Author Topic: ACA  (Read 26201 times)

0 Members and 1 Guest are viewing this topic.

Offline hefdaddy42

  • Whiskey Bent and Hell Bound
  • Global Moderator
  • *****
  • Posts: 39621
  • Gender: Male
  • RIP Dad 1943-2010
Re: ACA
« Reply #700 on: October 31, 2016, 09:26:03 AM »
It could, in theory, be scrapped, if it is being replaced with some other vehicle to do the job better.

But JUST scrapping it, and letting things just naturally revert to how they used to be, would be an awful, awful idea.

The vehicle is already there, and is providing a lot of good for a lot of people.  The option that makes the most sense to me is to fix the problems.  Or just declare a single payer system, and jettison the entire ACA.

Hef is right on all things. Except for when I disagree with him. In which case he's probably still right.

Offline Tick

  • Cleavage is a drug! Dracula is a junkie
  • DTF.org Member
  • *
  • Posts: 9047
  • Gender: Male
  • We will, we will, Trump you, boom boom, clap!
Re: ACA
« Reply #701 on: October 31, 2016, 09:26:13 AM »
It is a big fucking deal.  Catastrophic is where you need insurance the most, as it can wipe you out completely.
Yeah I get that.
But 650 a month and you cant even use it for normal visits

Which was one of the main talking points for having "more people insured"; so they could GET the normal visits and not have to rely on things like the emergency room for "catastrophic events".   

I don't think it's the end of the republic, and I do think it can either be scrapped or fixed with equivalent results, but I don't think anyone with a straight face can really say that it was a transparent, fair, even-handed application of principles.    It is a political tool as much as it is a health and wellness tool.  It is a wealth redistribution mechanism (for better or worse) and it relies on misleading numbers to show it's efficacy. 

"Number of insured" is, in theory, probably, "better" the higher the number, but it's misleading.  If people aren't using it (or aren't capable of using it) it doesn't matter if they're insured or not.  If costs aren't going to down, it doesn't matter if they're insured or not.   If the government is still subsidizing it, it doesn't matter if they're insured or not.  When you add to that the trick of the "penalty" to coerce people to get insurance that otherwise don't want to, it's a false metric.
YES! You get it! Thank you
Yup. Tick is dead on.  She's not your type.  Move on.   Tick is Obi Wan Kenobi


Offline Tick

  • Cleavage is a drug! Dracula is a junkie
  • DTF.org Member
  • *
  • Posts: 9047
  • Gender: Male
  • We will, we will, Trump you, boom boom, clap!
Re: ACA
« Reply #702 on: October 31, 2016, 09:29:05 AM »


The vehicle is already there, and is providing a lot of good for a lot of people.  The option that makes the most sense to me is to fix the problems. 
Its doing great for poverty level people who don't pay for it. They have good coverage. For people like myself and countless others its awful.
Stadler was spot in in his last post
Yup. Tick is dead on.  She's not your type.  Move on.   Tick is Obi Wan Kenobi


Offline Phoenix87x

  • From the ashes
  • Posts: 4318
  • Gender: Male
  • The Phoenix shall rise
Re: ACA
« Reply #703 on: October 31, 2016, 04:14:41 PM »
Just got my rate for 2017 for independence blue cross

I am 28 and completely healthy. I did not go to the doctor or hospital at all last year. Getting the standard plan, Last year it was $253 a month and next year it is $327 a month, so I no longer can afford this. I was just breaking even with how it was.

Before the Affordable care act, it was was around $150 a month which was affordable , so what the hell is going on.
« Last Edit: October 31, 2016, 04:51:18 PM by Phoenix87x »
All people die, but not many people ever truly live

Offline cramx3

  • Chillest of the chill
  • DTF.org Alumni
  • ****
  • Posts: 13762
  • Gender: Male
    • The Home of cramx3
Re: ACA
« Reply #704 on: October 31, 2016, 04:45:28 PM »


The vehicle is already there, and is providing a lot of good for a lot of people.  The option that makes the most sense to me is to fix the problems. 
Its doing great for poverty level people who don't pay for it. They have good coverage. For people like myself and countless others its awful.
Stadler was spot in in his last post

Depends on the definition of "a lot of people".  I certainly know the ACA has been good for some people, but not entirely sure it's "a lot" at least compared to the entire population.

