The number of uninsured in Texas has dropped significantly under the ACA. http://www.sciencedaily.com/release...cedaily+(Latest+Science+News+--+ScienceDaily) To be specific the drop is 31%
Regardless,Texas remains the state with the highest percentage of uninsured people, the study found, and for the first time, the state has the largest raw number of uninsured residents in the country. For one reason, they have one of the highest numbers of illegals, and the State chose not to expand the substandard Medicaid program that reimburses providers less than their cost to treat the patients enrolled in the Medicaid program. But, beyond that, it doesn't matter how many more people have been insured under Obama Care Exchange Insurance Plans because for those with serious medical needs they may still be unable to pay for the medical they need due to provisions of the policy they purchased excluding various care, various providers and facilities, high deductibles to meet and high yearly out of pocket expenses to meet and not to mention co-payments. For many it means basically paying out of pocket for the majority of their care before their insurance begins to kick in. And, what most fail to forget is that the ACA did little if anything to regulate Health Insurance Companies and instead gave them basically free reign to do as they like when processing and either approving or disapproving payment for services. And, also promises Health Insurance Companies providing insurance plans through the Exchange a bailout if they lose money on these policies. What a bunch of you know what.
Sounds to me like you are advocating a single payer system which would actually eliminate all your problems with the ACA. Or, do you have another solution.
Well goody, goody. More people have health insurance that they will likely find doesn't cover the majority of their health care costs. High deductible, high co-pay, out of pocket expenses, their usual physicians and surgeons not covered and many of the hospitals they prefer. And, even worse, they don't find this out until they present for care(so much for the transparency of these policies). You have to actually contact your company and ask specific questions to find out if your chosen providers and facilities are covered. And, even then, many of our patients and even our office has been told treatment is covered, only to find "after" treatment is provided that they refuse to pay for it. This is the type of problem PPACA was suppose to correct. Instead Obama and the Dems sold out to the big health insurance companies, allowing to basically what they want when it comes to coverage of treatments and benefits and "even" promising them a subsidy if they lose money by offering plans through the "exchanges". What a crock. It was always Democrats who were "in bed" with the health insurance companies; not Republicans. And IMO both failed by not regulating through legislation such as the Sherman Act and laws against price fixing and Monopolies that would have required health insurance companies to offer premiums based on the deductible charged, the required co-payment charged and out of pocket required and the benefits covered as requested by the individual or group purchasing the policy. Instead, HHS took away the ability for an individual, small business or corporation to determine which benefits they need and are willing to pay for. Instead mandating what they call Minimum Essential Benefits set by HHS without Congressional intervention, thus without the will of the people that elected them. And, never were we told that we the taxpayer would be subsidizing Private Health Insurance companies if they lost money due to providing Exchange policies that provided Minimum Essential Benefits and free medical tests. Perhaps if they would have provided this information upfront, prior to the final vote on PPACA, more people would have opposed it pushing disapproval well over the 50%+ American's that already opposed it. It would only be "good news" if those people were now insured by a policy that allowed them to see what ever physician/surgeon they chose and choose their Hospital or Clinic they trust. And, if the premium they pay was commensurate with the deductible charged, annual out of pocket to be met and co-payment and finally the ability to see a complete and total list of all benefits, including every procedure, every drug and every illness covered by their policy, plus. That would be transparency. Without all this information it is impossible to "compare" policies as Obama and the Dems promised. Due to my 40 years of medical administration experience I can tell you that providing the transparency they promised is not an easy task and that is likely why it has not been accomplished as promised. The Obama Administration and Dems relied on consultation given by so called "experts" that no longer provide medical care or never did to begin with. And, when the "medical panel" kicks in in 2016, more egg heads will be deciding who gets treatment and under what circumstances and will base their decisions on "cost effectiveness". So throwing Grama over the Clift may become a reality after all. This "board" must be include members from each medical/surgical discipline, nursing home administrator, medical company representative, pharmacist representative. And these members should be still practicing or a representative of these various groups selected/voted on by these groups to represent them. Scholars and professors are just not in touch with the day to day reality of providing medical/surgical care to patients and are too far removed from the day to day office management and insurance procedures that the average patient and provider encounter.
how would we know this would happen if it based on other countries then why is it when we bring up negatives from those countries they are not considered?
