The PPACA Thread Part III - Let's have a healthy debate!

[ScoobyDoo]

Re: The PPACA Thread Part III - Let's have a healthy debate!

You didn't see that from the start? Now ask the younger generation (just older than 26 when the law passed) how they feel about the older generations' situation in this law, about how the young had their premiums jacked up while the old had theirs reduced - at least initially, then they went up with everyone else's.

To be honest I was apprehensively supportive and hopeful they would find some savings. I wasn't wrong, but it sure did turn out worst case scenario which I didn't think would happen. So, I was foolish.

 

[FreshFish]

Re: The PPACA Thread Part III - Let's have a healthy debate!

You didn't see that from the start? Now ask the younger generation (just older than 26 when the law passed) how they feel about the older generations' situation in this law, about how the young had their premiums jacked up while the old had theirs reduced - at least initially, then they went up with everyone else's.

the underling math mandated by the law is inherently unstable; mathematics alone (any and all political opinions extracted) predicted this outcome.

There are three major, interlocking elements involved:
-- coverage levels
-- risk assessment
-- loss ratios.

These three are intrinsically interwined on a fundamental level: in the long run, you can set any two of these three and then the third must rise or fall to its own level[SUP]1[/SUP].

The law specifies all three of these elements as if each one of them could be separately locked into place by statute. that is mathematically impossible to sustain[SUP]2[/SUP].

There is an apocryphal story about a state legislature that wanted to change the value of pi by statute. PPACA is exactly the same except more subtle to discern.






[SUP]1[/SUP] Similar to PV=nrT for gas laws; you can set any two of P, V, or T but eventually the third will necessarily find its own level in relation to the other two.
[SUP]2[/SUP] Technically, you could resign yourself always to run the plan at a loss; but then where does that money come from? a technical exception with no real value.

 

[FlagDUDE08]

Re: The PPACA Thread Part III - Let's have a healthy debate!

You didn't see that from the start? Now ask the younger generation (just older than 26 when the law passed) how they feel about the older generations' situation in this law, about how the young had their premiums jacked up while the old had theirs reduced - at least initially, then they went up with everyone else's.

Aren't the old forced into the Medicare system (at least to be eligible to receive Social Security)?

 

[St. Clown]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Aren't the old forced into the Medicare system (at least to be eligible to receive Social Security)?

Yes, I believe they are. But there's still that segment of the population with a higher healthcare risks who are older yet not quite of Medicare age. They're much more expensive to insure than a 27yo man, if you're to ask an insurance actuary.

 

[SJHovey]

Re: The PPACA Thread Part III - Let's have a healthy debate!

I have determined based on my own experience and what I have read and all the insurance companies that are bowing out that all this law was in the long run was a middle class tax increase to help pay for the poor and uninsured.

In a nutshell, here is the problem with the ACA.

For that segment of the population on Medicare, the ACA had no impact.

For that segment of the population who were covered by employer sponsored plans, the ACA has had virtually no impact. So all employees of relatively large employers and all public employees have seen no changes.

For the tiny fraction of the population who was a) uninsured, b) poor enough to be eligible for significant subsidies, and c) actually went out and followed the law and got themselves enrolled, there has been a positive impact. They are now insured, and a lot of it is subsidized by the government. So it looks great for them now, but their day is coming. The costs will go up, the subsidies will drop, and candidly they'll simply go back to being uninsured.

For everybody else, bend over because your buddy Obama has a present that's going to keep on giving. If you're self employed, or if you work for a small employer who doesn't provide insurance, if you're one of those countless numbers of people sitting out there making $40,000 a year and trying to live the dream, you are looking at a diminishing number of insurers from whom you can buy coverage and whopping premium increases.

But, don't worry. Rover continues to give us his best Wallace Hartley imitation and says everything is great.

 

[ScoobyDoo]

Re: The PPACA Thread Part III - Let's have a healthy debate!

For that segment of the population who were covered by employer sponsored plans, the ACA has had virtually no impact. So all employees of relatively large employers and all public employees have seen no changes.
.

Employer sponsored plans that are not public sector or of the larger company vein were massively affected. This is where I fall.

 

[St. Clown]

Re: The PPACA Thread Part III - Let's have a healthy debate!

For that segment of the population who were covered by employer sponsored plans, the ACA has had virtually no impact. So all employees of relatively large employers and all public employees have seen no changes.

I wouldn't say that's true at all. The quality of my insurance, even though it's through the same insurance company, is much worse. I have far more out-of-pocket expenses than I did prior to the ACA going into effect.

 

[unofan]

In a nutshell, here is the problem with the ACA.

For that segment of the population on Medicare, the ACA had no impact.

For that segment of the population who were covered by employer sponsored plans, the ACA has had virtually no impact. So all employees of relatively large employers and all public employees have seen no changes.

