Demand surges? How about some numbers! Or is it like selling one cheeseburger on Monday and on Tuesday the "demand surges" all the way up to two cheeseburgers?
1
Only in Washington D.C. (and New York) is being forced to buy something you don't want by the threat of force considered "demand" (or "Constitutional")...
2
If you have a mortgage, your taxes go down. Great!
If you have health insurance, your taxes go down. Tyranny!
If you have health insurance, your taxes go down. Tyranny!
1
No, your tax s go up if you don't buy something. Not the same at all.
Wanna make it fair? How about since you can deduct your mortgage interest from your taxable income, do the same for your medical insurance? That way the people who buy it get a tax break, not the freeloaders.
Wanna make it fair? How about since you can deduct your mortgage interest from your taxable income, do the same for your medical insurance? That way the people who buy it get a tax break, not the freeloaders.
1
Who wouldn't want overpriced insurance that covers nothing, has a 5 figure deductible, and will cost double next year- if it hasn't gone bankrupt
6
The tens of millions unemployed because of ObamaCare, are paying bone crushing taxes, or who had their insurance cancelled because of ObamaCare eagerly anticipate its imminent demise
5
Tens of millions? The are fewer than 6 million unemployed in the U.S. You must get your facts from Foxx News.
2
If you watched Fox News occasionally you would get the big picture. Many "employed" people work part time jobs because of
Obamacare, many people who don't count as officially unemployed have quit looking for work because they can't find work and benefits have run out.
So, get nit picky because that is your only defense.
Obamacare, many people who don't count as officially unemployed have quit looking for work because they can't find work and benefits have run out.
So, get nit picky because that is your only defense.
1
As of Nov 2015, according to the BLS, there were 7,937,000 persons officially unemployed, plus 5,636,000 unemployed who want a job but were not counted as officially unemployed because they had given up looking for more than four weeks. So about 13,500,000 in total.
In addition, there were 6.1 million who wanted to work full-time but could only find part-time jobs, so that brings the total to about 19.6 million. For context, the total civilian labor force is 157,301,000.
All data from BLS website.
In addition, there were 6.1 million who wanted to work full-time but could only find part-time jobs, so that brings the total to about 19.6 million. For context, the total civilian labor force is 157,301,000.
All data from BLS website.
1
ObamaCare has been a complete and total disaster. It has not met even one of the goals Obama promised it would achieve. Where's my $2500? It has less than half the enrollees it needs to stay financially viable; collapse is guaranteed!
4
The website and phone system for Obamacare continues to be utterly dysfunctional after over 2 years of criticism and billions of dollars. I'm speaking from personal experience: I filled out the long form online and paid the initial premium after selecting a plan only to get a message on the final application page that the open enrollment period has ended (even though today is the final day to signup). I own my own business and do my own taxes through turbotax, am internet savvy, and have never encountered such website bugs. Where did all the billions go?
4
All I can say is that for the 2014 and 2015 enrollments,the ACA computer system was virtuall unusable. However, for the 2016 enrollment, it worked perfectly, in every way, and exceeded my expectations by far. They really have come a long way with the software!
2
Are you in San Jose, CA? Doesn't California have its own Marketplace rather than a Federally run Marketplace?
2
You wait until the last minute to do something that you should have done weeks ago. Now you and millions of others who waited until today to sign up. are encountering problems with the site. Yup, we're all scratching our heads on that one. I did it two weeks ago, on the phone to Healthcare.gov It was fast and easy. I got affordable insurance with great benefits and low premiums, thank you Obama :)
6
When I was unemployed recently, he ACA enabled me to sign on to Medicare at zero cost, just like the moneyless person that I was deserved -- no questions asked. Lifesaver. When I found a good job with employer-provided insurance, I dropped Medicare, just like the fortunate person that I had become.
This is how the system 'works': to each according to their need, from each according to their ability/fortunate circumstances.
To denigrate this philosophy is one's right, but it is far from virtuous.
This is how the system 'works': to each according to their need, from each according to their ability/fortunate circumstances.
To denigrate this philosophy is one's right, but it is far from virtuous.
4
"...to each according to their need, from each according to their ability..."
Wow. Communist, exactly word for word. Gee - what happened to that system I wonder?
Wow. Communist, exactly word for word. Gee - what happened to that system I wonder?
The ACA forced insurance companies to cover my son with Type 1 insulin-dependent diabetes when none would. His "red" state had no high-risk insurance pool for those with chronic diseases which would have served his needs better. When he lived in another state with a high-risk pool, he got better coverage for a much lower premium. States can, when they choose, make health insurance and care affordable and available to all but most choose to shift that burden onto the federal government, then blame the federal government for everything that goes wrong. States could, right now, subsidize the Obamacare premiums of their low-income residents or offset high deductibles for all with state income tax credits. But will they? Not a chance. That would mean raising taxes on corporations and high-income residents of their states and no Republican governor or legislature would do that, even to save hundreds of lives. They won't even expand Medicaid for free under the ACA and pick up 10% of the cost in the future. Shameful.
16
It is never good news when there are no data...yet, they claim "We are seeing unprecedented demand." It going to be another dud year for the ACA.......
1
At least it's something.
Yeah...2 cheeseburgers instead of one.
From the NYT Upshot article about Medicare vs private Insurance pricing. WHAT? People who are not policy-makers, think-tankers, political operatives understood this years ago.
"Health care researchers who have seen the new findings say they are likely to force a rethinking of some conventional wisdom about health care. In particular, they cast doubt on the wisdom of encouraging mergers among hospitals, as parts of the 2010 health care law did."
Econ 101 about monopolies. They charge whatever they can get away with. The US Healthcare-Industrial Complex is a massive monopoly with its $3T (near 20% of our GDP) tax on our economy.
"Larger, integrated hospital systems...can often spend less money in Medicare, by avoiding duplicative treatments. But those systems also tend to set higher prices in private markets, because they face relatively little local competition."
“Price has been ignored in public policy,” said Dr. Robert Berenson...Dr. Berenson is a former vice chairman of the Medicare Payment Advisory Commision, which recommends policies to Congress. “That has been counterproductive.”
The price-gouging of the Healthcare-Industrial Complex means that all Americans are spending twice, around $4500/year MORE than we need to spend on health care.
What could you do with $4500 in your pocket every year? Vote for everyone who wants to back Medicare-For-All which is the Anti-Monopoly.
"Health care researchers who have seen the new findings say they are likely to force a rethinking of some conventional wisdom about health care. In particular, they cast doubt on the wisdom of encouraging mergers among hospitals, as parts of the 2010 health care law did."
Econ 101 about monopolies. They charge whatever they can get away with. The US Healthcare-Industrial Complex is a massive monopoly with its $3T (near 20% of our GDP) tax on our economy.
"Larger, integrated hospital systems...can often spend less money in Medicare, by avoiding duplicative treatments. But those systems also tend to set higher prices in private markets, because they face relatively little local competition."
“Price has been ignored in public policy,” said Dr. Robert Berenson...Dr. Berenson is a former vice chairman of the Medicare Payment Advisory Commision, which recommends policies to Congress. “That has been counterproductive.”
The price-gouging of the Healthcare-Industrial Complex means that all Americans are spending twice, around $4500/year MORE than we need to spend on health care.
What could you do with $4500 in your pocket every year? Vote for everyone who wants to back Medicare-For-All which is the Anti-Monopoly.
2
coukld not agree more about the monopolies and the price-gouging. but i ask you all - What did you expect? Health care is the only sector of our economy where those involved see NO connection between the prices they charge for services and products, and the ability of the customer to pay. think about that for a moment, let it sink in. Who else can charge whatever they feel they want for their efforts without a concern about thecost, or "market"? no one. because there is no market. for 30 years now we have been purposely distrcting into a revoloving, perpetual conversation about WHO will pay for health care ,not WHY things cost what they cost. someone else will always pick up the tab - emplyers, health insurace companies, the government. but in the end we all pay for it as consumers, wither through co pays, insurance premiums, taxes. every major component of our economy operates either with the natural contraints of market comoetitive forces or federal price controls. Health care in this country will never work until we introduce one or both of these controls back onto the system and get the pigs off the trough.
4
Get the lawyers out, period. Nothing will change until they are banned from coming anywhere near health care.
Thank you Obama for our new Health Care. While others might complain about the price and all of the other things they disagree with the bottom line for me is it will keep me alive. I had a spinal fusion. No one would cover me but my current provider. One missed payment, mail gone wrong, a billing problem and I would be on the street. Then I got cancer. See who wants to insure you after that? I lived in terror my healthcare would be taken away, then my home and everything I have. Bottom line: I'm alive. For all those who talk about money....think about how it saved many lives. When it's your life on the line, your grateful! People complain about their healthcare choice but they have a choice! Covered California has been wonderful in helping me, explaining everything. Bottom line again. I'm alive! Thank you Obama for keeping me alive.
12
Year-over-year premium price increase: 25%
Year-over-year copay increase: 40%
Year-over-year deductible increase: 20%
Obama is not paying for your health care. Individual Americans are paying for your health care. You need to thank those around you who are well and paying into the system for you.
Year-over-year copay increase: 40%
Year-over-year deductible increase: 20%
Obama is not paying for your health care. Individual Americans are paying for your health care. You need to thank those around you who are well and paying into the system for you.
4
Dean - the ACA "Obamacare" (so named by its opponents initially) is the bill by which Liz knows she actually has coverage, where likely she would have been rescinded from her plan before, to face cancer and bankruptcy together.
And all you can think of, is your deductions ...
Perhaps you're not aware of the basic concept that insurance is exactly about spreading risks over large numbers of people. *Anyone* insured, who faces medical problems, have those around them to thank. ACA or no ACA.
And all you can think of, is your deductions ...
Perhaps you're not aware of the basic concept that insurance is exactly about spreading risks over large numbers of people. *Anyone* insured, who faces medical problems, have those around them to thank. ACA or no ACA.
10
Is there a Republican official who isn't as thin-skinned as a blanched tomato? Really Michael J. Winters of Montana? 'They were rude' is a professional-level reason to sit on your hands with regard to making access to insurance easier for your constituents? (Rhetorical question).
4
Drug wars are horrific now between Medicare Part D providers and recipients. AARP /United Healthcare and I have had huge battles this year where i get shorted the amount of insulin i need for 30 b/c my M. D. did not specifically write on the prescription "30 day supply". I am given a 26 day supply which means that United charges me two extra copays /annually, rather than the pharmacist take the time out to call my M.D. and get a month's supply of insulin. What alternative do they think i Have? not to take my insulin? The pharmacists are driven to the edge by their employers to work with the insurance companies. I took them all to task about 3 months ago. And now i get a FREE month's supply at the end of the year. I am sick of being robbed by corporate America.Best i could do was get them to split the difference of MY loss. I cannot live without my insulin.
4
Sorry.
I still won't be getting healthcare insurance.
The penalty for the year will still be less than what insurance would cost.
Translation: I'd rather pay a less costly penalty than pay more money to some corrupt corporate insurance company CEO who cares more about his or her yearly bonus than he or she cares one iota about anyone's health, let alone mine own...
I voted for President Obama twice, but I still think the ACA was nothing more than a massive giveaway to the insurance companies. It was a terrible law, but that just goes to show you how bad healthcare is in this country: a terrible law was better than what we had.
Oh well. Another year without a visit to the doctor.
Thanks for nothing, insurance companies!
I still won't be getting healthcare insurance.
The penalty for the year will still be less than what insurance would cost.
Translation: I'd rather pay a less costly penalty than pay more money to some corrupt corporate insurance company CEO who cares more about his or her yearly bonus than he or she cares one iota about anyone's health, let alone mine own...
I voted for President Obama twice, but I still think the ACA was nothing more than a massive giveaway to the insurance companies. It was a terrible law, but that just goes to show you how bad healthcare is in this country: a terrible law was better than what we had.
Oh well. Another year without a visit to the doctor.
Thanks for nothing, insurance companies!
8
Eventually this "penalty" will get to 7.5% of your gross income. Couple that with the "Cadillac Tax" on employer insurance, people are going to be squeezed in multiple ways. But, this was Mr. Obama's idea of having "more skin in the game". Pay for more and more for insurance and get less and less in return. A nice revenue stream for insurance companies.
4
If you had a car, you would pay auto insurance - for nothing. You would get nothing. Unless you had an accident. In which case, you would be treated, your car repaired, the injured parties helped.
