Obamacare A Big Lie From The Start...

You can't have patiant protection and the insurance regulations and not have the mandate and added funding, that makes the insurer demands workable. Now the law may need work ,I agree, funding needs to be tightened up and I think the Medicaid expansion redone to say a similar coverage with more out of pocket costs and fees unless you get into regular Medicaid. And this only up to 100% of the poverty line. And the exchange subsidies should be a bit less generous at the low end.

For example we could have regular Medicaid, Medicaid Plus (for those not qualifying under the rules but on income) which would cost more to use say twice for day to day expenses in my state an office visit $10, drugs $8 and so forth and then exchanges that help a great deal but maybe less generous. And I would like a commitment states do what they can letting them free to add to the law with regulations and Federal help in new plans and ideas. If you want to add providers this must be done at the state level. One last idea Federal immunity from lawsuits for anyone providing care under plans using Federal money unless a judge panel allows a lawsuit with regs that the malpractice is adjusted down 1.25% per 1% of patiant risk removed (up to 20% of the caseload) so if Dr. Smith takes 20% government patiants his malpractice insurance drops 20% with government oversight of this. You want MD's and others that will matter if they pay $100k now and pay $75,000 it might help.

I'm not unreasonable but your not going to handle the cost increases long term unless you have a mandated universal system of some sort, show me one nation that managed that trick using capitalism as a model? Germany and other nations are not communists they just looked at the numbers and it doesn't work without such measures.

 

So, it seems to be an ungrounded fear of the unknown sort of thing.

Well, I live in Massachusetts. I am self employed and buy my non-subsidized health insurance on the state run exchange. For someone like me it is an absolute godsend. Before the exchange it was impossible to find out what private health insurance cost and what was covered for my money without going through a high pressure sales pitch from a salesperson in my living room. If I wanted to comparison shop I had to put up with this multiple times. The plans I ended up with cost a lot and covered little.

Basically all the state did was set a tiered criteria for coverage and a allow insurers and direct providers to offer plans that meet those criteria. The exchange is also open for small business employers. It is hugely popular. No politician in this state can be against it and hope to get re-elected.

The plans offered on the exchange all offer the same extremely comprehensive coverage, better than many corporate plans my friends are enrolled in. The only real difference is how much of the expense you are willing to take on yourself. Co-pays are $15-30 in all the plans. Routine exams and preventive care are free. Deductibles vary from zero to $2,000 depending on the plan you choose. The absolute maximum out of pocket expense is $5,000, and that is only for the cheapest plans. The most expensive have zero deductible and zero out of pocket. There is no upper limit on care. They will pay whatever it takes to fix you. There is no exclusion for pre-existing conditions.

I have saved many thousands of $$$, have far better health insurance than I ever had before and cannot be bankrupted by health care expenses. My premium has not gone up for next year and I just got a rebate check. If I was in my twenties I could get a plan that cost less than $100 a month. This is hugely attractive to the entrepreneurial set from MIT and Harvard and all the Tech companies already here, which is all of them. They can strike out on their own and not have any worries about health insurance coverage, which can be quite problematic in other states. Massachusetts has gained an edge in keeping cutting edge entrepreneurs here. It is far more difficult for a tiny start up to get health insurance for its people in Texas or California than it is here, and if your lead programmer has diabetes.....

At the beginning there were only four providers on the exchange but that has now expanded to seven. It apparently has a lot of appeal for health care providers. The demographic is ideal, higher income self employed or small business people since everyone with an adjusted gross income of less than $40,000 or so can get a subsidized plan and that is not us.

The PPACA has funds for the states to set up exchanges. If they fail to do so the Feds will use those funds to set one up for them. The mere fact that shoppers would be able to compare coverage and premiums on line would be a huge improvement for everyone, except maybe those who sell insurance. Hmmmm.....why again are the republicans so against the exchanges? Are they really going to toss the people under the bus to protect insurance salesmen?

 

You can have regulation of Health Insurance Companies and protections for insureds without the mandate and added funding. The mandate is only necessary due to requiring companies to insure non-group coverage for individuals who have already been diagnosed with illnesses that will require costly surgery or ongoing costly treatment and full payment of preventative tests. Insureds should atleast be responsible for their co-payment for preventative test. Those insureds with pre-existing conditions requiring surgery or continued care should be insured through high-risk groups or added to the Medicare program by creating another part to Medicare, say for example Medicare Part E that covers high-risk individuals and that requires they pay premiums for the coverage that will cover a certain percentage of the Governments cost to insure them. To do otherwise will cause others premiums to increase, not decrease and instead of paying for the uninsureds seeking ER treatment we will be paying far more to subsidize premiums and pay for pre-existing coverage and preventative testing.

