obamacare missing something

Nope this stuff goes back to the Nixon years. Originally Posted by royamcr

Me, too! Now: what "stuff"? "Socialized Medicine"?

I do remember HillaryNoMore's failed attempt to get shit done.

What's wrong with some social medicine in basic health care? Why should someone die because an insurance company puts money ahead of that person's life? This is complex stuff and each case is different. I'm all ears to the Republican solution. I just don't see how taking millions of new payers out of the pool solves anything. If 20 million people pay just 50 a month, that is $12 billion of organic money flowing into the system. And what if 200 million others paid double that? That is a half trillion bucks. Or 1300 per person per year. Some wont use any at all and some will use a lot.

What's wrong with some social medicine in basic health care? Originally Posted by royamcr

I'm not sure what "social medicine" is, but if that is "socialized medicine" it doesn't work .... see ObaminableCare!

California tried it (what amounted to it) as part of their retirement package with salaried doctors and clinics ... with a "oversight board" to approve procedures and pharmaceuticals. Long waits, mediocre service, rejections.

If one didn't know better, you'd have thought they were trying to kill off the retirees sooner to end their retirement earlier to save money.

It was going broke so Pelosi started up this ObaminableCare shit.

One of Nixon's guys came up the idea of putting a "network" or hmo together to reduce costs predicted to support medicare law that Nixon past.

I don't correlate that to obamacare

I think where we went off track when coal worker unions forced coal companies to provide healthcare to employees....in the 20s?

then other industries followed suit.

to me, my employer is the second worst option to manage my healthcare.....with government being the first worst.

What's wrong with some social medicine in basic health care? Why should someone die because an insurance company puts money ahead of that person's life? This is complex stuff and each case is different. I'm all ears to the Republican solution. I just don't see how taking millions of new payers out of the pool solves anything. If 20 million people pay just 50 a month, that is $12 billion of organic money flowing into the system. And what if 200 million others paid double that? That is a half trillion bucks. Or 1300 per person per year. Some wont use any at all and some will use a lot. Originally Posted by royamcr

I would gladly pay $50-$100 a month for health insurance. I use to pay $155.00 now it's $560.00 with a $6000.00 deductible.
Thanks Obama care, and BTW, if I choose to go it on my own I have to pay a penalty to the gov't. That is called Fascism.

No if you provide your own insurance or prove you don't need insurance because of wealth there is no penalty.

+1

You nailed it with the Risk Corridors. Yes, states/counties where health insurance companies had the most claims submitted is where you would see a spike in premium price and deductibles. In addition to raising rates, companies like UHG and Aetna simply stopped selling health insurance on the government exchanges in states with the worst risk pools. Aetna went from offering health insurance on the exchanges in 15 states in 2016 to just 4 in 2017.

http://www.cnbc.com/2016/08/16/aetna...s-in-2017.html Originally Posted by flghtr65

Yep all these people bitch bitch bitch about ACA and their premiums and are too dumb or ignorant to educate themselves on exactly why it is. The ACA isn't directly responsible for it.

It was two fold on premiums. First the insurance companies with out the risk corridors raised rates. Then second, insurance companies pulled out of markets all together lessening competition. KS just has BCBS... A year or 2 ago there were at least 3. Send a bill to Marco if you are paying double or triple premiums. I agree they are ridiculously high. They are high enough now might as well just pay the 700 penalty and take your chances.

It was pretty clever what the GOP quietly did and they can all get fucked in the ass as far as I'm concerned. They know most voting Americans are dumb and just vote based on what they are now paying in premiums.

One of Nixon's guys came up the idea of putting a "network" or hmo together to reduce costs predicted to support medicare law that Nixon past.

I don't correlate that to obamacare

I think where we went off track when coal worker unions forced coal companies to provide healthcare to employees....in the 20s?

then other industries followed suit.

to me, my employer is the second worst option to manage my healthcare.....with government being the first worst. Originally Posted by GlobeSpotter

It is very complex. At some point it seems we could benefit from Health care Insurance agents. Regulated of course. I think each family or person should have customized coverage for exactly what they need. I think some are way over insured and some are way underinsured or have none at all.

As far as companies managing health care, they really don't. They negotiate "in big numbers" and let multiple insurance companies bid on their business. Your personal healthcare is managed by a professional doctor.

It is very complex. At some point it seems we could benefit from Health care Insurance agents. Regulated of course. Originally Posted by royamcr

Insurance agents are "regulated" about like realtors ... varying amounts of agency oversight.

With the internet insurance agents are getting obsolete quickly, since one can enroll with a health insurance company online ...

.. with State government agencies regulating insurance which have links to available carriers and support information on premiums and benefits (generally) it should not be a problem to find coverage one can afford and/or be able to determine that one is qualified for some level of health care assistance ....

.. the short version: if you can find a provider to fuck you, you can find a health insurance carrier to fit your budget.

It's the same principles involved. Searching, screening, pricing.

