• Welcome to OGBoards 10.0, keep in mind that we will be making LOTS of changes to smooth out the experience here and make it as close as possible functionally to the old software, but feel free to drop suggestions or requests in the Tech Support subforum!

ACA Running Thread

I am for making health insurance like other insurance. People pay for their own insurance other than health insurance. The only reason employers pay for health insurance is due to a WWII wage control work-around - wages were capped, but benefits were exempt. So employers enticed potential employees with benefits like health insurance. That point solution, for better or worse, is long behind us, and needs to go. But health care needs to be affordable first.

If the government either caps (at 2x Medicare, for example) or sets provider charges outright, then health insurance rates would become reasonable and payable by employees. When health procedures cost tens or hundreds of dollars instead of thousands of dollars, then the money needed to cover that would drastically decrease. Imagine health insurance rates more in line with auto insurance or health insurance - hundreds of dollars instead of thousands. More people could afford health insurance, and even those that opt out have a chance at "self-insuring" at these more reasonable rates.

Even if the employer provision of health care remains, I don't think providers will want to negotiate much, if at all, from a 2x Medicare cap.

Health insurance companies would whine and moan about having to win each customer individually like all other types insurance do. They are not used to it, but they can adjust. Providers will really complain about a 2x cap or outright price setting. But they can't keep gouging customers. Making health insurance like other types of insurance is better for the country. The economy would soar.
 
Sounds like awaken has a lot of stock in health insurance companies. The concept that everyone has to buy their own would explode prices upwards. If you aren't in a group, they can gouge until the cows come home or deny you coverage or have surcharges for anything from having had a baby to asthma.

Why should we cap at 2X Medicare? If Medicare can provide services at a cost, why should people have to pay 120-200% of that price? What do you get other than a series of middlemen who don't provide better outcomes for you?

EDIT: If insurance companies have to go to each individual to sign them up, rather than getting 50,000 B of A employees at once, the cost of customer acquisition will go through the roof and be passed along to the buyer. If they can't do that, the insurance will either go out of business or dramatically cut coverage. Without being allowed to charge for those costs, there really aren't any other options.

awaken's concept is fatally flawed. It can't work in the real world.
 
Last edited:
I buy my own auto insurance, home owners insurance, etc without being in a group. I am not gouged nor are those rates out of control. This is a real world example.

Medicare is designed to cover costs and a have a modest profit. Providers complain, perhaps rightfully so, that Medicare's profit margin is too low. That is why they limit the number of Medicare patients they see. The 2x is a completely arbitrary number. I'll let the experts determine if 1x, 2x or 3x is a number that allows providers to sustain and innovate. The 2x used for demonstration purposes here is still a magnitude less than the multiplier used today. See examples below.



Competition will keep the insurance companies in line. People need the freedom to choose another insurance company without changing employers.

Ironically, believing that insurance companies NEED to acquire customers in groups makes you sound like the insurance company shill, not me. My plan would reduce premiums 90%, and the insurance companies profit margin is only a small percentage of premiums.
 
No, I think everyone should be able to buy into Medicare at the current rate.

I believe the very nature of private insurance companies is about massive waste by design. Medicare has about 2-3% overhead cost. Private insurance is 15+%. They also have to make a profit. This doesn't help a single person get better treatment.

Believing insurance companies need to get people in groups to keep their costs down is not supporting them. It's understanding how the marketplace works. If you can't understand why being in a group for private health insurance helps the consumer, then you shouldn't be talking about the subject.
 
Interesting, albeit somewhat of simplistic take, on Medicare admin rates linked below. Medicare is largely a FFS managed by a single medical policy, subsidized by private insurance reimbursement levels. Its vary hard to compare the two looking at a simple variables like admin. In addition to whats called out here, also never assume admin is "waste". There are countless examples of a $1 in admin reducing medical expenses by many many $. Always look at the total cost of care.

https://www.forbes.com/sites/theapothecary/2011/06/30/the-myth-of-medicares-low-administrative-costs/#1c61b17e140d

I always like to cite the example of managed medicaid as why private insurance may be better than, or at least provide a model for a path forward, akin to Medicare Advantage. States routinely turn over Medicaid to private insurers who can do it cheaper and arguably better. Both blue and red states do this.

I like keeping group insurance as there are some inherent advantages to it. But an individual market is certainly viable and plausible and shouldn't be dismissed. I've seen multiple proposed models of how it can be quite viable (these were done when there was worry that the ACA would end group coverage). A national rate (likely 125-175%) of medicare is probably the right place to land if we tie value payments to it. Pushing everyone to 100% in a FFS world would be a disaster.

One more link is below which is a serious read (non political) on a path forward for Medicare and reform in general. Its dense but good.

https://journals.sagepub.com/doi/pdf/10.1177/0002716219885582

-CHShill
 
GTB asked on another thread for me to explain my claim that Republicans were dishonest and destructive wrt their asinine hyper-artisan posturing on the ACA.


That this is so should be obvious to any informed person paying attention.


Anyhow, here's a brief history/analysis from not too long ago that hits some highlights: Republicans used to have a health care plan. Now all they have are lies.


And here's another from a couple of years ago...Republicans are now paying the price for a years-long campaign of Obamacare lies


Basically, instead (quite intentionally) of "compromising" or coming together and supporting an essentially REPUBLICAN plan to improve access to health care and coverage, Republicans chose to lie, lie, lie and oppose "Obamacare". Because it was in their short-term political interest. But their deceitful posturing was NOT in the interest of anyone else.
 
Bloomberg commercials here in NC quickly say he will cap medical charges. Sounds good to me.
 
 
DistrictDeacon said:
Click to expand...

This is one of the reasons I am opposed to government running healthcare. It becomes a political football, and a can that kicks down the road. I admit I am not sure what this ER doctor is referring to, but it may be the Medicaid expansion from the ACA. The federal government was going to fund short term expansion, but it would eventually end and fall to the states. Some states took it, some did not (and took a lot of heat at the time). Is this the states that took it now complaining that the federal contribution is ending as designed in ACA? Honest question.
 
awaken said:
This is one of the reasons I am opposed to government running healthcare. It becomes a political football, and a can that kicks down the road. I admit I am not sure what this ER doctor is referring to, but it may be the Medicaid expansion from the ACA. The federal government was going to fund short term expansion, but it would eventually end and fall to the states. Some states took it, some did not (and took a lot of heat at the time). Is this the states that took it now complaining that the federal contribution is ending as designed in ACA? Honest question.
Click to expand...

No, this doctor is referring to the new Trump administration block grant plan, which would lower Medicaid spending and allow states to limit benefits and coverage in various ways that currently wouldn't be allowed. In general, the Medicaid expansion from the ACA has been universally praised as a massive success, probably the single best part of the entire ACA. Some recent economic analysis suggests that had all states accepted the Medicaid expansion, we could have avoided about 16,000 medically preventable deaths.

https://www.nber.org/papers/w26081
 
Yep

And the dumb expansion holdouts (like NC) are just hurting themselves. And their working poor.
 
Not expanding when given the opportunity is one of the ultimate fuck yourself to own the libs (unfortunately the people getting fucked are often unaware or full of propaganda bs)
 
 
Last edited:
You must log in or register to reply here.
Back
Top