Yes the other solution would have been for the Federal government to offer Medicare Part E(everyone) for that had pre-existing uninsurable conditions with premiums based on overall cost to insure those in the group. Much less expensive than subsidizing premiums, forcing private insurers to insure people whose medical care will in most cases exceed the premiums they pay on an annual basis and forcing all American's to buy "minimal essential coverage that they may never need to use because they are post menopausal and have no young children and don't need contraception. Or just because they don't want to pay the higher premiums for this coverage. The problem of higher medical care costs hasn't been solved other than the Federal government setting reimbursements for those that provide the medical care at a level that is often less that the cost of those providers and hospitals that provide the care. The cost of providing health care has gone up not down due to lower reimbursement by the Government and Private Insurance following the Governments lead; and the continual addition of costly regulations that providers must comply with. Most of which do nothing to improve the medical care provided patients but only raises providers operating costs. The PPACA has raised the cost to taxpayers as there are still hundreds of thousands of insured's including illegals that seek ER care and are not subject to the individual mandate . And, while more are insured, they still can not afford medical care because their deductible is too high and therefore still seek emergency care and/or cannot pay medical debt they owe. I am not for Universal Health Care because I don't believe the Federal government is capable of managing such a large health care program because they have and are still unable to properly manage Medicare. Through lack of management they cause Medicare waste and provider administrative costs to increase when claims must be resubmitted over and over due to improper processing by Medicare staff. Their CS is worse than that of the IRS. Sorry but the Federal Government is the biggest reason Medicare costs increase, not providers. And I predict Providers will continue to refuse to accept Medicare if the inferior payment trend and poor management continues. As far as Medicaid; this program has always reimbursed poorly and reimbursements have not increased to keep up with the higher operating costs providers experience on a yearly basis. The system worked far better in the 50's and 60's before the Federal Government intervened and prices were lower due to competition among doctors and hospitals. During those years insurance was just that, "insurance". People paid cash when going to their doctor for routine medical care and had insurance that helped them pay for hospital care and surgical care. The Federal Government should regulate Health Insurance Companies just as it does Life, Auto, homeowners insurance. Regulating the premiums based on covered benefits, deductible, out of pocket and co-pay amounts. They have still failed to do this. And, people should pay more when demanding the Company cover all medical costs incurred. When you treat health insurance as an "all inclusive club membership" you will pay a higher price. Insurance should be individualized and left up to the individuals to purchase the coverage they are willing to pay for, period.
Because nobody has managed to bring up any fact based negatives except that the truly wealthy are able to bypass the system by going to another country. And that is not much of a problem and occurs with every government program.
Somehow going back to the fifties is probably not going to happen. And if you really think Medicare is so poorly managed how about supplying some proof.
I stated in another thread that grouping a bunch of sick people together is going to result in a high-premium, difficult to insure group. I stand by that statement. In a normal situation, if you are looking for an insurable group, you want a group where 20 % of the people are sick and 80 % are healthy. The 80 % will subsidize the claims of the 20%. You are suggesting a group where 100 % of the insured are chronically ill. More than likely this group will death spiral. In this situation, I'm guessing everyone in "Medicare part E" would be very sick. If someone is deemed uninsurable by a private health insurance company and they want to roll the dice and see if they can go uninsured they probably won't sign up for "Medicare part E" because the premiums would be super high. The only way the premiums would be reasonable would be if the government paid for part of the premiums, like 48% like they do in Medicare. got a link for this claim? Ah life before Medicare. Where about half of seniors were uninsured...Doesn't sound like such a great system http://www.politifact.com/wisconsin...-ron-kind-says-thanks-medicare-75-fewer-seni/ That doesn't sound that much different than having a high deductible plan today. When you go in for an office visit, you pay the contractually agreed upon rate. When you get surgery, the insurance kicks in.
I am not for a single payer system. I am for choice. Choice of insurance plans, choice of deductible you want to pay and out of pocket you want. Choice of doctor and hospital. None of which you get with a universal health care system.
Per NEBRASKAN: "I stated in another thread that grouping a bunch of sick people together is going to result in a high-premium, difficult to insure group. I stand by that statement. In a normal situation, if you are looking for an insurable group, you want a group where 20 % of the people are sick and 80 % are healthy. The 80 % will subsidize the claims of the 20%. You are suggesting a group where 100 % of the insured are chronically ill. More than likely this group will death spiral. In this situation, I'm guessing everyone in "Medicare part E" would be very sick. If someone is deemed uninsurable by a private health insurance company and they want to roll the dice and see if they can go uninsured they probably won't sign up for "Medicare part E" because the premiums would be super high. The only way the premiums would be reasonable would be if the government paid for part of the premiums, like 48% like they do in Medicare.". Your wrong and this is why, not all pre-existing conditions that are uninsurable through private health insurance are costly and many of these individuals won't require treatment for these conditions. If you average, lower cost pre-existing conditions with the higher cost pre-existing conditions, it brings down the average cost and the money the Federal Government is paying to subsidize insurance for this group will be lower as it is applied to subsidize overall lower premium cost for the PART E(hypothetical)group of insureds. It is less costly than medicare which groups all patients together regardless of what costly diseases or medical care they have/need. Medicare groups a bunch of people, old people, many sick people together and I suggest for the group with pre-existing conditions, the cost of medicare premiums is based in part on the cost of the Government insuring the members.
