patrick.net

No, you pretty much got it right, but also know this: Obama originally did not want to force everyone to purchase insurance. The insurance companies lobbied extremely hard for this to be put into the plan. Make no mistake, the insurance companies are making out hand over fist. When money instead of merit makes decisions in government, the system is fatally flawed.

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

Am I misunderstanding something here?

YOu wont get an honest answer for that. That was the problem I had with it from the git go. But I was told I'm just being jealous with sour grapes and all that, because a Black man came up with the healthcare plan.

TPB says

But I was told I'm just being jealous with sour grapes and all that, because a Black man came up with the healthcare plan.

Actually, if my memory serves me right, you were told that you made no sense during your rants that appeared to be heavily fueled by medication of some type.

The insurance companies found loopholes - of course. And they have huge lobby firms to ensure they'll always win. We need socialized medicine.

TPB says

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

Am I misunderstanding something here?

YOu wont get an honest answer for that. That was the problem I had with it from the git go. But I was told I'm just being jealous with sour grapes and all that, because a Black man came up with the healthcare plan.

William E Baughb

It's Bob Dole's healthcare bill from the nineties.

Both sides of the aisle would like to get rid of it. One side admits it, the other side doesn't for obvious reasons.

If we get socialized medicine, we won't have the money to defend the Canadians, Japanese and most of Europe. For that reason alone, it won't happen.

rootvg says

TPB says

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

Am I misunderstanding something here?

YOu wont get an honest answer for that. That was the problem I had with it from the git go. But I was told I'm just being jealous with sour grapes and all that, because a Black man came up with the healthcare plan.

William E Baughb

It's Bob Dole's healthcare bill from the nineties.

Both sides of the aisle would like to get rid of it. One side admits it, the other side doesn't for obvious reasons.

If we get socialized medicine, we won't have the money to defend the Canadians, Japanese and most of Europe. For that reason alone, it won't happen.

You mean we won't get it because we as a culture are far too greedy and corrupt to ever implement anything without it turning into an unsustainable orgy of Graft. There is nothing wrong with other methods of health care such as the NHS style health care, or highly effective yet cheap state health care such as Singapore.

For us its not a matter of taxes nor is it even a matter of military spending. The problem is we are screwed up country full of morons digging their own grave from top to bottom, left to right. No matter how fail safe the USA will always snatch defeat from the jaws of Victory. Ever since LBJ, Nixon and all the other embarrassments of the era; our government is too corrupt to do anything anymore with effort but War.

If I ever meet Obama I wont be interested in knowing any deep presidential secrets, I will want to know how does he do it. How does fuck up time and time again, and it be everyone's fault but his.

elliemae says

TPB says

But I was told I'm just being jealous with sour grapes and all that, because a Black man came up with the healthcare plan.

Actually, if my memory serves me right, you were told that you made no sense during your rants that appeared to be heavily fueled by medication of some type.

The insurance companies found loopholes - of course. And they have huge lobby firms to ensure they'll always win. We need socialized medicine.

Eschew Obfuscation

I need a BMW X5 with the diesel engine. It won't happen.

I imagine Obamacare will be as effective in making Health Care more accessible and affordable as No-Fault did for Car Insurance.

thunderlips11 says

I imagine Obamacare will be as effective in making Health Care more accessible and affordable as No-Fault did for Car Insurance.

Homo Economicus. Like Bigfoot, reported to exist in fantasy books, but never seen in the wild.

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

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?

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.

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

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

zzyzzx 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.

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.

zzyzzx 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.

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.

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.

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.

wthrfrk80 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?

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?

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.

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.

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.

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.

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

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.

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.

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.

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.

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

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

God Bless America!

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.

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).

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.

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.

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?

Health Care Bill:

1. For starters, rents will go up thanks to the 5% passive income tax that was attached to the bill. By how much? Around 7% (you tax the gross). Rising rents trickle out to everything which causes price inflation for all goods and services.

2. The bill: it's probably the largest make-work project in the history of the US funded by the middle class (see #1 and #3).

3. Because many employers offer health insurance, rising premiums will obviously be paid through a) higher revenue, made possible through price increases, and/or b) lower wages. Both options will screw the common middle class American.

4. How to keep health care affordable: the only way is through higher deductibles and where the patient pays a percentage of the costs. Also, allowing the patient to shop around. But the bill virtually prohibits all of this. Why? To force premiums higher.

4. How to keep health care affordable: the only way is through higher deductibles and where the patient pays a percentage of the costs.

Kill the employer tax deduction for providing health insurance (160B savings) and instead promote HSA's (tax exempt). Seeing as how individuals are not allowed to purge student loans in bankruptcy (or even death), let the citizenry get on the other side of that trade. Play creditor to the health care student debtors, so the value of the savings accounts will grow(incentive)

Better yet, be the change you see in the world. Get healthy. The "western diet" is killing us slowly. Be an American and take your health responsibility into your own hands. Stop eating sugar. Won't cure all that ails us, but it would cut the national health bill in half. Sugar consumption is deadly

Whether we like it or not, at some point the whole 'retirement' and dying as slowly as possible model is going to have to be remodeled. The majority of health care dollars are spent helping us die as drugged up and as dragged out as possible. Have some dignity

housingcasino4865 says

Health Care Bill:

1. For starters, rents will go up thanks to the 5% passive income tax that was attached to the bill. By how much? Around 7% (you tax the gross). Rising rents trickle out to everything which causes price inflation for all goods and services.

2. The bill: it's probably the largest make-work project in the history of the US funded by the middle class (see #1 and #3).

3. Because many employers offer health insurance, rising premiums will obviously be paid through a) higher revenue, made possible through price increases, and/or b) lower wages. Both options will screw the common middle class American.

4. How to keep health care affordable: the only way is through higher deductibles and where the patient pays a percentage of the costs. Also, allowing the patient to shop around. But the bill virtually prohibits all of this. Why? To force premiums higher.

My doctor from fifteen years ago in Dallas said the only possible solution to all this is going back to fee-for-service and eliminating the insurance companies completely. I'd like to think we could do that but here again, what the insurance companies want they usually get. Most venture capital firms are backed by insurance. That's just how it is.

I cut back on sugar years ago. I still have salt on scrambled eggs but it's sea salt instead of the stuff out of the round box with a girl's picture on the side. Even the chefs will tell you to use sea salt. Tony Bourdain uses sea salt.