OBAMA/TRUMPCARE MEGATHREAD

[Jenksismyhero]

Yeah we'll see what happens. Congress also didn't just exempt staffers from insider trading reporting either.

[StrangeSox]

Yeah we'll see what happens. Congress also didn't just exempt staffers from insider trading reporting either.

They did, and f*** them for that.

 

But that's manifestly different than what (allegedly, for three years now) going on here. There's a specific provision in the bill that moves a handful of federal employees from the large insurance program they are currently a part of and which would be 100% compliant with the rest of ACA's provisions to the Exchanges. There appears to be legitimate concern that current law would not allow the federal government to continue covering the health care premiums that are shifted to the exchanges, thus leaving Congress and their staffers with 100% of the bill. It's not so much about "exempting themselves from Obamacare" as it is about eliminating one specific provision of the law that changed their already-complying insurance plan.

[StrangeSox]

That means nothing to me?

it's charles pierce's phrase but essentially just think of politico as a dumb gossip adolescent rag equivalent to Tiger Beat

[Soxfest]

Congress knew from day 1 they would opt out.

[Balta1701]

Healthcare post, not on the subject of this law. The federal government this morning released some of the data that regular proles like us don't get to see; their massive database of the list prices hospitals use as their starting point for treatment of various procedures. If you have insurance these rates get negotiated down, but if you're uninsured and show up for this treatment, this is what shows up as the starting point on your bill until you file bankruptcy and the court sorts things out.

Huffpo put together a nice little graphic, selecting out treatment for 1 particular procedure and plotting up what the hospital charge for that procedure across the NY Metro area.

[StrangeSox]

[StrangeSox]

Wasn't brought up here yet, but the Incidental Economist blog has a whole bunch of posts covering the Oregon Medicare study that came out.

 

Oregon Medicaid – Power problems are important

 

You see, the study did not prove Medicaid hurts people. Nor did it prove that Medicaid doesn’t help people. It failed to prove that Medicaid improved some metrics like A1C a certain predetermined amount. But what was that predetermined amount? That question is vitally important, because the study found that more people on Medicaid did improve their A1C, just not “enough”. Is that because the study was underpowered (had an insufficient number of participants)? We think that may be the case. But that question should be answerable…

 

How should the new Medicaid study change our policy preferences?

 

First of all, as evidenced by our latest post, we’re still digging into the details of the new Oregon Health Study results. If, as it seems, it was underpowered, it does not provide as clear guidance as we might have hoped. Either way, as Cowen points out, the study doesn’t differ from what we know from prior work. How much should it change our thinking, then? Or yours? It’s quite reasonable to say, “Not that much,” though it depends on your starting point. And that is (or can be) an evidence-based interpretation, whether that is incorrectly spun as a distraction or a dodge or not. Shouldn’t we all want to interpret the evidence properly before applying it to policy? Well, that’s our ambition.

 

Nevertheless, some reconsideration of the Medicaid policy space is a worthwhile exercise because elected officials in many states are still contemplating whether to expand Medicaid and, if so, how. Let’s step back and look at that space.

 

Oregon Medicaid experiment “is a Rorschach test of people’s views of the ACA”

 

What about power for the blood pressure result? (And so much more)

 

[bmags]

Wasn't brought up here yet, but the Incidental Economist blog has a whole bunch of posts covering the Oregon Medicare study that came out.

 

Oregon Medicaid – Power problems are important

 

 

 

How should the new Medicaid study change our policy preferences?

 

 

 

Oregon Medicaid experiment “is a Rorschach test of people’s views of the ACA”

 

What about power for the blood pressure result? (And so much more)

 

That study is a prime example for Nate Silver's prescription in "The Signal and the Noise" to prefer a Bayesian method of scientific knowledge.

[StrangeSox]

Yeah, failing to reject the null isn't proving the null and a lot of people seem to be missing that.

 

Plus, you know, there actually were substantial gains in some areas, like 30% better results for depression.

[Jenksismyhero]

If true, this is comforting:

 

http://www.weeklystandard.com/articles/pri...ned_741033.html

[Reddy]

If true, this is comforting:

 

http://www.weeklystandard.com/articles/pri...ned_741033.html

 

Never mind the 50% drop in health care cost, you have to find something to freak out about. haha

[mr_genius]

Never mind the 50% drop in health care cost

 

There's absolutely no way health care costs drop 50%. It would be a miracle if they just stay the same.

