patrick.net

So the aca passes and we see rates increase substantially...

Meccos says

So the aca passes and we see rates increase substantially...

Because the ACA failed to include any limits on premium rates.

Meccos says

So the aca passes and we see rates increase substantially...

Rates were ALREADY increasing before ACA. If you look at the actual data, not just anecdotal evidence, rate increases are LESS than they were before.

Because the ACA failed to include any limits on premium rates.

That's not true. Profit and overhead can only be a certain percentage of total income. They are legally barred from raising rates beyond that.

errc says

We are the ones to blame, for this silly concept that we can't have medical care, without "insurance"

I don't think everyone has several million dollars set aside in case they need cancer treatment. I know I don't.

Meccos says

So the aca passes and we see rates increase substantially...

Because the ACA failed to include any limits on premium rates.

Aca requires more services with the threats of less reimbursement... how could rates go lower?

Homeboy says

Meccos says

So the aca passes and we see rates increase substantially...

Rates were ALREADY increasing before ACA. If you look at the actual data, not just anecdotal evidence, rate increases are LESS than they were before.

The data I've seen indicated a higher rate of increase at least in the last year. Nevertheless the point of my comment was that one of the promises of the aca was to make healthcare more affordable... we obviously have not and likely will not see it....

Homeboy says

Because the ACA failed to include any limits on premium rates.

That's not true. Profit and overhead can only be a certain percentage of total income. They are legally barred from raising rates beyond that.

Think about that for a second. Sure insurers can take only 20% of premiums as profit now, but there is still no cap on total premiums.

So now the insurer's motive is to pay out much more for medical care so that their 20% is 20% of a bigger number.

And premiums have obviously continued to skyrocket.

Quit lying Patrick, I've been assured by every Okeydoke Liberal in the world that insurance premiums never went up, that is impossible, because Nancy Pelosi passed Obamacare with out even seeing what was in it. Insurance went up years ago under Regan, we just didn't notice until now.
And how dare you bitch about healthcare, what are you a Republican? You must not want illegal aliens to have the best Gold club member healthcare in the world, while you pay through the nose and receive shit.
Quit being a teabagger.

I just don't understand the utility of health insurance in the first place. I understand that people need health care services. I understand that people are on the other end of that trade, ready to provide health care services. For the life of me, I don't understand the need for health insurance standing in between the two.

It seems to me, that the large, unnecesary cost in this transaction, is the health insurance itself. Not only does it seem that we can do without, but they seem to be the largest inefficiency in the market of health care. I mean, if you operate under the (debatable) assumption that "everyone eventually needs health care" than why the need for a product/service that is billed as an "insurance"?

Insurance-

Risk-transfer mechanism that ensures full or partial financial compensation for the loss or damage caused by event(s) beyond the control of the insured party. Under an insurance contract, a party (the insurer) indemnifies the other party (the insured) against a specified amount of loss, occurring from specified eventualities within a specified period, provided a fee called premium is paid.

So do we ever bother to ask the role and functionality of the health insurance companies in our health care system? Is the price you pay for the risk transfer to this so called insurance, a fair market value? In a so called capitalist society, how are we to view what is "beyond the control of the insured"? And why the hell does using health care services, increase ones likelihood of going bankrupt exponentially?

There's so many questions that need to be answered if "we" are to solve this "health" "care" "problem", but we don't seem to be asking the right ones. Instead its purely political, with both sides looking to seemingly make things worse!

errc says

I just don't understand the utility of health insurance in the first place. I understand that people need health care services. I understand that people are on the other end of that trade, ready to provide health care services. For the life of me, I don't understand the need for health insurance standing in between the two.

Liberal failed logic #105792

"Yeah but if we can make a national health care system based on mandating that every one in America has to feed these greedy bastards pocket while they are free to raise the price at will. Then that's a start..."

errc says

And why the hell does using health care services, increase ones likelihood of going bankrupt exponentially?