Its pretty much the same for health insurance. You're paying for 'air'. Until you need it. And believe me, if you didn't have health coverage and got cancer or had a calamitous accident? You would end up paying and paying and paying and paying and paying and paying. You would lose everything you own.
Its pretty much the same for health insurance. You're paying for 'air'. Until you need it. And believe me, if you didn't have health coverage and got cancer or had a calamitous accident? You would end up paying and paying and paying and paying and paying and paying. You would lose everything you own.
6
But you get nothing in return paying the penalty... Are you in the habit of always cutting off your nose to spite your face? Medicaid and ACA subsidies are available. Don't you qualify for one of these plans? No insurance if you bet wrong is mighty expensive.
2
Universal healthcare or nothing. I have my Obama care, it costs me a mortgage, it is useless, extremely limited. I am better off without any insurance and pay as a go along for my regular checkups. The only winners are the insurance companies. I am planning on relocating back to Canada it is free and I get to choose my doctors. It is a much better deal than anything the US has to offer.
12
Well, it is not "free", you pay taxes fro it, but Ontario Health is far better than what you get down here. And look at the bright side; no more "Ask your doctor ads"; they are illegal everywhere except the US.
3
Yes you will get healthcare as you say in your post but after talking with many Canadian friends....will you have to wait your lifetime getting those services. I have friends who do not have the luxury of time and need to be treated now. They are waiting and waiting and waiting.
You are only better off without insurance until the time comes when you need it. And then it's too late. Yes, health insurance in the United States is hugely expensive. But that's because our fee for service for-profit model of health care is hugely expensive compared to...well...pretty much the entire rest of the world. And don't get me started on the price of prescription drugs in the United States.
I was no fan of the ACA because I object to any model which imposes a fine on people for not doing business with a for-profit corporation. I wanted the old Kennedy solution, AKA "Medicare for All." But lacking a single payer system, it can't be denied that the ACA, especially in states which expanded Medicaid under the law, does a great deal of good. Just ask any transplant recipient, heart attack or cancer survivor who was basically uninsurable before the ACA. As the adult children up to age 26 who are able to stay on their parent's policies. Ask anyone who absolutely could not get care they needed because they simply could not get insurance before.
There are many issues with the ACA that need to be fixed. I want to see them fixed, not have the law thrown out.
I was no fan of the ACA because I object to any model which imposes a fine on people for not doing business with a for-profit corporation. I wanted the old Kennedy solution, AKA "Medicare for All." But lacking a single payer system, it can't be denied that the ACA, especially in states which expanded Medicaid under the law, does a great deal of good. Just ask any transplant recipient, heart attack or cancer survivor who was basically uninsurable before the ACA. As the adult children up to age 26 who are able to stay on their parent's policies. Ask anyone who absolutely could not get care they needed because they simply could not get insurance before.
There are many issues with the ACA that need to be fixed. I want to see them fixed, not have the law thrown out.
12
I'm not sure why people believe health care should be free. I don't understand what fantastical world provides this. Enlighten me. Please.
1
We don't expect it to be "free." We expect it to be provided cost-effectively by our government, rather than be routed through for-profit corporations. Paid for by taxes just like roads, airports, bridges, libraries, hospitals, colleges, schools, Social Security, Medicare and other elements of the public good -- all of the above open to all citizens -- are paid for.
As to "what fantastical world," well, you don't get around much, do you? Just about every other developed or remotely civilized nation in the world provides socialized medical care for its citizens.
As to "what fantastical world," well, you don't get around much, do you? Just about every other developed or remotely civilized nation in the world provides socialized medical care for its citizens.
8
Well, maybe because in every Western, civilized country except the US before the ACA, health care was and is considered a right, for every citizen by the simple virtue of being a human being, not a privilege that is only awarded to those who are fortunate enough to have an employer with a group plan, and who are healthy enough (!!!) not to be turned down- in case they needs to get an individual plan-by the insurance company for not being in perfect health. This was a shameful, shameful situation-people needing it most, like cancer patients, those with diabetes, cardiac conditions, asthma, MS and so on being turned down by those mammoths only greedy for more profits. I don't even understand, frankly, that so many Americans have no compunction in voicing their opinion that health care is a privilege. A citizen of most European countries or a Canadian, would never dare say such a thing-he or she probably wouldn't even THINK it in the first place-and if he did, he would be treated with scorn and disgust. This was an untenable, anti-social system-or lack of one- that had to end, and thank G'd it did. I have really been disappointed by the President in his second term, and I'll be glad to see him go, but this is for sure one thing for which I am truly grateful to him. Next thing would be to get a single payer system!
3
"We expect it to be provided cost-effectively by our government, rather than be routed through for-profit corporations."
If I didn't read this comment in the NYT, I would have believed it satire. Only NYT's reader's believe that our venal, corrupt government capable of cost-effectively providing anything. Ever. To anyone.
If I didn't read this comment in the NYT, I would have believed it satire. Only NYT's reader's believe that our venal, corrupt government capable of cost-effectively providing anything. Ever. To anyone.
1
It appears that the 'glue' holding this abomination together is subsidies, to both the consumer and the insurance companies as the article points out that "four out of the five" of those covered were "receiving subsidies to help pay their premiums". What this means of course, is that this favorite program of Liberals will require huge sums of taxpayer dollars to keep it functioning.
I am sorry, but the only solution to health care is to have unfettered competition on a national basis from insurance companies. The free market we enjoy shows that competition, real competition, keeps costs down by making insurance companies compete as do all other consumer goods in the USA. Obamacare is an overly complex and inefficient system, that needs to be replaced with a more simple free market system.
As I always tell people, I would love to see free college, free medical, unlimited minimum wages, etc that Obama and his ilk like, if only there was a way to pay for it. Of course there isn't any way except to saddle us and businesses with suffocating expenses, which would perhaps eventually bankrupt the country. Obamacare is one of the worst examples of Government running our lives - remember the old adage, if you get a knock on your door and someone says :"I am here from the Government, and am here to help you", you better run the other way!!
I am sorry, but the only solution to health care is to have unfettered competition on a national basis from insurance companies. The free market we enjoy shows that competition, real competition, keeps costs down by making insurance companies compete as do all other consumer goods in the USA. Obamacare is an overly complex and inefficient system, that needs to be replaced with a more simple free market system.
As I always tell people, I would love to see free college, free medical, unlimited minimum wages, etc that Obama and his ilk like, if only there was a way to pay for it. Of course there isn't any way except to saddle us and businesses with suffocating expenses, which would perhaps eventually bankrupt the country. Obamacare is one of the worst examples of Government running our lives - remember the old adage, if you get a knock on your door and someone says :"I am here from the Government, and am here to help you", you better run the other way!!
3
Competition among insurance companies with policies sold across state lines? I used to live in a state that had very loose insurance regulations. The policies I was offered as a self-employed person were cheap, but they were so full of exclusions that they were essentially worthless.
I'm on Medicare now, and with the most expensive supplement available in my area, I'm saving $350 a month in premiums over last year, and I have *no deductibles.* It is such a relief after years of putting off needed treatments.
Why should people have to wait till age 65 to experience this?
I'm on Medicare now, and with the most expensive supplement available in my area, I'm saving $350 a month in premiums over last year, and I have *no deductibles.* It is such a relief after years of putting off needed treatments.
Why should people have to wait till age 65 to experience this?
8
Couldn't Congress mandate various kinds of medical issues/circumstances be covered in a range of insurance policy options at various prices, and still allow policies to be sold across state lines providing both individual choice and competition?
You do realize that the money you paid into Medicare for your working life, plus the premiums you and other beneficiaries pay for Part B and Part D, cover less than half the cost of Medicare? You are welcome. The taxpayer is subsidizing your health insurance.
Slightly misleading headline, given the content of the article.
4
Agree. The unprecedented demand is going to result in an increase in the insured number going from 9.9 million to 10 million, a 1% increase.
1
Those (i.e. Republicans) who oppose a national health care program for all Americans, which ideally would have involved an expansion for Medicare, have no heart, no sham, no patriotism. They don't care about the common good, just what's good for themselves, their "kind of people."
11
May you get what you ask for "national health care" just like Europe.
How is an insurance product more expensive than you can afford a net positive for the 'common good'? How is an insurance product that must be subsidized with producer tax dollars any good when they very same people who receive those subsidies cannot use the insurance because the deductible, which is not subsidized, is so outrageously high as to negate the effect of having a policy? And finally, considering how many Republicans it took to pass this piece of legislation, how is it is any way the fault of Republicans?
3
Explain, please, why the Democrats didn't enact single payer instead of ObamaCare. The Democrats passed this with zero Republican votes, so they could have done whatever they wanted. They took zero input from Republican legislators, negotiated the whole thing behind closed doors, and then had to "pass it to find out what was in it".
What the Democrats wanted, and what they got, was a system that increased profits for drug companies, insurers and big hospital chains. Higher costs for consumers, higher profits for big Med. Which is exactly what every thoughtful person predicted as details of the plan were floated while it was being written.
In what universe is any of this the Republicans fault? Personally, I have issues when either party grants special gifts to their cronies. But it is laughable to describe the Republicans as the party that gives the most to the rich.
It is no accident that income inequality has grown during the last seven years or that median income has declined. When the government gives enough gifts to the rich, somebody has to pay, and it is always the middle class.
What the Democrats wanted, and what they got, was a system that increased profits for drug companies, insurers and big hospital chains. Higher costs for consumers, higher profits for big Med. Which is exactly what every thoughtful person predicted as details of the plan were floated while it was being written.
In what universe is any of this the Republicans fault? Personally, I have issues when either party grants special gifts to their cronies. But it is laughable to describe the Republicans as the party that gives the most to the rich.
It is no accident that income inequality has grown during the last seven years or that median income has declined. When the government gives enough gifts to the rich, somebody has to pay, and it is always the middle class.
Based on what I and people I know are experiencing, the surge is not about demand for new coverage. It is about individuals seeking alternatives to the huge increases in premiums for the same coverage they had in the past. The president sold a big lie to the insurance companies and the public and now it is coming home, but he spins it again. The truth is, and was, the legislation just costs a whole lot more and someone has to pay.
8
Well, part of this problem is state insurance regulators creating rating districts, your insurance varies with each state. It also varies from state to state. So, a $400 policy in Denver, would could $800 where I live and $1200 in Grand Junction. The more rural the area you live the; the more you pay in insurance premiums. Add to this insurance inflation of 5% to 20 %, even though official inflation is 0% (No increase in Social Security benefits).
As there was zero cost containment anywhere, these kind of increases, and getting less for it. The ACA will collapse under it 11000 page weight; probably as soon as 2019. The first year after the "Cadillac Tax" takes affect and employees start being forced into the exchanges.
As there was zero cost containment anywhere, these kind of increases, and getting less for it. The ACA will collapse under it 11000 page weight; probably as soon as 2019. The first year after the "Cadillac Tax" takes affect and employees start being forced into the exchanges.
3
Thank you Chip. You are 100% correct.
1
The ACA law states almost every American purchase health insurance, however, there is nothing in the law that states CMS/HHS/CCIO has to have a system that works! Yesterday the FF Marketplace was down and today it remains down. The American people need MORE TIME to Enroll!!!
2
If people wait until late sadly this is the case. Unfortunately things are far from perfect with our new system but they not dumping people who cannot get through on phone lines. They are extending the period to enroll as said in the article.
2
It was not down. I enrolled last night and with some help from one of the supervisors found a very good plan that covered all 7 of my providers, many from different groups. You complainers forget what ACA has done for all of us: no pre=existing clause, no lifetime limit where a baby could meet its lifetime limit by age two with a heart defect, etc., children covered until age 26, health costs decreased with those who now have insurance instead of emergency room care only. Imagine how much better it could have been if the repubs had actually wanted their constituents to have health coverage and didn't use all their time and our money investigating and re-investigating if they didn't like the answer they got on bipartisan committees.
1
There is a companion article in today's New York Times showing a comparison between Medicare spending and private insurance spending across America. Combined with this article it is clear that it is time for MEDICARE FOR ALL in America. Vote only for socially conscious democrats and independents so WE can get it done NOW!
23
I agree! In 2008, Hillary Clinton supported a single payer plan. On this as well as how to exit from Iraq, Clinton was the grownup in the room. But she got thoroughly waterboarded by the thrill-up-the-leg crowd. Single payer is so superior, even Donald Trump supports it.
