Quote :

""Republicans predicted it would collapse on itself (didn't happen), while Democrats swore the public would embrace it as time went on (also didn't happen).""

still early.
personally i think both are correct. it'll be embraced more and more, and eventually it will collapse. from a bird's eye view, its lifespan will look like social security.

3/31/2014 3:10:45 PM

Quote :

"still early. personally i think both are correct. it'll be embraced more and more, and eventually it will collapse. from a bird's eye view, its lifespan will look like social security."

This is why I just don't bother engaging most Obamcare critics in actual debate. It's a giant waste of time when the person is basing their argument on a purely imaginary set of assertions. To that point,

http://www.latimes.com/business/hiltzik/la-fi-mh-obamacare-numbers-20140331,0,4488747.story#axzz2xZ0cT2xz

Point by point assassination of every anti-Obamacare claim you've heard the past 3 months. None of it is new to anyone who's actually paid attention to the real numbers, but it just goes to show how fanciful the whole "death-spiral" argument has always been.

[Edited on March 31, 2014 at 3:26 PM. Reason : wrong article]

3/31/2014 3:22:49 PM

When I was in Switzerland, I was amazed to find out that they have almost a carbon copy of the ACA. They require every citizen to be insured in the private market.

The outcomes: The Swiss have one of the most expensive healthcare systems in the world, yet they are extremely satisfied with the coverage and are in the top 5 life expectancies in the world (they may be number 1, but I'm not going to look).

3/31/2014 4:16:50 PM

if we are copying anyone, i vote France

^ you can't use subsidies to control costs, subsidies have the opposite effect and will increase costs

[Edited on March 31, 2014 at 4:19 PM. Reason : .]

3/31/2014 4:18:47 PM

Quote :

"This is why I just don't bother engaging most Obamcare critics in actual debate. It's a giant waste of time when the person is basing their argument on a purely imaginary set of assertions. "

i don't engage.. but let me engage for a moment.
i said what i personally think will happen. i figured one of you people would pick up on the social security comparison, which is why i intentionally said "from a bird's eye view". ACA may actually work for a little while but it won't survive. that's not a "death spiral". it's simply not a sustainable idea and quite frankly i'd be shocked if the people actually behind it really thought it would be. it was a great marketing ploy though, i'll give them that much credit. it's easy to buy votes with fantasy ideas (ask pretty much any politician ever elected).

3/31/2014 4:44:37 PM

Quote :

"Yeah, huge benefits like long lines, rationed care, and lack of innovation. Man, I can't wait! "

Again, propaganda... What are you actually basing this on? I live in a country now that has universal health care. When I get sick or need to see a doctor, most of the time I don't make an appointment and just go there after my lunch break, and it is just a walk in service to get medical aid. And, I get great care!

So, I could just as easily use that experience to say that socialized health care is the best option for shorter lines and good service.



[Edited on March 31, 2014 at 5:28 PM. Reason : z]

3/31/2014 5:26:45 PM

I'm not sure how you can say ACA isn't sustainable. All the costs were already being shunted to other insurers/the government anyway.

I just had a friend tell another friend who's mom got cancer (and didn't have a job) to not even bother signing up for a insurance (even though it would likely be mostly subsidized anyway) because "the government" will just pay for things regardless (which is partially true-- the debt will just get written off by the hospitals/medicaid).

All of this still happens under ACA, except there is now documentation of where these costs are going.

ACA isn't an entitlement, it's a process change. It's pretty much completely incomparable to Social Security.

When people get sick, they go to the hospital regardless, and they always have.

3/31/2014 5:50:48 PM

Also if you actually look inside your login for your insurance, the plan is usually paying less than 1/3 of what the provider originally bills for service. My wife just had a $4300 hospital visit get settled for around $1500 by BCBS. Explain to me how that is fair to a cash customer....

What the hospitals are doing is inflating the bills 3 times over so when they get settled by a bill collector its still enough money to pay what they are supposed to get, but if you actually pay your bill like a decent human you are paying 3-4 times what an insurance company would pay.

Its insane.

3/31/2014 9:29:04 PM

Quote :

"eventually it will collapse... like social security."

Off topic, I know, but where does this notion that Social Security will collapse come from?

I'm fairly confident that the stock market will have collapsed again before Social Security does.

