, the uninsured poor would use the ER paid for by the hospital/government, after ACA the insured poor use health care paid for by the government. Wow big difference.

 

[cubby1223]

Interesting comment by Pfizer's CEO the other day:

http://video.cnbc.com/gallery/?video=3000265368

Most of the people, I understand from the analysis, have gone into the exchanges, have already been transferred from one insurance to another. There's very few new insured.

 

[fskimospy]

How exactly have the cost been shifted?

Before Obamacare, the uninsured poor would use the ER paid for by the hospital/government, after ACA the insured poor use health care paid for by the government. Wow big difference.

Thanks for making my point for me!

 

[fskimospy]

Interesting comment by Pfizer's CEO the other day:

http://video.cnbc.com/gallery/?video=3000265368

Then how do you explain the large drop in those reporting they are uninsured?

 

[michal1980]

Thanks for making my point for me!

so you agree, Obamacare did nothing about costs.

The poor got free health care before, and after ACA.

Talk about a wasted effort then.

 

[fskimospy]

so you agree, Obamacare did nothing about costs.

The poor got free health care before, and after ACA.

Talk about a wasted effort then.

Lol of course not. No person with even a rudimentary understanding of the law would say it did nothing to control costs. What would make you say such a silly thing?

 

[Jhhnn]

America's great industry provided the post-WW2 era. We've since shipped that overseas, tanking the value of labor. American workers now compete with Chinese slaves.

At the bidding of America's wealthiest people, the Jerb Creators! of Multinational Capitalism.

If they can't be induced to employ Americans, then they can be induced to pay higher taxes to see to the general welfare through redistribution. Or we can all suffer the breakdown of society that their craven greed & lust for power creates.

It's really their choice until the rest of the country gets sick of their shit & forces the latter upon them. That's what egalitarian democracy does when it becomes necessary. It binds us together to serve the general welfare when the people deem it should be so.

Which is why America's right wing works so hard to tear down the govt of the people, indoctrinates idiots to help them. It's the only thing really standing in the way of a return to the ancien regime, the rule of a wealthy few. It's what the multi billionaire sponsors of the poisonous right wing noise machine want- to Rule, to do any fucking thing they want w/o govt interference, w/o any consideration for the rest of us in the slightest.

 

[ttown]

to the title: In other words.... We lost our freedom so Obama the incompetent guy could solve 20% of what he thought was a problem.

Yay.

 

[Jhhnn]

to the title: In other words.... We lost our freedom so Obama the incompetent guy could solve 20% of what he thought was a problem.

Yay.

Your freedom to do what, exactly? Is this kinda like losing your freedom to fall into an open manhole when they put up barriers around it, or what?

 

[MongGrel]

America's great industry provided the post-WW2 era. We've since shipped that overseas, tanking the value of labor. American workers now compete with Chinese slaves.

+1

 

[MongGrel]

At the bidding of America's wealthiest people, the Jerb Creators! of Multinational Capitalism.

If they can't be induced to employ Americans, then they can be induced to pay higher taxes to see to the general welfare through redistribution. Or we can all suffer the breakdown of society that their craven greed & lust for power creates.

It's really their choice until the rest of the country gets sick of their shit & forces the latter upon them. That's what egalitarian democracy does when it becomes necessary. It binds us together to serve the general welfare when the people deem it should be so.

Which is why America's right wing works so hard to tear down the govt of the people, indoctrinates idiots to help them. It's the only thing really standing in the way of a return to the ancien regime, the rule of a wealthy few. It's what the multi billionaire sponsors of the poisonous right wing noise machine want- to Rule, to do any fucking thing they want w/o govt interference, w/o any consideration for the rest of us in the slightest.

another +1