For the tiny fraction of the population who was a) uninsured, b) poor enough to be eligible for significant subsidies, and c) actually went out and followed the law and got themselves enrolled, there has been a positive impact. They are now insured, and a lot of it is subsidized by the government. So it looks great for them now, but their day is coming. The costs will go up, the subsidies will drop, and candidly they'll simply go back to being uninsured.

For everybody else, bend over because your buddy Obama has a present that's going to keep on giving. If you're self employed, or if you work for a small employer who doesn't provide insurance, if you're one of those countless numbers of people sitting out there making $40,000 a year and trying to live the dream, you are looking at a diminishing number of insurers from whom you can buy coverage and whopping premium increases.

But, don't worry. Rover continues to give us his best Wallace Hartley imitation and says everything is great.

All of which points to single payer or some other form of nationalized healthcare as the solution. Personally, I'd just open up Medicare to everyone, raise taxes in proportion to whatever health insurance premiums will no longer need to be paid to private insurers, and call it a day.

 

[ScoobyDoo]

Re: The PPACA Thread Part III - Let's have a healthy debate!

I wouldn't say that's true at all. The quality of my insurance, even though it's through the same insurance company, is much worse. I have far more out-of-pocket expenses than I did prior to the ACA going into effect.

This.

 

[FlagDUDE08]

Re: The PPACA Thread Part III - Let's have a healthy debate!

All of which points to single payer or some other form of nationalized healthcare as the solution. Personally, I'd just open up Medicare to everyone, raise taxes in proportion to whatever health insurance premiums will no longer need to be paid to private insurers, and call it a day.

I'll give you that's the goal of PPACA, but it's not the best solution. Do you really want the same bureaucrats screwing you over presently to still be in charge of potentially screwing you over when they have, instead of an indirect monopoly, a direct monopoly? Not to mention, good luck handling the scope of 300 million people (assuming the Georgia Guidelines don't happen), because the states aren't going to want to do that. The USSR failed because of scope.

 

[FlagDUDE08]

Re: The PPACA Thread Part III - Let's have a healthy debate!

I wouldn't say that's true at all. The quality of my insurance, even though it's through the same insurance company, is much worse. I have far more out-of-pocket expenses than I did prior to the ACA going into effect.

Tack on higher premiums with that for a lot of cases, and beyond the rate of the Federal Reserve intentionally de-valuing the currency (you may know it better as "inflation").

 

[FreshFish]

Re: The PPACA Thread Part III - Let's have a healthy debate!

All of which points to single payer or some other form of nationalized healthcare as <strike>the</strike> [one possible] solution.

The most fundamental rule of economics, the foundation of everything else, could be translated as "there is always rationing in one form or another," although generally it is phrased as "human beings have unlimited wants and limited resources."

If you do not ration by price, then you ration by time; and every country in the world that has tried nationalized healthcare as a way to control price finds that waiting times get extended instead. Then we have a two-tier system, one for the rich and for people in high levels of government, and another one for everyone else.

I'm not so sure that the latter is really the "best" solution we can come up with. However dysfunctional the current system, it serves a majority of the people well enough. your "solution" would make everyone miserable in order to help out a minority.

I agree that we can do better for that minority, but saying "let's make healthcare equally inaccessible to everyone" is not how I'd go about fixing things. Basically you are holding up the VA as a model for the rest of us. No thank you!




I am reminded of the old story, "either you are a Democrat and have no brains, or a Republican and have no heart." We need a middle way. Government as payor is definitely not it.






In fact, you can pretty clearly correlate increased government meddling/"activity" in the market with increasing costs and restricted access. The health insurance market was far more rational in the 1980s than it is today; because we did have single-payor back then: the payor was the patient him/herself. Perhaps s/he would then submit receipts for reimbursement to the insurance company, but a major part of the problem started when healthcare providers and insurance companies began doing business directly with each other with the patient no longer involved at all in the billing process.

 

[unofan]

If you do not ration by price, then you ration by time; and every country in the world that has tried nationalized healthcare as a way to control price finds that waiting times get extended instead. Then we have a two-tier system, one for the rich and for people in high levels of government, and another one for everyone else.

Meanwhile, in reality, when you ration by price you end up with rich people getting all the care they need and the poor people dying because they can't afford their care.

And somehow nationalized healthcare works in pretty much every other industrialized country on the globe, and even some that aren't (looking at you, Cuba).

 

[Kepler]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Meanwhile, in reality, when you ration by price you end up with rich people getting all the care they need and the poor people dying because they can't afford their care.

Which is why you need the second myth that conservatives cling to in order to sleep at night: the poor deserve it because they're lazy.

The morality Fish defends is the simplest in human history: "I'm OK so the system is fair." Every paid for surrogate or useful idiot of the rich has maintained some form of that morality since the first monkey busted another monkey's head, took his banana, and thought to himself, "I'm entitled to this because I am stronger."

We'll never be rid of it, but happily the more people intermingle and learn each others' stories the less they lie to themselves that it's anything but a self-justification.