2
Been a family doc for 26 years. Medicare doesn't pay in these parts. Four years of college, 4 years of med school, 3 years of residency--> 150k per year for 45 hours per week if you do 100% Medicare at current rates.
What kind of idiot would do that? Not any medical student I know. Multiply the income by 1.67 and then America and the med students might have something to talk about.
Not going to happen of course. The primary care system will continue to spin down.
What kind of idiot would do that? Not any medical student I know. Multiply the income by 1.67 and then America and the med students might have something to talk about.
Not going to happen of course. The primary care system will continue to spin down.
2
You don't think $150,000 a year for a 45-hour white collar workweek is fair? Hmm.
I do think we need a way to pay for medical school without saddling new doctors with a quarter million dollars in loans. But I don't think that doctors necessarily deserve to make more than three or four times the median household income. They're not that rare or special, frankly, although the ones I know personally do seem to feel they're a cut above ordinary humans.
I do think we need a way to pay for medical school without saddling new doctors with a quarter million dollars in loans. But I don't think that doctors necessarily deserve to make more than three or four times the median household income. They're not that rare or special, frankly, although the ones I know personally do seem to feel they're a cut above ordinary humans.
5
I lost my health insurance with divorce. Prior to getting married I was self employed & paid for my own ins. Obamacare came into play when I needed it, & I don't know where I'd be without it. I wouldn't be eligible for private insurance due to recent pre existing condition, let alone cost. For years I paid $500 a mo before getting married, yet barely used my insurance. Now that I am using it people would like me to think I'm taking handouts? What about all the years I paid into it & never used it? While I'm sure it can be improved, it has been a godsend for me.
33
Well, now what is happening, is more sicker people are using insurance, and those who don't use, are seeing ever increasing premiums. Now become those who don't use or can't, because they have deductibles of over $1000 a month.
1
Exactly! When others are unhappy those with pre-existing conditions like you and me are thinking. Hey, I'm alive. If were alive we can then have the luxury to complain but I am with you on this.
1
You don't know what you are talking about. In California, pre-ObamaCare, if you had been continuously insured and lost your health insurance, you were legally entitled to community rating, you couldn't be cancelled or re-rated if you got sick and the available plans were far superior and less expensive than the ObamaCare plans.
You would be better off if ObamaCare had not become law, as long as you are living in California. About half the population of the country was in a similar situation, and 75% of the population lived in states that provided subsidies for high risk enrollee who had been uninsured.
ObamaCare was a solution looking for a problem. For the 5 million or so people who were uninsurable or priced out of health insurance because of age or pre-existing conditions, there were much better alternatives than adding $1.3 trillion to the national debt.
You would be better off if ObamaCare had not become law, as long as you are living in California. About half the population of the country was in a similar situation, and 75% of the population lived in states that provided subsidies for high risk enrollee who had been uninsured.
ObamaCare was a solution looking for a problem. For the 5 million or so people who were uninsurable or priced out of health insurance because of age or pre-existing conditions, there were much better alternatives than adding $1.3 trillion to the national debt.
There is no evidence that "competition" by insurers lowers prices. In an industry that is necessary for all citizen, the compelling evidence is that insurers will tacitly collude to keep prices as high as possible and that is what they do. When 25-30% of you healthcare dollar is wasted on the insurance bureaucracy, there is a strong case for a single payer model. Too bad most Americans would rather fall on the sword of capitalism then support a model that the significantly lowers health delivery costs and significantly improves healthcare outcomes.
22
Well, very soon there will be only three major health insurance companies. If you think premiums are high now; wait a couple years. Also, health insurance companies are not subject to anti-trust laws. The ACA never removed this provision, so some states may just end up with one health insurance company, just like it was before the ACA in places like Wyoming.
4
I took my dogs to the vet at 8 a.m. today for a day of boarding and, as long as they are there, routine blood work, exams, nail trims etc. Before I left I was handed two sheets of paper with the exact cost of each service plus the cost of heartworm medication and a new vaccine I want them to add.
I know that by tomorrow afternoon the veterinarian herself will phone me with detailed results of the bloodwork and any other lab tests that are performed on the dogs today.
If we can do this for dogs why can't we be as transparent and easy-to-understand abut health care for humans? Cut out the middleman insurance companies with their 60,000-plus codes, indecipherable discount deals with providers and legions of paper pushers.
I know that by tomorrow afternoon the veterinarian herself will phone me with detailed results of the bloodwork and any other lab tests that are performed on the dogs today.
If we can do this for dogs why can't we be as transparent and easy-to-understand abut health care for humans? Cut out the middleman insurance companies with their 60,000-plus codes, indecipherable discount deals with providers and legions of paper pushers.
15
You helpfully list your location as "USA". I live in Flushing, Queens County, NYC. The prices our vet charges scare me, and we avoid doctoring as much as possible. Mostly we pray our 3 year old shi-tzu mix mutt doesn't get sick. I wonder where you live that veterinarians are inexpensive. Not here. And Im not mad at the vets. They have to pay staggering sums to gt to Vet Medical school. Are you sure you live in USA? Really sure?
the "codes" are mandated by the fed govt as part of the re-imbursement process.
1
I didn't say they were inexpensive; I'm expecting today's charges to be close to $500 and that is for young, healthy dogs.
My point is that the veterinarian is able to tell me up front what each service she offers will cost. Because I -- the single payer in this instance -- need to know and because there is no idiotic insurance company bureaucracy standing between me and the information.
I called about getting refractive eye surgery recently (laser) -- because it's elective it's not covered by insurance and hence it took me about 90 seconds to get the price from a major university medical center near me.
I could call their dermatology department and ask the cost of some botox and get a true answer.
But if I call their main hospital to ask the cost of, say, breast cancer surgery or setting a broken ankle or getting a stent or having an EKG -- there is no way I would get a straight answer. Because of the convoluted dance that health care providers play with insurance companies. Bloated regional and university health care systems providing skimpier and skimpier "care" yet charging more and more for it with every passing month. And we can't comparison shop because the information is hidden in code known only to two of the three parties in the cursed three-way transaction.
My point is that the veterinarian is able to tell me up front what each service she offers will cost. Because I -- the single payer in this instance -- need to know and because there is no idiotic insurance company bureaucracy standing between me and the information.
I called about getting refractive eye surgery recently (laser) -- because it's elective it's not covered by insurance and hence it took me about 90 seconds to get the price from a major university medical center near me.
I could call their dermatology department and ask the cost of some botox and get a true answer.
But if I call their main hospital to ask the cost of, say, breast cancer surgery or setting a broken ankle or getting a stent or having an EKG -- there is no way I would get a straight answer. Because of the convoluted dance that health care providers play with insurance companies. Bloated regional and university health care systems providing skimpier and skimpier "care" yet charging more and more for it with every passing month. And we can't comparison shop because the information is hidden in code known only to two of the three parties in the cursed three-way transaction.
6
The government has such a history of releasing false numbers on the ACA, this is probably just another propaganda piece to try to create some demand for something no one really wants to buy and are even reluctant to take when free. ACA is failing. Everyone knows that
5
I appreciate your unsubstantiated, biased claim based on heresay and conjecture. I see you've avoided using the same tactics you claim they use.
17
Tell that to the millions of people that now have insurance and did not before
Tell that to the people under 26 who can still be covered under their parents policy
Tell that to people with pre-existing conditions who could not previously get insurance at all
Finally, give us details of this history of releasing false numbers on the ACA. Are you confusing estimates before the law with numbers after the law?
Tell that to the people under 26 who can still be covered under their parents policy
Tell that to people with pre-existing conditions who could not previously get insurance at all
Finally, give us details of this history of releasing false numbers on the ACA. Are you confusing estimates before the law with numbers after the law?
21
No need to let the facts complicate your thinking. The facts, supported by hard statistical evidence gathered by multiple public and private organizations, prove that the ACA, what republicans like to call Obamacare, has been phenomenally successful in expanding coverage, improving treatments and containing costs. It remains a work in progress, but the improvement in our historically greed-driven healthcare system is already very substantial. In fact, the ACA provides the last chance for our for-profit healthcare insurers to prove that the entire system shouldn't be scrapped and replaced by a public single-payer system.
10
Funny but I never see comments about how defense spending will bankrupt America, only health care for tax paying citizens.
45
Yes, not to mention the wild disparity in the end product of the two systems.
8
Federal health care programs (Medicare, Medicaid, Children’s Health Insurance Program and Affordable Care Act marketplace subsidies) accounted for 24 percent of the budget in 2014, or $836 billion a year. Defense spending accounted for about 18 percent of the budget, or $615 billion a year. However, federal health care expenditures are expected to triple or quadruple as the baby boom ages until it equals 100 percent of the present-day budget. Of course, in addition to paying taxes for federal health care programs, the vast majority of Americans pay for their own medical expenses until they reach age 65 and become eligible for Medicare. Until then, they don’t use any of the federal health programs. Except for tax dollars, Americans have no out-of-pocket costs for national defense as they do health care.
Probably because people are incapable of paying their own way for defense, but are capable of paying their own way for healthcare.
3
All this screaming about how quote, free market healthcare, unquote does not work. Health care and health insurance has always been one of the most heavily regulated industries in the United States. Wise up people.
1
Its not "unprecedented demand' when the consumer is facing fines and penalties for not buying the product. Its people realizing this is the last chance to enroll before the BIG fines kick in. The ACA, or Obamacare, or Romneycare (lets be honest) is so conservative, so obviously pro-corporation, pro-insurance industry, its repulsive to hear Democrats sing its praises without bringing up how desperately we need, not should but NEED to move to a universal health care for all single payer system. All the subsidies we're giving to the insurance industry, all profit to them, to trick people into thinking the costs "aren't that bad," all this money could've been put to such better use creating new single payer systems, in each state, to provide health care, not access to insurance but HEALTH CARE to everyone. Businesses wouldn't have to pay huge costs for employee plans anymore, nobody would have to worry, we could reign in the REAL COSTS of health care. This ACA/Obamacare/Romneycare is a corporate mess, and both parties need to get back to where they were over a decade ago and start implementing state-run single payer health care systems throughout the country.
14
The only ethical and feasible solution is single payer, i.e. socialized medicine. Because we have s many individual insurance and supplemental insurance plans, the cost is unrealistically high. The Europeans, especially the French, British and Germans, have it right. Health Care is a national concern and a privilege accorded to the citizens. The idea that it is a responsibility that organizations can profit from, clouds the issue. In the United States, we have the medical services and treatment industry. There is no health care. The ACA is not affordable, and the insurance companies, initially handed a boondoggle by the law, are now looking to get out, one by one. While Bernie Sanders is the only politician that promotes socialized medicine, it will be the insurance companies that will force the country to evolve to that point and catch up with the rest of the world. Only Big Pharma will stand in the way, but they will also lose in the long run.
17
I recall when Obamacare was considered ethical and feasible. I recall how it was defended vigorously right here in the comments' sections. Being against it was considered greedy, evil and selfish. People with adequate health care were considered "liars" for stating as such.
Now, suddenly it's the republicans' fault and a bigger, more bureaucratic system is being touted as the answer.
It's always the same. Liberal utopian plan fails to deliver. Republicans get blamed.
Now, suddenly it's the republicans' fault and a bigger, more bureaucratic system is being touted as the answer.
It's always the same. Liberal utopian plan fails to deliver. Republicans get blamed.
3
Enough with the slant.
The ACA is nothing more than a regulatory act. The insurance and health care provided are PRIVATE.
There is NO bureaucracy standing between one and their medical provider.
Now, however, there are regulations that make the system a tad bit more transparent and fair and, finally, absolute in their requirements they cannot drop you for getting sick and they cannot charge you more if you are sick.
The ACA has been the most important piece of social legislation since Medicare.
The ACA is nothing more than a regulatory act. The insurance and health care provided are PRIVATE.
There is NO bureaucracy standing between one and their medical provider.
Now, however, there are regulations that make the system a tad bit more transparent and fair and, finally, absolute in their requirements they cannot drop you for getting sick and they cannot charge you more if you are sick.
The ACA has been the most important piece of social legislation since Medicare.
10
Come on, AACNY. All along it's been clear that the ACA was the best law that could get past obstructive Republicans -- no Democrat lawmaker has EVER claimed that the ACA, which perpetuates for-profit health insurance, would be superior to single-payer. It's always been seen as a stop-gap until wiser heads prevail and we could eliminate the profiteering middlemen.
8
I am heartened to see the enrollment in the OCA. The next President, who will not be a Republican, needs to get busy and improve it.
