Obamacare, the greatest theft of all time?
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Obamacare, the greatest theft of all time?

By anonymous following x   2017 Nov 12, 7:36pm 1,260 views   58 comments   watch   quote     share    


#politics Our healthcare has degraded into the worst of all possible situations. A family of 4 will be stuck with paying $1500/month easy. If the family is close to the federal poverty level, heavy subsidies from taxpayers are applied so we can cover essential health benefits such as transvestite gender reassignment surgery and hormone replacement medications.

If the family of 4 is poor, there is a high likelihood that the subsidized health insurance is the single largest consumption of resources made by that family, most likely eclipsing housing and dwarfing car payments.

The system is broken, and we have government intervention to blame. There is close to nothing in our healthcare system that resembles a free market. This system appears designed to fail, as the critics of Obamacare have said for a while.

The question: is there a solution?

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41   errc   ignore (2)   2017 Nov 13, 11:40am   ↑ like (2)   ↓ dislike (0)     quote      

anon_983ac says
bob2356 says
anon_38c3f says


You just proved why. The COST.

Unless cost controls are put in place (Obamacare NEVER controlled cost of procedures and care), single payer will bankrupt the country.


You are very confused on terms. ACA isn't single payer or anything close to single payer. It's government subsidized health care insurance.


If healthcare was affordable, the government wouldn't have to subsidized the ability to pay for it.


You’re conflating health insurance with healthcare. Be smarter
42   anon_983ac   ignore (0)   2017 Nov 13, 11:42am   ↑ like (2)   ↓ dislike (0)     quote      

mell says
bob2356 says
mell says


Good list. This is exactly what a productive discussion on patnet should look like. Upfront pricing would rip the mask off this racket.


Great, How does one price something up front if you don't know what is wrong yet? Goran dodged this question also.


Standard visits all have fixed prices you just don't know them they are billed to the insurance, same for most diagnostics. The majority are standard procedures, probably 80% of procedures who can be priced upfront very easily, if not more. I see no issue here.


What bob doesn't realize is that there is this thing called HCPCS (The Healthcare Common Procedure Coding System) that all major insurance companies use for billing. It details pricing for the majority of treatments and procedures. You can get that list from any insurance provider along with the allowance they pay for each one.
43   HEY YOU   ignore (7)   2017 Nov 13, 12:15pm   ↑ like (1)   ↓ dislike (0)     quote      

anon_983ac says
You can get that list from any insurance provider along with the allowance they pay for each one.


Insurance to healthcare providers & vice versa,you scratch my back,I'll scratch yours.

Pay cash in the free market system & see if your itch is scratched.
44   HEY YOU   ignore (7)   2017 Nov 13, 12:27pm   ↑ like (0)   ↓ dislike (1)     quote      

Greatest theft of all time- Republicans' TBTF.
At least no wingnuts lost their homes.
45   Booger   ignore (0)   2017 Nov 13, 3:06pm   ↑ like (2)   ↓ dislike (0)     quote      

This is Obamacare:
46   mell   ignore (1)   2017 Nov 13, 3:13pm   ↑ like (1)   ↓ dislike (0)     quote      

anon_983ac says
mell says
bob2356 says
mell says


Good list. This is exactly what a productive discussion on patnet should look like. Upfront pricing would rip the mask off this racket.


Great, How does one price something up front if you don't know what is wrong yet? Goran dodged this question also.


Standard visits all have fixed prices you just don't know them they are billed to the insurance, same for most diagnostics. The majority are standard procedures, probably 80% of procedures who can be priced upfront very easily, if not more. I see no issue here.


What bob doesn't realize is that there is this thing called HCPCS (The Healthcare Common Procedure Coding System) that all major insurance companies use for billing. It ...


Yes, and if we had upfront pricing one would realize that a Dermatologist charges you $300+ to use one application of cryo spray to remove a sunspot/freckle/wart, which has product costs of maybe 25 cents and takes less than a minute. Now graciously add in 4 more minutes for the consultation/visit and you have $300 for 5 minutes billed. Note that applying the cryo spray takes no skills at all and can be done by yourself or anybody else. If that's not a racket then I'd like to hear what is.
47   CBOEtrader   ignore (1)   2017 Nov 13, 3:16pm   ↑ like (2)   ↓ dislike (0)     quote      

bob2356 says
So that's why health care costs twice as much in America. The inherent cost control. I knew I was missing something.


You are mistaking the disaster we have here w a free market? I put 6 families into ACA plans today. Total annual value of their premiums is > $60k . Total value they are paying < $4k.

Any family that is required to pay the full out of pocket price finds an alternative to the ACA. This is pure cronyism. It has nothing to do w a free market.
48   Booger   ignore (0)   2017 Nov 13, 3:17pm   ↑ like (2)   ↓ dislike (0)     quote      

bob2356 says
Great, How does one price something up front if you don't know what is wrong yet? Goran dodged this question also.