[Edited on April 1, 2014 at 12:28 AM. Reason : ]

4/1/2014 12:27:27 AM

Bottom line, I think we can officially stick a fork in the repeal movement. It's just never going to happen at this point. By November we could be looking at up to 15 million previously uninsured Americans covered under either an exchange plan, medicaid expansion, or their parents insurance. You're always going to have the morning talk show kooks and trolls from gerrymandered districts, but no serious candidate in a competitive race will be calling for repeal anymore. At least not until the GOP proposes some sort of viable alternative.



Honestly, at this point, I'd be willing to bet that within 10 years Republicans start claiming the ACA was their idea all along and that Democrats just copied it. It would be the most truthful thing they ever said about the law.

[Edited on April 1, 2014 at 2:46 PM. Reason : :]

4/1/2014 2:36:04 PM

I think a lot of people don't realize that the pre-existing condition coverage mandate goes hand-in-hand with most other aspect of the healthcare law. If the republicans sweep congress and starts talking about this, they'll have to acknowledge this fact, or end up alienating the insurance companies (who would be hurt the most, sadly, under a repeal).

4/1/2014 4:22:59 PM

CNN says 7.1 million applied.

4/1/2014 4:47:09 PM

When you consider that they took the teeth out of all the mandates for now, and allowed insurance companies to continue offering substandard plans, that's pretty good.

4/1/2014 7:14:50 PM

How many will pay?

4/1/2014 7:51:29 PM

People not paying is just another myth. Those who signed up at the end of March don't have their first payment due until some time in May and figures from the state run exchanges show 85-90% of applicants have already paid.

[Edited on April 1, 2014 at 8:00 PM. Reason : :]

4/1/2014 7:59:05 PM

the only reason their first payment is not due is because Obama asked the insurance companies to delay payment and still provide coverage because the site is not fixed yet, and the insurance companies luckily said okay. the reason the state funds can pay is that their sites work, the federal site doesn't work.

4/1/2014 9:29:26 PM

Quote :

"Also if you actually look inside your login for your insurance, the plan is usually paying less than 1/3 of what the provider originally bills for service. My wife just had a $4300 hospital visit get settled for around $1500 by BCBS. Explain to me how that is fair to a cash customer.... What the hospitals are doing is inflating the bills 3 times over so when they get settled by a bill collector its still enough money to pay what they are supposed to get, but if you actually pay your bill like a decent human you are paying 3-4 times what an insurance company would pay. Its insane."

The thing you don't understand is why this is happening. You are thinking "evil hospital, billing so much!" What you don't understand is how insurance works: it pays a set percentage of what the provider bills. The doctor and the hospital aren't fleecing cash customers; on the contrary, they HAVE to set the sticker price high in order to get what they actually want from the insurance company.

To put it in simpler terms, suppose insurance pays 50% for a procedure. The doctor wants to be paid $50 for the procedure. If he bills the insurance company $50, he gets $25. Instead, he bills the company $100 and gets $50. This is how medical insurance (and Medicare and Medicaid) work. They DO NOT pay the full sticker price. The end result, then, is that in order to get what they actually want, providers HAVE to increase their price. But instead, you blame the provider, because you don't understand economics or insurance.

So, you naturally ask "why can't providers have a cash price and an insurance price?" Simple: provider are paid based on the average charge for a procedure; give a cash discount, and you get paid less by insurance. Even worse, in some states, that's not even legal, and insurers will SUE providers for billing fraud for having two different charges.

The simple fact is, insurance is the problem, not the providers, yet Obamacare pushes us further down the road of insurance. We have a problem with price discoverability and transparency, and it's due in large part to insurance covering so much.

4/2/2014 11:10:48 PM

Insurance is the only private cost sharing mechanism, and modern healthcare system can't exist witHouT cost sharing.

So you either support socialized systems, or you accept the insurance system.

4/3/2014 12:05:56 AM

most of the time you can negotiate the cost down if you are paying cash at a hospital.

4/3/2014 12:14:41 AM

True, sometimes even if you have insurance.

No negotiation is going to bring a 30,000$ appendix surgery, or $400,000 cancer treatment down to where the average person can afford it though.

4/3/2014 12:17:59 AM

Which is fine; catastrophic things like that should be covered by insurance. But complaining that the hospital is gouging you over it is silly; they are just working within the confines of our current insurance system.