10
"needs to get busy and repeal it".
There, I fixed it.
There, I fixed it.
4
Amazing! Obamacare requires Americans to purchase health insurance, and will impose a tax penalty on those who don't. It imposes huge taxes on some Americans so that the government can subsidize free or low cost care to others. The government spends huge amounts of taxpayer money to advertise the program and beg people to sign up. And now, the Obama Administration is claiming that the program is a huge success because people are signing up rather than being penalized. I am an American retired upon my savings and receiving no company-paid health or retirement benefits. I am too young for Medicare and too wealthy for Medicaid. My deductible just increased by $2400 per year and now applies on a first-dollar basis to everything except basic wellness visits. Thanks for nothing Mr. President.
16
If you've retired before 64, you're doing pretty well. Thats heartening.
2
I guess it is the government's fault that you did not have a job that paid health or retirement benefits? Perhaps, you should focus your dismay on the obscene profits your insurance company earns rather than blame the government that you are too young for medicare. I am sorry that you are caught in the middle but I do applaud the fact that 25% more americans do have some health insurance coverage now.
8
I am in the same position as you. I retired Jan. 1, 2014(first day of ObamaCare) at age 59. I am too young for Medicare and not poor enough for Medicaid, actually not poor at all. But I would never have been able to retire without ObamaCare, I would not be able to purchase health insurance. Regardless of the cost for ObamaCare, I would not have been able to retire without it. I would have to work until age 65. So, there is an upside to ObamaCare. I am retired and living off of my savings and there is some younger person that now has a job. So, would you have been able to retire without ObamaCare?
11
Act one in the socialism show. Obamacare has always been as it was designed to be: A giveaway to the ever-dependent Democrat base paid for by the largest tax on the working class in the modern era. Who cares if we turn doctors and our children and grandchildren into indentured servants? Shut up and pay the bill, indeed.
What are we really getting for our trillions upon trillions of dollars? Lower wages and a shrinking middle class... I guess we will all be poor together, just like in Cuba and Russia. Social security and 401k are the next assets to be seized.
What are we really getting for our trillions upon trillions of dollars? Lower wages and a shrinking middle class... I guess we will all be poor together, just like in Cuba and Russia. Social security and 401k are the next assets to be seized.
11
We will all be poor together? No. There will be a ruling class and the rest of us. You'll blame the poor and ignore who is actually getting all the benefits of our society so this can continue to go on in the same way.
8
DecliningSociety wrote "Act one in the socialism show. Obamacare has always been as it was designed to be: A giveaway to the ever-dependent Democrat base..."
My reply is simply this. The Affordable Care Act is modeled on Republican Mitt Romney's plan in Massachusetts, and Romney's plan was itself modeled on the conservative Heritage Foundation's "market-based" plan with subsidies that the Republicans pushed as an alternative to Hillarycare in the early to mid-90's, a plan that Democrats at the time found so loathsome that it was rejected out of hand. Now that same Republican plan, a give away to big insurance, has been adopted by Dems and made law, so suddenly it's "socialist"? Nah, I don't think so.
The Dem ACA was an effort to play the game on Republican terms. But as with all else, Republicans have no idea what they stand for. All they seem to know is that if Obama is for it, they're against it.
The ACA is flawed in many ways. It's only better than the Republican alternative...which is absolutely nothing other than "You're on your own."
My reply is simply this. The Affordable Care Act is modeled on Republican Mitt Romney's plan in Massachusetts, and Romney's plan was itself modeled on the conservative Heritage Foundation's "market-based" plan with subsidies that the Republicans pushed as an alternative to Hillarycare in the early to mid-90's, a plan that Democrats at the time found so loathsome that it was rejected out of hand. Now that same Republican plan, a give away to big insurance, has been adopted by Dems and made law, so suddenly it's "socialist"? Nah, I don't think so.
The Dem ACA was an effort to play the game on Republican terms. But as with all else, Republicans have no idea what they stand for. All they seem to know is that if Obama is for it, they're against it.
The ACA is flawed in many ways. It's only better than the Republican alternative...which is absolutely nothing other than "You're on your own."
10
Giveaways to Americans? Who else would you want those giveaways directed to? How about to transnational companies who care Nothing about you or yours? Why shouldn't WE take care of our own, as opposed to taking care of the ever dependent pharma. companies, whose unbridled power to loot the wealth of those American citizens you are talking about; who depend on the drugs those companies make? You can fault ACA for not lowering the cost medicines, but if you'll recall, POTUS got NO HELP from those "patriots" across the aisle, whose constituents needed/demanded medical coverage. Moreover, Your lower wages are the result of 'offshoring' of American industry, meant to destroy the 'union movement;' The movement which was the main reason for the higher paying jobs which are now lost, and which now whine about. Offshoring was empowered by Your Congress, over the past forty years. And Obviously would vote for more of the same. You think Any of those so-called Republicans would even consider repatriating those industries? Don't you get it?
7
Unprecedented demand?
Is that the same kind of unprecedented demand the donut shop down the block from me gets on the owner's birthday when he gives away free donuts?
Is that the same kind of unprecedented demand the donut shop down the block from me gets on the owner's birthday when he gives away free donuts?
5
its morally despicable for a nation as wealthy as th usa to have a for profit health care system
but then america has entered th post-moral stage
but then america has entered th post-moral stage
16
The Obama Administration got it fabulously wrong. It didn't have a clue about competition and pricing (see The Times' front page article).
I recall listening to a former Aetna CEO or president (cannot remember which) on Chicago's NPR affiliate. He explained to the host how consolidations would raise prices. What Obama was saying about competition was backwards. (Obama claimed competition would reduce prices.) The host asked why Obama was saying these things (as if there must be some truth to them). The exec answered that Obama simply had gotten it wrong.
The health care market is complex, obviously too much so for an Administration hell bent on shoving something through and refusing to listen to reason.
I recall listening to a former Aetna CEO or president (cannot remember which) on Chicago's NPR affiliate. He explained to the host how consolidations would raise prices. What Obama was saying about competition was backwards. (Obama claimed competition would reduce prices.) The host asked why Obama was saying these things (as if there must be some truth to them). The exec answered that Obama simply had gotten it wrong.
The health care market is complex, obviously too much so for an Administration hell bent on shoving something through and refusing to listen to reason.
8
Noah:
Look at Obama's actions through the prism of "Community Organizer Desperate to Finally Achieve Something, Anything" for the poor would explain quite a bit.
Look at Obama's actions through the prism of "Community Organizer Desperate to Finally Achieve Something, Anything" for the poor would explain quite a bit.
1
Yes indeed, trust kindly Mr. Grossly Overpaid CEO to tell you the truth about his business. Listen, have you ever considered bridge ownership?
1
There's one thing that no one told us: affordable premiums do not equal affordable, accessible health care. What it means in America is narrow networks, hidden costs, lack of choice, and limitations that have nothing to do with what patients actually need.
18
Want reform?
1. Eliminate networks. All doctors and hospitals have to either take all ACA patients or none.
2. All insurance companies pay a standard rate for each service, with geographical variations based on cost.
3. Offer no more than 5 standard policies with set deductibles and co-pays.
4. Encourage, rather than discourage, employers to move their employees into ACA plans.
Now what happens? Doctors and hospitals have to take ACA patients or have their business volume drop. Insurance companies all offer the same plans with the same doctors, so they compete solely on price. Individuals find it much easier to select a suitable plan, and don't have to change every year.
1. Eliminate networks. All doctors and hospitals have to either take all ACA patients or none.
2. All insurance companies pay a standard rate for each service, with geographical variations based on cost.
3. Offer no more than 5 standard policies with set deductibles and co-pays.
4. Encourage, rather than discourage, employers to move their employees into ACA plans.
Now what happens? Doctors and hospitals have to take ACA patients or have their business volume drop. Insurance companies all offer the same plans with the same doctors, so they compete solely on price. Individuals find it much easier to select a suitable plan, and don't have to change every year.
19
Amen.
Despite a lot of the nonsense in these comments, the health care mafia makes far more than any other sector of society. The NY Times did a spread on this and found that, their whining to the contrary, doctors are the #1 most lucrative profession, lawyers not even being a close second (4th or 5th if I recall).
I agree that mandatory acceptance of ACA programs is the way to go.
Single-payer is the only way to go, but the myopic GOP will only continue their broadsides against the best interests of the public at large.
Their absurd proposal for 'vouchers' will lead us down the same extortionist path that student loans has given us in the academic world - overpriced systems that don't deliver.
Despite a lot of the nonsense in these comments, the health care mafia makes far more than any other sector of society. The NY Times did a spread on this and found that, their whining to the contrary, doctors are the #1 most lucrative profession, lawyers not even being a close second (4th or 5th if I recall).
I agree that mandatory acceptance of ACA programs is the way to go.
Single-payer is the only way to go, but the myopic GOP will only continue their broadsides against the best interests of the public at large.
Their absurd proposal for 'vouchers' will lead us down the same extortionist path that student loans has given us in the academic world - overpriced systems that don't deliver.
4
@Dmj - So the only way to put the squeeze on costs is to lower the income of providers. That is what my proposals would do, only very gradually. The best doctors would work for cash only, and still make lots of money caring for the rich. But the overall average prices would have to come down, as more and more people moved into ACA plans and there was not enough other business available.
While we are at it, let's fix prices for cars, computers, tractors, socks, lawyers, pickles, hairdressers, garden rakes....
1
only americans could have concocted a scheme as insanely convoluted as th aca
socialized medicine is good enough for th rest of th civilised world, but not for you
oh, i did say civilised, didnt i
carry on then
socialized medicine is good enough for th rest of th civilised world, but not for you
oh, i did say civilised, didnt i
carry on then
10
If folks want their socialized medicine, then they can get it themselves and spend their own time doing so. It's not the government's responsibility to make sure you get your healthcare. A little more than half the country doesn't support Obamacare so there is no reason to help the other half, if you want healthcare go get a job or find some healthcare and be patient.
3
Unfortunately, the majority of people opposing a single payer healthcare system do so on a weak premise: capitalism=good, socialism=bad. Healthcare economics are far more complex and in a world where everyone will rely on healthcare services a multiple times in their lives, capitalist, for-profits competitive models do not work. Such models are hugely inefficient and only effective for the elite class. The current systems sanctions that most people should risk bankruptcy in obtaining healthcare services. That makes no sense.
14
Unfortunately, the majority of people supporting a single-payer healthcare system do so on a weak premise: freebies at the expense of others = good, being responsible, hard-working, and self-reliant = bad.
Unfortunately people like me who are disabled can't go out and get a job. Workman 's compensation is cutting off so many medications it's a major problem in getting proper healthcare and having medications cut down to zero.
A good article might be one which lists the countries to which I can move in my retirement years and take advantage of their rational, single payer health system. When health insurance premiums, deductibles, and the incredibly obscure and obtuse insurance coverage details becomes overwhelming, I'll be looking to emigrate.
So do some research, NYTimes, and provide me a list of the top 10 countries with good health care sustems.
So do some research, NYTimes, and provide me a list of the top 10 countries with good health care sustems.
5
ill field that
any country other than th usa
any country other than th usa
1
Mexico, but you would have to become a Mexican citizen.
its easy for americans, canadians to live in mex on a tourist visa
health care in mex is so cheap most expats can afford to pay cash
border towns are flooded every winter w americans getting dental care, buying meds, etc bc of th price
and farther into mexicos its cheaper still
health care in mex is so cheap most expats can afford to pay cash
border towns are flooded every winter w americans getting dental care, buying meds, etc bc of th price
and farther into mexicos its cheaper still
1
Seems to me there are three roads forward:
1. No regulation of disease insurance, which has left a lot of people uninsured, and some dying for lack of money to pay for care,
2. The ACA, which is not turning out to be affordable for some and hasn't decreased medical costs for our country,
3. Regulation of costs of care with universal coverage, like all the other rich democracies (and some not so rich) with better outcomes and lower costs.
I prefer number 3 over numbers 1 or 2 (Uh-duh!).
Stephen Rinsler, MD
1. No regulation of disease insurance, which has left a lot of people uninsured, and some dying for lack of money to pay for care,
2. The ACA, which is not turning out to be affordable for some and hasn't decreased medical costs for our country,
3. Regulation of costs of care with universal coverage, like all the other rich democracies (and some not so rich) with better outcomes and lower costs.
I prefer number 3 over numbers 1 or 2 (Uh-duh!).