[Y2HH]

Never mind the 50% drop in health care cost, you have to find something to freak out about. haha

 

Not happening.

[EvilMonkey]

Never mind the 50% drop in health care cost, you have to find something to freak out about. haha

You sure that wasn't supposed to be green type?

[greg775]

Somebody should do an Obamacare for Dummies piece.

 

a.) In the middle class world, let's say I get laid off tomorrow and have no insurance. I want to buy Blue Cross on my own but they say 'no' because I have diabetes. Obamacare means Blue Cross has to take me? What if Blue Cross says, OK, and has some premium for me 5 to 10 times higher than what my employer was paying?

Does Obamacare mean whatever company I desire has to take me for the regular price? How do I pay for it if I have no job??

 

b.) Does Obamacare mean all small businesses have to provide insurance for their employees, meaning many more businesses will go out of business or lay people off to pay for it?

 

c.) When the Republicans win the next election (Hillary is un-electable, folks) can and will the Republican president just throw out Obamacare? Or would it take a year or two to dismantle it? Seems to me that WILL happen.

 

What the hell is Obamacare and who does it benefit the MOST?

Edited August 8, 2013 by greg775

[Balta1701]

When this law comes into effect next year, Blue Cross will not be able to say "no" to insuring you. In fact, I believe that part of the law has already taken effect, insurers cannot turn you down for insurance entirely based on pre-existing conditions.

 

This law also includes what is called "Community rating". What that means is...an insurer cannot decide your rates based on your individual conditions. They can't decide your rates based on what disease you have. They can only decide your rates based on a few categories: Age, Gender, tobacco usage, and a 4th that I forget.

 

The law states that employers with more than 50 employees will have to pay a penalty if they do not offer insurance as a benefit. Instituting that requirement has already been complex and it has been delayed until the 2015 tax year. Yes, more businesses will have to provide insurance for their employees, but the government already foots a huge portion of the bill for that through the employer-insurance tax credit.

 

This bill benefits a couple groups of people the most. People with pre-existing conditions who could not get health coverage beforehand because of that condition will be able to get care for that condition. People who are self employed or work for a small business will benefit hugely because this bill drastically reforms insurance for people who are buying it on their own, they don't have to deal with being singled out because of an injury 5 years ago. They will pay much lower rates and that has already been seen in most of the states complying with the law.

 

The other group that will benefit hugely is the lowest-income group. I think your state may be one of the ones trying to kill that group, but this bill provides a very large increase in funds for Medicaid. Those funds will allow the poorest people in the 30 or so states accepting the funds to actually find medical care other than just by going to an emergency room.

[greg775]

When this law comes into effect next year, Blue Cross will not be able to say "no" to insuring you. In fact, I believe that part of the law has already taken effect, insurers cannot turn you down for insurance entirely based on pre-existing conditions.

 

This law also includes what is called "Community rating". What that means is...an insurer cannot decide your rates based on your individual conditions. They can't decide your rates based on what disease you have. They can only decide your rates based on a few categories: Age, Gender, tobacco usage, and a 4th that I forget.

 

The law states that employers with more than 50 employees will have to pay a penalty if they do not offer insurance as a benefit. Instituting that requirement has already been complex and it has been delayed until the 2015 tax year. Yes, more businesses will have to provide insurance for their employees, but the government already foots a huge portion of the bill for that through the employer-insurance tax credit.

 

This bill benefits a couple groups of people the most. People with pre-existing conditions who could not get health coverage beforehand because of that condition will be able to get care for that condition. People who are self employed or work for a small business will benefit hugely because this bill drastically reforms insurance for people who are buying it on their own, they don't have to deal with being singled out because of an injury 5 years ago. They will pay much lower rates and that has already been seen in most of the states complying with the law.

 

The other group that will benefit hugely is the lowest-income group. I think your state may be one of the ones trying to kill that group, but this bill provides a very large increase in funds for Medicaid. Those funds will allow the poorest people in the 30 or so states accepting the funds to actually find medical care other than just by going to an emergency room.

 

Thanks. Good stuff here.

