Ted Kennedy's Dream

[Tunnelcat]

This is quite revealing as to why the ACA may be imploding. It appears it was done on purpose and both sides wanted it to happen, but for different reasons. The Dems ultimately want single payer, the Republicans want government out of healthcare. Who will get what they want?

http://www.cnbc.com/id/101187368

[callmeslick]

still, IMHO, the ACA has to work, somewhat, to pave the way to single-payer. If it does, the cost-savings, overall efficiency and lifting of burden on larger corporations to provide healthcare should become an easy sell.

[Spidey]

I would love someone to explain just how a single payer health care system based on Medicare would be funded.

Medicare is a payroll insurance program. (sort of) People have to pay into the program for 10 years to qualify for benefits. (and only after a certain age)

You can also get Medicare if you haven’t met the 10 year requirement by buying coverage. (Part A)

Your employer must also match your payments into the program.

So all of this is neither here nor there, I just want to know how a new system would be funded?

[callmeslick]

I would love someone to explain just how a single payer health care system based on Medicare would be funded.

by replacing the current method by an increased income tax, most likely.

perhaps, there would be an employer component, as currently the case with Medicare and Social Security. After all, large employers would be saving hundreds of millions in health insurance premiums under such a plan.

[woodchip]

Lets see now.
Premiums are triple
Higher taxes in the wings
Can't keep your doctor
Waste up the wazoo

Whats not to love about it.

[Spidey]

So it would shift “hundreds of millions” onto the taxpayer thru increased income taxes.

Yea, that’s going to fly…like a bus.

[Krom]

You are kinda forgetting that if we move to a single payer system, the hundreds to thousands of dollars a month you or your employer pisses away on for-profit insurance will instead go into the single payer system (or perhaps some of it will also end up in your pocket). You might actually get to keep more of your money without having to be heavily invested in insurance stocks in order to make back what they normally gouge out of the premiums.

[woodchip]

Krom the govt will piss away more than the insurance companies ever could.

[Spidey]

Assuming the government can actually set up an efficient system, but I’m doubtful of that going on its current record, and the deliberate avoidance of tackling the actual health care costs with the ACA.

Basically they took a very complex problem…and applied a simple solution to it, which would be very elegant if it weren’t so dumb.

I understand the basic theory, I’m just a cynic when it comes to huge government programs…we can all see how efficient the military is.

Not to mention that Medicare still pays way more than the market would if there was no insurance, and providers still complain that it doesn’t pay enough….but that is another can of worms altogether.

Well…if people believe that a government owned by the rich, would actually provide low cost health care….go for it, but I have a huge can of “told you so” when they don’t.

[Tunnelcat]

Private insurance will STILL piss away your health care dollars on bloated profits and expensive advertising. That's not even going towards your health care or any hospitals or doctors either. In fact, insurance IS the problem. In the end, it will comes down to which system gives you more in return for your health care dollar.

[Spidey]

No…in the end, it’s going to come down to socializing medicine.

The most efficient bang for your buck, would be forcing the industry to charge prices the market can bear.

[Will Robinson]

Private insurance will STILL piss away your health care dollars on bloated profits and expensive advertising. That's not even going towards your health care or any hospitals or doctors either. In fact, insurance IS the problem. In the end, it will comes down to which system gives you more in return for your health care dollar.

There wont be any customers for a private healthcare policy under the single payer. The government will be paying the patients bills to the doctors and hospitals etc. etc.

Insurance companies will still sell other insurance product and lose the customers for health care coverage. Why would anyone buy coverage that they already have mandated by law and likewise are taxed/paying in advance to cover their 'premium'?

[Spidey]

Something occurred to me while watching a report on the ACA tonight on the NewsHour…

They had this yoga teacher on there and she was saying she wanted insurance, she is one of those young people the system needs so badly. She is thinking of getting a silver plan that would cost something around 2428.00 or so bucks a year, but with subsidies of 2188.00 her cost would only be something around 240.00.

Someone please tell me how a paltry few hundred dollars paid by the young and healthy, is enough to make the ACA work.

I thought the plan was to get the money from the young and healthy to offset other costs…not get it from the taxpayer.

What the hell is wrong with this picture???????

