OBAMA/TRUMPCARE MEGATHREAD

[StrangeSox]

But that doesn't seem to apply to cknoll's plan. It's already existed for two years under those coverage requirements and will exist for three more years.

 

[CrimsonWeltall]

That's the problem, though. Post hoc ergo propter hoc. You need to at least demonstrate that, statistically, the rate hike or cancellation was at least plausibly caused by the ACA. There were rate hikes and plan cancellations/changes every year prior to the ACA.

 

eta: my plan has not changed and my insurance rates went up less than inflation last year. This is no more or less proof than cknoll's situation of the effects of Obamacare. Obama was dumb to make that promise; it's not something he could even control

 

Prior to the ACA, insurance companies could refuse to cover or dump unprofitable customers who needed a lot of expensive treatments. Now they have to take them. Why wouldn't we expect insurers to pass those increased costs onto everyone else?

 

This is not to say that all the shady practices and rejection of people with pre-existing conditions is something we should let happen again, but we can't pretend that they don't have an effect.

[Cknolls]

So in 2018 should we call you Cait?

 

LOL. I can use both bathrooms...

Edited September 16, 2015 by Cknolls

[bmags]

I don't think a lie is "less bad" just because the effect of the lie wasn't as bad.

 

Getting 30 million more Americans health insurance is a good thing, but if you are competent at your job you find a way to accomplish that without screwing over millions of other Americans, or at the very least be honest with them and tell them that they are going to get screwed over.

 

Being competent at your job has no relation to trying to pass a national health care bill through two chambers of Congress. If it was one person just creating a bill to implement and not trying to satisfy Bill Nelson and Mary Landreiu I'm sure we'd have something quite different.

[StrangeSox]

Sure, and to counterbalance those there's a big mix of cost-control measures. Kaiser Family Foundation has done annual surveys since 1999, and you can see the average premium increase here:

 

http://kff.org/interactive/premiums-and-wo...-contributions/

 

You can see that the overall premium increases from 2013 to 2014 (the year the ACA really started taking effect) grew by 2.4%. For comparison, the five previous yearly increases were 3.4%, 7.5%, 4.6%, 2.5%, and 5.0%.

 

But if you toggle over to "workers contributions," you'll see that those increases are higher than the overall premium growth rate. For example, worker contributions rose 8.2% in 2014 compared to 2.4% premium increase. That's just your employer cutting your pay, not anything driven by the ACA.

 

On the individual plan side, it's a bit harder to find steady comparisons, but the average premium increase for Exchange plans has been fairly low in each of the last two years now.

Edited September 16, 2015 by StrangeSox

[greg775]

Healthcare is pretty ridiculous. I know somebody's work gives a 50 dollar per month discount if they get bloodwork done at workplace through a testing company and their levels are all in an acceptable range. That seems a little big brother to me. Most people get a physical once a year and have their levels checked that way. Seems a little HR happy intrusive, uncalled for type thing to me.

[Cknolls]

Feel free to post some data showing a higher rate of premium increases or plan cancellations post-ACA. Otherwise it doesn't look like there's much of a point being made.

 

 

Feel free to show "my" premiums would have increased pre-ACA like they are post ACA?

[StrangeSox]

Feel free to show "my" premiums would have increased pre-ACA like they are post ACA?

Conversely, feel free to show that they wouldn't be increasing absent the ACA.

 

I did post KFF's employer plan data above, though. For at least the one year that includes ACA so far, the premium increase was less than any of the previous 5 years (didn't check the rest because I have to hand calculate, not just a table with %'s, but eyeballing the graph shows they follow the same trend).

[Cknolls]

My premiums have increased almost 50% in the last five years. Nothing to do with Obamacare I'm sure. I do not give a flying f*** what your Kaiser stats say. The law passed in 2009. Companies started planning for the abomination. They didn't wait four to five years to plan. I don't have to prove anything to you. I am living it right now and it's because of the ass clown you libs elected.

Edited September 17, 2015 by Cknolls

[StrangeSox]

My premiums have increased almost 50% in the last five years.

 

So that's pretty much right in line with rates of increases prior to 2009. Also, the law passed in late 2010, not 2009.

[StrangeSox]

This study is forcing economists to rethink high-deductible health insurance

 

In 2006, about one in 10 employees had a health insurance deductible over $1,000. Today? About half do.

 

To health economists, this sounded like good news; they've long theorized that higher deductibles would force down health-care costs. The idea was that higher deductibles would make patients become smarter shoppers: If they had to pay more of the cost, they'd likely choose something closer to the $1,529 appendectomy than the $186,955 appendectomy (yes, some hospitals really do charge that much). This would push the really expensive doctors to lower their prices so cheaper physicians didn't steal their business.

 

This was, however, just a theory. And a massive new study suggests it might have been all wrong.