Stephen Rinsler, MD
14
in the UK national health is used only for emergencies. anything else is months and of waiting. if you want immediate service you pay for it.
Canadians cross the border for health care.
'
ever wonder why?
Canadians cross the border for health care.
'
ever wonder why?
6
Here in the USA, I have a Medicare supplemental plan with one of the top providers in the country UPMC. If I have an acute health problem, I am directed to the emergency room. If I want an appointment with my physician, I typically have to wait for months. There are some grey areas in between, since my doctor can sometimes squeeze me in due to a cancellation, but for the most part, the situation here in the US is not that different from what you described for the UK. Only you need not pay for the service, while I pay about 80 bucks a month plus around 100 deducted from my Social Security per month, plus numerous co-pays, even with Medicare.
3
Both are myths. In fact, in a survey of Canadians three years ago, an overwhelming majority included national health care as one of the important elements of their national identity.
8
Yeah, a Canadian friend once said it best; he saved thousands of dollars over the years NOT paying for health insurance which not only created wealth and value elsewhere in his life, that when he did want something immediate or elective, HE had the opportunity to make a decision and cross the boarder and PAY for what he wanted. Too funny, other countries exploit our crazy system. Just like the person who has free health care in the UK and comes to the US for dental work, which is a few thousand dollars. This is always the thing people neglect to mention or consider with the (well other people come here for our healthcare). In some cases yes, but it's because they're richer on the front end. If a health person pays $8k-$10k a year in premiums for 3-4 years in the US and another say in Canada, saves that same $24k-$40k over the same period, it's a little easier to go get what you want no? This is what some Americans do and go to Mexico for dental care or various medications.
2
The rising premiums along the disparity in costs for the same care in different geographic locations are exactly why this legislation should not have been ruched through Congress. In the very near future, the tax assessed on what is refered to as "Cadillac" plans will be the other shoe dropping upon business and the American worker. What constitutes a Cadillac plan is yet to be seen. My sense is that it will include many workers for Public Entities that turns into a tax for working for State, Federal ,City , County and School Districts.The premise of the ACA was laudable and we needed a solution for those that do not meet the means test for Medicare/ Medicaid coverage and those that are not provided insurance through their employer. But in our push to pass this Legislation while the Democrats held a majority in Congress created a terrible bill where Lobbyists had too much input and power. ( Alas, that is how our Government functions) A telling bit of Data will be the number that signed up for the ACA but stopped paying premiums because of high costs. I am also seeing a pattern of those that are advisors to President Obama are the B or J-V team. They underestimate often. The ACA will be cited as one of his most important accomplishments likened in importance to the advent of Social Security. But the costs of the ACA are growing exponentially for the public as compared to the early costs of Social Security. This feeds into the Republican's mantra against our President.
7
This country is still behind the curve when it applies to reigning in these absolutely OUTRAGEOUS mortgage sized monthly health insurance premiums, whether they are ACA "subsidized" or not. You KNOW something is terribly wrong when a completely healthy 49 year old with no previous health history is quoted an out of pocket monthly premium of $489 (They are just barely over the 50K income threshold) with an out of pocket DEDUCTIBLE of $6850. Ridiculous. What I'd like to know is WHO is making out like bandits and why, as a nation, we're not calling out these fat cat insurance private Pharma welfare King CEO's who are quietly laughing all the way to the bank, at the expense of the rest of us. When is somebody going to rise up and demand real answers!!
9
When is somebody going to rise up and demand real answers!!
in america, never
you just had th bad luck to live in an insane country
in america, never
you just had th bad luck to live in an insane country
4
I truly believe the ACA would have worked fantastically had Republicans in Congress been willing to negotiate and put in their own two cents. People seem to forget that before the Affordable Care Act, health care was unmanageable in this country. Insurers were able to drop people from their roles pretty much at will. A unacceptably high percentage of Americans were not insured. We needed to do something and the Republicans offered nothing. When the ACA finally passed there was no flexibility because Republicans refused to work with the administration on fixes. There are many problems with the ACA, but they can be tackled if Congress were willing to work on it. Unfortunately, for the last seven years gridlock has been the norm and we have been paying the price.
61
It was unmanageable, I've worked and had healthcare through employers for 25 years so I never had an unmanageable issue. The healthcare system needed tweaking not a wholesale change, it was not unmanageable. Hyperbolic speech like yours doesn't help things.
3
Danny...'gridlock' has not been the norm for the last seven years.
Republican obstruction. sabotage and sedition have been the norm, unlike anything ever witnessed in American history.
Republican obstruction. sabotage and sedition have been the norm, unlike anything ever witnessed in American history.
19
Health care is far more unmanageable due to the ACA, as is the insurance industry.
As for the article, it is heavy on rah rah and light on facts. What is "unprecedented demand"? That could mean one more person than called in last year. What I hear from a friend in the insurance industry who specializes in Obamacare enrollments is that it's much slower than he expected, to the point that he's looking for another line of work.
As for the article, it is heavy on rah rah and light on facts. What is "unprecedented demand"? That could mean one more person than called in last year. What I hear from a friend in the insurance industry who specializes in Obamacare enrollments is that it's much slower than he expected, to the point that he's looking for another line of work.
1
It is good news that the conservative model of ACA piloted by Mitt Romney and adopted nationally by Congress is working. The negative comments reflect some real issues that our current legislators refuse to discuss. Rather than refine and repair, they seem to long for the good old days when taxpayers bailed out hospitals annually (DSH payments) for the unpaid bills of the uninsured, while other providers cost-shifted to the steadily declining number of employer-sponsored health plans. I prefer a business model where individuals take responsibility for securing insurance (as John McCain advocated in the 2008 debates), and taxpayers help underwrite the cost where needed. The status quo ante was a shell game and the costs were soaring while 54 million uninsured Americans relied on the rest of us when they got sick.
2
LOL. Pathetic attempt to spread the blame.
Not a single vote from republicans on ACA.
Not a single vote from republicans on ACA.
2
That doesn't change the fact that it was originally Mitt Romney's plan.
"Unprecedented demand"! Hilarious. This turkey called Obamacare is about cooked. As the insurance death spiral begins and co-ops go out of business because Government bailouts are blocked you will see a groundswell of support to eliminate this program asap.
Of course if you are giving away healthcare for free through Medicaid or subsidies to many people who were never responsible for their own well-being it may look like it is chipping away at the uninsured. But once Unions get hit with the Cadillac Health Tax and penalties go up for non-compliance this disaster of a law will go the way of Obama, out the door come 2017.
Of course if you are giving away healthcare for free through Medicaid or subsidies to many people who were never responsible for their own well-being it may look like it is chipping away at the uninsured. But once Unions get hit with the Cadillac Health Tax and penalties go up for non-compliance this disaster of a law will go the way of Obama, out the door come 2017.
12
This system is so utterly ridiculous and broken and unwieldy. Requiring people to sign up, and not ensuring the capacity is there to handle the "unprecedented demand." Encouraging competition... I have ACA and while it makes my premium affordable, I remain underinsured with a $6,200 deductible (down from $15k before ACA). And ACA doesn't take care of the people in between, who don't qualify for the subsidies but don't make enough to manage absurd private premiums.
Let's stop playing this ridiculous game and enact Medicare for All. Primaries coming up, vote accordingly. For crying out loud.
Let's stop playing this ridiculous game and enact Medicare for All. Primaries coming up, vote accordingly. For crying out loud.
6
Why isn't Medicare one of the plans available for purchase? Maybe a government plan would be more affordable than a for-profit insurance company plan. Why should Medicare patients get no-deductible plans and working patients are paying out-of-pocket for most treatments. Unfairness causes anger. Premiums are said to be fair at 10% of gross wages, and then what about the out of pocket expenses on top of that. Some people have chronic illness, that pushes the out of pocket expenses to the limit every year.
1
"Why isn't Medicare one of the plans available for purchase?"
Because Joe Lieberman would have voted with the Republicans to kill the ACA had that been included in the legislation. And because the Democrats didn't have even one vote to spare, they gave in to him.
Because Joe Lieberman would have voted with the Republicans to kill the ACA had that been included in the legislation. And because the Democrats didn't have even one vote to spare, they gave in to him.
1
It is now obvious that getting the insurance companies and their need to generate profits out of health care! The previous article about the difference in Medicare and private insurance costs in the same locale demonstrate that Medicare for all is the cost effective and health promoting way to go.
4
Maybe it's because so many small business stopped offering health insurance after the plans they did offer were ruled "bad" and "non-compliant with the ACA." The result is what the insurance companies wanted:
A glut of people forced into the exchanges where they have segregated their most profitable plans -- the ones that almost never have to pay claims because they cover nothing.
Our employees are so much worse off under this system, but their story is of interest to no one.
A glut of people forced into the exchanges where they have segregated their most profitable plans -- the ones that almost never have to pay claims because they cover nothing.
Our employees are so much worse off under this system, but their story is of interest to no one.
9
OBAMACARE: ACA
A perfect example of how holding an insurance card in America does not ensure access to safe, quality affordable preventive, medical, surgical or palliative health care.
A perfect example of how holding an insurance card in America does not ensure access to safe, quality affordable preventive, medical, surgical or palliative health care.
7
As someone who grew up in Montana, I assure you Montanans are no more sensitive to phone call rudeness than anyone else in America. Great Falls Mayor Michael Winters is just playing the "rugged individualist" card that is so frequently used by Republicans to scam their constituents into letting themselves be fleeced by one or another "free-market" robber. Folks in Great Falls are smarter than that I think ..or at least they used to be.
11
Pretending that the ACA is working is an opinion piece because it is certainly not news, The truth is that insurance companies and coops are going bankrupt and pulling our of the ACA at a horrific rate. They are running a huge deficit and the entire OBAMACARE myth is falling apart rapidly.
12
Yes, as you can see, this piece of "journalism" appears under the Politics section of the NYT, not News.
1
"The truth is that insurance companies and coops are going bankrupt and pulling our of the ACA at a horrific rate."
Ummm.... No. I know these are just facts and opinions are much more important, but the fact is that there are just as many or more insurers in the Health Insurance Marketplaces as there were in 2014.
http://kff.org/other/state-indicator/number-of-issuers-participating-in-...
Ummm.... No. I know these are just facts and opinions are much more important, but the fact is that there are just as many or more insurers in the Health Insurance Marketplaces as there were in 2014.
http://kff.org/other/state-indicator/number-of-issuers-participating-in-...
4
Other than suppressing comments that doesn't fit their narrative, the NY Times obviously was asleep at the wheel when the comments fro this article were written. If sampling is accurate, the comments tell me ACA is one huge disaster and I can't agree more. The problem the NY Times and DC have never figured out is , Medical Care and Medical Insurance are two different animals. I also believe citizens across the country are being tired of hearing just shut up and pay the bill.
14
Again, more vacant, alternative-less criticism of the ACA. The ACA is not a "disaster," but represents a first, difficult step forward, involving growing pains and (like the commenter, apparently) a stubborn resistance to change felt by the less intrepid.
Opponents must compare their complaints about the ACA to the pre-ACA system, supplemented with trajectories of cost increases and service limitations that would have emanated therefrom. None of us supporters of the ACA like it, except as a part of a necessary transition. We were stymied by the conservatives in both parties that prevented a single payer system and even a public option.
You want "affordable" health care? Change what needs to be changed: (a) insanely high pharmaceutical costs and limitations on purchases; (b) excessive payments to specialist doctors and to hospitals (who deserve to be well-paid, but not at the too-high current levels); (c) remove the unnecessary administrative costs and the third-party profit margins; and perhaps most important of all, (d) reduce our indulgent, unsustainable levels of medical intervention, especially regarding end-of-life care.
Note to voters: Republicans are against most of these critical changes. They won't bring us affordable health care; they'll drive us deeper into debt. To repeal the ACA would reinstitute the preexisting system, with higher costs for most people over time, and less coverage. Oh, and uncovered poor people still require others to "pay the bill."
Opponents must compare their complaints about the ACA to the pre-ACA system, supplemented with trajectories of cost increases and service limitations that would have emanated therefrom. None of us supporters of the ACA like it, except as a part of a necessary transition. We were stymied by the conservatives in both parties that prevented a single payer system and even a public option.
You want "affordable" health care? Change what needs to be changed: (a) insanely high pharmaceutical costs and limitations on purchases; (b) excessive payments to specialist doctors and to hospitals (who deserve to be well-paid, but not at the too-high current levels); (c) remove the unnecessary administrative costs and the third-party profit margins; and perhaps most important of all, (d) reduce our indulgent, unsustainable levels of medical intervention, especially regarding end-of-life care.
