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ACA Running Thread

Wrangor said:
They should just use self verification.
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Everyone knows that left-handed Polish people are ill-situated to conduct self verification, and any attempts to promote self verification are really just insidious attempts to suppress health care to left-handed Poles. Why do you hate SouthPoles, Wrangor?
 
Deacon923 said:
More good news, the income and citizenship verification process for the subsidies is apparently non-existent or badly broken.
http://reason.com/blog/2014/05/19/obamacare-has-granted-1-million-incorrec
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"The Obama administration doesn't really want to talk about any of this, because they promised this wouldn't be a problem. Or, as the Post puts it, "members of the Obama administration are sensitive because they promised congressional Republicans during budget negotiations last year that a thorough income-verification system would be in place." So far, that obviously isn't the case.

And it won't be for at least several more months. Work will proceed by hand, but income discrepancies won't be up for review until this summer. That's because the administration has another million applications with a different problem: questions about the applicant's citizenship. Those issues will be dealt with first. Even that doesn't fully capture the extent of the application glitches. "Of the roughly 8 million Americans who signed up for coverage this year under the health-care law," the Post says, "about 5.5 million are in the federal insurance exchange. And according to the internal documents, more than half of them — about 3 million people — have an application containing at least one kind of inconsistency." This isn't a small problem, and it likely won't be going away soon."

Amazing
 
I'm still in the system and I haven't paid (I won't be paying). They have probably spent $20 on paper alone with all the mailings they have sent me. After wasting hours on the phone trying to get removed from something I never signed up for in the first place I finally gave up and am going to let them waste their paper as I immediately throw their correspondence in the recycling bin.
 
Real world results of ACA in Arkansas:

http://www.arktimes.com/ArkansasBlo...-visits-and-number-of-uninsured-patients-down

Here are the three key statewide findings, comparing the first quarter of 2014 against the first quarter of 2013 (see after the jump to see the range in results between hospitals):

* The total number of emergency department visits declined by 2 percent.

* Of those who did visit the emergency department, the number of uninsured patients was reduced by 24 percent.

* For people who required hospitalization, the number of uninsured patients was reduced by 30 percent.

OMG, it's saving money and people.
 
RJKarl said:
Real world results of ACA in Arkansas:

http://www.arktimes.com/ArkansasBlo...-visits-and-number-of-uninsured-patients-down

Here are the three key statewide findings, comparing the first quarter of 2014 against the first quarter of 2013 (see after the jump to see the range in results between hospitals):

* The total number of emergency department visits declined by 2 percent.

* Of those who did visit the emergency department, the number of uninsured patients was reduced by 24 percent.

* For people who required hospitalization, the number of uninsured patients was reduced by 30 percent.

OMG, it's saving money and people.
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Time will tell but theres nothing in this data that the ACA is saving $. Reducing ER visits does not mean saving $. We need to be careful looking at the data from both sides of the aisle, esp just a few months into the program. Th irony of course of Arkansas private model of Medicaid is probably fueling some of these #s, mainly the increased % of inpatient people who are insured. The hospitals are thrilled since this covers some of the Medicare cuts they are expecting. But the broader point is that more insured people doesn't mean lower costs (and out actually might mean the opposite). Its in all how we deliver care.
 
RJKarl said:
Real world results of ACA in Arkansas:

http://www.arktimes.com/ArkansasBlo...-visits-and-number-of-uninsured-patients-down

Here are the three key statewide findings, comparing the first quarter of 2014 against the first quarter of 2013 (see after the jump to see the range in results between hospitals):

* The total number of emergency department visits declined by 2 percent.

* Of those who did visit the emergency department, the number of uninsured patients was reduced by 24 percent.

* For people who required hospitalization, the number of uninsured patients was reduced by 30 percent.

OMG, it's saving money and people.
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http://www.huffingtonpost.com/2014/05/21/obamacare-emergency-room_n_5352987.html?utm_hp_ref=healthy-living&ir=Healthy+Living

"ER Visits Jump As Obamacare Kicks In, Doctors Say..."

"The survey findings underscore the challenges beyond extending health coverage to more people, including improving access to primary care and changing the habits of patients accustomed to using the emergency room as a one-stop-shop for medical care. One of Obamacare's selling points was its potential to reduce costly emergency room visits for care that could more efficiently be delivered in a doctor's office or other setting, especially for patients who previously were uninsured. Increases in ER visits may provide critics fodder to contend the law isn't fulfilling that promise."

Ooooops!
 
Last edited:
OOPS..reading is fundamental:

"More people may be visiting hospital emergency departments this year as health benefits from Obamacare went live, according to a survey of physicians published Wednesday.

"Over the next three years, 86 percent of these doctors believe emergency room use will increase."

"May" and "believe" are opinions not facts. There are facts about what's happening in Arkansas, but don't let the facts in the way of your opinion.

I can't wait to see your dance to get around using opinions as facts.

Also re"CH" unless there are both dramatic increases in costs and lowering of number of admissions to hospitals, it's impossible having a 30% decrease in admissions of the uninsured won't save money. Further, if there are fewer admissions, money is being saved there as well.
 