[Will Robinson]

Something occurred to me while watching a report on the ACA tonight on the NewsHour…

They had this yoga teacher on there and she was saying she wanted insurance, she is one of those young people the system needs so badly. She is thinking of getting a silver plan that would cost something around 2428.00 or so bucks a year, but with subsidies of 2188.00 her cost would only be something around 240.00.

Someone please tell me how a paltry few hundred dollars paid by the young and healthy, is enough to make the ACA work.

I thought the plan was to get the money from the young and healthy to offset other costs…not get it from the taxpayer.

What the hell is wrong with this picture???????

I'm pretty sure they got the numbers wrong. Maybe her results were monthly?
I just looked up a similar example, someone earning $30,000 a year pays around $2100 per year for the silver plan after subsidies.
I think the subsidy is supposed to result in a net cap on your health care expense at around 8% of your income.

[Spidey]

They didn’t mention what this woman’s income was, and I have no idea how to verify if the NewsHour had the numbers correct.

This is from PBS’s website (transcript)

FREDERICA FREYBERG: According only to estimates, because she couldn't get into the online marketplace, Curry's insurance premium for 2014 for a mid-tier plan would be $2,428 a year. But, because of her income, she could get a government tax credit of $2,188, making her premium $240 a year.

GEORGIA CURRY: I know some people who I would venture to guess will not buy insurance the first year and pay the penalty. But as the penalty increases year to year, I think you get to a point where it's worthwhile to just pay and have the coverage.

BRIAN BURRELL: The choice that people think that they would rather pay the penalty, then they can definitely do so. But I think especially starting in 2016, the penalties will actually be quite a bit higher. It will be a minimum of $700. And so, in some instances, when you're getting those tax credits, it could actually be cheaper just to buy health insurance.

[callmeslick]

Lets see now.

let's, shall we?

Premiums are triple

no, they aren't. Overall, they are LOWER for comparable plans. Why do you keep repeating this proven, cherry picked lie. Less than 0.3% of all individuals would see a rise anything close to that. The overall costs are shown, clearly to DROP. Why lie, as it weakens your credibility?

Higher taxes in the wings

discussed for a whole sea-change in healthcare(Universal, single-payer).

Can't keep your doctor

in less than 1% of all cases, as has been well documented. Sticking to reality, I lose no doctors, nor do I know of one person who does.

Waste up the wazoo

Medicare has 3 times the operational efficiency of private insurers, and has LONG been proven so.

Whats not to love about it.

if you stick to the truth, and not made up scary lies, not too bad. Far from perfect, but not too bad.

[Spidey]

Operational efficiency isn’t going to get the results we need unless the “actual” cost of “actual” health care is dealt with, as I pointed out before. (many times)

You can’t just change to a single payer system without changing the way providers get their education, the ongoing cost of running the “actual” health care system, tort reform…etc…etc…

I’m not going to list every little detail here, but I know for a fact that you can’t make that kind of change (single payer) and simply impose it onto an infrastructure not designed to handle it.

And no simple answer please, like…well Spidey…they will just have to adjust and suck it up…because if it were that simple…a simple solution like price controls would eliminate the need for a single payer system in the first place.

Hell, if health care were affordable, a person with an average credit rating could get a personal loan to cover just about any health emergency…and have no need for insurance in the first place.

Price controls and low interest loans combined with saving accounts would solve the problem. (and the poor could simply receive government help)

But people want to socialize…that’s the real goal here…to spread the cost around, because as I have said before…there are probably some pretty good alternatives.

[Will Robinson]

...

Can't keep your doctor

in less than 1% of all cases, as has been well documented....

First your percentage is off I believe the administration gave a higher number than that.
Second, and quite important, the temporary exemption for businesses to comply has kept the real number from being much higher since all the people with an employer plan aren't getting those notices....yet.

Since most people with a plan have it through their employer the numbers you and the Obama team are playing with are quite dishonest and the real impact of the lie is conveniently put off to keep the negative effects from showing up until after the mid term election!

In short, the problem is much worse than you are trying to imply. Imagine that.

[callmeslick]

Time will tell, Will. The facts are that the support numbers for the law are gradually rising, despite the horror tales from the right, and I suspect by mid summer 2014, the support for the ACA will be much stronger. As I say, we'll just have to wait.

