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ACA Running Thread

Actually, Trump is raising health insurance premiums

Pennsylvania regulators said Monday that rates will jump 30.6%, on average, rather than the 7.6% hike that was expected had Trump continued funding the subsidies.
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Most Obamacare enrollees, however, won't feel any hikes in rates. That's because they can still receive premium subsidies that reduce their rates to less than 10% of their household income.

Instead, taxpayers will foot the bill. The federal government will have to spend an estimated $7.2 billion more next year because it will have to shell out more in premium subsidies to cover these higher rates, according to an Urban Institute analysis.
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a prediction that was known months ago as the "worst case scenario" when insurers filed their rates
 
Re 60 votes, no. Not unless one of them is McConnell and he can steal Speaker Ryan's copy of "Atlas Shrugged" and hold it hostage until Ryan puts the same plan up for a vote in the house.
 
Really interesting to see how this plays out.

Its amazing how much this story is mis-represented on both sides. As someone mentioned above, these programs will exist, insurers will just rate for it. Who loses? The schlub who isn't subsidy eligible and their rates went up to cover the cost. And this isn't an insurer bail out. Its a function of poorly written law.

Im pretty sure these facts are known but the poils stick to their TPs to keep the masses happy (Rs hate the poors, the ACA is an insurance company invention). At least I hope this is a case. If our politicians don't get how this works, we are very screwed.
 
sounds like the carriers are passing on the pain to small group as well in '18. We're renewing 12/1 as a result.
 
61raddeac said:
America is addicted to fee for service.

http://www.kevinmd.com/blog/2017/10/u-s-addicted-fee-service-health-care.html?utm_source=dlvr.it&utm_medium=twitter
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1000% agree. Great find.

Breaking the habit will require painful changes for doctors and hospitals. After all, America’s most efficient medical groups provide outstanding quality with 40 percent lower utilization of hospital beds per population when compared to the rest of the nation. If the care provided by doctors in all hospitals emulated this best-in-class efficiency, then 40 percent of all hospitals beds would suddenly empty, and many facilities would go out of business. It will be equally problematic trying to get doctors — particularly highly compensated specialists — to give up lucrative but ineffective procedures. As Upton Sinclair once said, “It is difficult to get a man to understand something when his salary depends on his not understanding it.”
 
CHDeac said:
1000% agree. Great find.

Breaking the habit will require painful changes for doctors and hospitals. After all, America’s most efficient medical groups provide outstanding quality with 40 percent lower utilization of hospital beds per population when compared to the rest of the nation. If the care provided by doctors in all hospitals emulated this best-in-class efficiency, then 40 percent of all hospitals beds would suddenly empty, and many facilities would go out of business. It will be equally problematic trying to get doctors — particularly highly compensated specialists — to give up lucrative but ineffective procedures. As Upton Sinclair once said, “It is difficult to get a man to understand something when his salary depends on his not understanding it.”
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It's good article, but I think focusing on hospital bed utilization isn't a particularly good metric. We don't use hospital beds any more than other OECD countries that spend far less with comparable or better outcomes.
 
CHDeac said:
1000% agree. Great find.

Breaking the habit will require painful changes for doctors and hospitals. After all, America’s most efficient medical groups provide outstanding quality with 40 percent lower utilization of hospital beds per population when compared to the rest of the nation. If the care provided by doctors in all hospitals emulated this best-in-class efficiency, then 40 percent of all hospitals beds would suddenly empty, and many facilities would go out of business. It will be equally problematic trying to get doctors — particularly highly compensated specialists — to give up lucrative but ineffective procedures. As Upton Sinclair once said, “It is difficult to get a man to understand something when his salary depends on his not understanding it.”
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The over and inappropriate utilization of imaging is mind boggling. Hopefully we are making some progress, but I thought we would have made more progress by now.

https://www.acr.org/Quality-Safety/eNews/Issue-15-September-2016/Mandatory-Consultation-of-Appropriate-Use-Criteria
 
61raddeac said:
The over and inappropriate utilization of imaging is mind boggling. Hopefully we are making some progress, but I thought we would have made more progress by now.

https://www.acr.org/Quality-Safety/eNews/Issue-15-September-2016/Mandatory-Consultation-of-Appropriate-Use-Criteria
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Bed usage isn't ideal but the theme of a FFS model driving over utilization is 100% spot on.

Imaging is downright crazy. Think you need a scan? No problem! And the relationship between the folks owning the scanners and ordering the scans is also worrisome.
 
For sure the incentives in our healthcare system are perverse and highly inflationary. Good for innovation (though too often the innovation is of really poor value) and facilitating availability (but not necessarily affordability) of technology. Also erosive for satisfactory encounters on a personal level for both patients and providers.

And it’s true that efforts to rewire them are resisted mightily. Interestingly, not just by medical industries, systems and providers but also by poorly informed consumers (aka voters). If incentives are altered, behavior will change. Yes, there will be unintended and sometimes undesirable or unsatisfactory consequences. But it’s the only way to get costs down.
 
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CBO says bipartisan bill will lower premiums and reduce the deficit.

 
Cool. So let's do it.
 
Went to the ER for about 5 hours yesterday because the wife has never experienced heartburn before. State of CA picking up the bill cause of #safetynets.

Solved the issue with some Tums once we got home.
 
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