 

Hmmmm.....why again are the republicans so against the exchanges? Are they really going to toss the people under the bus to protect insurance salesmen?

 

You don't understand the law, it is a money maker for insurance companies due to the mandate, they won't lose money but will make money, while the current insureds will see their premiums rise due to subsidizing premiums for the current uninsureds.d

And, Exchange does not mean cheaper or affordable premiums. And, those with costly pre-existing conditions that require expensive future surgery and continued medical treatment should be insured through a high risk plan. Mandating that insurance companies cover them is going to increase everyones premiums far more than we currently pay for those uninsureds that receive free care by providers and hospitals and visit ER's

 

The law is the best we are going to get save it can be modified or worked with, face it there is not going to be a one payer system or any reforms unless insurers, medical providers and drug companies have their interests they will want to make money and get things they want out of it. This is the USA not Europe and not a communist state one leg of our society is private companies.

As for medical care the reason for the individual mandate is to get everyone into insurance or Medicaid they can based on ability to pay. Are some of you ignorant to the fact a poor person needs insurance they can afford to use for health care seeing doctors, getting medicines, going to hospitals and be not financially broken? Lets say I worked my normal hours and number of days and earn $9,000 a year how exactly can I afford a premium, co-pays and related costs without serious help paying for this? I'm not a criminal, I'm not a bad person just a disabled man with issues that doesn't want to go on SSI and be more of a burden taking your tax dollars. But if I end up going blind or losing a foot or something at some point I will need all I can get if I get medical care I could maybe avoid this altogether being less of a burden just needing some help with medical care.

And there is no free care in my state the hospitals can't bill me that is true but everyone else can if they choose to so far I was able to avoid collections, some opt not to try and others take payments and work with me. But I still have cerebral palsy, a bad heart and low level diabetes all uncared for with no drugs or regular medical care.

Something must be done and the Republican have no plan to replace ACA with so why would I trust them to repeal and replace with anything in time to help me if they replace at all?

 

we were suppose to get ObamaCare.. that included a public option, what we got instead was CongressCare with the conservatives individual mandate


.

 

I did come up with a way to help states on the Medicaid expansion since its a loophole in the law, and propsed this to my Republican state senator. Here it is just drop everyone currently on Medicaid and the new people and auto re-enroll them under income this will immediately drop the state costs to ZERO and reduce the costs longterm with an impressive 45 cent savings per dollar (we pay 55 cents and the Feds 45 cents currently). It will of course burden the Fed side but that is not the states problem and they just need to find the money.

 

Part of the law requires health insurers to spend 80% of their premiums on care. If the spend less they are required to give rebates to policy holders. States are allowed to set higher rates for this. Massachusetts has set a rate of 88% and just I got a rebate. Insurers are also required to take on people with pre-existing conditions and are not allowed to set annual or lifetime limits for care. This is no windfall for insurers and some of the most profitable in the past are considering getting out of the business entirely since their high profits came from spending less than 80% on care, denying coverage for people with pre-existing conditions, putting annual and lifetime limits on care, arbitrarily dropping coverage and other things they are now prohibited from doing.

I live in Massachusetts, am self employed and buy my insurance through the state run exchange and it covers more for less money than any plan I could get before. Over 96% of the people in Massachusetts now have health insurance and the cost of caring for the uninsured has declined precipitously. Premiums have not gone up by double digits every year like in the past either, in fact this years premiums have not gone up at all and are slated to go down next year because emergency room use, a huge expense for hospitals, has declined so much because so many of the people who used to go to them can now see a local doctor instead.

One thing a lot of people do not understand is that everyone already pays for the uninsured and these free riders increase the cost of health care for everyone. Hospitals are required to treat everyone who shows up in their emergency room. It is far cheaper to get these free riders, many with chronic conditions, into a managed care situation via insurance than leave them to go to emergency rooms when their condition deteriorates into a crises. It saves money for everyone.

 

Click on link at bottom for more...

CBO ON ACA – An Expensive Half-Loaf:

The Congressional Budget Office produced two reports on Obama Care yesterday. The first (A – Link) did an analysis of what the cost would be if we just junked the Affordable Care Act (ACA). The second (B – Link) looked at the consequences to ACA as a result of the recent Supreme Court decision.

The House has recently put forward a bill to scrap almost all of ACA. This legislation is not going anywhere, it’s just a “show pony” for Republicans, so they can say they voted to repeal an unpopular law. The CBO is required to review all legislation, even if if it has not a ghost of a chance of passing

The CBO concluded that repeal would cost (increase deficit) by$109Bn over ten-years. This number assumes that government spending would actually decline by $890Bn, but the government would collect $1Trillion less in revenue.