[Tunnelcat]

Operational efficiency isn’t going to get the results we need unless the “actual” cost of “actual” health care is dealt with, as I pointed out before. (many times)

You can’t just change to a single payer system without changing the way providers get their education, the ongoing cost of running the “actual” health care system, tort reform…etc…etc…

I’m not going to list every little detail here, but I know for a fact that you can’t make that kind of change (single payer) and simply impose it onto an infrastructure not designed to handle it.

And no simple answer please, like…well Spidey…they will just have to adjust and suck it up…because if it were that simple…a simple solution like price controls would eliminate the need for a single payer system in the first place.

Hell, if health care were affordable, a person with an average credit rating could get a personal loan to cover just about any health emergency…and have no need for insurance in the first place.

Price controls and low interest loans combined with saving accounts would solve the problem. (and the poor could simply receive government help)

But people want to socialize…that’s the real goal here…to spread the cost around, because as I have said before…there are probably some pretty good alternatives.

There's one thing no one want's to talk about. How do you ration health care? That IS at the core of the containing costs problem whether people like it or not. It is something that has to be rationed because the demand is higher than the supply or available access. Right now, it rationed via cost to the consumer. Those who can afford it simply pay for it and those who can't afford it either go without and get sick, or sponge off the system, in which we all bear the costs anyway. Sarah Paling kept fear mongering the whole time she was running about "death panels". Well, we already have death panels in the form of insurance companies and skyrocketing costs. Some type of ethical decision is going to have to be made soon about how much we need to spend as a society to keep every person alive for as long as they want, or it's not possible for ANY system to have any hope of functioning at all.

Price controls are not something that works in a free market system either. Cost transparency would be a big start however. Right now, getting sick only guarantees you're probably in for a humongous bill of an indeterminate amount. Only in a socialized system can costs be regulated and controlled, which would probably have the negative effect of stifling innovation and research. And we already have those stupid HSA's that no one seems to be using anyway, because you'd spend way over what you've already saved just once when you got some major illness, forcing you to resort to a loan or charity in the end anyway. Back to square one.

[CobGobbler]

People don't want to socialize the system. They'd just like more than third-world access to a supposed first-world healthcare system.

[woodchip]

Lets see now.

let's, shall we?

Premiums are triple

no, they aren't. Overall, they are LOWER for comparable plans. Why do you keep repeating this proven, cherry picked lie. Less than 0.3% of all individuals would see a rise anything close to that. The overall costs are shown, clearly to DROP. Why lie, as it weakens your credibility?

Higher taxes in the wings

discussed for a whole sea-change in healthcare(Universal, single-payer).

Can't keep your doctor

in less than 1% of all cases, as has been well documented. Sticking to reality, I lose no doctors, nor do I know of one person who does.

Waste up the wazoo

Medicare has 3 times the operational efficiency of private insurers, and has LONG been proven so.

Whats not to love about it.

if you stick to the truth, and not made up scary lies, not too bad. Far from perfect, but not too bad.

Do try and link something to back up what you say, there's a good boy. If you can't then stop pretending you know what you are talking about.

[Spidey]

Price controls are not something that works in a free market system either.

Why?

The ACA just placed profit limits on the free market, and forces people to buy a service provided by the same "free market".

[Tunnelcat]

Price controls are not something that works in a free market system either.

Why?

The ACA just placed profit limits on the free market, and forces people to buy a service provided by the same "free market".

I see how well that's working out. The insurance industry has already found ways around the ACA's profit lid by dumping people with good policies, jiggering acronyms and anything else they can think of to get around the system.

http://www.huffingtonpost.com/2010/04/1 ... 39572.html

http://abcnews.go.com/Health/HealthCare ... id=9818699

And this from Ol' Bubba Clinton himself. I'll bet this is sticking in Obama's craw right now.

http://news.yahoo.com/clinton-obama-hon ... itics.html

[Krom]

Yeah, the moment Spidey mentioned profit caps, I immediately laughed and assumed that it probably has more loopholes then is humanly possible to count, or probably more loopholes than is physically possible to count with the data storage capacity of the entire universe. You know, just like the best fiction out of Hollywood isn't actually anything on film, rather it is on their Accounting books.

[Spidey]

But yet people believe the government can pull of a single payer system…


Oh, and Clinton needs to stfu, because as slick keeps pounding into my head…it’s the law now, get over it.

[callmeslick]

Something occurred to me while watching a report on the ACA tonight on the NewsHour…

They had this yoga teacher on there and she was saying she wanted insurance, she is one of those young people the system needs so badly. She is thinking of getting a silver plan that would cost something around 2428.00 or so bucks a year, but with subsidies of 2188.00 her cost would only be something around 240.00.

