"""Diabetes was nearly twice as common among newly enrolled consumers as among those previously enrolled, the report said. Hepatitis C was more than twice as common, and H.I.V. was more than three times as common, it said."""
This para gives away why we needed some form of ACA. Can you imagine that even more people with Hep C and HIV lie untreated but have not been counted? Highly communicable diseases like HIV and Hep C are allowed to run rampant in a modern-world country like ours? And it is still not "profitable" to curtail such diseases? Go figure........
This para gives away why we needed some form of ACA. Can you imagine that even more people with Hep C and HIV lie untreated but have not been counted? Highly communicable diseases like HIV and Hep C are allowed to run rampant in a modern-world country like ours? And it is still not "profitable" to curtail such diseases? Go figure........
7
More propaganda to support next year’s rate increases. But we are already paying huge rate increases — when our (very similar) Medical Mutual of Ohio plan went on the Marketplace in 2014, our premium went up 224%. (that’s right, 224%!) Additionally, Medical Mutual has been granted double-digit rate increases every year after that. Give us a break about the affect of covering a few sick people. The Ohio high risk pool insured about 15,000 people in 2013. That’s less than 10% of the 242,000 Ohioans who now buy individual insurance on the Exchange. A mere drop in the bucket, and a cost that has been totally overcompensated for, again and again. I can’t believe that the healthcare industry is not making money hand over fist. As insurance rates went up, healthcare costs seemed to have doubled as well. In Toledo, healthcare systems are thriving and can’t spend their money fast enough — not on doctors, that they claim there is a shortage of, but on multiple multimillion dollar construction projects all over town. You’d think they’d be hiring more doctors instead -- maybe offering medical students scholarships for them to come work for them later, but apparently they don’t need them, as they can cheaply replace them with nurse practitioners. We are for a single-payer system, and it can’t come soon enough.
11
Our Blue Plan received a widely-circulated research document in early 2013 that CMS via CBO to estimate the relative health of the newly insured we could expect to pick up beginning in January 2014.
Our actuaries looked it over and thought it too conservative. They added 20% and used that as a basis for pricing.
Sadly, if we consider the CBO number 1.0, and our pricing basis 1.2, the ACTUAL 2014 population (tens of thousands of people) came in at a cost per person of 1.8. A huge miss. Clearly these poor folks were in DIRE need of healthcare, and I'm honored we could help to finance it for them.
I'm forced to ask myself this question though: If i was a time traveler who had the actual costs and priced the coverage at the REAL rate would regulators have approved the (highly accelerated) pricing?
No way. They would have called us "unreasonable" and shut us down. And don't give me that noise about risk adjustment, it doesn't BEGIN to cover the losses. Risk Corridor payments might have helped, but Marco Rubio cut those off. The red ink is still flowing in buckets on individual policies.
Your premiums on individual policies? They still aren't high enough to cover the actual cost of insuring the uninsured at the new "essential health benefit" coverage levels imposed by PPACA. Rates will have to go up more before it's over. Costs should have gone DOWN in 2015, but they went UP.
WR
Our actuaries looked it over and thought it too conservative. They added 20% and used that as a basis for pricing.
Sadly, if we consider the CBO number 1.0, and our pricing basis 1.2, the ACTUAL 2014 population (tens of thousands of people) came in at a cost per person of 1.8. A huge miss. Clearly these poor folks were in DIRE need of healthcare, and I'm honored we could help to finance it for them.
I'm forced to ask myself this question though: If i was a time traveler who had the actual costs and priced the coverage at the REAL rate would regulators have approved the (highly accelerated) pricing?
No way. They would have called us "unreasonable" and shut us down. And don't give me that noise about risk adjustment, it doesn't BEGIN to cover the losses. Risk Corridor payments might have helped, but Marco Rubio cut those off. The red ink is still flowing in buckets on individual policies.
Your premiums on individual policies? They still aren't high enough to cover the actual cost of insuring the uninsured at the new "essential health benefit" coverage levels imposed by PPACA. Rates will have to go up more before it's over. Costs should have gone DOWN in 2015, but they went UP.
WR
2
Can you explain why the premiums on individual policies have to be so much higher than the group policies sold to businesses? Also, why can't groups of individuals band together to get a group rate? Some time ago I read that insurance companies get a disproportionate amount of their profit from individual policies.
