OBAMA/TRUMPCARE MEGATHREAD

[Y2HH]

I work for one of the largest employers in the world. Our group health plan does not depend on how much you make. I've honestly never heard of that anywhere.

 

You are, oddly, arguing in favor of socialism here. You're arguing for progressive pricing for the same service based on your income level.

 

I work for BCBS, as you probably know...and it works like that for us.

 

There are 5 tiers of costs for the same exact plans, all based on how much you make. The more you make, the larger share you pay per month.

[StrangeSox]

These cost controls are only benefiting those on Medicare, which while good, doesn't help anyone else, as they simply shift the cost down. If Medicare patients pay less for Drug X, you and I make up the difference by paying that much more for Drug X.

 

These cost savings haven't materialized like people keep saying.

 

How do other countries keep their costs drastically lower than ours?

 

Why shouldn't I believe the CBO reports that cost growth has slowed?

[Balta1701]

And merely shifted elsewhere.

 

These reports are smoke and mirrors.

 

The same amount of money is going into that sector, whether less is coming from Medicare and more is coming from elsewhere, it doesn't matter.

And again...if "The same amount of money is going into that sector" and 25 million additional people get basic health insurance...then the results are spectacular because we've taken the wasted money going in and turned it into productive health care outcomes....productive enough that the spending on the program which covers everyone in the country when they reach a certain age is already seeing big cost improvements.

[Jenksismyhero]

Well first of all, I think I meant pre-PPACA.

 

Second, if what you are saying is true... then before PPACA, those costs were NOT going to the taxpayers. The hospitals had to take them as collection items like any other business does, try to recover as much as they can, and write off the rest. But now with PPACA, the hospital can pass that cost onto Medicaid, or just keep doing the same thing?

 

So in other words, for states that TOOK the expansion, we are now charging the taxpayers, when we weren't before? And for the other states, we will continue to NOT pass it on to the taxpayers?

 

If that person was poor enough to be covered under Medicaid, they have employees at hospitals who literally fill out the paperwork so the hospital/clinic can ask the state for the money. They'll get paid 30 cents on the dollar, but it's something.

 

Of course, chances are that person who doesn't have insurance is going to be taken to a public health facility anyway, which means it's paid for out of our pockets whether they can pay or not.

[Y2HH]

How do other countries keep their costs drastically lower than ours?

 

Why shouldn't I believe the CBO reports that cost growth has slowed?

 

The CBO report isn't a lie, per-say, but it's cherry picked.

 

Are you on Medicare?

 

No.

 

So that report means f*** all to you. Yes, less money is flowing into that Health and Services sector from Medicare, HOWEVER, the same amount of GDP is still flowing into that sector, it's just coming from other areas now...like you and I.

[StrangeSox]

I work for BCBS, as you probably know...and it works like that for us.

 

There are 5 tiers of costs for the same exact plans, all based on how much you make. The more you make, the larger share you pay per month.

 

Is the actual plan pricing different, or is the portion covered by your employer different? I was taking Jenks' proposal and what he said about his plan to mean that the plan cost itself would change based on your income, not the benefits package you receive from your employer.

[Y2HH]

And again...if "The same amount of money is going into that sector" and 25 million additional people get basic health insurance...then the results are spectacular because we've taken the wasted money going in and turned it into productive health care outcomes....productive enough that the spending on the program which covers everyone in the country when they reach a certain age is already seeing big cost improvements.

 

No.

 

The same amount of money is flowing into it WITHOUT those added 25 million.

 

They will increase the amount going into it, by a lot.

 

Which is why insurance and health care companies stock prices have all skyrocketed, along with their revenues.

 

If the opposite was actually true, their stocks would be tanking right now.

 

But that isn't happening.

[Jenksismyhero]

 

 

The effect, seemingly, will be a large stimulus.

 

Didn't we just discuss how this claim is bulls***? And that some people who have an employer-sponsored plan are having options taken away, and price may go up?

[Balta1701]

The CBO report isn't a lie, per-say, but it's cherry picked.

 

Are you on Medicare?

