The Sad Case of the Patient Protection and Affordable Care Act

[amherstblackbear]

Re: The Sad Case of the Patient Protection and Affordable Care Act

It's too bad that health insurance in this country developed so closely with employment. I have to think we'd have a better chance of real reform if it had always been an individual purchase. As it is, current health care debates remind me of the Lewis Black line

instead of writing it, I'll just link (nsfw language)

[Wol4ine]

Re: The Sad Case of the Patient Protection and Affordable Care Act

I'm getting a kick out of the numerous people planning to just drop their insurance and pay the penalty because "it's cheaper."

Well, A) You could do that now and not pay anything at all. 2) Enjoy crushing debt when your good luck in health runs out.

I mean, I understand being upset, but the 2016 candidate of the Republican party is only getting billionaire money because everyone else is going to be bankrupt from medical bills because they dropped their insurance to prove that the government can't make them.

The other thing that many don't seem to understand is that the penalty may be less than the premium "now'. But in a few years after the program is securely in place the penalty will skyrocket. This will have 2 effects; A) Companies will drop coverage now and those employees will get gov't ins. Private insurance companies will lose business since costs will go up having to cover pre-existing conditions. B) As mentioned, the gov't will then be the only option for insurance, and it will be expensive. Obamacare will save money only after someone shows me the cost of health care decreasing.

[bronconick]

Re: The Sad Case of the Patient Protection and Affordable Care Act

You're forgetting one important caveat to why people are choosing to drop coverage: According to the PPACA, a person cannot be denied insurance on account of health status. When the "good luck in health runs out", that is when they will get the "insurance". Once they've gotten better, instead of continuing to pay the premiums, they'll simply drop the coverage, thereby passing the burden to those that continue to get insurance. From what I described, there is absolutely no government collection at all; the only way the government is involved is by regulation.

Eventually, premiums will go so high that the insurance companies will lose so many customers that they'll have to go out of business, thereby destroying the government corporation's competition, and creating a monopoly.

Perhaps the government should be sued under the Clayton Antitrust Act.

I now have a mental image of a guy on his smart phone frantically trying to sign up for some kind of insurance before he gets admitted to ER.

[Kepler]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Eventually, premiums will go so high that the insurance companies will lose so many customers that they'll have to go out of business, thereby destroying the government corporation's competition, and creating a monopoly.

This must be why the insurance companies lobbied so hard for this legislation, which they mostly wrote.

But you know more than they do about their business.

[5mn_Major]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Seems like most Republicans do not approve of the ruling...even as most here seem to agree with Roberts/majority pov:

Friday's poll from USA Today/Gallup showed 46% of Americans agree with the court's ruling, with 46% saying they disagree. Opinions were predictably split along party lines: 79% of self-identified Democrats agreed with the decision to uphold the president's law, while 83% of Republicans disagreed with the ruling.

[Rover]

Re: The Sad Case of the Patient Protection and Affordable Care Act

The other thing that many don't seem to understand is that the penalty may be less than the premium "now'. But in a few years after the program is securely in place the penalty will skyrocket. This will have 2 effects; A) Companies will drop coverage now and those employees will get gov't ins. Private insurance companies will lose business since costs will go up having to cover pre-existing conditions. B) As mentioned, the gov't will then be the only option for insurance, and it will be expensive. Obamacare will save money only after someone shows me the cost of health care decreasing.

Why hasn't this happened already in Massachusetts? Focusing specifically on the point of employers dropping coverage and insurers not being able to do business in the state. Its been 6 years already.

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

This must be why the insurance companies lobbied so hard for this legislation, which they mostly wrote.

But you know more than they do about their business.

They lobbied for it because of the mandate, assuming that people would be forced to buy. Since it was made clear that people cannot be forced to buy, but a tax may be issued to pay for care (and I don't think we've heard the last of the arguments regarding the tax, either), it put a thorn in the insurance companies.

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Seems like most Republicans do not approve of the ruling...even as most here seem to agree with Roberts/majority pov:

Friday's poll from USA Today/Gallup showed 46% of Americans agree with the court's ruling, with 46% saying they disagree. Opinions were predictably split along party lines: 79% of self-identified Democrats agreed with the decision to uphold the president's law, while 83% of Republicans disagreed with the ruling.

Maybe it's because we aren't "Republicans".

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Why hasn't this happened already in Massachusetts? Focusing specifically on the point of employers dropping coverage and insurers not being able to do business in the state. Its been 6 years already.