8
Yes, costs need to be addressed. And if people are to tolerate the system, then it's also vital to require that we be given honest, clear customer information and service (for example, networks need to be known PRIOR to purchase). My spouse and I, both in early 60s, pay almost 2000/month for a medium-range (silver) plan that we bought privately because our doctors would no longer take any exchange plans regardless of quality or subsidization. That had been impossible to predict/verify, and still was when we decided to avoid the exchange and buy privately. Our deductible is about 12000, plus more for any drugs -- so total cost without the rising co-pays and absurd ones for testing is at least 36000 per year. And SURPRISE, now that we have the new policy, our doctors don't take it either, apparently because it was changed to parallel the exchange policies. Infuriating! So is the mandate to pay into such a corrupt system with hospital/insurance executives making millions in salary, patients being treated like livestock "cared for" for profit only, online hackable medical information, and ins co techniques that create so much red tape that people, especially sick old or weak ones, can't deal with it (and why try: most things are not covered). So I avoid doctor visits even for very important monitoring or preventative testing. Better to die early than deal with all this for the benefit of a cruel greedy power group who will also dictate what treatments are best for me.
8
Although I fully support the ACA on ethical grounds, it remains nothing more than a band-aid to fill in the accessibility gaps that have resulted from a fragmented system with thousands of insurance companies, multiple private and public payers, and private care providers that can charge virtually whatever prices they want in a completely deregulated system. The window for implementing relatively successful band-aid measures such as price caps on services has officially closed. When the middle-class can no longer afford basic health care, it is only a matter of time until the bubble bursts. Even Conservative Republican voters have been fighting against establishment Republican calls for cutting back on entitlements like Social Security and Medicare, and it's only a matter of time before this constituency begins calling for universal health care.
8
When I had BC/BS insurance in 2013 I chose not to treat a serious problem because the insurance coverage was so BAD. Even under the ACA, with the limitation on doctors I could see with my PPO plan, I waited. I became eligible for Medicare in Feb 2016 and am almost finished with treatment for the serious problem, having found a less expensive and simpler procedure with a doctor who I would not have had access to under BC/BS or my ACA plans. I am supporting Bernie Sanders in part because he favors a Medicare-for-all type single payer health insurance system. Private insurers are looking to make a profit and they will disadvantage as many insured as they can to make sure their bottom line is secure. If the focus was to bring Medicare fraud down to a minimum, then a single payer system would save taxpayers millions if not billions of dollars.
17
A friend of mine, a Canadian with free health care, collapsed on the golf course in January (he was in Florida). He'll find out (for free) if he had a heart attack sometime in late April.
7
You are making that up. That is obvious who knows anything about medicine or Canadian health care.
6
At 65 I am getting Medicare A&B for $280 per month and Advantage for $140 which is about $5000 per year.
My wife at 62 pays $8400 for basically catastrophic coverage (through CIGNA) from her former employer with a $2000 deductible to really get any thing covered (tests, Rx, visits, etc.).
Fortunately we are both relatively healthy but I would gladly pay $5000 for her to have the same coverage I have.
We have Joe Lieberman to thank for killing Medicare for all as the "public option" enlarging the pool with younger, paying, healthier subscribers.
You remember Joe, right? And his wife the Big Pharma lobbyist?
My wife at 62 pays $8400 for basically catastrophic coverage (through CIGNA) from her former employer with a $2000 deductible to really get any thing covered (tests, Rx, visits, etc.).
Fortunately we are both relatively healthy but I would gladly pay $5000 for her to have the same coverage I have.
We have Joe Lieberman to thank for killing Medicare for all as the "public option" enlarging the pool with younger, paying, healthier subscribers.
You remember Joe, right? And his wife the Big Pharma lobbyist?
13
Until the powers at be recognise that cost of treatment top to bottom-physician's charges, hospital fees, lab tests, diagnostic tests, medical devices, everything, is way out of line of where it is in other developed nations, the outrageous American health care "system" we will be stuck with ever-escalating, stratospheric costs. This is a cash cow business, not a healthcare business.