Offline El Barto

  • DTF.org Alumni
  • ****
  • Posts: 17763
  • Bad Craziness
Re: ACA
« Reply #705 on: October 31, 2016, 04:52:36 PM »
Just got my rate for 2017 for independence blue cross

I am 28 and completely healthy. I did not go to the doctor or hospital at all last year. Getting the standard plan, Last year it was $253 a month and next year it is $327 a month, so I no longer can afford this. I was just breaking even with how it was.

Before the Affordable care act, it was was around $150 a month which was affordable , so what he hell is going on.
If you don't use it, why not buy a cheaper plan? Is that the lowest cost plan in Penn? Also, as state plans increase in cost, so does the amount of the tax credit. Since this is open-enrollment time I'd be reevaluating.
Argument, the presentation of reasonable views, never makes headway against conviction, and conviction takes no part in argument because it knows.
E.F. Benson

Offline Phoenix87x

  • From the ashes
  • Posts: 4318
  • Gender: Male
  • The Phoenix shall rise
Re: ACA
« Reply #706 on: October 31, 2016, 05:52:55 PM »
Just got my rate for 2017 for independence blue cross

I am 28 and completely healthy. I did not go to the doctor or hospital at all last year. Getting the standard plan, Last year it was $253 a month and next year it is $327 a month, so I no longer can afford this. I was just breaking even with how it was.

Before the Affordable care act, it was was around $150 a month which was affordable , so what he hell is going on.
If you don't use it, why not buy a cheaper plan? Is that the lowest cost plan in Penn? Also, as state plans increase in cost, so does the amount of the tax credit. Since this is open-enrollment time I'd be reevaluating.

This is the cheapest plan available for me to purchase



Nothing is covered until I hit the deductible. So If I were to actually need to go to the ED, unless its over $7,150 then I basically don't have insurance since I am paying for the cost of care.

The next cheapest is $284 with nothing being covered until $6000 dollar deductible, so I still am paying out of pocket if I actually need care, short of something costing $6,000.



I have 3 grand to my name and I am limping to the finish line of graduating in May and then I go on my employers, thank god, but I don't know how I would have handled this otherwise. I am just getting the cheapest one to hold me over until May. 

Still, before the affordable care act, I could afford healthcare and it was a decent plan.
All people die, but not many people ever truly live

Offline cramx3

  • Chillest of the chill
  • DTF.org Alumni
  • ****
  • Posts: 13762
  • Gender: Male
    • The Home of cramx3
Re: ACA
« Reply #707 on: October 31, 2016, 05:58:35 PM »
Those deductibles  :omg:

Offline El Barto

  • DTF.org Alumni
  • ****
  • Posts: 17763
  • Bad Craziness
Re: ACA
« Reply #708 on: October 31, 2016, 06:01:37 PM »
Those aren't showing a tax credit. Are you ineligible for some reason? And if you have no income, didn't Penn expand their medicaid?
Argument, the presentation of reasonable views, never makes headway against conviction, and conviction takes no part in argument because it knows.
E.F. Benson

Offline Phoenix87x

  • From the ashes
  • Posts: 4318
  • Gender: Male
  • The Phoenix shall rise
Re: ACA
« Reply #709 on: October 31, 2016, 06:45:40 PM »
Those aren't showing a tax credit. Are you ineligible for some reason? And if you have no income, didn't Penn expand their medicaid?

I will look into the tax credit and medicaid.
All people die, but not many people ever truly live

Offline Skeever

  • Posts: 1013
Re: ACA
« Reply #710 on: October 31, 2016, 07:14:19 PM »
Also being south of 30, if that happened to me I'd go catastrophic or without and just put my faith in the CVS minute clinic.

Offline PowerSlave

  • Posts: 1127
Re: ACA
« Reply #711 on: November 15, 2016, 05:16:30 AM »
http://www.latimes.com/business/hiltzik/la-fi-hiltzik-insurance-state-lines-20161114-story.html

Any thoughts on this article? I'll admit that I'm weak in my knowledge of this kind of stuff.
Thankee-sai

Offline Tick

  • Cleavage is a drug! Dracula is a junkie
  • DTF.org Member
  • *
  • Posts: 9047
  • Gender: Male
  • We will, we will, Trump you, boom boom, clap!
Re: ACA
« Reply #712 on: November 15, 2016, 06:24:19 AM »
Also being south of 30, if that happened to me I'd go catastrophic or without and just put my faith in the CVS minute clinic.
Go health care! Yay!
Yup. Tick is dead on.  She's not your type.  Move on.   Tick is Obi Wan Kenobi


Offline Stadler

  • DTF.org Alumni
  • ****
  • Posts: 7326
  • Gender: Male
Re: ACA
« Reply #713 on: November 15, 2016, 08:06:54 AM »
http://www.latimes.com/business/hiltzik/la-fi-hiltzik-insurance-state-lines-20161114-story.html

Any thoughts on this article? I'll admit that I'm weak in my knowledge of this kind of stuff.