Note to voters: Republicans are against most of these critical changes. They won't bring us affordable health care; they'll drive us deeper into debt. To repeal the ACA would reinstitute the preexisting system, with higher costs for most people over time, and less coverage. Oh, and uncovered poor people still require others to "pay the bill."
16
Free market healthcare didn't work. According to the commenters here, ACA doesn't work. So isn't time for single payer? Like Winston Churchill said, ""You can always count on Americans to do the right thing - after they've tried everything else."
#FeeltheBern
#FeeltheBern
25
What free market healthcare?
How is a system free where government requires employer to provide healthcare and consumers of healthcare do not care about the cost because they do not have to pay it directly.
How is a system free where government requires employer to provide healthcare and consumers of healthcare do not care about the cost because they do not have to pay it directly.
1
Having a $5000 deductible isn't "paying directly"?
PJ .. I was talking pre-ACA.
I'm receiving spam from the Feds like crazy about this deadline; two to three emails daily for the last week. That did not occur in past years. We had to take ACA plans after losing our jobs during the Obama depression and therefore our employer coverage. We are allowing our plans to automatically continue for 2016, as the cheaper plans do not have a doctor or hospital within over 50 miles of our house, just a single nurse practitioner whose office is over 20 miles away.
When we started receiving this massive amount of spam from the government I called my health insurance plan despite the fact that I had already received communication from them that my plan would continue in 2016 unless I made changes. I didn't want to deal with the uninformed people on the other end of the government's phones but rather my insurance carrier, who has answered every call quickly and with an American with no impossible to understand accent to boot!
Bottom line, this massive amount of spam I'm sure has caused at least part of this surge.
When we started receiving this massive amount of spam from the government I called my health insurance plan despite the fact that I had already received communication from them that my plan would continue in 2016 unless I made changes. I didn't want to deal with the uninformed people on the other end of the government's phones but rather my insurance carrier, who has answered every call quickly and with an American with no impossible to understand accent to boot!
Bottom line, this massive amount of spam I'm sure has caused at least part of this surge.
2
Obama depression? Really? Seems to me it’s the Obama Recovery. It also seems you could show just a teensy shred of gratitude that the ACA was there for you when you lost your jobs.
All of my communications with the government have been answered by Americans, unlike my calls to most any private sector service or business. Still, it is easier to understand the accents of some of those people than your tortured logic about the ACA.
All of my communications with the government have been answered by Americans, unlike my calls to most any private sector service or business. Still, it is easier to understand the accents of some of those people than your tortured logic about the ACA.
18
Amen to Janet Camp
5
Thank you Janet. Well said.
4
Lots of one-male-name posters here ("Rob" "Bud" "Bill" etc.) mouthing very scripted right-wing talking points against the ACA.
The minions of the Brothers Koch hard at work, it seems.
The minions of the Brothers Koch hard at work, it seems.
11
And yet there is no coherent response to those talking points, but the usual name calling and attacks have begun.
2
Why can't US citizens have single payer --- like citizens of every other industrialized nation on earth? Oh, yeah, the health insurance executives have to make a billion dollars.
4
The only country that has true single payer is Canada. Most European countries use a mix of public care for the poor and private insurance for everyone else.
Check out the systems in Germany and Switzerland.
Check out the systems in Germany and Switzerland.
1
Jonathan:
Which is why calls for "single payer" should be taken with a grain of salt (at this point).
Most people calling for Canada's system or England's have no idea what those systems entail.They just want to be able to walk in, receive care and not be bankrupted in the process.
There is no reason to believe that a federal attempt at "single payer" would not be as screwed up as Obamacare. The federal government probably couldn't even reconcile the Medicare and Medicare systems at this point, judging from how little technical expertise it had building the ACA interface.
Which is why calls for "single payer" should be taken with a grain of salt (at this point).
Most people calling for Canada's system or England's have no idea what those systems entail.They just want to be able to walk in, receive care and not be bankrupted in the process.
There is no reason to believe that a federal attempt at "single payer" would not be as screwed up as Obamacare. The federal government probably couldn't even reconcile the Medicare and Medicare systems at this point, judging from how little technical expertise it had building the ACA interface.
1
Al we get from proliferation of more insurance companies is more overhead and less power over provider pricing.
1
The headline article accompanying this one is titled 'Doubt is Cast on Medicare as a Model' for lowering healthcare costs, and yet the article itself and the study indicates that in fact Medicare costs are much lower than private insurance costs -- and the ACA is nothing but slightly supported and minimally regulated private insurance.
Medicare for all is the only reasonable model. How absurd to pretend that private, for-profit health insurers, or any other profit-driven component of our insane and inhumane health care system, would somehow magically lower their costs based on the 'wisdom of the market' or whatever nonsense their apologists spout.
The health exchange here in NY has in many cases (mine for example) literally doubled the price of premiums with no expanded benefit, and is a torturous maze of 'Sophie's Choices': do I gamble on a thousands of dollar deductible for emergency/hospital care for a very low cost on primary care, or the other way around -- the medications my family needs now may be covered in one formulary but not the next and can change at the whim of the insurer -- my doctor takes this plan but that rules out my children's long-time provider -- this one will cover labs but not imaging -- and don't try to travel out of state because while emergency and urgent care may be technically covered (after your astronomical deductible) nothing they actually do there will be.
Health care in a decent society should never be profit-driven.
Medicare for all is the only reasonable model. How absurd to pretend that private, for-profit health insurers, or any other profit-driven component of our insane and inhumane health care system, would somehow magically lower their costs based on the 'wisdom of the market' or whatever nonsense their apologists spout.
The health exchange here in NY has in many cases (mine for example) literally doubled the price of premiums with no expanded benefit, and is a torturous maze of 'Sophie's Choices': do I gamble on a thousands of dollar deductible for emergency/hospital care for a very low cost on primary care, or the other way around -- the medications my family needs now may be covered in one formulary but not the next and can change at the whim of the insurer -- my doctor takes this plan but that rules out my children's long-time provider -- this one will cover labs but not imaging -- and don't try to travel out of state because while emergency and urgent care may be technically covered (after your astronomical deductible) nothing they actually do there will be.
Health care in a decent society should never be profit-driven.
51
Exactly. You hit the nail on the proverbial head. The profit motive and the fair delivery of healthcare are fundamentally at odds. That is the root of the problem in our healthcare system.
1
One fact that many people forget when discussing the number of people "dropping" ACA plans - we are approaching full employment and many former ACA recipients are now back in employer sponsored insurance.
ACA coverage was a godsend for me when I was freelancing - I could never have afforded my $850/month COBRA plan.
ACA coverage was a godsend for me when I was freelancing - I could never have afforded my $850/month COBRA plan.
3
Full employment?
Employment participation rate is currently 62.6% down ~5% since Obama took office, and lowest in last 38 years.
Congratulation - it worked for you.
I am sure that at least the robber is happy when he successfully robs the bank.
Employment participation rate is currently 62.6% down ~5% since Obama took office, and lowest in last 38 years.
Congratulation - it worked for you.
I am sure that at least the robber is happy when he successfully robs the bank.
1
For tonight's GOP slugfest, I mean debate, I would like the moderators to ask the candidates one simple question: Why do you believe that all Americans should not have access to affordable health care? The follow up: If you do think Americans should have access to affordable health care, what are your policy solutions for delivering it?
I might be wrong but I don't think I've heard this questions directed to the GOP in such a direct fashion.
I might be wrong but I don't think I've heard this questions directed to the GOP in such a direct fashion.
3
Being French, I feel sad for All Americans concerning health care. My wife had a gall bladder operation in in France in October. Cost: Zero; my brother, American living in Oregon working for a hospital had an eye operation. Cost: 5000 dlrs. My Friend here in Florida where I am visiting has a 'deductible' of 5000 dlrs a year and still pays 400 dlrs a month for so called 'insurance'. Obama did his part, now the insurance companies are trying to do their part; 'game' the system. All those comments about 'free' market are from people who are led to believe there is 'competition'; all you have is monopolies, collusion, price rigging. I could go on and on; but in the end, the America I knew 35 years ago has become a country of interest groups and monopolies. The middle class, and even the slightly upper middle class and of course the lower class all suffer this system.
16
Viva la France! The most sensible comment I have read about this article. Maybe having someone on the outside express an opinion is more objective.
4
Think about handing over your country's health care system to a large bureaucracy like the EU. That's what Americans think about when they consider turning over their health care to a large bureaucracy like our federal government.
Most Europeans have little understanding of our size and structure. California has a GDP the size of your country's. That's one state. Imagine all states being run by one bureau. Americans have good reason to be wary of nationalized health care.
Obamacare did little to build trust in large federal bureaucracies. Our government couldn't even build a front end system (the insurers' were the back end systems). It essentially rewrote our entire health care system just to move people into Medicaid. If anything, it set health care reform back a decade.
Most Europeans have little understanding of our size and structure. California has a GDP the size of your country's. That's one state. Imagine all states being run by one bureau. Americans have good reason to be wary of nationalized health care.
Obamacare did little to build trust in large federal bureaucracies. Our government couldn't even build a front end system (the insurers' were the back end systems). It essentially rewrote our entire health care system just to move people into Medicaid. If anything, it set health care reform back a decade.
1
The New York Times pushed for the ACA, so you are not going to get an article about what it has done to health care costs, drug costs, out of pocket costs and shrinking networks. You are not going to get that that prescription drugs wlll outpace that of inflation, or companies taking cheap drugs and raising the price thousands of times. The government created "Robin Hood" with teh subsidies. In 2018, employee based health insurance will be scaled back, so employers do not have to pay a tax. This so people have "more skin in the game". In other words, you are being forced to buy insurance, but you are also told not to use it or, due to very high deductibles, you will never be able to use it.
Medicare fro All was the way this was suppose to go. With health care costs reigned in. With drug costs reigned in. A single payer system, in which no matter where you get sick, in the US, you did not have to deal with out of network issues, or drug companies and insurance regulators gouging residents. Nor having to pay for the same policy in Longmont that is over twice the same cost in Denver, as a glaring example.
Sign ups are up so people beat the deadline, so they can claim they have insurance on their income tax; then, they will drop it as soon as they can. There is nothing affordable paying $1000 a month for a family of four, or $8000 a year for a single person; who do not get subsidized.
Medicare fro All was the way this was suppose to go. With health care costs reigned in. With drug costs reigned in. A single payer system, in which no matter where you get sick, in the US, you did not have to deal with out of network issues, or drug companies and insurance regulators gouging residents. Nor having to pay for the same policy in Longmont that is over twice the same cost in Denver, as a glaring example.
Sign ups are up so people beat the deadline, so they can claim they have insurance on their income tax; then, they will drop it as soon as they can. There is nothing affordable paying $1000 a month for a family of four, or $8000 a year for a single person; who do not get subsidized.
29
So, what are you doing to change things? Vote blue, at least! The GOP in power would mean no chance of making improvements--they just want to repeal it, with no alternative.
3
The have an alternative. Keep what we got, just get rid of the subsidies and the so called "taxes on the job creators". The ACA was a GOP plan, through and through. The GOP did not expect extending Medicaid, subsidies, or taxes employers would have to pay. For the rest, buy insurance or pay a fine; they were all for it. So, "repeal and replace" means drop what they don't want and keep teh rest.
2
We might well have single-payer / Medicare for All but for the intransigence of Joe Lieberman, the "Senator from Prudential."
1
"As of June 30, about 9.9 million people had coverage through the federal and state marketplaces, and more than four out of five of them were receiving subsidies to help pay their premiums."
And the people who have to pay cash - where are they? They're not going to sign up, because they get little for the high premiums they have to pay.
And the people who have to pay cash - where are they? They're not going to sign up, because they get little for the high premiums they have to pay.
14
As I review taxes paid in 2015,I just feel so very good(sarcasm intended) that I'm now paying even more taxes to fund someone else's healthcare under Obamacare.Neither Obamacare nor Universal Healthcare are the answers to our healthcare problems.
8
What are the answers? Go back to the previous model of the uninsured showing up at the emergency room?
Single payer.
Single payer.
2
So what is your answer?
Single payer is the answer. Every other industrialized nation on earth provides health care for its citizens. Why can't the USA?
1
"As Health Care Act Insurance Deadline Nears, ‘Unprecedented Demand’”
A colossal failure?