 

[SJHovey]

All of which points to single payer or some other form of nationalized healthcare as the solution. Personally, I'd just open up Medicare to everyone, raise taxes in proportion to whatever health insurance premiums will no longer need to be paid to private insurers, and call it a day.

I can't disagree.

 

[FlagDUDE08]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Meanwhile, in reality, when you ration by price you end up with rich people getting all the care they need and the poor people dying because they can't afford their care.

And somehow nationalized healthcare works in pretty much every other industrialized country on the globe, and even some that aren't (looking at you, Cuba).

And how large are those countries, and how many people are dying from illnesses? There's no way that countries like China and India are working well for these sorts of things. It's no wonder they're looking for opportunity in other countries, such as US. Sure, you look at European countries as a model, but each one is about the size of one state. The more you expand scope, the more of a problem you're going to have.

 

[Rover]

Re: The PPACA Thread Part III - Let's have a healthy debate!

(lots of stupidity)

For everybody else, bend over because your buddy Obama has a present that's going to keep on giving. If you're self employed, or if you work for a small employer who doesn't provide insurance, if you're one of those countless numbers of people sitting out there making $40,000 a year and trying to live the dream, you are looking at a diminishing number of insurers from whom you can buy coverage and whopping premium increases.

.

I like your reasoned and adult analysis, particularly the highlighted portion above. You seem to be angry all the time, probably due to a lack of success. That's your problem to solve though, so don't take it out on me.

But lets address your points. If you're making 40K and have a family you most likely get a subsidy for coverage. So what are you whining about? Beyond that everyone should have health care. I'm not paying for you to game the system and show up at the emergency room whenever you get a hang nail. Furthermore if you have a serious medical issue and have insurance by law you aren't out more than 10K total during the year. That saves countless people from never ending medical bills. Lastly, penalties are waved if insurance in your area is unaffordable.

So, stop complaining already. You sound like an old guy who just missed out on the all you can eat buffet at Denny's.

Moving on, I could envision a Medicare buy in for people who don't have access to affordable insurance either through their employer or an exchange. I'd do it on a sliding scale based on income obviously but it would be a good way to supplement the current system without a drastic upheaval in the market.

 

[SJHovey]

Re: The PPACA Thread Part III - Let's have a healthy debate!

I like your reasoned and adult analysis, particularly the highlighted portion above. You seem to be angry all the time, probably due to a lack of success. That's your problem to solve though, so don't take it out on me.

But lets address your points. If you're making 40K and have a family you most likely get a subsidy for coverage. So what are you whining about? Beyond that everyone should have health care. I'm not paying for you to game the system and show up at the emergency room whenever you get a hang nail. Furthermore if you have a serious medical issue and have insurance by law you aren't out more than 10K total during the year. That saves countless people from never ending medical bills. Lastly, penalties are waved if insurance in your area is unaffordable.

So, stop complaining already. You sound like an old guy who just missed out on the all you can eat buffet at Denny's.

Moving on, I could envision a Medicare buy in for people who don't have access to affordable insurance either through their employer or an exchange. I'd do it on a sliding scale based on income obviously but it would be a good way to supplement the current system without a drastic upheaval in the market.

I'm not angry at all. On a personal level the ACA has not affected my coverage, or what I pay, one iota.

I just enjoy mocking the fact that you are literally the only person on the planet who for that past year or two continues to rave about how well the ACA is working. Personally, I just like reminding everyone about that, and giving you another opportunity to come here and tell us all how great it is.

I've always been a big supporter of giving the mic to people who only spout nonsense. It's a great self-identifier.

 

[Rover]

Re: The PPACA Thread Part III - Let's have a healthy debate!

I'm not angry at all. On a personal level the ACA has not affected my coverage, or what I pay, one iota.

I just enjoy mocking the fact that you are literally the only person on the planet who for that past year or two continues to rave about how well the ACA is working. Personally, I just like reminding everyone about that, and giving you another opportunity to come here and tell us all how great it is.

I've always been a big supporter of giving the mic to people who only spout nonsense. It's a great self-identifier.

If you're this obsessed with me, might I suggest you find a hobby or adopt a pet? Might be a better use of your time.

However, for the like billionth time I will dismiss the pathetic straw man argument of every knuckledragger when it comes to the ACA. Nobody said the law will solve all problems, nor not require any adjustments as time goes on. But I will say the law accomplished what it set out to. 1) More people are covered. 2) The cost curve is lower than expectations had the law not being passed. In the discussions leading up to the law's passage, that was my criteria for judging success. Done and done. If the law hasn't affected you any, why are you whining so much? Is that just like what you do?

 

[5mn_Major]

Re: The PPACA Thread Part III - Let's have a healthy debate!

I just enjoy mocking the fact that you are literally the only person on the planet who for that past year or two continues to rave about how well the ACA is working.

Just to be clear. Ten years ago we were sleep walking with mediocre care outcomes. Industry changes have generally been for the better.