The PPACA - Implementation Phase I

[FreshFish]

Re: The PPACA - Implementation Phase I

Thesis: people in government can't be trusted to administer a program "fairly"
Evidence: the language of PPACA said that whatever was passed, members of Congress and their staffs had to participate in it just like everyone else.
the exchanges haven't even started yet, and already members of Congress and their staffs are now exempted from PPACA.

 

[Priceless]

Thesis: people in government can't be trusted to administer a program "fairly"
Evidence: the language of PPACA said that whatever was passed, members of Congress and their staffs had to participate in it just like everyone else.
the exchanges haven't even started yet, and already members of Congress and their staffs are now exempted from PPACA.

So who should administer the program? Whatever it is, doesn't matter. Who do you think would be best to administer whatever program we have?

 

[Priceless]

I thought a democracy was when your friends and neighbors think an idea is horrible, it dies (the tyranny of the majority) but a republic is when your friends and neighbors think it's a horrible idea, but it still passes because it's best for everyone, not just your friends and neighbors.

I made the Republic vs Democracy argument because if I had said we live in a Republic someone would have said "We live in the Democracy!" and we would be left arguing which it is

The point is, he doesn't have to move to Vermont if he can convince enough people near him that it's a good idea.

 

[unofan]

Re: The PPACA - Implementation Phase I

The problem with that is we live in a Republic (not a Democracy like almost everyone assumes).

The bigger problem with that is that most people probably wouldn't mind living in Vermont in the grand scheme of things. At the least, you could have a nice comfortable life there if you chose.

I doubt any selfish d-bags...err...libertarians would actually want to move to Somalia.

 

[joecct]

Re: The PPACA - Implementation Phase I

The Chicago Tribune is concerned.

Cheeseheads are going to take it on the chin?

 

[Rover]

Re: The PPACA - Implementation Phase I

Well how about THIS joey, turns out premiums are coming in lower than expected. You can read the whole study if you'd like...

http://wonkwire.rollcall.com/2013/09/05/study-finds-lower-expected-obamacare-premiums/

 

[LynahFan]

Well how about THIS joey, turns out premiums are coming in lower than expected. You can read the whole study if you'd like...

http://wonkwire.rollcall.com/2013/09/05/study-finds-lower-expected-obamacare-premiums/

You realize that your "lower than expected" does not necessarily contradict joe's "higher than they were before," right? Right?

 

[Rover]

You realize that your "lower than expected" does not necessarily contradict joe's "higher than they were before," right? Right?

Depends on the starting point. "Higher than before" if you previously had no coverage? Sure as the rest of us were paying that bill for them. Its also higher if you had a plan that covered nothing short of a visit to the ER's trauma center.

Problem with much of the analysis we see is it doesn't take into account the tax credits for purchasing the insurance, unlike the link I posted which does include that info.

 

[St. Clown]

Re: The PPACA - Implementation Phase I

Depends on the starting point. "Higher than before" if you previously had no coverage? Sure as the rest of us were paying that bill for them. Its also higher if you had a plan that covered nothing short of a visit to the ER's trauma center.

Problem with much of the analysis we see is it doesn't take into account the tax credits for purchasing the insurance, unlike the link I posted which does include that info.

The tax credits for premiums is still a cost assigned to me and you. It just comes from the IRS and not the insurance companies or hospitals anymore.

And my starting point is what my insurance premiums were last year vs. what they are this year and what I get out of it. So far I'm losing with this Obamacare compliant insurance my company moved us into vs. the "Cadiallac" coverage we had in the past.

 

[Rover]

The tax credits for premiums is still a cost assigned to me and you. It just comes from the IRS and not the insurance companies or hospitals anymore.

And my starting point is what my insurance premiums were last year vs. what they are this year and what I get out of it. So far I'm losing with this Obamacare compliant insurance my company moved us into vs. the "Cadiallac" coverage we had in the past.