Sometimes you do know. That is one reasons why pricing should be upfront. That, and if you don't know, you can still look at the proverbial menu and find out if you entered an expensive restaurant, or a reasonably priced one before you order
49   Goran_K   ignore (0)   2017 Nov 13, 3:34pm   ↑ like (0)   ↓ dislike (0)     quote      

bob2356 says
Great, How does one price something up front if you don't know what is wrong yet? Goran dodged this question also.


I didn't dodge any question. I said for those procedures/drugs/etc for which we can know. I'm not an MD, or a healthcare professional, and neither are you, so I'll leave it to those who have knowledge and work in that market to determine if that is possible.
50   curious2   ignore (1)   2017 Nov 13, 4:27pm   ↑ like (1)   ↓ dislike (0)     quote      

Goran_K says
bob2356 says
Great, How does one price something up front if you don't know what is wrong yet? Goran dodged this question also.


I didn't dodge any question. I said for those procedures/drugs/etc for which we can know. I'm not an MD, or a healthcare professional, and neither are you, so I'll leave it to those who have knowledge and work in that market to determine if that is possible.


It is possible at scale. For example, Mayo Clinic negotiates with insurers to handle diagnoses on a fee-for-diagnosis basis, rather than fee for service. The law of large numbers enables the individual variations to cancel each other out, and the flat billing discourages over-utilization.

It is also possible to solve the expert service problem by separating diagnosis from service. For example, if you open the VA to all, they could do diagnoses, then post the diagnosis for competitive bidding by approved providers.
51   bob2356   ignore (1)   2017 Nov 13, 6:48pm   ↑ like (0)   ↓ dislike (2)     quote      

Booger says
Sometimes you do know. That is one reasons why pricing should be upfront. That, and if you don't know, you can still look at the proverbial menu and find out if you entered an expensive restaurant, or a reasonably priced one before you order


Goran_K says

I didn't dodge any question. I said for those procedures/drugs/etc for which we can know. I'm not an MD, or a healthcare professional, and neither are you, so I'll leave it to those who have knowledge and work in that market to determine if that is possible.


I've done substantial work in health care and know quite a bit about the economics of health care for a number of different countries systems. Speak for yourself.

So how does this all work for the procedures that could have a price posted? Why would people go shopping when it's third party payer? What is the incentive? How do they get out of their insurance network to go to a cheaper provider? Nothing stops anyone from shopping now. You can call and ask. What is the triggering event that would suddenly make millions of people shop for providers by price?

Not to mention it would be pissing in the wind anyway. Doctors pay accounts for only 8% of health care spending in the US. If doctors worked for free the cost of health care would still be almost double the rest of the first world.
52   anon_08dee   ignore (1)   2017 Nov 13, 7:22pm   ↑ like (0)   ↓ dislike (0)     quote      

Single payer is the answer. Those who fear it don't comprehend the proportion of our total health care that's already covered by single payer. Get the remaining third or whatever it is on Medicare, and it lowers off per capita cost substantially. This should be obvious, and the government will set prices. The problem is it's paid by taxes, and god forbid someone pays in more than what goes toward their own health care (even though that's basically the definition of insurance - some take out way more than they put in).

The mantra that the government fucks everything up is just based on paranoia about communism and propaganda from 50 years ago. We won, so we don't have to be opposed to the any efficiencies that the government can bring into services such as health care.

I believe the numbers, that is the amount spent by Medicare - and the health services paid for by that, versus the amount spent by insurance of people under 65 (which includes Medicaid) relative to the services acquired for those expenditures could be put together and presented to the public in a way that would make the correct decision extremely obvious.
53   anon_62240   ignore (0)   2017 Nov 13, 7:40pm   ↑ like (0)   ↓ dislike (0)     quote      

Goran_K says
What you're asking me to do is subsidize the health care of some non-contributor in addition to what I pay for myself already. How is that fair?


Yes! That non-contributor should die of a easily treatable ailment. It isn't fair that Goran should have to subsidize someone else's survival.
54   Satoshi_Nakamoto   ignore (0)   2017 Nov 13, 8:23pm   ↑ like (0)   ↓ dislike (0)     quote      

anon_62240 says
Goran_K says
What you're asking me to do is subsidize the health care of some non-contributor in addition to what I pay for myself already. How is that fair?


Yes! That non-contributor should die of a easily treatable ailment. It isn't fair that Goran should have to subsidize someone else's survival.


"From each according to his ability, to each according to his need"
55   Sniper   ignore (8)   2017 Nov 13, 8:39pm   ↑ like (0)   ↓ dislike (1)     quote      

anon_08dee says
Get the remaining third or whatever it is on Medicare, and it lowers off per capita cost substantially.


How will it do that, the medical treatment will still need to be done, there's no volume discount on treating bodies?

anon_08dee says
This should be obvious, and the government will set prices.


The government already sets the prices with Medicaid and Medicare. That's a big part of the problem, no cost controls. Then add in, doctors can do whatever procedures or treatment they want, and Medicaid and Medicare just pays the bill, no oversight. In fact, Medicare uses a "Pay and Chase" business model and won't investigate fraud unless there is a huge outcry.

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