[greg775]

Please read this column in the University of Kansas student newspaper about this poor kid who can't get coverage, finally has some sort of coverage, where he's at the mercy of the system to get treatment, which in his case is inadequate. We are barbaric in this country now. You read this and tell me what you think of our healthcare system.

My god, we are NOT TAKING CARE OF OUR OWN PEOPLE. This kid can't get treatment.

 

• By Will Webber
• Sep. 19, 2013
• 0 Comments
• udkne.ws/15ExHLq

I'm well aware at this point that the fiscally responsible thing for me to do is die.

 

And I know now that when I was denied coverage by every health insurance company in the nation, it was for the benefit of the American taxpayers. I get sick a lot and it's really expensive to keep me alive.

 

My name is Will and I was born with an immune deficiency. That means my body doesn't protect me from diseases. I was in and out of the hospital all through infancy, and my mom almost didn't graduate because she was taking care of me 24/7. Looking back, I'm really lucky just to be here. I could've died in the womb when my umbilical cord was wrapped around my neck, or possibly from any of my five bouts with pneumonia. But I'm here now and I can say with certainty that I would've been just another dead baby if I were born in a different decade. Nineteen years is a lot to be thankful for.

 

I think all any of us ever wants is to go to bed each night with the knowledge that we'll wake up the next morning and everything will still be there. We want to look into our loved ones' eyes and be confident that they'll always feel the same way. We want to know that we'll be taken care of when everything collapses. That's all insurance is.

 

And I had it, briefly. I had a treatment that worked for me. I didn't worry about going to the hospital again. I woke up in the morning and felt a little bit of control over my life, like I could get out of bed and take on the day.

 

It's not like that now, since I lost my coverage. I set my alarm 30 minutes ahead of when I actually need to get out of bed so I have time to convince myself that it's worth it. It's not always an easy argument when the insurance companies send the message that I'm not worth keeping alive.

 

They wouldn't cover me. And then they wouldn't cover my family if they were in any way linked to me. The only thing I'm allowed is student insurance, and even then, they refused to cover the weekly blood infusions that keep me functioning. I'm getting treated now, but it's on their terms.

 

I honestly don't know what medicine is coursing through my IV from one week to the next. I don't know where I'll get it either – they can send me to a clinic or a hospital across town, regardless of where I am. They don't care when I get it – sometimes even a day's delay can shut my entire body down. I remember when the hospital was closed on the 4th of July, and I just sat on my blanket, praying for the fireworks to end so I could go home and pass out.

 

I've lived the past year at the mercy of the insurance companies. They can do whatever they want with me, and I'll suffer the consequences, the bill and the side effects. I don't have control over any of it. I try to pretend I do, but I have constant reminders that I only wake up each morning because of modern medicine and the people who ration it. One of my lowest moments ended with me covered in tears and Cheerios – my limbs were trembling so severely that I couldn't grip my cereal bowl. That's not control.

 

I wish just one time that my doctor would hesitate before telling me that I'll be like this forever. I wish that my parents never had to worry about outliving me. I wish I could talk about my future with my girlfriend without her voice wavering a little. I wish people would stop doing that little sympathetic double-nod when I tell them I'm gonna live to be 100, the same nod they give me when I say I want to be an anchor for CNN someday. But above all else, I wish people would stop thinking that an inconsequential amount of their tax dollars is in anyway more important than my life, or any other.

 

I could die tomorrow and you might save a little bit on your premium. The taxes on your paycheck might round down a cent. But I don't plan on dying. I've made it this far largely because I'm 19 and my body is strong enough to take daily abuse, but mostly because I have the best support system in the world and my parents can spare thousands of dollars in medical expenses, time-consuming phone calls and arguments with insurance companies.

 

But other people do the fiscally responsible thing and just die.

 

The economy is in a bad place right now, but I think I'd rather be morally responsible instead.

 

Will Webber is a journalism and political science major from Prairie Village. Read more from Will Webber.

Edited September 20, 2013 by greg775

[EvilMonkey]

Please read this column in the University of Kansas student newspaper about this poor kid who can't get coverage, finally has some sort of coverage, where he's at the mercy of the system to get treatment, which in his case is inadequate. We are barbaric in this country now. You read this and tell me what you think of our healthcare system.