Perhaps not.
A colossal failure?
Perhaps not.
2
"Unprecedented demand" on the final day to sign up for anything is not newsworthy, it's normal. What is newsworthy is that 3 years in, the total number enrolled is HALF of what the CBO scored.
Colossal failure? Perhaps..
Colossal failure? Perhaps..
5
The National Alliance of State Health Coops reported that 50% of the insurance coops created by the AFCA will not offer plans in the coming year. Prices have gone up as choices have gone down and the penalties are going up. No wonder the private health insurance companies were so ecstatic when the bill was passed. Failure to actually lower prices and the certain rise of profits was built in.
11
Single payer. Bernie Sanders.
69
Stop equating health insurance with actual health care and there is nothing 'affordable' about the ACA for the majority.
40
So what's your better solution?
2
Nothing is affordable about healthcare to anyone, and the while the ACA didn't help, it didn't create the problem either. It granted access to some, but not all, who were denied either because of illness or cost.
To make healthcare affordable, everyone - everyone - has to agree to give something up. Patients have to use less, test less, use less expensive drugs when they can. We have to get serious about end of life care cost control. Providers have to charge less, take less profit or whatever it is non-profits call excess earnings. Pharma has to pull back on pricing. So far, everyone wants every thing, and no one wants to give anything up.
Before the ACA we just managed all this by hiding the total cost from patients through third party business plans, and by letting 15% of our citizens - or 45 million people - go without.
For all the rhetoric about repeal and replace, only repeal has had legs. Any suggestions at replace don't solve the problem of cost or access either. They just count on an insane level of misery, as sick people look for unaffordable access, to drive cost down. It is an intersting gamble, because market driven change could work, or it could just be the last straw that drives people towards the pitchforks and flaming torches.
To make healthcare affordable, everyone - everyone - has to agree to give something up. Patients have to use less, test less, use less expensive drugs when they can. We have to get serious about end of life care cost control. Providers have to charge less, take less profit or whatever it is non-profits call excess earnings. Pharma has to pull back on pricing. So far, everyone wants every thing, and no one wants to give anything up.
Before the ACA we just managed all this by hiding the total cost from patients through third party business plans, and by letting 15% of our citizens - or 45 million people - go without.
For all the rhetoric about repeal and replace, only repeal has had legs. Any suggestions at replace don't solve the problem of cost or access either. They just count on an insane level of misery, as sick people look for unaffordable access, to drive cost down. It is an intersting gamble, because market driven change could work, or it could just be the last straw that drives people towards the pitchforks and flaming torches.
3
100% agree. If anything, the ACA requirements have made health *care* unaffordable. A friend of mine has two children, ages 8 & 5. Prior to ACA they were paying ~$25/mo per child through the state's public/private program. Seemed reasonable. Now this year, she's panicking because the renewal notice came in with a ~$400/mo per child price.
Likewise, the prices AND deductibles have skyrocketed and coverage has decreased for my own insurance through my employer. What used to cost $50/mo now is $370/mo for individual insurance, $700/mo to $2192/mo for my whole family.
Even if people have insurance now, the deductibles are so high that they can't actually afford to use it.
The issue never was access to health care. Rather, it's that healthcare costs too **** much in the USA.
Likewise, the prices AND deductibles have skyrocketed and coverage has decreased for my own insurance through my employer. What used to cost $50/mo now is $370/mo for individual insurance, $700/mo to $2192/mo for my whole family.
Even if people have insurance now, the deductibles are so high that they can't actually afford to use it.
The issue never was access to health care. Rather, it's that healthcare costs too **** much in the USA.
3
I am ambivalent about the Health Care Act. I do believe that the subsidies help those who fall through the cracks of making too much for medicaid, being too young for medicare, and yet not being covered by a work health plan. But most of the plans seem to only cover catastrophic expenses. Day to day health care still seems to be out of reach for most of these plans. I am not sure that these plans are really changing the status quo much when all is said and done, and I am also not sure that it simply would not have been better to increase the availability of Medicaid and Medicare instead.
What I have noticed however is that the low level of coverage and the high co-pays of these plans are influencing the offerings of insurance offered by employers. Since the health care law came out, my work health plan has raised deductibles, co-insurance and co-pays. The coverage offered to the uninsured through the Health Care Act is setting the bar for insurance offered through employers and coverage is actually getting worse not better for many of us on plans through our employers.
What I have noticed however is that the low level of coverage and the high co-pays of these plans are influencing the offerings of insurance offered by employers. Since the health care law came out, my work health plan has raised deductibles, co-insurance and co-pays. The coverage offered to the uninsured through the Health Care Act is setting the bar for insurance offered through employers and coverage is actually getting worse not better for many of us on plans through our employers.
18
Do youo have any evidence that the changes to your employer's health care plan are a result of the ACA? Premiums, deductibles, and copays have been rising for years--well before the ACA went into effect. Certainly they did for me--significantly. I'd bet there is no link whatever, except the coincidence of timing. Did you really not see similar changes in the early years of this century? I doubt it.
1
You have nothing to complain about it you have a work health plan.
Such an upbeat article. Unprecedented demand, a competition amongst mayors, 10,000,000 participants!
You might believe the ACA is a great success. Except for the fact that 2,000,000 dropped their plans last year, the target numbers for this year were supposed to be 20,000,000, and the premiums for 2016 have risen substantially. The subsidized policies that are being praised almost all have high deductibles of at least $5000, and very restricted networks of Doctors and hospitals. Many that buy them cannot afford to pay that out of pocket and when they realize that they will be paying cash if they need a CAT scan or surgery they drop the insurance. Since the ACA was passed I have not seen a single article that tries to assess whether these patients have better access to care and whether their health is actually better, just a bunch of bean counter articles about the number of enrollees which is actually quit meaningless. For this the American taxpayer is paying more than a Trillion dollars.
In addition insurers are pulling out and the state exchanges are failing. The verdict is still out on the ACA. By most measures of what it was supposed to do it appears to be failing. It did succeed in disrupting the insurance market for those who had good plans and were happy with them. And it did produce a massive transfer of wealth from the upper and middle classes to those that were previously uninsured.
You might believe the ACA is a great success. Except for the fact that 2,000,000 dropped their plans last year, the target numbers for this year were supposed to be 20,000,000, and the premiums for 2016 have risen substantially. The subsidized policies that are being praised almost all have high deductibles of at least $5000, and very restricted networks of Doctors and hospitals. Many that buy them cannot afford to pay that out of pocket and when they realize that they will be paying cash if they need a CAT scan or surgery they drop the insurance. Since the ACA was passed I have not seen a single article that tries to assess whether these patients have better access to care and whether their health is actually better, just a bunch of bean counter articles about the number of enrollees which is actually quit meaningless. For this the American taxpayer is paying more than a Trillion dollars.
In addition insurers are pulling out and the state exchanges are failing. The verdict is still out on the ACA. By most measures of what it was supposed to do it appears to be failing. It did succeed in disrupting the insurance market for those who had good plans and were happy with them. And it did produce a massive transfer of wealth from the upper and middle classes to those that were previously uninsured.
41
I disagree that the ACA transfers money from the middle class to the previously uninsured.
In fact, the ACA transfers money the middle class doesn't have to the insurance industry.
In fact, the ACA transfers money the middle class doesn't have to the insurance industry.
There are so many inaccuracies in this post it's not worth responding to, except to say that the ACA has helped millions of Americans. It's not perfect (what is?) but it's done a lot of good.
2
Rob, I presume you have a better solution. So what is it?
2
I would like to see an article in two months telling us how many people actually signed up. We've heard this hype before and that is what it turned out to be. There is unprecedented demand for a lot of things until people figure outfits real cost.
9
"Administration officials declined to provide enrollment data for the 20 cities they said were participating in the president’s Healthy Communities Challenge."
Good luck getting the truth out of this Administration.
Good luck getting the truth out of this Administration.
Contact the insurer before you sign up. I selected a plan on the Marketplace from an insurer that had four bronze plans listed. On the insurers website, they show 10 bronze plans. They were able to set me up with a much better plan for the same money. I originally selected a plan with a $6450 deductible that only pays for one annual check up and then everything comes out of the deductible. I ended up with a plan that has a $6850 deductible but I can go to the doctor as often as I want with a $30 copay and have a $100 copay for urgent care, which should keep me out of the ER unless something terrible happens. The cost is a whopping $526/month.
My plan also has 0% coinsurance after the deductible is met. Most plans have a 10% coinsurance which is a real minefield. If you had to go to the hospital and ran up a $100,000 bill, you would owe an additional $10,000.
So long as I only need to go to the doctor and not have any outpatient or hospitalization, the huge deductible is not a problem. At least I can go to the doctor if I feel I need to for $30.
In any event, the prices are outrageous. At least with this plan I can go to the doctor and am covered in case of catastrophic illness or injury. That will cost me $13,162 a year. Oh joy. I don't dare get sick.
My plan also has 0% coinsurance after the deductible is met. Most plans have a 10% coinsurance which is a real minefield. If you had to go to the hospital and ran up a $100,000 bill, you would owe an additional $10,000.
So long as I only need to go to the doctor and not have any outpatient or hospitalization, the huge deductible is not a problem. At least I can go to the doctor if I feel I need to for $30.
In any event, the prices are outrageous. At least with this plan I can go to the doctor and am covered in case of catastrophic illness or injury. That will cost me $13,162 a year. Oh joy. I don't dare get sick.
15
It is cheaper to pay for your broken arm, ear ache, or ingrown toenail out of pocket.
I read this and weep. We are still fighting over the validity of providing all Americans access to basic healthcare, a policy taken for granted in every developed nation in the world.
I read with great dismay about Senator Rubio's stealth move to sabotage the ACA last year, inserting a late night amendment in a funding bill to deny the Administration the right to subsidize insurer losses during the ACA's transition period of 2014-2016. While he frames it as a "taxpayer bailout", it designed to help insurers not go under as they absorbed a sicker group of patients lacking healthcare for many years. It was a key part of the law, and with the stroke of a pen, Rubio abolished it.
I don't know what is going to happen to the ACA ultimately, but I do know this: we still have the most convoluted "system" of delivering a basic human service in the world. That an entire party would deny that right, or throw all these patients into a nonregulated open market of greedy insurance plans is testament to their Darwinian view of the universe.
I read with great dismay about Senator Rubio's stealth move to sabotage the ACA last year, inserting a late night amendment in a funding bill to deny the Administration the right to subsidize insurer losses during the ACA's transition period of 2014-2016. While he frames it as a "taxpayer bailout", it designed to help insurers not go under as they absorbed a sicker group of patients lacking healthcare for many years. It was a key part of the law, and with the stroke of a pen, Rubio abolished it.
I don't know what is going to happen to the ACA ultimately, but I do know this: we still have the most convoluted "system" of delivering a basic human service in the world. That an entire party would deny that right, or throw all these patients into a nonregulated open market of greedy insurance plans is testament to their Darwinian view of the universe.
126
They distort Darwin as tortuously as the rest. Social Darwinism was, as you probably know, discredited long ago.
2
"Unprecedented" for a system a couple of years old is nothing to brag about.
3
unprecedentedly LOW demand
Deductible of 3X one's net worth = useless insurance.
Deductible of 3X one's net worth = useless insurance.
14
uhm, yeah, if your net worth is one or 2 thousand dollars, you've got other issues to complain about there, Neal
1
Another New York Times article dead on arrival after the first sentence. Seems to me "competing" for Milwaukee, Detroit, and Philadelphia, three proverbial ghetto's is more along the lines of "free" pitching to poorer individuals versus Dallas, Denver, Las Vegas, three areas (of mixed political affiliation I might add) that are "lagging." Or perhaps the people that actually pay for it and don't want too, since it doesn't work.
13
I don't know where you get the idea it doesn't work, it works just great for me.
1
It's still a mess. I tried to help my son sign up and called several places that were supposed to help with selecting a plan. No one even answered the phones at most numbers and if they did, they didn't do individual plans. We were finally able to choose something but it's still $450 per month with a high deductable. He's healthy so basically it amounts to paying for all his medical care out of pocket on the rare occasions he goes to the doctor. He doesn't qualify for medicaid because we pay his rent and utilities. He works in a store that offers no insurance.
17
You called several places that were supposed to help with selecting a plan? Why didn't you just call the Health Care hotline? They will get you the best deal. If your son is working in a store and still has to pay $450 you are getting shafted. He should only be paying about $100, go back into the system and fix it.