 

No.

 

So that report means f*** all to you. Yes, less money is flowing into that Health and Services sector from Medicare, HOWEVER, the same amount of GDP is still flowing into that sector, it's just coming from other areas now...like you and I.

Let's be 100% clear what you're saying though.

 

Everyone in the country is covered by Medicare once they reach a certain age.

 

If the amount being spent by Medicare is actually dropping...that means that Medicare is either refusing more procedures or is spending less per patient already.

 

Although Medicare should be refusing more procedures (the IPAB, if it ever gets off the ground, should be doing exactly that based on science), that part of the bill has yet to take effect. The only ways for Medicare to be saving money already are either; the average person turning 65 is already healthier or the rate of cost growth has actually slowed.

 

The results actually are in the 2nd...costs are actually growing at a rate less than predicted prior to passage of the PPACA.

[StrangeSox]

No.

 

The same amount of money is flowing into it WITHOUT those added 25 million.

 

They will increase the amount going into it, by a lot.

 

Which is why insurance and health care companies stock prices have all skyrocketed, along with their revenues.

 

If the opposite was actually true, their stocks would be tanking right now.

 

But that isn't happening.

 

Wait, so this wasn't a socialist scheme from the Marxist Kenyan Obummer to destroy the free market and have the government agents take over my healthcare with death panels?!!

 

That's why a lot of people on the left dislike ACA, actually.

[StrangeSox]

Didn't we just discuss how this claim is bulls***? And that some people who have an employer-sponsored plan are having options taken away, and price may go up?

No, I think we saw some assertions that it was bulls***?

[Jenksismyhero]

I think his basic point is, is that if they're being heavily subsidized to buy this insurance, we're still paying for their bills anyway.

 

Perhaps this is a better method of doing so, but in the end, it's still being paid by the taxpayer.

 

Yep. We shifted the pile of money from one place to the next. At a significant cost.

[Y2HH]

Is the actual plan pricing different, or is the portion covered by your employer different? I was taking Jenks' proposal and what he said about his plan to mean that the plan cost itself would change based on your income, not the benefits package you receive from your employer.

 

Portion covered by the employer.

 

For example, those making less than 35,000$ at my company would pay 87$ a month for the HMO family coverage, where as I pay more than 400.

 

It's broken into tiers.

 

35,001-50,000

50,001-75,000

etc...

 

The higher the tier you are in, the more you pay.

 

This isn't unlike subsidizing insurance in the ACA, I subsidize employees at my company that make less than me. And I'm ok with doing that. If more companies did this, they'd be able to give employees better care.

 

But if your company is charging the same price for insurance for the CEO as the janitor...well...that's why we need the ACA in the first place, to basically force this system.

Edited November 1, 2013 by Y2HH

[Balta1701]

Didn't we just discuss how this claim is bulls***? And that some people who have an employer-sponsored plan are having options taken away, and price may go up?

You're 100% right..."Some people" will see their plans change. However, it continues to be a small minority - and it is again offset by people who will spend less because they have also received improved coverage.

[StrangeSox]

Let's be 100% clear what you're saying though.

 

Everyone in the country is covered by Medicare once they reach a certain age.

 

If the amount being spent by Medicare is actually dropping...that means that Medicare is either refusing more procedures or is spending less per patient already.

 

Although Medicare should be refusing more procedures (the IPAB, if it ever gets off the ground, should be doing exactly that based on science), that part of the bill has yet to take effect. The only ways for Medicare to be saving money already are either; the average person turning 65 is already healthier or the rate of cost growth has actually slowed.

 

The results actually are in the 2nd...costs are actually growing at a rate less than predicted prior to passage of the PPACA.

 

Okay, but what Y2HH is saying (and I'd be curious to see some background to support it) is that the reduced Medicare costs are just being shifted into increased costs for private insurance patients, so the net effect is a transfer from the young(er) to the older.

[Balta1701]

No.

 

The same amount of money is flowing into it WITHOUT those added 25 million.

 

They will increase the amount going into it, by a lot.