Its also a cost to treat un-insured people at the ER as well as those who wait too long to seek medical help. Hence an offset to those costs now via Obamacare.

 

[LynahFan]

Re: The PPACA - Implementation Phase I

The tax credits for premiums is still a cost assigned to me and you. It just comes from the IRS and not the insurance companies or hospitals anymore.

And my starting point is what my insurance premiums were last year vs. what they are this year and what I get out of it. So far I'm losing with this Obamacare compliant insurance my company moved us into vs. the "Cadiallac" coverage we had in the past.

This.

The entire premise of Obamacare is that if everyone is covered, people will stop using emergency care and people will get preventive/early care, so total costs should come down. There are two major "sources" of health care spending: government subsidies (i.e. the portion of our taxes that go to pay for healthcare) and premium payments by those who are covered. If total costs were really coming down, then one or both of those entities (government and premium payers) should be spending *less* than they were before. So far, I've seen precious little evidence that this is occurring or will occur in the near future.

 

[Priceless]

Re: The PPACA - Implementation Phase I

This.

The entire premise of Obamacare is that if everyone is covered, people will stop using emergency care and people will get preventive/early care, so total costs should come down. There are two major "sources" of health care spending: government subsidies (i.e. the portion of our taxes that go to pay for healthcare) and premium payments by those who are covered. If total costs were really coming down, then one or both of those entities (government and premium payers) should be spending *less* than they were before. So far, I've seen precious little evidence that this is occurring or will occur in the near future.

Not necessarily. If more people are using preventative care more often that might offset the gains made by them waiting and using critical care at the ER. It will lead to a higher quality of life for those impacted, but that's not something that fits neatly in a bar graph or an income statement.

 

[LynahFan]

Re: The PPACA - Implementation Phase I

Not necessarily. If more people are using preventative care more often that might offset the gains made by them waiting and using critical care at the ER. It will lead to a higher quality of life for those impacted, but that's not something that fits neatly in a bar graph or an income statement.

Sure it does. You'll find it filed under R for "Redistribution of Wealth."

 

[Rover]

This.

The entire premise of Obamacare is that if everyone is covered, people will stop using emergency care and people will get preventive/early care, so total costs should come down. There are two major "sources" of health care spending: government subsidies (i.e. the portion of our taxes that go to pay for healthcare) and premium payments by those who are covered. If total costs were really coming down, then one or both of those entities (government and premium payers) should be spending *less* than they were before. So far, I've seen precious little evidence that this is occurring or will occur in the near future.

The point of Obamacare from its supporters wasn't that you'd be seeing lower costs year over year. This is a false argument and frankly an impossible task. The point was to bend the cost curve so that health care expenditures got more in line with the growth in inflation, i.e. a sustainable rate. Healthcare costs aren't there yet, but even the CBO has downgraded the expected future increases in projected health care expenditures.

http://thinkprogress.org/health/2013/02/21/1623151/medicare-spending-drops/


The key to all of this is delivering the care more efficiently, not random cuts (or for that matter random tax hikes). Obamacare to its credit and something we don't always see out of govt policy is forward looking as it seeks to change the way care is delivered on a patient by patient basis instead of billing by procedure. That as well as getting people out of the ER for routine care is what will continue to bend the cost curve.

 

[Priceless]

Re: The PPACA - Implementation Phase I

Sure it does. You'll find it filed under R for "Redistribution of Wealth."

I forgot...there are some people who watch It's a Wonderful Life and think Potter is the good guy.

 

[St. Clown]

Re: The PPACA - Implementation Phase I

I forgot...there are some people who watch It's a Wonderful Life and think Potter is the good guy.

In what way could this possibly have ties to It's a Wonderful Life? At what point does either Bailey or Potter make comment on government spending? As best I could tell, George Bailey's doing everything he can with is customers to keep his S&L open, not petitioning the government.

 

[Rover]

In what way could this possibly have ties to It's a Wonderful Life? At what point does either Bailey or Potter make comment on government spending? As best I could tell, George Bailey's doing everything he can with is customers to keep his S&L open, not petitioning the government.