7
The people with negative comments about the ACA fail to do two things: 1. Understand that while not perfect, it is FAR better than what we had before. That so many sick people have now enrolled, which naturally, and as expected, created a huge spike in costs (which will eventually come down) - shows how bad what we had prior to the ACA was. Having all those sick people unable to get HI was a horrible disgrace. The ACA fixed that. The ACA is not perfect but can and will improve (like when GOP governors start accepted federal money to provide Medicaid to the poor in their states) as more and more get coverage and things start to level out. 2. Fail to understand the complexities of health care and how challenging changing a system that was so bad for so long can be. I'm all for Single Payer, but I think even that is more complex than people think it is, won't happen over night and probably won't happen at all. Even if Bernie Sanders won the election (and that's a huge IF) it's not going to happen. Do people really think that Single Payer is going to pass the US Legislature? If you do then clearly you haven't been paying attention. President Obama, a gifted politician with a national mandate, couldn't even get a public option and the ACA as is BARELY passed with both Dem houses! So some think Obama couldn't do it, but Bernie can get more? The ACA is not perfect and will improve. And for every negative anecdote out there, there are hundreds of successes no one hears about.
7
Why is ACA far better? Now a bunch of sick people have policies they can barely use paid for with my money. I would choose a different word than "better" for the ACA.
11
You raise some good points, but (1) I have not seen any data that shows our health outcomes are any better today than before ACA, so saying everything is "FAR" better than before seems more anecdotal than factual. True, more people are covered in some form, but I don't think we can praise it too strongly at this point, though as you say it (may) improve. (2) I agree on your point about complexity, but I think it is not only critics who underestimate that, deliberately in some cases. The politicians acted as if they could pass one big bill and in one fell swoop create a much better system. Instead in many cases they created a bureaucratic nightmare, with ever more power to unelected officials and big insurance companies, neither of which care about the public or are accountable to them. If Obama is as gifted as you assert (and because he was elected did NOT mean that he had a mandate to create something unworkable - the fact that the ACA has continued to fare badly in public opinion shows that the mandate claim is unfounded; perhaps a mandate to do something, but just not this mess, would be a better way to assess it) then he could and should have tried to be less "my way or the highway" in his approach. Sanders may not be able to achieve more but clearly who ever is the next president needs to remember they are not the king and must govern with the Congress.
6
For "every one...hundreds"? I doubt that. I'm sure people have benefited but not all.
3
My insurance (Blue Shield) allows my doctor to double bill for ONE appointment. She bills for my annual preventative care visit ($290) & at THE SAME TIME bills for an office visit ($160 & $40 co/pay), and, apparently, this is legal. It's no wonder healthcare costs have risen, they are being driven.
4
This is not only legal but required/mandated by government regulations. This happens only if you are seen for an annual preventative care visit as well as being treated for an illness. The system is such that doctors have to document and bill for EVERYTHING they see you for. The amount of documentation and information shared is staggering. Doctors are subject to audits and reviews and are regulated more now than ever before. Which is good....and bad. It increases costs and decreases time spent practicing medicine and replaces it with time spent making sure the doctors are compliant. This comes from the government and spreads into private insurances. I'm no fan of either. I am just saying there are reasons behind it. I don't like the consequences of the ACA, but I agree with many that have said at least someone did "something". The system has been broken for so long and there are many little things that could be done so easily that no one even talks about.
Yes, these patients are sicker now but I wonder if they'll be less costly to insure in the future not that they're actually getting care. i.e. How much of this is actually just deferred maintenance?
7
"Federal and state officials and consumer advocates said they hoped that premiums would become more stable and predictable in the next couple of years."
Hope is not a plan.
Hope is not a plan.
8
I don't see this as a surprise. People with chronic illnesses are more likely to take advantage of insurance (with no "pre-existing condition" limitations) than are healthier individuals.
Many of these people were shut out of getting any kind of coverage in the past.
Figuring our how to care for all insured people - the healthy and the not so healthy - is now the insurers' problem to solve. They can't cherry pick and extend coverage only to those who need few if any services.
Many of these people were shut out of getting any kind of coverage in the past.
Figuring our how to care for all insured people - the healthy and the not so healthy - is now the insurers' problem to solve. They can't cherry pick and extend coverage only to those who need few if any services.
7
What is needed next is a single payer system which will lower costs on average.
4
Simply enacting single payer will not guarantee lower costs. We must also change a lot of supporting matters, such as medical salaries, cost of drugs, cost of litigation and "defensive medicine", sometimes unrealistic expectations of patients, and so on.
