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ACA Running Thread

2&2 Slider To Leyritz said:
I mean, yeah it is. It did a great job of making that bill affordable, didn't it? Instead, treatment prices went up and insurance costs went up because of additional uncollectibility and another layer of administration, which is one of the greatest testaments to ineptitude in political history. The hospital has to bill you $2,000 for doing basically nothing because they get $0 from plenty of other patients who they have to do things for. Obamacare did a great job of addressing that problem, didn't it? Not to mention the absurd mandated "wellness" expenditures that the healthcare systems have to pay for yet have gotten absolutely no ROI on because there is no patient incentive to adhere to anything, so your bill for treatment goes up to cover that shit.

Plus the fact that you went to the ER instead of urgent care for a soup burn.
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yeah, urgent care was closed, bro.

but the ACA isn't causing the hospital to attempt to collect $2k for a nurse wrapping my wife's arm in gauze
 
ImTheCaptain said:
of course we have health insurance, but that was what the hospital billed the health insurance company

I owe $125 after the HI paid $670 and the hospital "adjusted" away $1,200
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Read up on the chargemaster, a monster developed due to Federal reimbursement regulations - I particularly like the comment from Frank P. (I used to do Medicare cost reports and actually created a chargemaster). http://www.beckershospitalreview.com/finance/deconstructing-the-enigmatic-hospital-chargemaster.html
 
"you know before it was Obamacare it was Hillarycare" -Hillary

No wonder the Dems pushed so hard to have this pushed out till 2017.

Not sure it will be enough at this point in the election. Dems bamboozle again.
 
ImTheCaptain said:
of course we have health insurance, but that was what the hospital billed the health insurance company

I owe $125 after the HI paid $670 and the hospital "adjusted" away $1,200
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ACA was written by and for providers, and blames health insurance companies (they get to deliver the bad news that your rates are going up although their profit margins are <5% and DOI oversees them). There are no cost savings on the provider side. Hospitals are having record setting years financially. Many pages ago, I mentioned Time magazine's "A Bitter Pill" article that documents exactly what ITC is experiencing. It is called the Chargemaster, and it makes a simple Tylenol cost $10 in a hospital....or bandages for a scalded arm cost $2k.

Meanwhile, big hospitals have been buying small hospitals to be as big as possible in order to strengthen their negotiating power against insurance companies, and to screw you even harder.
 
awaken said:
ACA was written by and for providers, and blames health insurance companies (they get to deliver the bad news that your rates are going up although their profit margins are <5% and DOI oversees them). There are no cost savings on the provider side. Hospitals are having record setting years financially. Many pages ago, I mentioned Time magazine's "A Bitter Pill" article that documents exactly what ITC is experiencing. It is called the Chargemaster, and it makes a simple Tylenol cost $10 in a hospital....or bandages for a scalded arm cost $2k.

Meanwhile, big hospitals have been buying small hospitals to be as big as possible in order to strengthen their negotiating power against insurance companies, and to screw you even harder.
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So, you agree, it is Obamacare's fault. As has been apparent from the jump, what fucking idiot politician would have proposed/supported/passed Obamacare?
 
Oh yeah. Passing ACA ignores a basic understanding of supply and demand. The predicted doom came true. What is needed is something to check what provider's charge. The floor is open to what that could be? A DOI analog for providers? Lawsuits alleging collusion and price fixing (bc all provider charge outlandish fees, so they are not competing against each other... so if they are not competing, then they're colluding?). Expanding Medicare? (Providers hate working for Medicare rates - they're reasonable).

Here's that Time article
http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,MedicalCostsDemandAndGreed.pdf
 
2&2 Slider To Leyritz said:
Not to mention the absurd mandated "wellness" expenditures that the healthcare systems have to pay for yet have gotten absolutely no ROI on because there is no patient incentive to adhere to anything, so your bill for treatment goes up to cover that shit.
.
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This is actually a good point by 2&2, things got mandated for coverage but unless there is adherence to what is covered it's a huge sunk cost for the insurance companies. The largest expenditures are for chronic long term care and end of of life care. Things like colonoscopy, mammograms, physicals, wellness checks etc... should all be mandated by the simple fact you have insurance. If you don't do these preventive things you should either pay a ton more or have your insurance dropped. This goes for smoking, obesity and other horrible life choices.
 