1
It is not paying for health care, or even health insurance. It is paying to avoid the penalty. In other words, the system works more like a extortion. I don't know if 450 is too much, but he is unlikely to be paying only 100 either. Worth trying again to see if you can get a lower premium. There is nothing to lose since you're paying hundreds for nothing.
the answer is, you want something, you pay for it yourself
While I am on Medicare my wife depends on her "Obamacare." The premiums went up again this year as did the co-pays and deductables, but at least she's covered.
We have come to regard the republicans who are working to take away her coverage as nothing more than a domestic terrorist cell, hoping to ruin us financially so their banker buddies can foreclose on our home. The GOP is more of a threat to us than ISIS will ever be.
We have come to regard the republicans who are working to take away her coverage as nothing more than a domestic terrorist cell, hoping to ruin us financially so their banker buddies can foreclose on our home. The GOP is more of a threat to us than ISIS will ever be.
196
Clearly Mr. Payne you have let your narcissistic, blindsided ideas all formed around the letter "D" to prevent you from basic understanding of what is taking place. Good luck & don't forget to thank Mr. Bush for Medicare Part D.
2
The working class is taking the hit with this tax. Also, the Wall Street crowd is having a great run under Obamas policies, and working class income is down and shrinking. Do even think about these liberal talking points before they are spewed forth?
Since when is it narcissistic to care about your wife and be grateful that she has coverage?
We should remember the history of healthcare in America, which has long been abandoned to an irrational and inhumane right-wing, capitalistic idea about the 'free-market' being able to address your cancer, your chest pains, your toothache, your accidents, your car crash injuries and all of your medical emergencies.
The fact that there is such a record demand for affordable healthcare insurance is perfectly understandable given America's historical abandonment of health care policy.
The ACA is a good start to a very serious medical problem in America which still disgraces the world with its egregiously expensive 17% of GDP greedy healthcare system.
The fact that America has professional misanthropes like Republican Mayor Michael Winters of Great Falls equating affordable healthcare access for Americans as pure politics is simply confirmation of the proud right-wing streak of immorality coursing through America's heartless heartland.
“It’s not something we want to be involved in” said the mayor “If the White House wants to push its agenda, they should do it without our participation.”
Translation: "we don't want to care for the sick, the poor, or the neediest....I got mine"
Thank you, President Obama and the Democratic Party, for introducing a modicum of Christian healthcare decency to a deeply unChristian land.
The fact that there is such a record demand for affordable healthcare insurance is perfectly understandable given America's historical abandonment of health care policy.
The ACA is a good start to a very serious medical problem in America which still disgraces the world with its egregiously expensive 17% of GDP greedy healthcare system.
The fact that America has professional misanthropes like Republican Mayor Michael Winters of Great Falls equating affordable healthcare access for Americans as pure politics is simply confirmation of the proud right-wing streak of immorality coursing through America's heartless heartland.
“It’s not something we want to be involved in” said the mayor “If the White House wants to push its agenda, they should do it without our participation.”
Translation: "we don't want to care for the sick, the poor, or the neediest....I got mine"
Thank you, President Obama and the Democratic Party, for introducing a modicum of Christian healthcare decency to a deeply unChristian land.
157
The only industrialized nation with for profit health insurance, which in the free market, means at the end of the day, if they have to decide between your kidneys and their profits--you will die.
45
Free markets such as we've had until now?
Yes, I've noticed all the bodies in the streets are gone now that we have the ACA. I've used single payer, it's not a panacea, but for the US there were so many other things we could have done on the way to such a plan. Instead we got the ACA rammed down our throats and it's a big stinking pile of government disaster. People don't want single payer because they think it will be worse than what they have. No worries now, not much could be worse than what the ACA gives us.
3
Very good news. Let's pour our trillion$ into affordable, high-quality health care rather than into wars of folly. Next step is universal coverage, with single-payer, weeding out the immense overhead of the insurance industry.
121
and not just the insurance co mark up, but the supply chain, a huge source of unpredictable costs. The cost of the artificial hip implant device can vary from $500 to $8,000. (source NYT 2013)
As consumers we've been tasked for decades to be 'smart shoppers." Yet it is nearly impossible to get accurate pricing in advance of medical procedures, and even less realistic to make medical decisions on such unreliable data.
In 1990 I had my small salary garnished to pay a (to me) massive debt from a successful neuro surgery. Why? the surgeon's fee was above 'reasonable & customary." by about half of my annual salary. Having a rare condition and needing a high tech procedure, I had no idea I should have been shopping for a cheaper brain surgeon.
As consumers we've been tasked for decades to be 'smart shoppers." Yet it is nearly impossible to get accurate pricing in advance of medical procedures, and even less realistic to make medical decisions on such unreliable data.
In 1990 I had my small salary garnished to pay a (to me) massive debt from a successful neuro surgery. Why? the surgeon's fee was above 'reasonable & customary." by about half of my annual salary. Having a rare condition and needing a high tech procedure, I had no idea I should have been shopping for a cheaper brain surgeon.
2
But single payer would cost much LESS than our for-profit system. LESS money -- NOT MORE --- LESS.
4
Oh yeah, can't wait for that day, the ACA was done so well. Anyone ever get fired for the disaster that it is? Ha-ha! A civil servant getting fired! I know it will come as a shock for you, but the overhead of the health insurance industry is no immense. Who do you think is going to be running single payer? The VA?
Lots of folks wait until the last minute for any kind of thing...let alone one which is complicated, expensive and sort of ethereal till you actually need it.
Meanwhile, my routine checkup resulted in $1200 in blood tests, which will be paid by my company at $200. The lack of price transparancy, the fact that private insurers divvy up markets and collude, and the fact you can't even get a price usually mean the concept of "consumer" is a farce. The only thing Trump has said that makes sense is that private insurance has to be nationwide "I own companies in a dozen states...why do I have to negotiate with a dozen companies for my employees".
If the system is to remain private, then we need a set basket of benefits, and nationwide rating...Let companies really compete, not section the state by County like they do here in NY.
Meanwhile, my routine checkup resulted in $1200 in blood tests, which will be paid by my company at $200. The lack of price transparancy, the fact that private insurers divvy up markets and collude, and the fact you can't even get a price usually mean the concept of "consumer" is a farce. The only thing Trump has said that makes sense is that private insurance has to be nationwide "I own companies in a dozen states...why do I have to negotiate with a dozen companies for my employees".
If the system is to remain private, then we need a set basket of benefits, and nationwide rating...Let companies really compete, not section the state by County like they do here in NY.
33
And here is the irony of your comment. I am currently uninsured and I walked into a CityMD recently for a sore throat and I also requested a full panel STD testing, along with cholesterol, and several other blood tests while I was there; the whole gamut of basic testing. You know how much it cost me? Just under $300 cash. The same process when I was insured was $1200 comparable to the number you mention and guess what? Because of my deductible and plan, I still had to pay out of pocket, only I worse off. Sure, this doesn't save me if I unfortunately develop cancer or some other chronic illness, but you get my point. I'm willing to role the dice in the meantime. The best part of my CityMD (I sound like a spokesman and I'm not), was that I asked them a question about a test and a price and I got an immediate answer. That's $15. That's $30. In all my life I've never done anything medical related and actually felt comfortable with the experience. Oh and if you require medication, say Penicillin for Strep throat, that too is going to be much less paying in cash. If you have a $20 or $25 copay, that's what you pay, but it was actually $11 in cash. This illustrates nothing more to me that health insurance in the US is a massive fraud and the only value it might hold if for chronic illnesses.
31
The reason for the disparity between the "list price" of a procedure and what insurance pays is that when providers sign up with an insurance company, they are told "We pay (some percentage) of customary charges." It's almost always less than 50%. If a provider is signed up with an insurer that pays 35% of "customary charges," and the provider needs to make $350 to break even, then the "list price" has to be over $1000.
I lost my Medicaid coverage November 1st, when I decided to collect Social Security at age 62. I was one of the poor saps trying to sign up yesterday at healthcare.gov. I was successful.
But I was lucky, because I still have all my marbles. Anyone unversed in the rigors of selecting a plan could well have been frustrated - because help is virtually nonexistent. None of the "help" agencies listed could, or would help, even if they answered the phone, which most did not. I was sent on a shuttle of disinterested, rude people who plainly could not wait to get rid of me.
Pay attention to the provider directory for your potential plan. I was startled to find Blue Cross Blue Shield did not include any of the wonderful doctors and the hospital I had been using under Medicaid. NONE. Providers do not make it easy to determine what is "in network" and what is not. Luckily, my hospital (Rockford Memorial in Rockford, IL) was very helpful and told me which companies insured services at their clinics and providers. Without that information, I might have gone down a dark path indeed and been left traveling 50 miles or more to see a doctor.
My Healthcare.gov grade = A. Your results may vary.
But I was lucky, because I still have all my marbles. Anyone unversed in the rigors of selecting a plan could well have been frustrated - because help is virtually nonexistent. None of the "help" agencies listed could, or would help, even if they answered the phone, which most did not. I was sent on a shuttle of disinterested, rude people who plainly could not wait to get rid of me.
Pay attention to the provider directory for your potential plan. I was startled to find Blue Cross Blue Shield did not include any of the wonderful doctors and the hospital I had been using under Medicaid. NONE. Providers do not make it easy to determine what is "in network" and what is not. Luckily, my hospital (Rockford Memorial in Rockford, IL) was very helpful and told me which companies insured services at their clinics and providers. Without that information, I might have gone down a dark path indeed and been left traveling 50 miles or more to see a doctor.
My Healthcare.gov grade = A. Your results may vary.
44
This point is key. I researched ACA plans, and called my docs. When I got there, I was told "oh, we don't take (brand name) FROM THE EXCHANGE. You cannot even trust the label, and if you have (brand name), you don't have the same flavor a private company gets, or your local civil servants....and they don't take it.
9
Executive summary:
Business in the USA today is the enemy of the people. The bigger the business, the bigger the enemy. We need to stop coddling them with tax breaks, deferments, limited liability, and all such nonsense.
Name me a business sector that is trying to actually do something positive for Americans' health, physical or mental.
Business in the USA today is the enemy of the people. The bigger the business, the bigger the enemy. We need to stop coddling them with tax breaks, deferments, limited liability, and all such nonsense.
Name me a business sector that is trying to actually do something positive for Americans' health, physical or mental.
3
The Health Care Act is the biggest scam by corporations to get even more money from the tax payers, with the help of Obama.
If you can afford it and sign up, you still have to pay for medical services because deductibles are extremely high.
If you cannot afford it and sign up, the government will pay, oh excuse me, subsidize it. But you still have to pay for medical services because the deductibles are extremely high.
So, who benefits? The insurance companies and the individuals with extremely high medical bills, not the majority of citizens, who again, have to pay taxes and get no benefits whatsoever.
If you can afford it and sign up, you still have to pay for medical services because deductibles are extremely high.
If you cannot afford it and sign up, the government will pay, oh excuse me, subsidize it. But you still have to pay for medical services because the deductibles are extremely high.
So, who benefits? The insurance companies and the individuals with extremely high medical bills, not the majority of citizens, who again, have to pay taxes and get no benefits whatsoever.
39
That's why Single Payer is the simple solution.
91
The deductibles are only high if you get a cheap plan. My plan has a $3500 deductible and no copay. The insurance company does benefit because they get all the money. However, without the ACA they would get all the money anyway. Obamacare is the best thing that's happened to uninsured working men and women.
3
Single payer doesn't address the fact that doctors and facilities charge way too much. Given the political power the AMA has, it never will either.
Just compare health care costs as a % of GDP by country and you'll see just how bad it really is. It might be excusable if our health care system actually provided results, but as a whole Americans are more sick (including those who have access to health care) than their peers around the world.
Just compare health care costs as a % of GDP by country and you'll see just how bad it really is. It might be excusable if our health care system actually provided results, but as a whole Americans are more sick (including those who have access to health care) than their peers around the world.
2
“We are seeing unprecedented demand,” - for more free stuff given away by the U.S. government. Hey, it's all "free." Don't worry, someone else will pay for it all. This is how the grand scheme, I mean dream of socialism works. Until the entire country goes broke like the former U.S.S.R. did, and then everyone lives in misery. At least we will all be "equal" then.
16
It's not "free", and I'd like to see where anyone ever said it was. You're just spitting from the cheap seats.
54
U R right Jerry, Equal but equally poor!
2
It's far from free.
21