Someone please tell me how a paltry few hundred dollars paid by the young and healthy, is enough to make the ACA work.

I thought the plan was to get the money from the young and healthy to offset other costs…not get it from the taxpayer.

What the hell is wrong with this picture???????

because the insurance company gets the $2400, and offsets the costs of insuring us old farts. The money is repaid the government in the form of vastly reduced compensation the feds currently pay to hospitals to cover the costs of treating uninsured patients.

[callmeslick]

People don't want to socialize the system. They'd just like more than third-world access to a supposed first-world healthcare system.

but the current public support for a socialized system is well over 50%

[callmeslick]

But yet people believe the government can pull of a single payer system…

they do it well enough for people over 65 that no one would dare take that plan away. Ever.

[callmeslick]

For Woody, who just doesn't learn, apparently:

references--
Medicare efficiency(actually I was conservative, overhead for Medicare is 1/10 of private insurers), from a much longer Reuters article:
"Although we hear plenty about fraud and abuse in Medicare - which is a legitimate area of concern - the program is dramatically more efficient than private insurance. Medicare spent just 1.4 percent of every dollar on administrative overhead, even including money spent to fight fraud and abuse, compared with 25 percent overhead in private plans, according to Richard Kaplan, a professor at the University of Illinois College of Law who specializes in elder law matters."

Overall change in policy pricing under ACA:
http://www.rand.org/news/press/2013/08/29/index1.html
3-fold my ass!! You've repeated that blatant lie for weeks, why?

Finally, I can find exactly ZERO proven instances where a person, unless choosing a plan that does so, loses their doctor. The now-well-known WSJ story about the woman who can't go to her cancer specialist is predicated upon her CHOOSING not to purchase a certain plan that would have covered her. Like I said, I googled for examples of people losing their doctors and found not ONE SINGLE example to date where the individual couldn't have an option that would have retained their doctors.

[woodchip]

Before you say anything about lies here is Blue Cross's price structure:

http://www.bcbsm.com/content/microsites ... plans.html

Now find the silver and gold plans with gold coming closest to what I have with "out of pocket" before 20/80 kicks in. Now remember I am paying 273 a month with no out of pocket before 20/80 kicks in. Now where am I lying? Stop responding like some ignorant red-neck.

[woodchip]

As for medicare efficiency:

"When administrative costs are viewed on a per-beneficiary basis, as in Book’s evaluation, and not as a percentage of total costs, Medicare’s administrative costs are seen to be slightly higher than those of private insurance, even though in private insurance these costs include money spent on non-administrative functions such as marketing."

http://www.nationalreview.com/articles/ ... ert-moffit

[woodchip]

On to zero examples:

"New York State Medical Society President Sam Unterricht is demanding a congressional probe after learning that one health carrier alone, UnitedHealthcare, is terminating contracts with up to 2,100 doctors serving 8,000 Medicare Advantage patients in the New York metro region."

http://nypost.com/2013/10/25/elderly-pa ... obamacare/

So are 8000 examples enough to show the lie of "If you like your doctor you can keep your doctor." Do you see anything in that statement about having to drop your plan and get another one? Or do you think the stress of an elderly person faced with the change is somehow nothing to care about? Demoscammers are the real uncaring people.

[Top Gun]

But yet people believe the government can pull of a single payer system…

Just about every other first-world government does so, and the vast majority of them produce measurably-better healthcare outcomes for the cost than our current system does. So why can't we?

[Spidey]

I knew someone was going to raise that argument.

Most other countries people use as examples have much better personal health habits than we do.

It’s true that our system is more expensive, but I am skeptical that the outcomes here are entirely due to poor care.

But the answer to your question is…sure we can do it, but will we…remember the rich own this government. And as I said earlier in this thread, you can’t just reform the system from the top down, because of all of the other reasons, I noted before. (cost of education, resulting in vision’s people who expect a return on their investment…etc…see my other post)

Sure I believe it “can” be done................