Well, any article that contains the phrase "as put forth by Republicans" and "as argued by Republicans" as many times as that one has to be taken with a grain of salt.   But I've run that idea by a senior executive (officer) of a major insurance provider, and he called bullshit on a lot of those complaints.  Not all of it, but a lot of it.   The one thing that it will do - the article didn't say this, but implied it - is demand a higher level of engagement from the individual buying the insurance.   As a Libertarian, I have no problem with that.  If you're one of those that thinks that even though I signed the loan documents that government should come in and absolve me of my responsibilities for commitments I made of my own free will and sound mind, well, then, you may not. 

It's a commercial transaction in that sense; if I live in CT, and I buy the cheapest plan out of TX, that's part of the bargain.  If I want something more robust and local, I can do that.  It's about CHOICE for the consumer, instead of having it crammed down our throats.   I'm the guy that puts together spreadsheets for the next TV or car I'm going to buy.  My HEALTHCARE (arguably the most important thing I pay for outside of my house)?   Clicking radio boxes "Yes" or "No" on a corporate website.

Offline El Barto

  • DTF.org Alumni
  • ****
  • Posts: 17763
  • Bad Craziness
Re: ACA
« Reply #714 on: November 15, 2016, 08:36:53 AM »
Seems to me that's it's only a problem if you're ethically unopposed to letting stupid people get suckered. We seem to have weirdly nebulous values in that regard.

And then there's this: https://youtu.be/kO2R_DDZPCM?t=36

On NPR they were discussing the possible death spiral of the private insurance game if Trump tries to keep the good parts of ACA without the bad parts. Seems pretty conceivable, if not even obvious, to me. He wants to keep the Pre-Existing Condition Mandate but dump the subsidies. What the anti-ACA never understood was that it was the PECM that was hurting those wonderful people at Aetna's bottom line. They weren't pulling out of markets because that awful ole Obama was paying them to cover poor people. They were leaving because it cost to much to insure the sick. If Trump tries to keep in place the PECM without helping to fund it, which seems to be his desire, the insurance companies are going to continue to raise rates every year, they'll have no choice, and Tick will continue to scream and holler about Obama. Since they'll no longer be required to have insurance he and others like him will simply dump their insurance, and once you remove the healthy people from the pool the bottom drops out.

I'd love to hear ideas about how to have and eat cake, but I'm not seeing or hearing any. Honestly, it seems like another of Trump's magical plans that are just supposed to work despite the fact that they can't.
Argument, the presentation of reasonable views, never makes headway against conviction, and conviction takes no part in argument because it knows.
E.F. Benson

Offline Stadler

  • DTF.org Alumni
  • ****
  • Posts: 7326
  • Gender: Male
Re: ACA
« Reply #715 on: November 15, 2016, 09:25:33 AM »
Seems to me that's it's only a problem if you're ethically unopposed to letting stupid people get suckered. We seem to have weirdly nebulous values in that regard.

And then there's this: https://youtu.be/kO2R_DDZPCM?t=36

On NPR they were discussing the possible death spiral of the private insurance game if Trump tries to keep the good parts of ACA without the bad parts. Seems pretty conceivable, if not even obvious, to me. He wants to keep the Pre-Existing Condition Mandate but dump the subsidies. What the anti-ACA never understood was that it was the PECM that was hurting those wonderful people at Aetna's bottom line. They weren't pulling out of markets because that awful ole Obama was paying them to cover poor people. They were leaving because it cost to much to insure the sick. If Trump tries to keep in place the PECM without helping to fund it, which seems to be his desire, the insurance companies are going to continue to raise rates every year, they'll have no choice, and Tick will continue to scream and holler about Obama. Since they'll no longer be required to have insurance he and others like him will simply dump their insurance, and once you remove the healthy people from the pool the bottom drops out.

I'd love to hear ideas about how to have and eat cake, but I'm not seeing or hearing any. Honestly, it seems like another of Trump's magical plans that are just supposed to work despite the fact that they can't.

I don't think that it's quite that clear.   PEC isn't bad in and of itself; the ACA also said that insurers couldn't underwrite it's population.  So not only are the insurers forced to take the entire population, but they can't price it.   The fear is that pricing it the prices will go through the roof, but that fails on logical and economic grounds:  if I can't ACCURATELY price something, I'm going to put a price out there with a factor of safety.  Removal of state lines works in that regard:  if I'm CIGNA, I can now consolidate that business in Texas and California, and offset those risks. 