Puhleeze. Instead of picking himself up by his bootstraps Bailey relied on the largesse of the public to fund his incompetence, which will only encourage even more risk taking on his part.

This is fun! My favorite was the parody Mad Magazine did about if Ronald Reagan had written A Christmas Carol.

 

[LynahFan]

Re: The PPACA - Implementation Phase I

The point of Obamacare from its supporters wasn't that you'd be seeing lower costs year over year. This is a false argument and frankly an impossible task. The point was to bend the cost curve so that health care expenditures got more in line with the growth in inflation, i.e. a sustainable rate. Healthcare costs aren't there yet, but even the CBO has downgraded the expected future increases in projected health care expenditures.

http://thinkprogress.org/health/2013/02/21/1623151/medicare-spending-drops/


The key to all of this is delivering the care more efficiently, not random cuts (or for that matter random tax hikes). Obamacare to its credit and something we don't always see out of govt policy is forward looking as it seeks to change the way care is delivered on a patient by patient basis instead of billing by procedure. That as well as getting people out of the ER for routine care is what will continue to bend the cost curve.

In which case, ObamaCare can't fail, because you're measuring it against a ghost. No matter how bad things get, all you have to say is, "well, they would have been worse." That's a cold comfort when the unsolved problem is still sitting squarely in our laps.

 

[FreshFish]

Re: The PPACA - Implementation Phase I

This.

The entire premise of Obamacare is that if everyone is covered, people will stop using emergency care and people will get preventive/early care, so total costs should come down. There are two major "sources" of health care spending: government subsidies (i.e. the portion of our taxes that go to pay for healthcare) and premium payments by those who are covered. If total costs were really coming down, then one or both of those entities (government and premium payers) should be spending *less* than they were before. So far, I've seen precious little evidence that this is occurring or will occur in the near future.

The way PPACA is structured, it nearly "requires" a spiraling premium structure: they have made it abundantly clear that they are overcharging the young, which would discourage the young from joining. Worse than that, they outlawed the one thing that makes insurance affordable, which is high deductibles (they also want to outlaw stop-loss coverage for self-insured groups, which is more insanity from novices with an overabundance of enthusiasm and a dire shortage of knowledge).

What really stinks is how Congress wrote into the law that Members and their staffs were required to participate in exchange-sponsored coverage, without any subsidies (due to their income levels), just like everyone else....except now that they've seen what that entails, they ran as fast as they could to get exemptions for themselves.

If the law as written requires them to obtain exchange-sponsored coverage, and they want an exemption from that requirement so badly, what does that tell you about their perceptions, eh?

I'm sure the Chief Cheerleader here will find a way to gloss over that one with some witty quip that totally evades a serious answer. sigh.

 

[Rover]

The way PPACA is structured, it nearly "requires" a spiraling premium structure: they have made it abundantly clear that they are overcharging the young, which would discourage the young from joining. Worse than that, they outlawed the one thing that makes insurance affordable, which is high deductibles (they also want to outlaw stop-loss coverage for self-insured groups, which is more insanity from novices with an overabundance of enthusiasm and a dire shortage of knowledge).

What really stinks is how Congress wrote into the law that Members and their staffs were required to participate in exchange-sponsored coverage, without any subsidies (due to their income levels), just like everyone else....except now that they've seen what that entails, they ran as fast as they could to get exemptions for themselves.

If the law as written requires them to obtain exchange-sponsored coverage, and they want an exemption from that requirement so badly, what does that tell you about their perceptions, eh?

I'm sure the Chief Cheerleader here will find a way to gloss over that one with some witty quip that totally evades a serious answer. sigh.

I'll just let the truth do the talking Fishy:

http://www.newrepublic.com/article/114284/congress-exempt-obamacare-latest-lie-wont-die

Seems you've been playing a little fast and loose with the facts, no?