TownieDeac said:
Yeah, like it was super honest of sailor to suggest that before ACA, healthcare wasn't an issue in America.

Feel free to actually elaborate instead of just popping in. Name a single supply side proposal you've seen a Republican make to cut costs. They're too in bed with private insurers and providers to ever propose anything that would make things harder for supply side to rake cash.
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Pencil.jpg
 
TownieDeac said:
Yeah, like it was super honest of sailor to suggest that before ACA, healthcare wasn't an issue in America.

Feel free to actually elaborate instead of just popping in. Name a single supply side proposal you've seen a Republican make to cut costs. They're too in bed with private insurers and providers to ever propose anything that would make things harder for supply side to rake cash.
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Destroying de facto monopolies artificially created by state lines increases competition within the market, giving consumers choice (the ultimate protection). I've said for years that there is a supply-side solution (fun exercise: How many times has the population of your state doubled since the last med school was opened?). That's where I'd start. Open a new med school for every 25 million people, with fellowships repaid by post-grad service in low income clinics.
 
TownieDeac said:
Yeah, like it was super honest of sailor to suggest that before ACA, healthcare wasn't an issue in America.

Feel free to actually elaborate instead of just popping in. Name a single supply side proposal you've seen a Republican make to cut costs. They're too in bed with private insurers and providers to ever propose anything that would make things harder for supply side to rake cash.
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You are lying again. I never said that. Furthermore, to believe that the involvement of the federal government in health care began with the ACA is simply ignorance.
 
TownieDeac said:
lol my bad, you're taking it even more extreme--i just assumed you meant the ACA, but clearly you mean medicare/medicaid too

healthcare was a perfect market before those pesky poors and olds got covered

nobody's lives were ruined by lack of care back then!
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If it's such a good idea, then why not shoot the American voters straight? Why mess around with the lies they had to tell to get it passed?
 
the following concepts
- health care quality/cost in America pre-ACA
- the legislative sausage-making that led to ACA
- current problems with ACA implementation

are all quite separate and distinct issues. Trying to conflate the evils of any one of them to justify or condemn any of the others is muddy thinking and, more importantly, inimical to solving the current problems with the ACA.*


*unless the proposal is repeal and replace with the pre-ACA status quo, in which case the pre-ACA status quo is relevant.
 
TownieDeac said:
Probably because they didn't have straight shooters like you in Congress.
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Congress didn't shoot this one, champ. These were somebody else's lies. Besides, he didn't need any votes from the hated Pubs from Congress (and didn't get them). He fucked this one up all on his own.
 
TownieDeac said:
I still have no idea how you got from demonstrating point A (it's dishonest to suggest Republicans don't have good supply side healthcare ideas) with point B (Obamacare is bad and it always has been). But ok.
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ACA makes changes that wreck the insurance market for insurers in many markets, forcing them to charge prices that consumers won't pay, and they eventually pull out of the market. So instead of expanding insurance, consumers have less choices.

The Republican plan was always to increase competition between poolers of risk to give consumers more choices. Under ACA, they have less (despite broken promises to the contrary). So...yeah. If only we could have seen this coming...
 
As someone else pointed out, tinkering around with the insurance markets has a very limited scope for improvement. Health lines have low profit margins and limited ability to compete in states where they don't already have networks. The GOP refrain of "let them compete across state lines!!" is held up as a panacea exactly because it has never been tried - unlike the other GOP idea which morphed into Obamacare. The truth is there aren't much cost savings left to wring out of the insurance side of health care. That ox has been gored; the only way to bend the cost curve is to take a chunk out of Big Pharma, Big Medical Device, Big Hospital, and Big Doctor. That's a fight that Obama and the Democrats didn't dare try, and that the GOP has absolutely no stomach for either. Everybody hates their insurance companies but everybody loves their doctor and their hospital.
 
Healthcare fails in a free market economy because it's the only commodity that has no true price. Most people would put their life as priceless, so you want to come in an try and get saved or get the drug that will cure you, the price pretty much can be anything I want it to be.
 
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