4
"...a new study is seen as evidence that there has been pent-up demand for the Affordable Care Act."
There has been pent-up demand for access to health care. Having private health care insurance is NOT the same as having access to health care. But Obama wanted a program that was agreeable to the health insurers and big pharma - access to health care and affordable medicine were always secondary concerns.
There has been pent-up demand for access to health care. Having private health care insurance is NOT the same as having access to health care. But Obama wanted a program that was agreeable to the health insurers and big pharma - access to health care and affordable medicine were always secondary concerns.
8
That was one of the major problems with the Obama plan. Trying to pacify the private insurers and big pharma. The second aspect was in not setting up a single payer system nationwide.
6
As more sicker people gain health care, the still small insurance pools will absorb them, raising the risk in the pool, thus increasing the cost of insurance. Come next year, one's health insurance premiums will go up; networks get smaller and deductibles increased. Continuing a vicious cycle.
To add to this; the penalty will go up, forcing people into buying insurance, that will be nothing more than a major medical policy. At the same time, more people may need subsidies, to pay for more higher cost insurance. At each state level, their insurance board will give in to increase premiums, and these higher costs are passed to the insured.
Very soon, the ACA will collapse under the same for profit system, as other attempts of providing health care in the US.
All this could have been solved with one large pool; we call it single-payer health care. Everyone one is insured with the basics, like Medicare. They want more coverage, they buy a supplemental policy. But, to make this work, health care costs must be regulated. A procedure, a drug, or medical equipment cost the same no matter where you live. You should eb able to use your insurance anywhere in the US. There should not be in network/out of network. Finally, really reduce the cost of health care, as it will ruin this country, on the current trajectory.
To add to this; the penalty will go up, forcing people into buying insurance, that will be nothing more than a major medical policy. At the same time, more people may need subsidies, to pay for more higher cost insurance. At each state level, their insurance board will give in to increase premiums, and these higher costs are passed to the insured.
Very soon, the ACA will collapse under the same for profit system, as other attempts of providing health care in the US.
All this could have been solved with one large pool; we call it single-payer health care. Everyone one is insured with the basics, like Medicare. They want more coverage, they buy a supplemental policy. But, to make this work, health care costs must be regulated. A procedure, a drug, or medical equipment cost the same no matter where you live. You should eb able to use your insurance anywhere in the US. There should not be in network/out of network. Finally, really reduce the cost of health care, as it will ruin this country, on the current trajectory.
16
People pay 1.5% of their income into Medicare their whole lives to pay for it, and they can't draw a nickel of benefits until they turn 65. And it STILL have premiums on Part B, copays, deductibles, and drug coverage costs extra.
How do you fund this program if you let everybody in from birth? How big will that tax be?
I'm scared to ask.
WR
How do you fund this program if you let everybody in from birth? How big will that tax be?
I'm scared to ask.
WR
1
Hospital admittance rate is higher 84%, Doctors visits are higher 26% but was there any increase on revenues of these insurance companies?
2
The question is not an increase in revenues - there likely was. The question is whether insurers are making or losing money on these policies. If the latter, then they won't for long.
1
Revenue went up, costs went up much faster. Blue Plans, for example, lost $4B total on the new individual marketplace between 2014-2015. 15 was WORSE, which is a bad sign.
What I don't get, is why are docs and hospitals still complaining? They picked up MILLIONS of customers who pay rates higher than medicaid or medicare in the last two years. That $4B in losses mostly went straight to medical providers as new revenue.
WR
What I don't get, is why are docs and hospitals still complaining? They picked up MILLIONS of customers who pay rates higher than medicaid or medicare in the last two years. That $4B in losses mostly went straight to medical providers as new revenue.
WR
1
Family doctor here, 36 years in the ballgame.
No surprise here. People who are sicker are less likely to have good jobs, and people who don't have good jobs are likely to be sicker.
The idea put out by advocates of Obamacare that it would save money was always absurd. I do support universal care, but it costs more, not less.
Another absurd assertion: That folks would get insurance and go see their family docs instead of going to the ER, thus saving money. Well, there's a shortage of family docs on, so easier said than done. Plus folks with chaotic lifestyles, which many of the poor have, prefer to go to the ED. Plus most of the newly insured have Medicaid, health insurance for the poor. Around these parts it pays us $ 40 for a standard visit, well less than half of what we get paid for a Blue Crosser and not even enough to make overhead. The guv'ment is perfectly willing to have docs work for free. Docs are less enthusiastic.