Ultimately all of this is due to the fact that no one in America can get elected unless they accept campaign money from the large financial interests that want medical prices to be:

1. ridiculously high
2. secret until billed, when it's too late to make any market-based choices

Fix campaign finance, and you fix everything. But how to fix campaign finance when all of our "representatives" got elected under the current system? They are not going to vote against themselves...

Here's the solution:
Don't buy health insurance. Secretly commit a crime that will land you in jail for about a year. If you get a serious illness turn yourself in to the authorities and while you are in jail they will provide you with health care.
While in prison you will learn valuable skills from other inmates so when you get released you can go into finance or politics or real estate.

Fix campaign finance, and you fix everything. But how to fix campaign finance when all of our "representatives" got elected under the current system? They are not going to vote against themselves...

I agree with you about fixing campaign finance. However Ron Paul, Dennis Kucinich are two names I would not associate with "being bought"

The people who are complaining and pontificating about the high cost of healthcare in the U.S. are generally the same people who oppose adoption of a Single Payer healthcare option which, in all of the first world countries that have had it for decades now, has produced significantly better healthcare for a fraction of what healthcare costs in the U.S.

It's very much like the "doctor shortage" which is really a shortage of Physician Assistants and Nurse Practitioners.

If everyone stopped buying health insurance medical costs would drop significantly. Getting your body "fixed" in a hospital should cost the same as getting your car fixed.
Oh, and stop putting cancer causing shit into your body. Most people take better care of their cars than their own bodies.

tovarichpeter says

has produced significantly better healthcare for a fraction of what healthcare costs in the U.S.

The problem with this statement is that it is actually quite difficult to determine who has better healthcare. Just looking at some numbers can not give qualitative measurements on healthcare because there are so many other factors which are not considered in these stats. For example, obesity and diabetes in the USA is much higher than some other nations. This will greatly skew numbers in a particular direction but does not reflect on the quality of healthcare in the USA.

tovarichpeter says

It's very much like the "doctor shortage" which is really a shortage of Physician Assistants and Nurse Practitioners.

Unfortunately the use of PAs and NPs is a problem in my opinion. The argument is that they can practice in the same scope as a physician. Being in the medical field, I can tell you that they do not and they can not. PAs and NPs are simply used because they are cheap replacement for physicians. But as we all know, you get what you pay for. When me or any of my family ever needs to go to a hospital or a medical office, I always demand to have a physician. This is because I want the best... not because I am biased.

Meccos says

The data I've seen indicated a higher rate of increase at least in the last year.

Post it. I have seen no such data. And it better be from a reliable source, not some crackpot right-wing rag.

David Losh says

All any one has asked for is access to the same Health Insurance Congress people enjoy.

Simply not true. Congress, government employees and anyone who qualifies for VA benefits are accessing a 'socialist' healthcare system. Which btw is awesome.

Unfortunately, the vast majority of Americans have rejected such healthcare for themselves, all the while complaining about their crummy healthcare and increasing health care premiums.

American's have not asked for such healthcare, they have rejected it

Meccos says

Nevertheless the point of my comment was that one of the promises of the aca was to make healthcare more affordable... we obviously have not and likely will not see it....

Perhaps that will be the case, but you are making a premature judgment. The main provisions of ACA are not in effect yet. Whether you agree or not, those who wrote the law believed that mandatory coverage was crucial to making it work. I think it was strange to phase in other parts of the law before the mandate is enacted, but that's how they chose to do it. So until the provisions of the law actually take effect, how can you declare it a failure? All you're doing now is indicting the FORMER system.

Think about that for a second. Sure insurers can take only 20% of premiums as profit now, but there is still no cap on total premiums.

But how could you put an absolute dollar-amount cap on premiums? If expenses rose beyond what you allow the company to charge, you would be forcing them to operate at a loss.

2011: $1344 per month
2012: $2325 per month

See that is the scary thing with Obamacare. if your company gives you 25k or some such health insurance, then you pay a 40% tax on that. Sigh...