My god, we are NOT TAKING CARE OF OUR OWN PEOPLE. This kid can't get treatment.

 

• By Will Webber
• Sep. 19, 2013
• 0 Comments
• udkne.ws/15ExHLq

I'm well aware at this point that the fiscally responsible thing for me to do is die.

 

And I know now that when I was denied coverage by every health insurance company in the nation, it was for the benefit of the American taxpayers. I get sick a lot and it's really expensive to keep me alive.

 

My name is Will and I was born with an immune deficiency. That means my body doesn't protect me from diseases. I was in and out of the hospital all through infancy, and my mom almost didn't graduate because she was taking care of me 24/7. Looking back, I'm really lucky just to be here. I could've died in the womb when my umbilical cord was wrapped around my neck, or possibly from any of my five bouts with pneumonia. But I'm here now and I can say with certainty that I would've been just another dead baby if I were born in a different decade. Nineteen years is a lot to be thankful for.

 

I think all any of us ever wants is to go to bed each night with the knowledge that we'll wake up the next morning and everything will still be there. We want to look into our loved ones' eyes and be confident that they'll always feel the same way. We want to know that we'll be taken care of when everything collapses. That's all insurance is.

 

And I had it, briefly. I had a treatment that worked for me. I didn't worry about going to the hospital again. I woke up in the morning and felt a little bit of control over my life, like I could get out of bed and take on the day.

 

It's not like that now, since I lost my coverage. I set my alarm 30 minutes ahead of when I actually need to get out of bed so I have time to convince myself that it's worth it. It's not always an easy argument when the insurance companies send the message that I'm not worth keeping alive.

 

They wouldn't cover me. And then they wouldn't cover my family if they were in any way linked to me. The only thing I'm allowed is student insurance, and even then, they refused to cover the weekly blood infusions that keep me functioning. I'm getting treated now, but it's on their terms.

 

I honestly don't know what medicine is coursing through my IV from one week to the next. I don't know where I'll get it either – they can send me to a clinic or a hospital across town, regardless of where I am. They don't care when I get it – sometimes even a day's delay can shut my entire body down. I remember when the hospital was closed on the 4th of July, and I just sat on my blanket, praying for the fireworks to end so I could go home and pass out.

 

I've lived the past year at the mercy of the insurance companies. They can do whatever they want with me, and I'll suffer the consequences, the bill and the side effects. I don't have control over any of it. I try to pretend I do, but I have constant reminders that I only wake up each morning because of modern medicine and the people who ration it. One of my lowest moments ended with me covered in tears and Cheerios – my limbs were trembling so severely that I couldn't grip my cereal bowl. That's not control.

 

I wish just one time that my doctor would hesitate before telling me that I'll be like this forever. I wish that my parents never had to worry about outliving me. I wish I could talk about my future with my girlfriend without her voice wavering a little. I wish people would stop doing that little sympathetic double-nod when I tell them I'm gonna live to be 100, the same nod they give me when I say I want to be an anchor for CNN someday. But above all else, I wish people would stop thinking that an inconsequential amount of their tax dollars is in anyway more important than my life, or any other.

 

I could die tomorrow and you might save a little bit on your premium. The taxes on your paycheck might round down a cent. But I don't plan on dying. I've made it this far largely because I'm 19 and my body is strong enough to take daily abuse, but mostly because I have the best support system in the world and my parents can spare thousands of dollars in medical expenses, time-consuming phone calls and arguments with insurance companies.

 

But other people do the fiscally responsible thing and just die.

 

The economy is in a bad place right now, but I think I'd rather be morally responsible instead.

 

Will Webber is a journalism and political science major from Prairie Village. Read more from Will Webber.

I think it is amazing that he was even born alive thanks to modern medicine. He should have been dead a long time ago but thru our medical system he is alive. He even stated it himself, born 20 years earlier or perhaps in a different place, he wouldn't be here at all. It says he lost his coverage. Do we know why?

[greg775]

I think it is amazing that he was even born alive thanks to modern medicine. He should have been dead a long time ago but thru our medical system he is alive. He even stated it himself, born 20 years earlier or perhaps in a different place, he wouldn't be here at all. It says he lost his coverage. Do we know why?

 

No, I was going to email the writer to ask why he lost his coverage. I would think he could be on his parents' plan. I thought it said he might have been dropped. Can they just drop you? My guess is yes.