We are saw this coming down the pike even if the rest of you did not.
No surprise here. People who are sicker are less likely to have good jobs, and people who don't have good jobs are likely to be sicker.
The idea put out by advocates of Obamacare that it would save money was always absurd. I do support universal care, but it costs more, not less.
Another absurd assertion: That folks would get insurance and go see their family docs instead of going to the ER, thus saving money. Well, there's a shortage of family docs on, so easier said than done. Plus folks with chaotic lifestyles, which many of the poor have, prefer to go to the ED. Plus most of the newly insured have Medicaid, health insurance for the poor. Around these parts it pays us $ 40 for a standard visit, well less than half of what we get paid for a Blue Crosser and not even enough to make overhead. The guv'ment is perfectly willing to have docs work for free. Docs are less enthusiastic.
We are saw this coming down the pike even if the rest of you did not.
15
You might write a letter to Bernie Sanders about "free" medical care. As you comment demonstrates nothing is free, you & your colleagues need to get paid, your family deserves a roof over their their head, and $40 per visit just doesn't cut it. Medicare (which isn't free)"for all" is a false promise which, when it goes unfulfilled, will produce more cynicism on the part of patients and their medical providers.
1
Medicine should NOT be a business. Full stop. Fire all the third parties/middlemen/parasites/bottom feeders/carpetbaggers who always have their hand in a till that they have NO RIGHT TO take.
13
When medicine is no longer a "business", we will cease to have innovation in medicine. Full stop.
1
Innovation in medicine doesn't come from profit incentives sir. The WORST R&D projects I've seen (and I'm in an informed position to KNOW) that: didn't work, didn't make a difference in outcome, injured people were in fact revenue driven products that were also vanity projects. Cue the music for the genome project: personalized medicine? A reality for those who are already receiving too much care to begin with and a very distant hope for patientents who would get better starting with quality WATER (and not all of those patients live in the "Third World" many of them live right here in the good ole USA).
3
Many I know and I are-supposedly-those who benefit most from the ACA: lower income workers who are not given insurance by companies thanks to new rules about what constitutes full time and low wages. However, making 10 dollars an hour for 40 hours a week means I dont get a stipend, unless Im a student. And forget about getting in trouble out of state, and with a 6K deductible, any emergency could mean more than a fourth of my yearly paycheck, which could take years to make up, gone. With 49 percent of people in the US living off 40K a year, how on Earth can we demand they pay anywhere from 12 to 20 percent of their yearly salary on deductibles? When 600 bucks a year at low wages cant get you an affordable doctors appointment beyond the first one-and one usually has to go back after a blodo test-whats the point? And the fee is also at least a hundred bucks. What a sham.
9
The solution in more civilized human societies is Universal healthcare. Healthcare for all provided by their government, government by the people for the people "One for All and All for One". The United States is still not a civilized human society.
10
Instead of inferring America is uncivilized,how about you and your western european neighbors thank the US and it's taxpayers for picking up the tab for your defense for the last 70 years.We kept your very uncivilized neighbor to the east at bay while western europe went on a spending spree......on our dime.Pick up a history book and a dictionary and learn a few things,especially the definition of gratitude.
2
I have a silver individual policy from BC/BS. Premiums, co-pays, and the deductible keep rising, but contrary to what many commenters seem to think, there is coverage before the deductible is fulfilled. Preventive care, all visits to my primary care doctor, prescriptions, and even physical therapy for a sports injury, are available for a co-pay. If you're really sick and you need surgery, you're going to have to pay the deductible. Besides those who want single-payer, do those who want to repeal the ACA have any proposal? Returning to the days of denying and cancelling coverage is not the answer.
10
Timing of the vote notwithstanding, this is of great concern to any American who remembers Pelosi advocating a yes vote for a law that she had not read and an excellent opportunity to consider the presidential choices carefully. Dismantle ACA, it is not affordable and with get more expensive as time goes on.
6
If Ted Kennedy hadn't died, we likely would have had single payer coverage. Universal health care was the reason Kennedy supported Obama over Clinton.