The fact is both reports come from surveys - 83 hospitals in one state (with 42 responses) vs 1800 ER physicians across the US. I wouldn't draw real conclusions from either one. I only posted the ER survey to show that you were jumping the gun on how wonderful the results of ACA are.

Remember how you attacked CH on 10/1 when he reported that healthcare.org wasn't working very well?
 
WFU71 said:
The fact is both reports come from surveys - 83 hospitals in one state (with 42 responses) vs 1800 ER physicians across the US. I wouldn't draw real conclusions from either one. I only posted the ER survey to show that you were jumping the gun on how wonderful the results of ACA are.

Remember how you attacked CH on 10/1 when he reported that healthcare.org wasn't working very well?
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Amazing, but sadly expected. You refuse to ever admit that you are wrong when challenging me.

It's astonishing that you try to justify this by saying both are "surveys". One is a "survey" of actual facts. The other is flat out "survey" of opinions. You'll Gumby anything up to avoid saying you are wrong.
 
RJKarl said:
Amazing, but sadly expected. You refuse to ever admit that you are wrong when challenging me.

It's astonishing that you try to justify this by saying both are "surveys". One is a "survey" of actual facts. The other is flat out "survey" of opinions. You'll Gumby anything up to avoid saying you are wrong.
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My question has nothing to do with the ACA, so for that I apologize. My question is this: When is the last time you admitted you were wrong when challenging someone?
 
How about last week? and the week before...but don't let reality in the way of your BS myth,,,,,
 
RJKarl said:
OOPS..reading is fundamental:

"More people may be visiting hospital emergency departments this year as health benefits from Obamacare went live, according to a survey of physicians published Wednesday.

"Over the next three years, 86 percent of these doctors believe emergency room use will increase."

"May" and "believe" are opinions not facts. There are facts about what's happening in Arkansas, but don't let the facts in the way of your opinion.

I can't wait to see your dance to get around using opinions as facts.

Also re"CH" unless there are both dramatic increases in costs and lowering of number of admissions to hospitals, it's impossible having a 30% decrease in admissions of the uninsured won't save money. Further, if there are fewer admissions, money is being saved there as well.
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I think you are mis-matching data here. Good to see ER use may go down. But this doesn't mean lower costs. And I think the 30% means more people are insured, not that there are 30% fewer admissions.

You need to look at total spend. For example, if ER use went down 2% but specialists visits / drugs went up 100% as a result of more people being insurance, its a net negative on costs. Also, even if ER use went down, you need to look at costs per visit. More insured ER patients could mean more costs in the ER as more tests etc get done.

There is a lot of evidence that people having insurance actually might increase utilization and overall costs.
 
CHDeac said:
There is a lot of evidence that people having insurance actually might increase utilization and overall costs.
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Increased utilization and cost in the short term could be a net positive long term though (if it prevents the diabetic from needing an amputation later, for example). The cost implications of this won't be known for a while.
 
DeacMan said:
At least we have not earmarked any funds to bail out insurance companies from losses because of the law . . .

Oops.

http://www.latimes.com/nation/la-na-insurance-bailout-20140521-story.html#page=1
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This has been a very wonky part of the law since it passed in 2010. When the law was originally passed, there were provisions that if insurers made too much or lost too much they would reconcile the differences between the plans. However, with the last minute change in 2013 (if you like your plan you can keep your plan), insurers were left facing big issues as they priced for their healthy books moving into the new ACA pools. When this didn't happen (ie Obama flipped) insurers needed financial protections to make it work.

Its a temporary program (expires in 2016) and doesn't fully cover the costs of the losses. It was a widely known challenge and there is a lot of political hay being made out of it. But its not really a bail out. It would have been priced for by carriers if we knew about the transition relief offered.
 
tiltdeac said:
Increased utilization and cost in the short term could be a net positive long term though (if it prevents the diabetic from needing an amputation later, for example). The cost implications of this won't be known for a while.
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Sure. But net net, it causes costs to rise over the long run all other things equal. I think people being covered is a good thing and good for the system, but it wont lower total spend without findamental change to the way we deliver , coordinate and integrate care delivery. The law does little to do that.
 
CHDeac said:
I think you are mis-matching data here. Good to see ER use may go down. But this doesn't mean lower costs. And I think the 30% means more people are insured, not that there are 30% fewer admissions."

It is 30% fewer uninsured admissions as I quoted: " For people who required hospitalization, the number of uninsured patients was reduced by 30 percent. "

To not have this save money, costs would have to be very, very dramatically higher. It would almost have to be irrationally higher.
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RJKarl said:
CHDeac said:
I think you are mis-matching data here. Good to see ER use may go down. But this doesn't mean lower costs. And I think the 30% means more people are insured, not that there are 30% fewer admissions."

It is 30% fewer uninsured admissions as I quoted: " For people who required hospitalization[/B], the number of uninsured patients was reduced by 30 percent. "

To not have this save money, costs would have to be very, very dramatically higher. It would almost have to be irrationally higher.
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The question is on total admissions, not who is paying for it. Admission rates didnt go down 30%. Its just a shift in payer mix.

Arkansas is an interesting model based on how they handled Medicaid. There's been a huge spike in the severity of the ACA population (older and sicker), pretty much as predicted by the actuaries. No value judgment here...Just a note that overall utilization and costs are going up as a result of the ACA.
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