When Justice Roberts made his now famous opinion that affirmed the constitutionality of ACA, he also made two important changes. He said that the government could not force a citizen to pay a penalty, but it could levy a tax, and he said that States could not be forced to provide Medicaid to those who did not have health care insurance.

The decision by Roberts does change the economics of ACA. The CBO concluded that 4 million people would not have access to health coverage as a result of the Medicaid “opt out” that the States now have. The reduction in the number of people covered translate to “savings” that amount to $84Bn over ten years.

Of course this is not really saving anyone a dime. ACA is going to cost a bundle. Post the Supremes decision, the CBO has concluded that ACA will cost a net of $1,168Bn over ten years. ACA will have expenses of 1,683Bn but will generate revenues of $514Bn to produce that net cost of $1.2 Trillion.

So we are screwed if we get rid of ACA, we are screwed 10Xs worse if ACA is kept alive.

What do we get for the $1.2Tn? The answer the politicians will tell you is that the country will finally have universal health coverage for everyone. But that is not true at all. ACA does widen the access to healthcare to millions of additional people, but it falls well short of the stated goals.

The CBO has concluded that as a result of ACA, the number of people today who do not have access to healthcare will fall from 53m to 30m over the next ten years. While the 46% reduction in uninsured is admirable, it still is a far cry away from what this law has been sold as. America will still have 10% of its population uninsured.

More...

 

If the ACA is repealed then it will be a return to business as usual and health care costs will continue to rise by double digits until the economy collapses under the weight of it. Exporters are having a hard time remaining competitive because of annual health care cost increases.

In Massachusetts, where Obamacare has been fully implemented for a few years the unemployment rate is 5.8% and declining. There is lots of start ups, companies from Europe and beyond are setting up shop and the small business sector is taking off. There are help wanted signs everywhere. A big reason for that is because there is certainty over health care.

Getting rid of the ACA will just make things worse for the economy because the uncertainty of repeal will be replaced with the even greater and longer uncertainty of replacing it, which the republicans have promised to do but have yet to say how.

btw, the 31 bills passed by the House to repeal the ACA without a hope of passing in the Senate have cost the government about $50million each in CBO analysis and other costs. This should make it quite clear that fiscal responsibility is not a concern of the republicans in the House.

 

The ACA still has many unknowns, as it is a monstrocity of a law. The CBO keeps revising its estimates upward. Businesses really do not know the full repercussions of it.

 

If that is the case how can you or other people of like mind be so sure the ACA will not be a good law, like you said its full of unknowns but that could mean after its in place the law could be largely a good thing to. The simple and sensible thing would be to let it go into action then over the decade after 2014 make adjustments and changes as needed if there are problems with it.

 

Just like Pelosi said. We have to pass it to see what's in it. Briliant.

It may be too late then.

 

Laws can be changed the sensible thing would be let it take effect then on occassion make needed adjustments and changes just like we do to other government programs say in 2018, 2022, 2026 and so forth every four years. But they want a full repeal okay then show me the ready to go replacement health care bill, post a link, since they said "repeal and replace? I can't find one.

Face the ACA is not perfect but its what we have I will take that over the nothing the Republicans have as an option.

 

And the lies continue with no end. This latest campaign commercial virtually blaming Romney for a woman's death...that's a whopper.

 

from the very start he says that they will provide the best care and proper treatment and care for the persons under Obama care centers but i must say that the actual picture is slight changed and is unbelievable when you come and face the problems on the ground.

 

It's too massive of a bill. I'm afraid it will bankrupt this nation even further.

 

Okay lets give you an example I gave in another thread Bob has an IQ of 90 and a great worker, doing a retail fulltime shift of 28 hours (Walmart considers that full time) earning before taxes $13,104 a year in a place employing 40 employees. Got that.

Now under the ACA if in an exchange he would pay at most $525 a year for premiums and get 94% of the out of pocket costs subsidized by the government in a Silver Plan the basic one all exchanges must offer, or he will be in Medicaid but assume an exchange.

Now what is the Republican plan to give Bob the law abiding and hard working citizen health care he can afford to use?

The ACA covers Bob, so what is the counter "repeal and replace" that does that.