 

Which is why insurance and health care companies stock prices have all skyrocketed, along with their revenues.

 

If the opposite was actually true, their stocks would be tanking right now.

 

But that isn't happening.

Then where do you come up with the claim that the Medicare cost decreases aren't significant? Because that's where the money is coming from to pay for those extra people.

[StrangeSox]

Yep. We shifted the pile of money from one place to the next. At a significant cost.

And millions of people at a minimum getting affordable health care access through the Medicaid expansion.

[Balta1701]

Okay, but what Y2HH is saying (and I'd be curious to see some background to support it) is that the reduced Medicare costs are just being shifted into increased costs for private insurance patients, so the net effect is a transfer from the young(er) to the older.

This is 100% true - that's where those savings are being put.

 

But the end result is 25 million people getting extra coverage thanks to those savings.

[Jenksismyhero]

I have to point out, again, that this is a pretty odd view of why people frequently need health care. It's not irresponsibility or moral failures that make you predisposed to getting cancer or catching the flu or just needing routine health care.

 

No, it's not totally. But my point was we should be designing a system whereby if you do choose to do those things (smoking, drinking excessively, eating horribly) and develop the known associated illnesses because of it, in general sense, I don't agree that the rest of society should just pick up the tab.

 

We have excise taxes on those types of things, why can't we do the same when it comes to healthcare? In fact, don't we already? Especially with smoking?

[StrangeSox]

This is 100% true - that's where those savings are being put.

 

But the end result is 25 million people getting extra coverage thanks to those savings.

 

But part of the goal was to bend the overall healthcare cost curve, not just for Medicare(aid). Otherwise we'll end up with 40% of our economy being healthcare in a few decades.

[Y2HH]

Then where do you come up with the claim that the Medicare cost decreases aren't significant? Because that's where the money is coming from to pay for those extra people.

 

I'm not claiming that.

 

Medicare cost decreases ARE significant.

 

But these cost decreases are simply getting shifted elsewhere...

 

If word got out that a trillion dollars was being lopped off of the medical industry, their stock prices wouldn't be skyrocketing.

 

The money is still flowing in, it's just not coming from Medicare patents anymore. But, it IS coming from somewhere.

[StrangeSox]

No, it's not totally. But my point was we should be designing a system whereby if you do choose to do those things (smoking, drinking excessively, eating horribly) and develop the known associated illnesses because of it, in general sense, I don't agree that the rest of society should just pick up the tab.

 

We have excise taxes on those types of things, why can't we do the same when it comes to healthcare? In fact, don't we already? Especially with smoking?

 

Smoking is specifically excluded from the community rating requirements, so yea you can be charged more for that.

[Jenksismyhero]

I work for one of the largest employers in the world. Our group health plan does not depend on how much you make. I've honestly never heard of that anywhere.

 

You are, oddly, arguing in favor of socialism here. You're arguing for progressive pricing for the same service based on your income level.

 

Really? Every employee pays the exact same rate? The CEO making 5 million a year pays the same as the mail clerk making 15/hour?

 

 

[Y2HH]

This is 100% true - that's where those savings are being put.

 

But the end result is 25 million people getting extra coverage thanks to those savings.

 

And I really don't have an issue with this.

 

Most of us here that have better jobs probably have no issue paying a bit more for insurance to help others, I know mine went up, but I don't care. I'm happy to help in this regard.

 

I don't have an issue with the ACA in it's intent. I have an issue that I feel they stopped short by NOT going after cost controls.

 

Someone asked how foreign governments do this, and that's exactly how they do it...they actually set costs based on a number of factors. We also do this, but ONLY for Medicare/Medicaid patients. The rest are left to fend for themselves...which sucks.

[southsider2k5]

I work for one of the largest employers in the world. Our group health plan does not depend on how much you make. I've honestly never heard of that anywhere.

 

You are, oddly, arguing in favor of socialism here. You're arguing for progressive pricing for the same service based on your income level.

 

You are arguing against the governments plan. By providing subsidies to people, they are pushing their costs down, and increasing costs as you go up income level.