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Net Effect Of Obamacare


By Patrick   Follow   Fri, 9 Mar 2012, 2:08pm PST   20,397 views   129 comments   Watch (0)   Share   Quote   Permalink   Like   Dislike  

Several years in, it seems to me that the net effect of Obamacare so far has been to do nothing but raise premium costs dramatically.

The core idea of Obamacare is that everyone will be required by law to pay private health insurance companies unlimited premiums.

Sure, health insurers now have to spend 80% of the premiums on medical care, but that just means they have a compelling motive to raise both premiums and medical care payments, so that their 20% profit is 20% of a much bigger number.

Insurers can no longer deny coverage based on pre-existing conditions, but that also means that insurers will both pay out more on medical costs, and raise premiums again to get back to 20% of an even larger premium amount. Their not going to reduce their profits voluntarily.

Insurers have to keep children on their parents' plans to a later age, but yet again, that will raise their payments and therefore raise premiums even more.

So premiums will be too high to pay, and yet we will all be required by law to pay.

Am I misunderstanding something here?

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CL   befriend   ignore   Mon, 12 Mar 2012, 3:33am PDT   Share   Quote   Like   Dislike     Comment 10

rootvg says

A lot of people don't think Obamacare will survive the SCOTUS challenge.

Who thinks that? Legitimate court watchers?

To answer Patrick's question, wouldn't this really just mean there should be a Public Option, and if we had one consumers would vote accordingly with their dollars?

rootvg   befriend   ignore   Mon, 12 Mar 2012, 3:57am PDT   Share   Quote   Like   Dislike     Comment 11

CL says

rootvg says

A lot of people don't think Obamacare will survive the SCOTUS challenge.

Who thinks that? Legitimate court watchers?

To answer Patrick's question, wouldn't this really just mean there should be a Public Option, and if we had one consumers would vote accordingly with their dollars?

You might want to read this:

http://www.nationalreview.com/critical-condition/270847/obamacare-decision-may-invite-supremes-limit-federal-power-grace-marie-tur

It's a little deep for those of us without law degrees but here again, it's not what they say but what they don't say.

If Obamacare is turned back in a 5-4 decision, that'll be the signal that our national politics are about to take a sharp turn to the right. How Jerry will handle the Republicans turning off the money spigot is anyone's guess.

Where in the Constitution does the government have the right to make someone buy a product just because he or she is alive? Don't give me the straw dog car insurance argument. You don't have to own or drive a car.

Patrick   befriend   ignore   Mon, 12 Mar 2012, 4:07am PDT   Share   Quote   Like (1)   Dislike     Comment 12

I just read a comic book explaining Obamacare, called "Health Care Reform" by Jonathan Gruber. The book was pretty good at explaining the plan, but on page 90 it says:

For those with nongroup insurance, the CBO finds that if they choose to keep the same type of policy they have today, then their premiums wil fall by 14% to 20%.

Wow, that is so WRONG. My own premiums went up 73% in one year:

http://patrick.net/?p=602077

I wrote Dr Gruber this email:

Hello Dr. Gruber,
I just read your comic book "Health Care Reform" and while the book is pretty good, the ACA has so far made my life much worse rather than better.

My own nongroup Blue Shield of California family premiums went up 73% in one year, and that's not due to any medical condition on our part. Just pure price gouging by insurers, which the ACA seems to have encouraged. All California insurers seem to have raised rates by about that amount in the last year or two. There is definitely no competition in that oligopoly. See this graph of my premiums:

http://realestate.patrick.net/?p=602077

Why is there no limit to what insurers can charge in premiums? Requiring insurers to spend 80% on health care costs just encourages them to pay much more for everything, so that their 20% is 20% of a bigger number.

I don't expect a reply, but I have to let you know that the ACA is definitely not working for me.

Patrick Killelea
Menlo Park, CA
p@patrick.net

zzyzzx   befriend   ignore   Mon, 12 Mar 2012, 5:05am PDT   Share   Quote   Like   Dislike     Comment 13

Patrick says

Several years in, it seems to me that the net effect of Obamacare has been to do nothing but raise premium costs dramatically.

rootvg   befriend   ignore   Mon, 12 Mar 2012, 5:07am PDT   Share   Quote   Like   Dislike     Comment 14

zzyzzx says

Patrick says

Several years in, it seems to me that the net effect of Obamacare has been to do nothing but raise premium costs dramatically.

If the homeowner isn't insulted by your offer...you didn't bid low enough!!!