Probably because insurance companies are still able to deny care on account of health status.

[Rover]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Probably because insurance companies are still able to deny care on account of health status.

What does that have to do with employers dumping people onto the state system? Wouldn't they dump their employees coverage regardless of how healthy they are as its cheaper to have the state insure?

I'll give you a few minutes to franctically check The Drudge Report before you get back to me on this one.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

With the mandate overthrown, and the incentive to purchase insurance now clearly identified as a tax, the law cannot work. If people try to skate on coverage and then require ER treatment, even if insurers (starting in 2014) can no longer deny people coverage based on "pre-existing" conditions, they still will not offer retroactive coverage, so the use of ER as backup "insurer" still produces uncompensated care. Without the mandate, if the tax has to increase, good luck, now it is a huge political debate.

It's such an easy fix, too, just a few tweaks that should have been included from the outset: you have a national open enrollment window, during which time period the insurers accept all comers except identified "high-risk pool" candidates who are handled separately. Once the window closes, you have to qualify to be accepted, until the next window opens. Allow a super-stripped down policy with basic coverage available across state lines as one option, and drop the "community rating" provisions: allow insurers to price risk based on morbidity within certain ranges.

What is most needed, above any other thing, is that the person who buys healthcare services have clear and direct price signals from the market. Most people today have no idea what any of their health care actually costs, we pay our co-pay and the insurance company pays the rest. That is why the cost keeps escalating.

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

With the mandate overthrown, and the incentive to purchase insurance now clearly identified as a tax, the law cannot work. If people try to skate on coverage and then require ER treatment, even if insurers (starting in 2014) can no longer deny people coverage based on "pre-existing" conditions, they still will not offer retroactive coverage, so the use of ER as backup "insurer" still produces uncompensated care. Without the mandate, if the tax has to increase, good luck, now it is a huge political debate.

It's such an easy fix, too, just a few tweaks that should have been included from the outset: you have a national open enrollment window, during which time period the insurers accept all comers except identified "high-risk pool" candidates who are handled separately. Once the window closes, you have to qualify to be accepted, until the next window opens. Allow a super-stripped down policy with basic coverage available across state lines as one option, and drop the "community rating" provisions: allow insurers to price risk based on morbidity within certain ranges.

What is most needed, above any other thing, is that the person who buys healthcare services have clear and direct price signals from the market. Most people today have no idea what any of their health care actually costs, we pay our co-pay and the insurance company pays the rest. That is why the cost keeps escalating.

So basically the governmental corporation is taking over their competition and telling them what they can and cannot do? Good luck with that one.

[Kepler]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Seems like most Republicans do not approve of the ruling...even as most here seem to agree with Roberts/majority pov:

Friday's poll from USA Today/Gallup showed 46% of Americans agree with the court's ruling, with 46% saying they disagree. Opinions were predictably split along party lines: 79% of self-identified Democrats agreed with the decision to uphold the president's law, while 83% of Republicans disagreed with the ruling.

The best part of this is that overnight every American became a Constitutional Law professor.

Asking people "is Obamacare Constitutional?" is like asking people "is nuclear power safe?" 99.99% of the people with an opinion on the topic are completely incompetent to give an answer, regardless of how strong their belief is.

It's one thing to ask people, "are you in favor of this law?" That's well within their expertise, since everybody is entitled to his opinion. But they shouldn't even ask people "as you in favor of this ruling?" That's just asking them "who did you watch today, Sean Hannity or John Stewart?"

[Rover]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Far be it from me to call into question the wisdom of the chattering class out there, but this polling always seems to miss a key point.

As I've seen, there's a roughly 50% against/35% for/15% don't give a s h i t breakdown of Obamacare pre-Roberts. The missing point is of that 50%, about 15% of it is people who think it isn't liberal enough. Given the recent court ruling, I'm wondering if some of those 15% are coming home as they realize just how close the whole thing game to being thrown out. Regardless, its not 50% dying to out the O over healthcare. Its the usual 35% who raise objections when he celebrates his birthday and are still bugging the h e ll out of the Hawaii Vital Records office.

[dxmnkd316]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Serious question:

You can't deny coverage for preexisting conditions. Can an insurer deny you for their top tier insurance that has say 90% of the costs covered by insurance and 10% covered by the patient vs a 50:50? How does that work?
Where is the maximum patient-covered split?