[callmeslick]

On to zero examples:

"New York State Medical Society President Sam Unterricht is demanding a congressional probe after learning that one health carrier alone, UnitedHealthcare, is terminating contracts with up to 2,100 doctors serving 8,000 Medicare Advantage patients in the New York metro region."

http://nypost.com/2013/10/25/elderly-pa ... obamacare/

So are 8000 examples enough to show the lie of "If you like your doctor you can keep your doctor." Do you see anything in that statement about having to drop your plan and get another one? Or do you think the stress of an elderly person faced with the change is somehow nothing to care about? Demoscammers are the real uncaring people.

so much of this stuff has exactly ZERO to do with the ACA. For anyone out there who has had insurance coverage over the past two decades, surely you must realize that the insurers change whole policies, provider lists, etc with routine regularity. I know mine did over 28 years with the same corporation(all before the ACA). What you are seeing, and blaming solely on the ACA is standard industry cost-cutting practices. Which, by the way, is EXACTLY why single-payer national insurance will become overwhelmingly appealing soon.

[callmeslick]

I knew someone was going to raise that argument.

Most other countries people use as examples have much better personal health habits than we do.

really? Ever eaten English food? Likewise, many of those countries have, if anything, comparable habits to the average US citizen regarding exercise and the like.

It’s true that our system is more expensive, but I am skeptical that the outcomes here are entirely due to poor care.

it isn't poor care so much as really bad access to ANY routine preventative care that is the issue. Generally this affects the poorer segments of society, but especially those folks with too much income for medicaid but too little to afford anything but garbage health insurance.

But the answer to your question is…sure we can do it, but will we…remember the rich own this government. And as I said earlier in this thread, you can’t just reform the system from the top down, because of all of the other reasons, I noted before. (cost of education, resulting in vision’s people who expect a return on their investment…etc…see my other post)

as I noted in another thread, I find more an more of the people you might call 'rich' coming to the conclusion that, at the very least, we need a minimal package of catostrophic and routine care provided to everyone, just for the sake of making societal and business costs of health more predictable.

[woodchip]

On to zero examples:

"New York State Medical Society President Sam Unterricht is demanding a congressional probe after learning that one health carrier alone, UnitedHealthcare, is terminating contracts with up to 2,100 doctors serving 8,000 Medicare Advantage patients in the New York metro region."

http://nypost.com/2013/10/25/elderly-pa ... obamacare/

So are 8000 examples enough to show the lie of "If you like your doctor you can keep your doctor." Do you see anything in that statement about having to drop your plan and get another one? Or do you think the stress of an elderly person faced with the change is somehow nothing to care about? Demoscammers are the real uncaring people.

so much of this stuff has exactly ZERO to do with the ACA. For anyone out there who has had insurance coverage over the past two decades, surely you must realize that the insurers change whole policies, provider lists, etc with routine regularity. I know mine did over 28 years with the same corporation(all before the ACA). What you are seeing, and blaming solely on the ACA is standard industry cost-cutting practices. Which, by the way, is EXACTLY why single-payer national insurance will become overwhelmingly appealing soon.

My primary care doctor I've been seeing for 30 years. Blue cross has never booted him due to policy changes. And as to the ACa having Zero impact:

"Federal funding to Medicare Advantage is being pared back by billions of dollars in coming years under the national Affordable Care Act. Obama said spending on the program was higher than regular Medicare and unsustainable."

So I have to wonder. When AHC becomes unsustainable, what will the Feds cut from it?

[callmeslick]

back to gloom and doom guesswork, I see.

[Spidey]

Look, I actually live with poor people, I don’t get my information second hand, and I can tell you for a fact that “poor” people have a serious cultural problem with preventative care, to the extent that is almost taboo in some cases.

Wow, English food, nice single example to poopoo what is the truth, just take Japan as the example instead….far less fat, salt and sugars in their diet and a much more active lifestyle. The proof of what I am saying is Japan has begun to see all of the health problems we do, as they become more like us…an undisputable fact, if you don’t believe me…ask someone from Japan…or look it up.

And regarding English food, it may be unhealthy, but the amount you consume has more affect than the food itself.

On your last line item veto…you still have never explained just how the problems I have described will be dealt with. (and there are plenty) And the government has proven itself to be inept when it comes to dealing with complex problems.

I don’t like the idea of shifting costs from large employers to the taxpayer, so it’s strike one for universal care, in my opinion. So you still have a long way to go convincing me, and I am exactly the type of voter you will need.

Sure polls might indicate a change in acceptance, but the public really doesn’t have all of the facts.