4/3/2014 12:28:02 AM

Yes, but now everyone will have insurance and get the negotiated rate, muahahahahahaha!

4/3/2014 8:20:19 AM

aaronburro just advocated for mandatory insurance

4/3/2014 8:49:46 AM

Quote :

"most of the time you can negotiate the cost down if you are paying cash at a hospital."

bullshit

maybe a 10% discount or something but thats not anywhere near the "discounts" the insurance companies are getting

4/3/2014 10:37:40 AM

http://www.washingtonpost.com/blogs/post-politics/wp/2014/04/04/paul-ryan-popular-parts-of-obamacare-too-costly-to-reinstate-after-repeal/

Quote :

""If you look at these kinds of reforms, where they've been tried before — say the state of Kentucky, for example — you basically make it impossible to underwrite insurance," Ryan said, according to an advance transcript. "You dramatically crank up the cost. And you make it hard for people to get affordable health care.""

You gotta love how he just coldy explains that the only affordable insurance should be unobtainable junk. This man is despicable by even his own parties standards, why the hell is he so respected by them? He then goes on to not name a single specific reform that would address any of the problem's Obamacare has addressed. It's hilarious, they aren't even advocating the shit they used to advocate when proposing health care reform. People should be able to buy insurance across state lines because everyone is playing by the same rules now. I mean, even the entire concept of people buying something on an exchange to spread the costs around is an entirely conservative idea. But nope, because it's Obama's thing, just destroy it and then try to clean up the rubble.

[Edited on April 4, 2014 at 7:01 PM. Reason : :]

4/4/2014 6:59:09 PM

Congresspeople in general don't seem to be that bright, and few of them stand for anything in particular, I can see how 1 person saying something specific draws the respect of his peers.

It's sad this is what passes for an intellectual though. This must be what makes the founding fathers spin in their graves more than anything.

4/4/2014 7:01:32 PM

Quote :

"I mean, even the entire concept of people buying something on an exchange to spread the costs around is an entirely conservative idea. But nope, because it's Obama's thing, just destroy it and then try to clean up the rubble."

Awwww, how cute... you think insurance is supposed to "spread the cost around". No wonder you don't understand why Obamacare is fundamentally broken

4/4/2014 11:29:37 PM

Insurance is supposed to make money by deny people coverage.

It originally was supposed to be a way if spreading the cost and managing risks in a pooled manner, look up the history of kaiser.

4/5/2014 12:32:11 AM

http://www.businessinsider.com/one-chart-that-shows-obamacare-is-working-2014-4

And Fox New's headline on this same Gallup poll:
"Gallup survey suggests sign-ups under ObamaCare not as high as White House says"
http://www.foxnews.com/politics/2014/04/07/gallup-survey-suggests-sign-ups-under-obamacare-not-as-high-as-white-housesays


[Edited on April 7, 2014 at 10:41 AM. Reason : ]

4/7/2014 10:16:39 AM

Quote :

"Awwww, how cute... you think insurance is supposed to "spread the cost around". No wonder you don't understand why Obamacare is fundamentally broken"

ACA is the "free market" solution. The mandate was required to force people to participate to spread costs, and the exchanges were supposed to reduce prices (because free market!).

4/7/2014 10:51:02 AM

^^
http://www.foxnews.com/politics/2014/04/07/gallup-survey-suggests-sign-ups-under-obamacare-not-as-high-as-white-house-says/

[Edited on April 7, 2014 at 11:04 AM. Reason : ^]

4/7/2014 11:03:54 AM

4/7/2014 12:53:16 PM

Quote :

"“This whole enterprise was just an elaborate excuse,” says Barry Blitt about his cover for this week’s issue. “I enjoyed drawing Ted Cruz, John Boehner, and Michele Bachmann as petulant children—and I especially wanted to draw an open-mouthed Mitch McConnell being spoon-fed his meds.”"

im sure shrike has a much more elaborate explanation of that cover

lets hear more about why obama makes you happy

4/7/2014 1:24:21 PM

Oh look, more facts proving every single negative prediction made about the ACA was completely wrong.

http://www.vox.com/2014/9/5/6108493/obamacare-premiums-lower-2015

Quote :

"A new report from the Kaiser Family Foundation finds that in seven major cities that have released data on 2015 premiums, the price of the benchmark Obamacare plan?— the second-cheapest silver plan, which the federal government uses to calculate subsidies — ?is falling."