If the seventies taught us anything, it's that wage and price controls (a significant element of Obamacare) do not work.

zzyzzx   befriend   ignore   Mon, 12 Mar 2012, 5:08am PDT   Share   Quote   Like (2)   Dislike (3)     Comment 15

Patrick says

Insurers can no longer deny coverage based on pre-existing conditions, but that also means that insurers will both pay out more on medical costs, and raise premiums again to get back to 80% of an even larger premium amount.

You have to understand the liberals typically don't understand or consider the negative consequences of their legislation.

rootvg   befriend   ignore   Mon, 12 Mar 2012, 5:11am PDT   Share   Quote   Like (3)   Dislike (2)     Comment 16

zzyzzx says

Patrick says

Insurers can no longer deny coverage based on pre-existing conditions, but that also means that insurers will both pay out more on medical costs, and raise premiums again to get back to 80% of an even larger premium amount.

You have to understand the liberals typically don't understand or consider the negative consequences of their legislation.

If the homeowner isn't insulted by your offer...you didn't bid low enough!!!

The upshot is, they don't care.

That's what the Constitution is for and they would LOVE to get rid of it.

EBGuy   befriend   ignore   Mon, 12 Mar 2012, 5:29am PDT   Share   Quote   Like   Dislike     Comment 17

In the long run, I think Kaiser's model prevails and we'll get lower rates. In the short term Kaiser has to build more hospitals and up staffing levels to meet a much larger demand. There's not a ton of incentive to blast the competition out of the water on price if they can't accommodate the additional customers and patients. So they price below the other insurers so as not to lose share, but not enough to bring down prices. Meanwhile, Sutter and the insurers battle it out (not sure the patients see much benefit there as they're negotiating higher prices for doctor/hospital reimbursement). I think Sutter eventually offers their own insurance to go head to head with Kaiser as they'd then have doctors groups, hospitals, and insurance under one roof.

freak80   befriend   ignore   Mon, 12 Mar 2012, 5:35am PDT   Share   Quote   Like (4)   Dislike     Comment 18

Patrick says

The core idea of Obamacare is that everyone will be required by law to pay private health insurance companies unlimited premiums.

Gotta love America. We take the worst ideas from the Left, and the worst ideas from the Right; and combine them into the worst possible legislation. Because that's how billionaires are made.

freak80   befriend   ignore   Mon, 12 Mar 2012, 5:37am PDT   Share   Quote   Like (2)   Dislike     Comment 19

Patrick says

Insurers have to keep children on their parents' plans to a later age, but yet again, that will raise their payments and therefore raise premiums even more.

Sheesh. It's almost like there's no free lunch or something.

rootvg   befriend   ignore   Mon, 12 Mar 2012, 5:38am PDT   Share   Quote   Like (1)   Dislike     Comment 20

wthrfrk80 says

Patrick says

The core idea of Obamacare is that everyone will be required by law to pay private health insurance companies unlimited premiums.

Gotta love America. We take the worst ideas from the Left, and the worst ideas from the Right; and combine them into the worst possible legislation. Because that's how billionaires are made.

The part of the law where college kids can stay on their parents' policies and then the part about covering people with pre-existing conditions will stick around but I don't see the mandate surviving.

Did you know Obamacare is the most unpopular piece of Federal legislation since Prohibition?

CL   befriend   ignore   Mon, 12 Mar 2012, 9:40am PDT   Share   Quote   Like   Dislike     Comment 21

rootvg says

You might want to read this:

http://www.nationalreview.com/critical-condition/270847/obamacare-decision-may-invite-supremes-limit-federal-power-grace-marie-tur

I said "Legitimate", not NRO!! I think it's well-known that it will not be overturned.

Even now, you don't need to buy anything. You can chose to be fined, n'est-ce pas? And the Government has the ability to fine.

I thought the right-wing was about personal responsibility? Why do we who have insurance have to pick up the tab for those who wrongly believe that they are invincible?

Patrick   befriend   ignore   Mon, 12 Mar 2012, 10:47am PDT   Share   Quote   Like (4)   Dislike     Comment 22

CL says

To answer Patrick's question, wouldn't this really just mean there should be a Public Option, and if we had one consumers would vote accordingly with their dollars?

I do think there should be a public insurance option.

Then at least if I have to buy insurance, I'd have the option of buying into Medicare instead of being forced by law to hand over money to extremely rich private insurers.

Blue Shield may be a "non-profit" but that doesn't stop it from paying the CEO gigantic bonuses for hiking premiums on people like me.