Are you suggesting the federal government subsidize the hypothetical Medicare Part E or not? If you're suggesting that the federal government subsidize Medicare Part E, then I could see this working (depending on how big the subsidy is). I still think it would be a pain in the ass compared to the ACA system. Oh I got sick time to hop into Medicare part E, now I'm better, time to go to the private market again. Community rating with subsidies just seems to be less of a hassle. In order for your system to work I think it would have to do a number of things: - Make people pay into it no matter if they're sick or not. Like Medicare. - Have the government subsidize premiums. Like they do with Part B. http://www.medicarenewsgroup.com/ne...aq?faqId=04eeb449-e830-49c0-baaa-4170b3a03036 If that's done it would work, though I don't see it being a better system than the ACA.
Because nobody seems to have actually brought up any negatives that show the single payer system has worked worse than the US pre ACA system. The only factual negative I have seen is that the wealthy get subjected to the same system as the average person so they use their money to bypass the single payer system. Of course that is hardly a negative compared to the old US system where the rich got the best care and the poor got little if any care.
of course there are negatives Canada Canadians do wait for some treatments and diagnostic services. Survey data shows that the median wait time to see a special physician is a little over four weeks with 89.5% waiting less than three months. The median wait time for diagnostic services such as MRI and CAT scans[11] is two weeks, with 86.4% waiting less than three months.[12] The median wait time for surgery is four weeks, with 82.2% waiting less than three months. In addition, there is concern of a "brain drain" as high-quality medical graduates leave Canada for better-paying careers in the U.S.[13] From Wiki.... What if doctors refuse to accept single payer , many Doctors will not take on new Medicare/Medicaid patients http://kaiserhealthnews.org/news/third-of-medicaid-doctors-say-no-new-patients/ http://www.nj.com/healthfit/index.ssf/2015/02/where_will_400k_new_nj_medicaid_patients_get_care.html Will there be enough Doctors ? and the rich will still have the best care because they can go to where it is best provided and pay for it
What I was referring to is the overall results for the health of the population. Simple measurements like life expectancy, infant mortality, overall cost of the system as percent of GDP, etc. hard to find any metric where the US system beats a single payer system. Suggest what he US actually has is three separate healthcare systems. One is Medicare, one is the healthcare for those with good insurance or wealth, and a final system for those with poor or no insurance and no money.
True but people without wealth will also get better service and the overall cost to the nation of healthcare will decrease if other developed countries are any indication. That said there is no underestimating the ability of the American government to screw up,almost any good idea.
"A second reason is that some of the most wasteful programs are also the most popular (e.g., Medicare), and lawmakers fear that opponents would portray them as "attacking" popular programs. Consequently, waste and inefficiencies continue to build up, costing taxpayers more while providing beneficiaries with less." (from the Heritage website). Beyond what I have said above, the remainder of my comment is based on my own observations and experience over the last 35 plus years in Medical and Payment Administration. IMO, medicare CS is similar to the IRS, you call with a specific question and they don't stand behind the answer you are given. Nearly 45% of claims submitted to Medicare have to be resubmitted do to errors on Medicare's side. Requiring more administrative time on the providers side. And, once paid they rate will be the same as what the physician was reimbursed in the 1990's. Because, while they haven't reduced Medicare reimbursements rates, they also haven't increased them. But, the costing of providing care has increased two-fold. Most of the claims of physician fraud are incorrect. Most of these cases involve incorrect coding for the care given. The care billed for "was" given, but the code the physician submitted is being called into question. This brings up the fact that a physician has a difficult time contacting Medicare regarding the correct codes to submit for a given service. And, the information they are given may or may not be accurate and HHS does not stand behind the information given. so a physician can use the code they were advised to use and later be called on the carpet for using an incorrect code. Still, the care they were billing for was provided. Fraud? I think not. PPACA included many more ways to "fine" or "prosecute" physicians for such things, regardless if the care billed for was in fact provided. It is a crock of you know what. Just another way for the Government to make money. With more and more costly regulation, ambiguous regulation it is no wonder the majority of physicians and surgeon don't want to accept Medicare patients, many removing themselves from the plan and requiring patients pay cash and submit their bill to medicare on their own.
There is no ACA good news and the bad news will keep coming once the "medical board" takes effect. Even less medical treatment and surgery will be covered and paid for by Medicare and Insurance. Why? because they will base their decisions on the patients age, health condition and whether the care/surgery will be cost effective. If your 80 and want a knee replacement it just may no longer be covered because of your remaining life expectancy. Doubt this? Google it. It is basically what Dr. E Emanuel has said over and over in the papers he has written.
According to Kaiser 70% of the doctors in Texas will accept Medicaid patients. That is above the national average.