Who would have thought that the scientists and economists who actually wrote the fucking thing would be right, and the dumbass politicians and pundits who blasted it would be wrong.

9/5/2014 2:12:40 PM

You should post the details of that plan and its costs. Then we'll tell if you if that statement is worth anything.

9/5/2014 2:39:19 PM

Hahahahha get the fuck out of here with that bullshit.

Hell, since you're apparently too lazy to click twice, I'll save you one.

http://kaiserfamilyfoundation.files.wordpress.com/2014/09/8627-analysis-of-2015-premium-changes.pdf

[Edited on September 5, 2014 at 2:55 PM. Reason : :]

9/5/2014 2:50:26 PM

Such harsh language. Do you kiss your mother with that mouth? I'm convinced though that most liberals are lab-generated and thus have no mothers.

Anyway, how is that not a valid question? If the plan that is quoted is crap, and nobody is buying it, then of course the cost is going to go down. What about good plans? And I don't know if the plan quoted is any good or not, that is why I asked.

And the response I get is useless.

^I'll check it out. Right now my pdf viewer is crapping out.



[Edited on September 5, 2014 at 2:57 PM. Reason : [Edited on September 5, 2014 at 2:56 PM. Reason : adobe sucks]]

9/5/2014 2:55:35 PM

I sometimes feel bad for Shrike. He wants so badly for his liberal wet dreams to make sense and work out, but they just never will. Poor guy.

9/5/2014 3:00:07 PM

None of the Obamacare plans are "crap". That was part of the point of the whole law. It eliminated junk plans that covered practically nothing with extremely high deductibles and copays. The average silver plan has a deductible ~$2000-3000, covers 80% of costs, with a maximum yearly out of pocket ~$5000-6000. Those are national averages, of course it varies state to state and city to city. Keep in mind, preventative care is covered 100% with no deductible for all plans, so most healthy people pay nothing but the premiums for their yearly doctor visits.

I apologize for the "harsh" language, but the mountain of bullshit heaped onto the Obamacare debate has a reached a point where hostility is cathartic.

^See like that, despite all evidence to the contrary, they still cling to their preconceived false notions that the whole thing is going to crumble onto itself. Never. Going. To. Happen.

[Edited on September 5, 2014 at 3:04 PM. Reason : :]

9/5/2014 3:02:51 PM

I looked for the most unbiased source on costs I could find:

http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/Proj2013.pdf

Quote :

"Health care spending sponsored (or financed) by federal, state, and local governments is projected to have grown 3.2 percent (to $1.3 trillion) in 2013. Reflecting growth trends in private health insurance and out-of-pocket spending, outlays by businesses, households, and other private sources are projected to have risen by 3.9 percent in 2013, compared to 4.6 percent in 2012, and to have reached $1.6 trillion in 2013. "

Our current GDP growth is less than 2%, and we can't reasonably expect any more than that. Some adjustment must be allowed to encompass the demographic transition, but generally a growth rate of health care spending in excess of overall economic growth can not be tolerated indefinitely.

Growing at a slightly less rate than last year isn't something to boast about, and given that premiums are still rising, this is putting downward pressure on disposable income. Wages will continue to remain stagnant at this rate, even if we assume a healthy recovery.

But 2013 was the first time we see major impact from the program anyway. The first few years are the real test. I would be tempted to accept the narrative that premiums have generally gone down because we've shifted more spending to government (which I still would not be happy with), but the data doesn't even support that position. Out-of-pocket spending has continued to increase similarly to how it has in the past.

I would not doubt that the fraction of uninsured has gone down. This was somewhat the objective of Obamacare, but I am more heartless. Those uninsured people did not pose a major threat to our economic health. Spending 2-3x more on health care than what we should demographically is the problem. I've argued time and time again that a copay can easily be equal to the full price if you compare and inefficient versus efficient system. It is, thus, no kindness jack up prices and insure someone for the very prices you inflated. Better to be uninsured in a healthy economy than insured in a bad one.