Homeboy says

Meccos says

Nevertheless the point of my comment was that one of the promises of the aca was to make healthcare more affordable... we obviously have not and likely will not see it....

Perhaps that will be the case, but you are making a premature judgment. The main provisions of ACA are not in effect yet.

You are right I am making a premature judgement. You are also right in that the main provision of the ACA are not in effect yet. We have yet to see the effects of this. However the ACA is requiring more services with less reimbursement. Do the math. More cost, less reimbursement. Someone has to pay.

Homeboy says

Whether you agree or not, those who wrote the law believed that mandatory coverage was crucial to making it work.

Yeah it being mandatory is crucial because they will need people to subsidize a part of this somehow.

Homeboy says

So until the provisions of the law actually take effect, how can you declare it a failure?

When did I declare this a failure?

In the end it appears that the costs associated with the ACA provisions are going to be passed down to the insurance holders, as experienced by many people on this forum including Patrick. As I stated before, we have not seen improving affordability, nor do I think we will see it (based on these provision). In fact I would argue that it will likely worsen. If you think that is a failure, so be it.

Buster says

American's have not asked for such healthcare, they have rejected it

At the beginning of the ObamaCare debate the question was raised why people of Congress get top of the line Health Insurance for a premium of $7K per year. That is about $600 per month, for the best.

That all gets lost when people start comparing a Blue Cross Health Insurance plan to the government managed health care Congress gets.

Blue Cross does nothing. Blue Cross is an accounting system that some people can afford, but not every one. Instead we have hundreds, maybe thousands of premium collection accounts all competing for the same dollars.

If all the dollars paid for premiums went into one pool that would be a monopoly. However if the government manages that pool of dollars it's called socialism.

Read the book by the owner of Telephonica where he explains that a monopoly is the most cost effective, and most profitable, system of ownership. You just can't leave it in private hands without sever over sight.

Look at Bill Gates. His monopoly is worth Billions, along with all the millionaires that company has made.

So you call it socialism, and I call it profitable. Those profits, by single payer, government managed health care, could be used for higher quality care.

Meccos says

When did I declare this a failure?

In the end it appears that the costs associated with the ACA provisions are going to be passed down to the insurance holders, as experienced by many people on this forum including Patrick. As I stated before, we have not seen improving affordability, nor do I think we will see it (based on these provision). In fact I would argue that it will likely worsen. If you think that is a failure, so be it.

I don't know if you're playing some semantics game with me or what. Obviously, a measure that was passed to control costs and did not do so would be a failure. I'm not sure what your point is as far as re-defining what "failure" means, nor do I think it's germane to this discussion.

I do think your argument is specious on 2 levels:

1. As I wrote, you can't honestly say that rising health premiums are a result of the law until the law has actually taken effect.

2. While premiums continue to rise, there has been improvement in the rate at which they do so. Although technically, what you say is true, you seem to imply that ACA has made the problem worse, when in fact the situation has improved. And I see no reason it will not improve even more as soon as everyone is contributing premium payments into the system in 2014.

http://www.washingtonpost.com/blogs/wonkblog/wp/2012/09/11/the-average-employer-health-plan-now-costs-15980-and-thats-kind-of-good-news/
Health insurance premiums rose by 4 percent between 2011 and 2012. That’s not nothing, but it’s a whole lot less than the double-digit premium increases that were common about a decade ago. In fact, since 2004, the Kaiser Family Foundation has not seen any double-digit increases at all. Just like national health expenditures, employer-based premiums are seeing a cost-growth slowdown.

Meccos says

Yeah it being mandatory is crucial because they will need people to subsidize a part of this somehow.

I agree. You can't have an insurance system where people just sign up AFTER they get sick. Why this point seems to be completely lost on so many people is beyond me.

I have thought about starting my own insurance plan. Take 2000 members each paying 5000 person for a 5 year period. This insurance applies to extreme incidents and not regual visits. Your coverage maxes out at 250,000.