I think the thing that many don't realize is that there are two factors here:  COST and UNCERTAINTY.  Cost can be high or low, and uncertainty can be high or low.   For many businesses, high cost/low uncertainty is better than low cost/high uncertainty.   For most consumers, low cost/high uncertainty is better than high cost/low uncertainty, and that's exacerbated when subsidies and yearly caps are put into place.   That's a MASSIVE disconnect.  Obama sought to fix that with the subsidy portion of the scheme.  It can be handled in other ways - without putting it on the consumer - but you have to let it happen.   The ACA doesn't do that, and it's one of it's major failings. 

Offline El Barto

  • DTF.org Alumni
  • ****
  • Posts: 17763
  • Bad Craziness
Re: ACA
« Reply #716 on: November 15, 2016, 09:39:14 AM »
Seems to me that it didn't fail on logical ground when it was actually happening in the real world. Underwriting the sick was how it worked, at least in Tejas, before ACA. Rates rose for the healthy people just as a matter of economics, and the sick were priced stupidly high. There was no uncertainty. There was just the business of making money by selling people healthcare coverage.
Argument, the presentation of reasonable views, never makes headway against conviction, and conviction takes no part in argument because it knows.
E.F. Benson

Offline mikeyd23

  • Posts: 3141
  • Gender: Male
Re: ACA
« Reply #717 on: November 29, 2016, 08:51:31 AM »
So Trump named Congressman Tom Price as Health and Human Services Secretary. Price is a Congressman from Georgia and also an orthopedic surgeon. He has previously developed a plan to repeal and replace Obamacare. Many of the ideas that Paul Ryan has put forth and also some of the talking points Trump hit on during the campaign are included in Price's plan.

Here is the press release Price made when announcing this previously:
https://tomprice.house.gov/HR2300

The full plan for those who care to read over 200 pages:
http://tomprice.house.gov/sites/tomprice.house.gov/files/HR%202300%20Empowering%20Patients%20First%20Act%202015.pdf

For those who don't here is a brief, 11 page summary:
http://tomprice.house.gov/sites/tomprice.house.gov/files/Section%20by%20Section%20of%20HR%202300%20Empowering%20Patients%20First%20Act%202015.pdf

It obviously seems that this move by Trump is to leverage this previous work by Price, who has put forth the most detailed repeal and replace plan, to do just that.... Thoughts?

Offline El Barto

  • DTF.org Alumni
  • ****
  • Posts: 17763
  • Bad Craziness
Re: ACA
« Reply #718 on: November 29, 2016, 09:18:39 AM »
So Trump named Congressman Tom Price as Health and Human Services Secretary. Price is a Congressman from Georgia and also an orthopedic surgeon. He has previously developed a plan to repeal and replace Obamacare. Many of the ideas that Paul Ryan has put forth and also some of the talking points Trump hit on during the campaign are included in Price's plan.

Here is the press release Price made when announcing this previously:
https://tomprice.house.gov/HR2300

The full plan for those who care to read over 200 pages:
http://tomprice.house.gov/sites/tomprice.house.gov/files/HR%202300%20Empowering%20Patients%20First%20Act%202015.pdf

For those who don't here is a brief, 11 page summary:
http://tomprice.house.gov/sites/tomprice.house.gov/files/Section%20by%20Section%20of%20HR%202300%20Empowering%20Patients%20First%20Act%202015.pdf

It obviously seems that this move by Trump is to leverage this previous work by Price, who has put forth the most detailed repeal and replace plan, to do just that.... Thoughts?
Looks like 2010 to me. With the exception that people who can afford to prepay will get a tax break. As for me, if we go back to the age of high-risk pools I have no idea what I'll do. I'm pretty sure it won't involve living in Texas an longer, though. I've first hand experience with Texas's risk pool insurance and I can't afford to purchase it or carry it.
Argument, the presentation of reasonable views, never makes headway against conviction, and conviction takes no part in argument because it knows.
E.F. Benson

Offline Stadler

  • DTF.org Alumni
  • ****
  • Posts: 7326
  • Gender: Male
Re: ACA
« Reply #719 on: November 29, 2016, 10:51:45 AM »
Seems to me that it didn't fail on logical ground when it was actually happening in the real world. Underwriting the sick was how it worked, at least in Tejas, before ACA. Rates rose for the healthy people just as a matter of economics, and the sick were priced stupidly high. There was no uncertainty. There was just the business of making money by selling people healthcare coverage.