9/5/2014 4:08:04 PM

Ok, so after a year of implementation, the number of uninsured is down and premium growth has slowed. Regardless of the overall economic picture, most of which has nothing to do with ACA or healthcare general, that's a far cry from the death spiral predictions we'd been inundated with for the better part of last year. I don't think anyone claimed that the ACA was going to fix everything for everyone, but at this point, the only honest conclusion you can come to is that's overall effect has been positive. Sounds like the real problem is GDP stagnation and anemic job growth, neither of which have been tackled by Congress because they are too busy trying to repeal Obamacare or fighting GOP obstructionism.

Let's also keep in mind that overall numbers would be even better if you didn't have 24 states continuing to refuse the Medicaid expansion. The fact that the law has managed to overcome what is essentially political sabotage is another point in it's favor.

[Edited on September 5, 2014 at 6:03 PM. Reason : :]

9/5/2014 5:58:43 PM

What is political sabotage?

9/5/2014 6:05:03 PM

I think it was a Beastie Boys song that came out some time ago.

9/5/2014 9:17:48 PM

[quote]Sounds like the real problem is GDP stagnation and anemic job growth, neither of which have been tackled by Congress because they are too busy trying to repeal Obamacare or fighting GOP obstructionism.
[quote]

One of the biggest questions and issues that I have with the Constitution. This can happen, which means any actual strong change made to the government is very difficult to achieve. The constitution, in a way, is designed so that things are functionally dis-functional.

9/6/2014 3:46:15 AM

Functionallly dos-functional can sometimes just be dis-functional.

I don't see our politicians or businesses doing the right things to adapt to the rapidly changing relationship between capital, labor, and profits.

9/6/2014 1:32:53 PM

Functionallly dos-functional can sometimes just be dis-functional.

I don't see our politicians or businesses doing the right things to adapt to the rapidly changing relationship between capital, labor, and profits.

9/6/2014 1:32:53 PM

Quote :

"See like that, despite all evidence to the contrary, they still cling to their preconceived false notions that the whole thing is going to crumble onto itself."

Are you talking about yourself again? There is no "evidence to the contrary". Simple economics dictates that this system will crumble, and it will crumble badly, because it was designed by Democrats to do just that: crumble. That way, when it does fail, they can sit there with a shit-eating grin, after adding mountains of regulations and government mandates into a market, and declare "see, the free market doesn't work!"

9/7/2014 4:26:34 PM

Shrike,

You should read the Kaiser results instead of parroting the shit that Vox has served up. The -.8% decrease is for a pretty narrow subset of all ACA enrollees, looking at other slices and we see the premiums increasing just as they always have.

9/7/2014 7:30:28 PM

Quote :

"Are you talking about yourself again? There is no "evidence to the contrary". Simple economics dictates that this system will crumble, and it will crumble badly, because it was designed by Democrats to do just that: crumble. That way, when it does fail, they can sit there with a shit-eating grin, after adding mountains of regulations and government mandates into a market, and declare "see, the free market doesn't work!""

A better explanation is that it was a giveaway to the insurance industry. They do good things like cover preexisting conditions and cover more people now, but allow loopholes so the insurance industry can get out of treating the newly covered. Some of the new plans have unusable features, like dental, which makes them look better on paper but have no real advantage over what people were buying before.

9/7/2014 9:09:24 PM

Quote :

"Are you talking about yourself again? There is no "evidence to the contrary". Simple economics dictates that this system will crumble, and it will crumble badly, because it was designed by Democrats to do just that: crumble. That way, when it does fail, they can sit there with a shit-eating grin, after adding mountains of regulations and government mandates into a market, and declare "see, the free market doesn't work!""

Quote :

"Shrike, You should read the Kaiser results instead of parroting the shit that Vox has served up. The -.8% decrease is for a pretty narrow subset of all ACA enrollees, looking at other slices and we see the premiums increasing just as they always have. "

What the fuck is this shit? Obamacare truthers? Did you morons learn nothing from the 2012 elections? YOU. WERE. WRONG. Deal with it.

Quote :

"They do good things like cover preexisting conditions and cover more people now, but allow loopholes so the insurance industry can get out of treating the newly covered."

And outlawed rescission, and capped non-medical care spending by insurance companies, and made preventative care free, and, and, and ..... Make no mistake, insurance companies don't like the law. They accepted it because they realized it was the only they could survive in a UHC world. They still lobby harder than anyone else to get it repealed.

[Edited on September 8, 2014 at 12:27 PM. Reason : :]

9/8/2014 12:16:00 PM