The ACA isn't directly responsible for it. Originally Posted by royamcr

Artificial inflation based on medicare coding and billing plus the requirements of the ACA are "responsible" for the spike in premiums!

A lot of great points made. But having been in the healthcare industry, and mainly in hospitals, I can tell you everything discussed above makes no substantial difference in the cost of your insurance. What causes your insurance to go up is that hospitals, by federal law, are forced to provide free treatment for anyone that walks in the ER (the most costly of healthcare) and being admitted with absolutely no way to identify the person, and therefore no way to collect on their bill. Luckily for hospitals before they all went broke, another law was passed granting them the ability to pass those uncollectable costs to people that have insurance. We have more of a single payer healthcare industry than people realize, it's just not all in one Obamacare bill, you have to string them together to understand where the redistribution of cost and payments come from.

It doesn't take that long for the rest of the world to realize that you can come to the United States legally or illegally, walk in the ER without any identification whatsoever, get free healthcare for months on end, and then simply go back home leaving their costs of healthcare for people with insurance to pay. Of course this goes for citizens who choose not to buy insurance as well.

This is also the main reason you see smaller specialized hospitals, outpatient treatments, and surgery centers WITHOUT ER's springing up everywhere but on the ground floor of commercial buildings, and they are MEGA profitable! They are exempt from being forced to provide free healthcare, but they get to charge the same amount as the other hospitals. If you are an evil capitalist, there is serious cash to be made in these "hospitals without ER's"! Since Reagan passed the treatment act, I don't see any chance of his law being repealed anytime soon either. Serious, serious cash to be made while it lasts!

^^^^That why immigration reform is necessary . Did anyone read the paper this morning DMN Insurer sues lab group -- MILIONS in bribes and kickbacks , My opinion when the feds get in the middle of healthcare it opens up fraudulent activity

... I can tell you everything discussed above makes no substantial difference in the cost of your insurance. What causes your insurance to go up is that hospitals, by federal law, are forced to provide free treatment for anyone that walks in the ER (the most costly of healthcare) and being admitted with absolutely no way to identify the person, and therefore no way to collect on their bill. Originally Posted by nwarounder

For reimbursement purposes the provider must establish an increase in the charges for this year (even though they will not get paid that much from the government or the carrier) so they can justify an increase next year based on the billing history for this year.

That drives up the premiums so the carrier can anticipate the increased benefit payout costs "next year"! They are following the "process" in place by the government to justify an increase in the medicare benefits paid. That scheme also applies to medicaid. The medical associations then set the billing costs based on the billing codes, which the government uses to establish how much the pay for specific procedures itemized by the billing codes...base on "units" of activity.

Artificial inflation based on medicare coding and billing plus the requirements of the ACA are "responsible" for the spike in premiums! Originally Posted by LexusLover

It is more than a "spike". The thing is the "requirements" of the ACA are what everyone likes, even Republicans. So we have these requirements that yes are expensive, but how can you try pay for them without "everyone" paying into the system? I'm not a big fan of the subsidies, but they are for accounting purposes and a way to adjust how much someone pays if their income rises.

A lot of great points made. But having been in the healthcare industry, and mainly in hospitals, I can tell you everything discussed above makes no substantial difference in the cost of your insurance. What causes your insurance to go up is that hospitals, by federal law, are forced to provide free treatment for anyone that walks in the ER (the most costly of healthcare) and being admitted with absolutely no way to identify the person, and therefore no way to collect on their bill. Luckily for hospitals before they all went broke, another law was passed granting them the ability to pass those uncollectable costs to people that have insurance. We have more of a single payer healthcare industry than people realize, it's just not all in one Obamacare bill, you have to string them together to understand where the redistribution of cost and payments come from. Originally Posted by nwarounder

Yep, it is pay me now or pay me later. Those with money pay at some point. That is what is so maddening about low income people whining about having to pay into the system. Lets level this out some, I don't care if you work at McDs making 7 an hour, you need to be paying "something" into the system. They can sure afford that box of cigarettes can't they?

In a lot of ways the health of the nation has deteriorated because of insurance paid healthcare. I'm guilty too. For a long time I never really felt the real cost of my health care. I've been lucky so far and haven't had anything more major than a kidney stone and bumps and bruises... All this stuff I could pay out of pocket if I had to. The same happens with High deductible plans. 35 out of 40 years of my adult life I really wont come close to touching the deductible. Maybe never hopefully. But I still pay, just like car insurance. That's how insurance works. It is there to protect you from the unforseen and expensive events. Not pay for your yearly health care needs.

With High Deductibles like they are now, I hope and bet millions of people are taking a better look at their life styles and choices. Before if things happened 80% was covered so no big deal, then eventually you could reach the deductible and get 100 %. Now that is mostly gone and maybe that is good in a way. People with insurance are still protected from that huge bill (cancer, heart, brain, lung, liver...). Insurance companies are spending less on small matters which frees up more money for the big stuff. When insurance companies have to pay out less then rates "should" go down. If people are generally healthier and use less health care, rates "should" go down.