Partick.

Our small business rates went up by 13% for next year. It's up about 60-70% since 2008.

WTF? Where is all this money going?

Where is all this money going?

I love answering this.

The money goes into building facilities, paying salaries, buying newer equipment, education programs, and increased insurance premiums based on a growing set of nonprofit costs.

David Losh says

The money goes into building facilities, paying salaries, buying newer equipment, education programs, and increased insurance premiums based on a growing set of nonprofit costs.

Twice as much money in about 6 years?

That is not believable. The facilities and salries have not doubled since then.

Buster says

David Losh says

All any one has asked for is access to the same Health Insurance Congress people enjoy.

Simply not true. Congress, government employees and anyone who qualifies for VA benefits are accessing a 'socialist' healthcare system. Which btw is awesome.

Unfortunately, the vast majority of Americans have rejected such healthcare for themselves, all the while complaining about their crummy healthcare and increasing health care premiums.

American's have not asked for such healthcare, they have rejected it

We get the government we deserve.

The facilities and salries have not doubled since then.

Here in Seattle they have.

We have University of Washington, Swedish Medical, Providence, and NorthWest Hospital. All are building like crazy, and expanding.

Of course they need to cut back on staff, and attempt to break the nurses union, but we have some very highly paid people here running the show.

I forgot the independents like the Poly Clinic which had a huge expansion this year.

Homeboy says

Meccos says

Yeah it being mandatory is crucial because they will need people to subsidize a part of this somehow.

I agree. You can't have an insurance system where people just sign up AFTER they get sick. Why this point seems to be completely lost on so many people is beyond me.

Yes I agree with you. However I think the ACA forcing people to buy insurance to subsidize the cost of others is not right. Hence you see premiums still rising and people like patrick and others on this forum paying more and more for their insurance...

WTF? Where is all this money going?

Part of the money is going to subsidize for those who did not have insurance previously but now will because of the ACA. Increasing coverage comes at a cost... unfortunately we will be paying for that...

David Losh says

and attempt to break the nurses union,

I am not sure about what is going on with nursing unions in seattle, but I can tell you that in california, the nursing unions run the show. In the hospital that I work in, there are many nurses making over 200k a year (more than most physicians), they decide who gets hired, where they work and how much they work. They decide what hours the clinics open and close. If nurses decide they do not want to work, clinics pretty much close. They even fight to keep nurses on staff even though they have been caught using illicit drugs on the floors. They pretty much dictate how the hospital runs. Its quite ridiculous.

Meccos says

WTF? Where is all this money going?

Part of the money is going to subsidize for those who did not have insurance previously but now will because of the ACA. Increasing coverage comes at a cost... unfortunately we will be paying for that...

That and there is a tax on medical devices now to fund the ACA,as well as 40% tax on policies offered by companies for I think that are worth 25k-which is pretty much the cheapest policy for a family now.

Meccos says

I am not sure about what is going on with nursing unions in seattle, but I can tell you that in california, the nursing unions run the show. In the hospital that I work in, there are many nurses making over 200k a year (more than most physicians), they decide who gets hired, where they work and how much they work. They decide what hours the clinics open and close. If nurses decide they do not want to work, clinics pretty much close. They even fight to keep nurses on staff even though they have been caught using illicit drugs on the floors. They pretty much dictate how the hospital runs. Its quite ridiculous.

What is your job at that hospital?

lostand confused says

That and there is a tax on medical devices now to fund the ACA,as well as 40% tax on policies offered by companies for I think that are worth 25k-which is pretty much the cheapest policy for a family now.

The tax on devices is 2.3% starting in 2014, and the 40% tax on "Cadillac plans" with premiums over $27,500/year doesn't start till 2018.

So those things can't explain the recent giant jumps in premiums.

I want to opt out based on my personal belief. I beleive i will die and do not want to pay for it over and over again.