 

The ACA sounds good to you libs on paper, but we'll see how it does in reality. Have you read the entire bill? It will cost us dearly. The Republican plan of Repeal & Replace starts off simpler, then we can see what needs to be done. Why enact this monstrosity of a bill right off the bat, without knowing its repercussions?

http://www.gop.gov/indepth/pledge/healthcare

 

I am in a new mode. The term "Obamacare" should be eliminated. Not because it is insulting to Obama, that I could care less about. However, "Obamacare" presupposes that Obama is capable of writing a 2000 page document. I don't think the nitwit could write a book report let alone a 2000 page bill and the authors of the bill would agree "if they were not on the dole".

 

Ensure Access for Patients with Pre-Existing Conditions
Health care should be accessible for all, regardless of pre-existing conditions or past illnesses. We will expand state high-risk pools, reinsurance programs and reduce the cost of coverage. We will make it illegal for an insurance company to deny coverage to someone with prior coverage on the basis of a pre-existing condition, eliminate annual and lifetime spending caps, and prevent insurers from dropping your coverage just because you get sick. We will incentivize states to develop innovative programs that lower premiums and reduce the number of uninsured Americans. - Quote from the Webpage

A local hospital adminstrator found a way to use this if someone comes in indigent with a need for care she was thinking why not find a great plan, they pay the premium for one month, give the person the care collectng the hospitals share on a good plan that could be 80% for all involved then drop the coverage when they are done with them. Think about this without the mandate a poor worker won't have to be on Medicaid right so what is stopping this. As they see it one months premium would be say $3000 for a high end plan if the person needs cancer care for $100,000 they would get $80,000 back over the likely nothing minus the $3000 or 6000 they are still way ahead over nothing they would likely get from the pauper. The only thing she noted is insurers can say no now under this they can't. Right? How long will they survive as an industry if hospitals do this?

I will note they try a repeal of this with removing the funding the Democrats can filibuster removing the mandate to provide care and the same thing happens. And the law kicks in largely in the bad spots without the funding the ACA set-up and will kill the Health Insurance industry.

So again what is the GOP plan for Bob someome making that much won't use HSA's, can't afford insurance without ample help and it will not benefit the system to not have him covered it just makes care when Bob ends up at the ER and Hospital far more expensive and that cost gets passed on to everyone else.

 

Make insurance coverage cheaper. The ACA is not the only answer, although I doubt it will reduce any costs. My premiums keep going up, and they will drastically go up once insurance companies are forced to cover all people.

Bob can get help from friends, look for charities that may help and utilize his State's Medicaid program, etc.

 

If Bob lives in Oregon his Medicaid enrolment is up to a lottery. Most states do not provide Medicaid for adults and many which do do so only for people on welfare who have dependent children. In other words, no health care for Bob except in the emergency room, which will set the debt collectors on him, or at a free clinic, which there are very few of in the US. So, it seems that Bob's health care is in the hands of his friends or some charity. It just seems to me that the USA, the wealthiest nation on the planet by far, should at the very least be able to give someone like Bob decent health care without putting him in endless debt or relying on friends and family and charity.

The right is all about supporting the military blah blah blah. But when it comes to one of the most cherished of military traditions and applying it to the nation as a whole, taking care of their own, they seem to be actively hostile. Apparently they would prefer to militarise the US without this meme. It is a conundrum.

Your premiums are more likely to go down since more people will be paying into the pool, many of them young and healthy with little need for extensive care, and the expense of caring for free riders will fall more on the government instead of on you and your insurer as it is now.

 

I'm moderate, but I'd like to offer you some logical trains of thought.

What you did in your statement was to take two unrelated thoughts that both came from a similar (not identical) people within a group and presented it as a single person contradicting himself.

I can play that game with the group that gets labeled as conservatives:

Conservatives are so illogical. Each one of them thinks that abortion is killing, but capital punishment is not.

Conservatives are so illogical. Each one of them thinks that monitory wealth is great and sacred but they all follow Christ who said "I tell you the truth, it is hard for a rich man to enter the kingdom of heaven. Again I tell you, it is easier for a camel to go through the eye of a needle than for a rich man to enter the kingdom of God." Matthew 19:23-24

Conservatives are so illogical. Each one of them thinks that Socialism is bad. At the same time they are all strong supporters of the military. The military is as un-free as it gets. It's a dictatorship with a socialist medical system, government provided housing (or extra government pay to live in your own), communist mentality of "Army of One", paid for by the government/"citizen tax dollar" while not being required to produce any kind of revenue to support itself.

There are other contradictions for conservatives and the liberal group has its own internal contradictions. That doesn't translate into "ALL liberals think..." or "ALL conservatives believe...". Stop lumping everything together. That includes yourself. Be an independent thinker and stop buying into all the rhetoric that's intended to manipulate you.

The time of the moderate, centrist, independent is here. Everyone Follow ME!!!