What really pissed me off is being forced by law to pay the very rich. I'd rather let the government blow my money. But maybe there is no difference between the 0.1% and the government anymore.

rootvg   befriend   ignore   Mon, 12 Mar 2012, 1:16pm PDT   Share   Quote   Like (2)   Dislike (1)     Comment 23

CL says

rootvg says

You might want to read this:

http://www.nationalreview.com/critical-condition/270847/obamacare-decision-may-invite-supremes-limit-federal-power-grace-marie-tur

I said "Legitimate", not NRO!! I think it's well-known that it will not be overturned.

Even now, you don't need to buy anything. You can chose to be fined, n'est-ce pas? And the Government has the ability to fine.

I thought the right-wing was about personal responsibility? Why do we who have insurance have to pick up the tab for those who wrongly believe that they are invincible?

So, I have to find a quote from Mother Jones or The Nation? Fuck that.

You just watch and see what happens. My understanding is the Court scheduled debate for three times the normal length given to both sides of a case. Whatever they decide, it will be a very big deal...just as Canada's highest court had to get involved with putting Medicare (their name for single payer) in force there during the 1960s.

freak80   befriend   ignore   Mon, 12 Mar 2012, 3:09pm PDT   Share   Quote   Like (2)   Dislike     Comment 24

CL says

Even now, you don't need to buy anything. You can chose to be fined, n'est-ce pas? And the Government has the ability to fine.

So you're ok with that? I don't think it's very "liberal" to force people to buy insurance from a private company. Heck, I'd much rather have some kind of single-payer "Medicare for All" system than some Rube-Goldberg broke-ass system that involves the worst of Big Government and Big Business.

Danaseb   befriend   ignore   Mon, 12 Mar 2012, 7:36pm PDT   Share   Quote   Like (2)   Dislike     Comment 25

EBGuy says

In the long run, I think Kaiser's model prevails and we'll get lower rates. In the short term Kaiser has to build more hospitals and up staffing levels to meet a much larger demand. There's not a ton of incentive to blast the competition out of the water on price if they can't accommodate the additional customers and patients. So they price below the other insurers so as not to lose share, but not enough to bring down prices. Meanwhile, Sutter and the insurers battle it out (not sure the patients see much benefit there as they're negotiating higher prices for doctor/hospital reimbursement). I think Sutter eventually offers their own insurance to go head to head with Kaiser as they'd then have doctors groups, hospitals, and insurance under one roof.

Forgive me for saying this; but only in America do you get people so naive that they think Kaiser's model is the answer. I had Kaiser Insurance for the majority of my life, they are scum same as everyone else and also have the distinction of being the original HMO.

That they are a nonprofit is a FARCE and their pioneering effort in HMO is the largest originator of our broken profiteer run Healthcare. The Answer is a real non profit, no fatass executives using non profit just as a tax dodge.

freak80   befriend   ignore   Tue, 13 Mar 2012, 12:26am PDT   Share   Quote   Like (3)   Dislike     Comment 26

Wasn't Kaiser defeated in World War I? And when was he ever involved in health insurance?

elliemae   befriend   ignore   Tue, 13 Mar 2012, 1:05am PDT   Share   Quote   Like (1)   Dislike     Comment 27

I just got a new plan - and it limits me to 4 migraines a month. That might seem okay, but when you're in the middle of a horrible headache that debilitates you to the point that you can't see, are vomiting and even the cat walks too loud, limits on medication don't make sense.

If the CEO of my non-profit insurance plan had migraines, the cap would be lifted.

bob2356   befriend   ignore   Tue, 13 Mar 2012, 2:21am PDT   Share   Quote   Like   Dislike     Comment 28

Patrick says

Blue Shield may be a "non-profit" but that doesn't stop it from paying the CEO gigantic bonuses for hiking premiums on people like me.

So why are you still with bc/bs? Get a catastrophic policy and pay day to day stuff out of pocket.

Patrick   befriend   ignore   Tue, 13 Mar 2012, 2:24am PDT   Share   Quote   Like (4)   Dislike     Comment 29

That is with just the catastrophic policy and paying day to day stuff out of pocket!

I checked the other insurers available in California. They all hiked rates in synch, defeating any notion of a "free market".

And of course, by law, I'm not allowed to get insurance from other states.

rootvg   befriend   ignore   Tue, 13 Mar 2012, 2:26am PDT   Share   Quote   Like   Dislike     Comment 30

wthrfrk80 says

Wasn't Kaiser defeated in World War I? And when was he ever involved in health insurance?

You're thinking of the wrong Kaiser.

