patrick.net

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.

Meccos says

in california, the nursing unions run the show.

Baloney!

What you are seeing is over time wages because of under staffing. Nurses have no say about the system they are forced to work under.

The same trick was tried here in Seattle to make nurses look over paid, they are not.

Meccos says

Part of the money is going to subsidize for those who did not have insurance previously but now will because of the ACA

No it's not, that is another load of crap that the Insurance Industry wants you to repeat.

The money is going into future reserves. All of this "investment" in structures will be sold off to increase future revenues.

Meccos says

However I think the ACA forcing people to buy insurance to subsidize the cost of others is not right.

Now let's see a link, or some reasonable logic for this statement.

More people paying into the pool will provide more income for future services. The future isn't now, so it's all speculation from the Insurance Industry, and hospitals.

Meccos says

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...

Noone has been forced to buy insurance yet, so how could that possibly be the cause of rising premiums?

As to it being "wrong" for some policy holders to subsidize others, I disagree. That is the very definition of how insurance works. You have a pool of people, all paying into the insurance fund. When you make a claim, the money you are given comes from that fund, so others are subsidizing you. Not a new concept.

Requiring people to have insurance is not a new thing. We're required to have auto insurance in California, and so far, the world hasn't ended.

David Losh says

Meccos says

in california, the nursing unions run the show.

Baloney!

What you are seeing is over time wages because of under staffing. Nurses have no say about the system they are forced to work under.

The same trick was tried here in Seattle to make nurses look over paid, they are not.

Um BS. I have personally seen their pay check. One nurse showed me her hourly wage. It was 59 dollars + change per hour. That is about 120-130K a year without overtime...

David Losh says

Meccos says

Part of the money is going to subsidize for those who did not have insurance previously but now will because of the ACA

No it's not, that is another load of crap that the Insurance Industry wants you to repeat.

The reality is that the ACA provides a lot more services, but the reimbursement will be lower... Where do you think this money is going to come from?

http://online.wsj.com/article/SB10001424052748703720004575478200948908976.html?KEYWORDS=health+care+insurance+premiums

Below are some requirements for insurance companies. More services = more costs.

1. Prohibit bans on pre-existing health conditions in children, lifetime and annual limits on expenses, and limits coverage exclusions of pre-existing health conditions in adults.

2. Requires family policies to include children up to age 26.

3. Requires direct access to obstetrical and gynecological care, which might include abortion.

4. Requires health plans to develop politically correct language services, community outreach and cultural competency trainings.

5. ObamaCare expands Medicaid (medical care for the poor) to everyone (under the Medicare age of 65) who has income less than 133% the federal poverty level. States must pay this enormous new burden, but federal government promises to reimburse costs of newly eligible patients under this program from 2014 to 2016.

Homeboy says

Noone has been forced to buy insurance yet, so how could that possibly be the cause of rising premiums?

If companies only reacted to events instead of planning ahead, then most companies would likely fail. The insurance industry knows that their costs will increase while their reimbursements fall. This is them planning ahead, knowing what they know will happen with the ACA.

Homeboy says

As to it being "wrong" for some policy holders to subsidize others, I disagree. That is the very definition of how insurance works. You have a pool of people, all paying into the insurance fund. When you make a claim, the money you are given comes from that fund, so others are subsidizing you. Not a new concept.

The problem here is that the ACA skews the number of people who will likely draw from the fund in addition to lowering the reimbursement to the insurance companies. The end result is that the previous policy holders will have to pay more now. No this is not a new concept, but if similar laws were to be passed into other areas of insurance, all insurance companies would fail and go out of business.

Homeboy says

Requiring people to have insurance is not a new thing. We're required to have auto insurance in California, and so far, the world hasn't ended.

You are actually wrong. You do not need auto insurance in california. All you need is proof that you can afford to pay out if you are at fault.

Meccos says

You are actually wrong. You do not need auto insurance in california. All you need is proof that you can afford to pay out if you are at fault.

Oh, I see - you want to be nitpicky about it, eh? O.K., then YOU are wrong. You will not be forced to buy health insurance. All you have to do is pay a tax. See, I can play that game too. :D

Meccos says

The problem here is that the ACA skews the number of people who will likely draw from the fund

No it doesn't.

in addition to lowering the reimbursement to the insurance companies.

Insurance companies were making record profits and gouging consumers. They will be fine.

The end result is that the previous policy holders will have to pay more now.

I disagree. There are about 181 million people who will be subject to the mandate. Of those, about 26 million currently uninsured people will have to get insurance. Let's say the average person pays $200/month. That would be a $5.2 billion increase in revenue for the insurance companies. How do you figure the 181 million will have to pay more? With that much more income coming in, they most likely would have to pay LESS.

Meccos says

If companies only reacted to events instead of planning ahead, then most companies would likely fail. The insurance industry knows that their costs will increase while their reimbursements fall. This is them planning ahead, knowing what they know will happen with the ACA.

If they are "planning ahead" for increased costs, then why are rates increasing at a slower rate than they did before ACA?

Meccos says

It was 59 dollars + change per hour.

What kind of nurse, and how many hours are they allowed to work?

I'm guessing Intensive Care with a limit on hours.

Now you are really changing things up to fit your opinions.

Meccos says

The reality is that the ACA provides a lot more services, but the reimbursement will be lower... Where do you think this money is going to come from?