Sorry, I missed this the last time; the answer, though is somewhere in between.  TAKE the sick in, make it so that there are caps on what you can charge the sick, but don't make the insurers guess on what the burden of the sick will really be.   Meaning, accept that we will distribute costs, but know what the costs ARE.   Assuming I'm 100% healthy (and unfortunately, I'm hitting that age where it's not "100%" anymore) I don't mind paying for YOUR care, what I mind is paying for the risk margins that the insurers arbitrarily put on the costs so they don't lose their shirts because they can't accurately account for what YOUR care will be.

(Sorry if it seems like I'm making this personal; I'm not). 

Offline El Barto

  • DTF.org Alumni
  • ****
  • Posts: 17763
  • Bad Craziness
Re: ACA
« Reply #720 on: November 29, 2016, 12:55:53 PM »
Seems to me that it didn't fail on logical ground when it was actually happening in the real world. Underwriting the sick was how it worked, at least in Tejas, before ACA. Rates rose for the healthy people just as a matter of economics, and the sick were priced stupidly high. There was no uncertainty. There was just the business of making money by selling people healthcare coverage.

Sorry, I missed this the last time; the answer, though is somewhere in between.  TAKE the sick in, make it so that there are caps on what you can charge the sick, but don't make the insurers guess on what the burden of the sick will really be.   Meaning, accept that we will distribute costs, but know what the costs ARE.   Assuming I'm 100% healthy (and unfortunately, I'm hitting that age where it's not "100%" anymore) I don't mind paying for YOUR care, what I mind is paying for the risk margins that the insurers arbitrarily put on the costs so they don't lose their shirts because they can't accurately account for what YOUR care will be.

(Sorry if it seems like I'm making this personal; I'm not).
Where was this uncertainty? Aetna's been insuring people for 200 years, so the costs shouldn't be a mystery to them, and they negotiate costs with the providers going in.
Argument, the presentation of reasonable views, never makes headway against conviction, and conviction takes no part in argument because it knows.
E.F. Benson

Offline Stadler

  • DTF.org Alumni
  • ****
  • Posts: 7326
  • Gender: Male
Re: ACA
« Reply #721 on: November 30, 2016, 08:55:29 AM »
Seems to me that it didn't fail on logical ground when it was actually happening in the real world. Underwriting the sick was how it worked, at least in Tejas, before ACA. Rates rose for the healthy people just as a matter of economics, and the sick were priced stupidly high. There was no uncertainty. There was just the business of making money by selling people healthcare coverage.

Sorry, I missed this the last time; the answer, though is somewhere in between.  TAKE the sick in, make it so that there are caps on what you can charge the sick, but don't make the insurers guess on what the burden of the sick will really be.   Meaning, accept that we will distribute costs, but know what the costs ARE.   Assuming I'm 100% healthy (and unfortunately, I'm hitting that age where it's not "100%" anymore) I don't mind paying for YOUR care, what I mind is paying for the risk margins that the insurers arbitrarily put on the costs so they don't lose their shirts because they can't accurately account for what YOUR care will be.

(Sorry if it seems like I'm making this personal; I'm not).
Where was this uncertainty? Aetna's been insuring people for 200 years, so the costs shouldn't be a mystery to them, and they negotiate costs with the providers going in.

Sure, they know if they have a case of THIS it is one million dollars on average, and if they have a case of THAT it's on average $250,000, but they don't know if they have one, two, or five of those in this population.  They can only go on demographic data, and we all know how that works out when you take the macro and bring it to the micro. 

Offline El Barto

  • DTF.org Alumni
  • ****
  • Posts: 17763
  • Bad Craziness
Re: ACA
« Reply #722 on: November 30, 2016, 08:59:33 AM »
A. I'm not sure how that can ever change, why it's different under ACA, and why it would be different than pre- or post- ACA. B. They're fucking insurers. It's their job to make that determination, just like Sir Edward Lloyed was doing in his coffee shop in 1688.
Argument, the presentation of reasonable views, never makes headway against conviction, and conviction takes no part in argument because it knows.
E.F. Benson

Offline PowerSlave

  • Posts: 1127
Re: ACA
« Reply #723 on: December 02, 2016, 01:31:59 AM »
http://www.bbc.com/news/world-australia-38153254?utm_source=fark&utm_medium=website&utm_content=link&ICID=ref_fark

Not directly related to the main topic, but an interesting little read. Probably relevant to the discussion if you consider over-all health care costs.
Thankee-sai