[Balta1701]

No, I was going to email the writer to ask why he lost his coverage. I would think he could be on his parents' plan. I thought it said he might have been dropped. Can they just drop you? My guess is yes.

A lot would depend on what his parents plan was. If his parents were part of a large employer it would be very difficult for the insurance company to find a way to drop him. However, if his parents were self-employed or worked for a small business, the business might have had to drop him or his parents might have had to buy insurance on their own.

 

Under the previous health system setup, it would have been literally impossible for his parents to buy an individual plan that would cover him unless they were millionaires and many small business plans might have had trouble also because insurers could set the price of insuring their family at enormous levels due to his pre-existing condition. If his parents had to change jobs or lost a job, he could have been in a lot of trouble for that reason; he would be basically uninsurable if his parents were not employed by a large employer with good insurance (a union would have helped a ton).

 

In addition, he might well have also hit the "lifetime cap" on spending from an insurer already (they used to have $1-2 million lifetime caps on many plans; go beyond that and you're SOL).

 

However, most of these things should have changed thanks to this law. Lifetime caps are banned and charging different costs based on pre-existing conditions are also banned. He's not very lucky to be in Kansas since they're not helping, but by January 1 he'll be able to buy some sort of insurance at a reasonable rate on the Obamacare health insurance exchanges.

[greg775]

A lot would depend on what his parents plan was. If his parents were part of a large employer it would be very difficult for the insurance company to find a way to drop him. However, if his parents were self-employed or worked for a small business, the business might have had to drop him or his parents might have had to buy insurance on their own.

 

Under the previous health system setup, it would have been literally impossible for his parents to buy an individual plan that would cover him unless they were millionaires and many small business plans might have had trouble also because insurers could set the price of insuring their family at enormous levels due to his pre-existing condition. If his parents had to change jobs or lost a job, he could have been in a lot of trouble for that reason; he would be basically uninsurable if his parents were not employed by a large employer with good insurance (a union would have helped a ton).

 

In addition, he might well have also hit the "lifetime cap" on spending from an insurer already (they used to have $1-2 million lifetime caps on many plans; go beyond that and you're SOL).

 

However, most of these things should have changed thanks to this law. Lifetime caps are banned and charging different costs based on pre-existing conditions are also banned. He's not very lucky to be in Kansas since they're not helping, but by January 1 he'll be able to buy some sort of insurance at a reasonable rate on the Obamacare health insurance exchanges.

 

Isn't it sad, though, that in our once great country this poor guy can't get consistent treatment, he doesn't even know what they are putting in him from day to day. I think 'barbaric' is the right word of what we've become as a nation. It's sick and sad. I mean we Americans can't be treated effectively for our illnesses?

[Jake]

This is why so many countries with the means don't like to leave healthcare to the markets. The markets don't have morals, for better and for worse. A greater overall economic good can be achieved by stringing kids like this along, allowing them to die if he strains things too much. Only public policy interventions can prevent the injustice that is leaving healthcare (which should be seen as an inalienable right) to market conditions.

 

Of course, even in the most benign of circumstances, the cornerstone of market philosophy is that our desire for a thing is measured by how much we're willing to pay for it. So, in market theory, this young man doesn't want life enough as evidenced by his not paying for it.

[Soxfest]

Obamacare is a disaster.

[EvilMonkey]

This is why so many countries with the means don't like to leave healthcare to the markets. The markets don't have morals, for better and for worse. A greater overall economic good can be achieved by stringing kids like this along, allowing them to die if he strains things too much. Only public policy interventions can prevent the injustice that is leaving healthcare (which should be seen as an inalienable right) to market conditions.

 

Of course, even in the most benign of circumstances, the cornerstone of market philosophy is that our desire for a thing is measured by how much we're willing to pay for it. So, in market theory, this young man doesn't want life enough as evidenced by his not paying for it.

When society as a whole is paying for it, there is still a finite supply. If it takes 25% of the available supply to keep him healthy, and that same 25% can keep 100 other people health, who gets the care? Do you tell the 100 people that they can't get what they need because his care is so extreme and expensive that he has used it all up? Because it will happen. There is only so much money, time and facilities to go around, and those may be shrinking as less people decide to become doctors.