Once again, Health Insurance has nothing to do with Health Care.

Homeboy says

Meccos says

You are actually wrong. You do not need auto insurance in california. All you need is proof that you can afford to pay out if you are at fault.

Oh, I see - you want to be nitpicky about it, eh? O.K., then YOU are wrong. You will not be forced to buy health insurance. All you have to do is pay a tax. See, I can play that game too. :D

Well if you are penalized, then you are being forced arent you? And no this is not being nitpicky. You do not need auto insurance, most people like you just do not know that. THere is no law that fines you for not having auto insurance.
You played the game and lost... :)

Homeboy says

Meccos says

The problem here is that the ACA skews the number of people who will likely draw from the fund

No it doesn't.

Um pre-exisiting conditions? insurance for the those at 133% of poverty level? Those are two groups who will for sure draw more from the fund than what they pay into it. Thus people like you, me, patrick and the rest of the people here have seen rates increase to make up for this.

Homeboy says

in addition to lowering the reimbursement to the insurance companies.

Insurance companies were making record profits and gouging consumers. They will be fine.

You really do not know what is in the ACA. there are tons of things in the ACA that will decrease reimbursements... BTW health insurance companies have some of the lowest profit margins...

Homeboy says

I disagree. There are about 181 million people who will be subject to the mandate. Of those, about 26 million currently uninsured people will have to get insurance. Let's say the average person pays $200/month. That would be a $5.2 billion increase in revenue for the insurance companies. How do you figure the 181 million will have to pay more? With that much more income coming in, they most likely would have to pay LESS.

Who do you think those people are? THey are most likely the people with pre-existing conditions or people who cant pay for insurance. Not only that ACA requires insurance to cover more and more things. These are costs that should be incurred by people using the system, but now it will be spread out to everyone.
Furthermore, just because you decide to simplify health care economics into a simple multiplication, it doesnt make it true does it? I wish the world was that simple...

David Losh says

Meccos says

It was 59 dollars + change per hour.

What kind of nurse, and how many hours are they allowed to work?

I'm guessing Intensive Care with a limit on hours.

Now you are really changing things up to fit your opinions.

A simple clinic nurse. Im serious. They are ENTITLED to 40 hours a week but works less if they want. In fact, there is one who takes off about 10 months of the year for medical leave and comes back 2 months each year so that she doesnt lose her "spot". Each time she comes back, she has to be "re-oriented" for almost a month with another nurse. Thus she is really useless. Unfortunately, nurses union wont let her be removed. Thus we have to hire someone else just for that spot. Oh... we cant even hire who we want, we have to take whoever the nurses union gives us.

This is not an opinion. I work with this every day.

David Losh says

Once again, Health Insurance has nothing to do with Health Care.

Health care laws directly affect health insurance plans which then directly affects health care given to the people... so tell us again how health insurance has nothing to do with health care...

Meccos says

so tell us again how health insurance has nothing to do with health care...

This one is simple, you are saying health insurance companies are dicating how health insurance laws are applied, and you don't see a problem with that?

Meccos says

A simple clinic nurse.

It always amazes me that in a huge multi billion industry the workers, at the lower end, who have a union, are always the cash drain on the company. It seems where ever I go, no matter what the industry, if we could just break the unions everything would be much better.

I don't buy it, and it sounds like you need some collective bargaing.

Meccos says

Um pre-exisiting conditions? insurance for the those at 133% of poverty level? Those are two groups who will for sure draw more from the fund than what they pay into it. Thus people like you, me, patrick and the rest of the people here have seen rates increase to make up for this.

No we haven't. The rate at which premiums are rising is LOWER than the rate at which premiums were rising before ACA. You simply cannot blame rising rates on ACA. Why is it I keep saying this over and over and you keep ignoring the facts?

And how do you think poor people are getting medical treatment now? Mainly, they're going to the ER. You don't think you're paying for that? If you don't think so, you're dreaming. ER treatment is much more expensive than regular treatment.

Meccos says

You really do not know what is in the ACA. there are tons of things in the ACA that will decrease reimbursements... BTW health insurance companies have some of the lowest profit margins..

Let me guess... You work for a healthcare insurance company.

Meccos says

Who do you think those people are? THey are most likely the people with pre-existing conditions or people who cant pay for insurance. Not only that ACA requires insurance to cover more and more things. These are costs that should be incurred by people using the system, but now it will be spread out to everyone.

Furthermore, just because you decide to simplify health care economics into a simple multiplication, it doesnt make it true does it? I wish the world was that simple...

Pure speculation. Several people on this forum have stated that they have no health insurance, but could afford it. In fact, many have complained about being "forced" to buy insurance. Quite obviously, these are not people who wanted insurance but couldn't afford it or were denied it. There are millions of people "gaming the system" right now, who will have to pay their fair share when the mandate kicks in. You have absolutely no proof for your contention that this will cause prices to go up.

When has more customers EVER caused prices to go UP? Doesn't work that way.

David Losh says

It always amazes me that in a huge multi billion industry the workers, at the lower end, who have a union, are always the cash drain on the company. It seems where ever I go, no matter what the industry, if we could just break the unions everything would be much better.

I don't buy it, and it sounds like you need some collective bargaing.

So basically I present facts, but you refuse to acknowledge it right? Fact is fact...