[NorthSideSox72]

This study is forcing economists to rethink high-deductible health insurance

The theory was crap to begin with. No one "shops" medical costs, because the entire system is set up such that you have NO idea what things will cost upfront. That plus the highly inflexible demand curve mean the shopping concept just doesn't work with health care.

 

[Iwritecode]

The theory was crap to begin with. No one "shops" medical costs, because the entire system is set up such that you have NO idea what things will cost upfront. That plus the highly inflexible demand curve mean the shopping concept just doesn't work with health care.

 

No one shops medical costs because when you have a medical emergency and call 911 shopping around for the cheapest option is probably the last thing on your mind.

 

Get me in an ambulance and get me to a hospital ASAP. I'll worry about the costs later.

[StrangeSox]

The theory was crap to begin with. No one "shops" medical costs, because the entire system is set up such that you have NO idea what things will cost upfront. That plus the highly inflexible demand curve mean the shopping concept just doesn't work with health care.

Yeah, Ken Arrow did his research in the 1960's showing that. It shouldn't surprise anyone, yet there are still lots of people pushing the "skin in the game" line.

[Chisoxfn]

The theory was crap to begin with. No one "shops" medical costs, because the entire system is set up such that you have NO idea what things will cost upfront. That plus the highly inflexible demand curve mean the shopping concept just doesn't work with health care.

I fully agree and I have that conversation with some key people in HR at my company every single year. It is an awful concept and not one that I will do. I have a million other things to spent time on. When I need a procedure done, I'm picking the doctor I'm comfortable with and not shopping by cost. Its my health...once I pick the doctor as long as I'm covered, deal with it. You can never get a straight answer on costs anyway.

[bmags]

I was hoping it would work in the case where doctors were recommending a high cost pill (best example was a pill for skin care that was $80 pill) when a generic was available. The deductible was the same, and when it wasn't, the pill manufacturer was providing coupons to make it the same.

 

This did some effort to remove that incentive.

 

I think competition and pricing only works in the places it alreayd works for, non urgent cosmetic procedures (braces, skin care, etc).

[southsider2k5]

Is there any other product in the world where the prices are hidden from you?

[Jenksismyhero]

Is there any other product in the world where the prices are hidden from you?

 

Is there any other product that is not paid by you directly in 99% of cases, but is instead paid by some intermediary?

 

End of the day, what's it matter what the actual cost of X is? It's a made up figure. The true figure is what the insurance company has contracted to pay with X provider.

 

Also, if you really want to know what X, Y and Z "costs," go look up the fee schedules on the workers' comp website. That'll give you an idea of what the state requires insurance companies to pay for X procedure. It's not easy, since you'll need billing codes, but it can be done.

[StrangeSox]

Even if you knew the "real" pricing up front, it will never work like a 'typical' market. How much do you want to bargain hunt for that next surgical procedure? How well can you even evaluate the differences between your options, what treatment really makes sense or not, etc.? And even with that, people aren't going to be entirely rational with their health care, anyway. It can often literally be a matter of life or death.

 

Edit: Also, the study linked to above did involve patients who knew what the prices were upfront through their insurer.

Edited October 15, 2015 by StrangeSox

[Harry Chappas]

Is there any other product in the world where the prices are hidden from you?

 

Cell phones service.

[southsider2k5]

Cell phones service.

 

Not really, no. I know my bill within pennies each month.

[farmteam]

Cell phones service.

There's a difference between hidden fees and literally having no idea what a procedure will cost, like in medical care.

Edited October 16, 2015 by farmteam

[greg775]

I have a question. With the high cost of health care, what happens if you are diagnosed with a terminal disease and you have no insurance and no money? Does the medical system have the right to kill you? Refuse to provide you meds and treatment? Isn't that involuntary manslaughter?

 

Secondly ... if you have a terminal disease, no insurance and no savings, can you deny treatment to avoid going into debt for your survivors? In effect you'd be killing yourself and I thought suicide was illegal. Hmmm...

[Jenksismyhero]

I have a question. With the high cost of health care, what happens if you are diagnosed with a terminal disease and you have no insurance and no money? Does the medical system have the right to kill you? Refuse to provide you meds and treatment? Isn't that involuntary manslaughter?

 

Secondly ... if you have a terminal disease, no insurance and no savings, can you deny treatment to avoid going into debt for your survivors? In effect you'd be killing yourself and I thought suicide was illegal. Hmmm...

 

1) you'd be able to get emergent care whether you can pay or not

 

2) if you're poor enough, you can sign up for medicaid. if you're old enough you can use medicare

 

3) any medical bills you incur will die along with you. no issues for survivors to deal with. I mean technically they could be a creditor and try to make some claim against the estate, but if you're that poor you have nothing in the estate to go after.

[StrangeSox]

Not necessarily with Medicaid, there are a lot of qualifiers in many states. It's not as bad now in the states that have accepted the expansion, but there are still big gaps that people can fall into.