Ship building magnate Henry Kaiser got into the healthcare business when he hired the first doctor to take care of people building his victory ships.

freak80   befriend   ignore   Tue, 13 Mar 2012, 2:47am PDT   Share   Quote   Like (1)   Dislike     Comment 31

Ah ok. My mistake. Henry Kaiser also invented sandwich rolls, right?

freak80   befriend   ignore   Tue, 13 Mar 2012, 2:48am PDT   Share   Quote   Like (2)   Dislike     Comment 32

Patrick says

And of course, by law, I'm not allowed to get insurance from other states.

God Bless America!

rdm   befriend   ignore   Tue, 13 Mar 2012, 5:06am PDT   Share   Quote   Like (2)   Dislike     Comment 33

The biggest failure of Obama care was lack of a public option, that could still be added and if the law is not overturned and if it doesn't keep costs down probably will be added. The frame work is already in place with Medicare.

Regarding the current increase in premiums for private/individual insurance, the theory is that the insurance exchanges will promote competition and allow consumers to compare policies more easily. They wont be in effect for another couple of years. The exchanges will make comparing coverage easier as to the cost control without out a public option I kind of doubt it, but time will tell. There were many failures in putting this piece of legislation together.

The republican mantra of repeal and replace hasn't panned out either. I have no doubt they would repeal it if given the opportunity but I have yet to see the proposed legislation to replace it. IMO a "free market" solution will not work, that is it will not provide reasonable coverage for all or even the close to the number covered by even the flawed Obama care concept. But until they put forth legislation that can be analyzed we really cant compare the two ideas. It is clear that the Ryan voucher plan for Medicare can not possibly work other than to reduce government costs by cost shifting, while creating a concurrent reduction in coverage by putting the cost burden more directly on the elderly private citizens. Someone should tell Ryan that there just aren't a lot of private insurers wanting to insure the 65+ year olds at a cost that could be afforded and possibly at any costs at all.

EBGuy   befriend   ignore   Tue, 13 Mar 2012, 6:51am PDT   Share   Quote   Like   Dislike     Comment 34

Forgive me for saying this; but only in America do you get people so naive that they think Kaiser's model is the answer. I had Kaiser Insurance for the majority of my life, they are scum same as everyone else and also have the distinction of being the original HMO.
Please share you experience with the rest of us. The doctors groups may be the weakest link in the Kaiser model. On the plus side, they are salaried and receive less remuneration than medical professionals in the fee for service model. This helps keep cost down. They are incentivized to have a healthy population. On the negative side, the doctor medical groups are for-profit, so there are no guarantees that lower costs get passed onto the consumer (though the insurance and hospital sides help provide some balance).
@wthrfrk80 - keep it coming. Always enjoy your low key sense of humor (a nice counterpoint to AF).

RedStar   befriend   ignore   Tue, 13 Mar 2012, 7:44am PDT   Share   Quote   Like   Dislike     Comment 35

Danaseb says

In the long run, I think Kaiser's model prevails and we'll get lower rates. In the short term Kaiser has to build more hospitals and up staffing levels to meet a much larger demand. There's not a ton of incentive to blast the competition out of the water on price if they can't accommodate the additional customers and patients. So they price below the other insurers so as not to lose share, but not enough to bring down prices. Meanwhile, Sutter and the insurers battle it out (not sure the patients see much benefit there as they're negotiating higher prices for doctor/hospital reimbursement). I think Sutter eventually offers their own insurance to go head to head with Kaiser as they'd then have doctors groups, hospitals, and insurance under one roof.

I have seen their plans for when Obamacare hits. They have NO plans to up hospital staffing levels, and are very slowly building a few hospitals here and there, but not enough to make a real difference.

Their basic plan is to drastically change their criteria for hospital admission: you'll have to be dying to get admitted, and when you are, they're going to discharge you(kick you to the curb) to outpatient treatment asap. A higher up bluntly told me there is no way they can keep the same level of service with the influx of new patients.

Patrick   befriend   ignore   Tue, 13 Mar 2012, 10:00am PDT   Share   Quote   Like (2)   Dislike     Comment 36

RedStar says

you'll have to be dying to get admitted, and when you are, they're going to discharge you(kick you to the curb) to outpatient treatment asap.

Ironically, kicking people out of the hospital quickly seems to save lives.

I know it sounds counter-intuitive, but I saw some study that showed that the less time people spend in the hospital, the better they recover, up to some limit of course. One reason is that there's less of a chance for opportunistic infections. No matter how clean a hospital is, it's full of sick people with various infections, and you just don't want to be near them when you're weak.

errc   befriend   ignore   Tue, 13 Mar 2012, 2:07pm PDT   Share   Quote   Like (1)   Dislike     Comment 37

What would the health of our nation, and the accessibility to healthcare services look like, if we didn't have to pay the insurance man his dues before being able to do business with the healthcare people?

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