After his death, Obama showed his lack of fight for this, and instead showed everyone what an amazing capitulator he was. We all saw how the insurance companies were going to profit by having more customers, but were told it was all good. Now it's painfully obvious it is a flawed program...levying fines to those can't afford to participate, higher rates and deductibles for those who can, and still leaving millions without care.
I wonder if Joe Biden would still make his same proclamation !!
After his death, Obama showed his lack of fight for this, and instead showed everyone what an amazing capitulator he was. We all saw how the insurance companies were going to profit by having more customers, but were told it was all good. Now it's painfully obvious it is a flawed program...levying fines to those can't afford to participate, higher rates and deductibles for those who can, and still leaving millions without care.
I wonder if Joe Biden would still make his same proclamation !!
9
When Nixon proposed that all businesses be required to provide health care insurance for employees, Ted Kennedy opposed the plan not based on its merits, but on his dislike of Nixon.
1
ACA ignored the first rule of medicine: "Do No Harm"
Instead of helping, it has made things worse for all but a select few. The obvious answer, like many here have already advocated, is to (kick out of the country all low education immigrants and low income minorities who do not pay into the system so we can be like Canada), and then implement a SINGLE PAYER system where everyone gains. GO BERNIE!!!
What?
You forgot to mention that little critical parenthetic detail of why Canada and Sweden have government health systems that work so well. If Everyone pays in, then Everyone will gain. In the US which is an amalgom of a first world country - mixed with giant swaths of third world South America, inner cities, and large areas of rural America who are chronically unemployed - obviously this won't work, and Single Payer would just exacerbate the problem.
But don't ever let politically incorrect reality get in the way of your Utopian fantasies.
Instead of helping, it has made things worse for all but a select few. The obvious answer, like many here have already advocated, is to (kick out of the country all low education immigrants and low income minorities who do not pay into the system so we can be like Canada), and then implement a SINGLE PAYER system where everyone gains. GO BERNIE!!!
What?
You forgot to mention that little critical parenthetic detail of why Canada and Sweden have government health systems that work so well. If Everyone pays in, then Everyone will gain. In the US which is an amalgom of a first world country - mixed with giant swaths of third world South America, inner cities, and large areas of rural America who are chronically unemployed - obviously this won't work, and Single Payer would just exacerbate the problem.
But don't ever let politically incorrect reality get in the way of your Utopian fantasies.
7
One little detail you forgot in your actually inaccurate comparison between Sweden and the U.S.--Sweden actually has more foreign-born residents than does the U.S., many of them from third-world countries. All of them get that national health care at no cost to themselves, even if they are unemployed and hence not paying taxes. And--Swedish health care is excellent.
3
I bet Sweden and the US have the same number of citizens and illegal immigrants right????
1
The problem with the substantial rate increases is that they are not distributed equally, but targeting the individually insured who don't qualify for subsidizes. When the ACA passed, I was paying $256 a month with a $2500 deductible. The most affordable plan available in 2016 had a $556 monthly premium with a $6000 deductible. With a yearly income of $55,000, I would have payed $12,800 before my "affordable" plan payed a penny. Assuming I don't have a major health issue, it made far more sense to pay the penalty, so for the first time in 20 years, I have no insurance. Apparently, 22 million Americans are in a similar position. Good laws don't create that much harm.
11
The BCBS study compares individual buyers before the ACA, individual buyers after the ACA and members of employer health plans. There is a difference in healthcare costs between the before and after individual buyers. What this article fails to mention is that there is not much difference between the new individual buyers and employer group health members - because neither one is denied coverage due to pre-existing issues. The individual buyers before the ACA were of course healthier - otherwise they couldn't have purchased coverage.
2
Missing from all of this is the fact that the ACA risk pool of about 15 million or so, a tiny risk pool, within in a nation of 300M+ citizens. If these individuals are the sickest and least treated in a nation of 300M+ then their cost is being borne mostly by the 15M, not the 300M+.
I am a healthy male, aged 58, early retired, in ACA until I am eligible for Medicare. When I was in a RATED risk pool, before ACA, my premiums were less than $400/mo and my deductible was $2500. Now, after being in the UNRATED ACA risk pool, my premiums are $750/mo and my deductible is $6000. While I'm grateful to be healthy and willing to "help" those who cannot pay, the situation feels deeply unfair. Worse is that most of the opinions about the "benefits" of ACA are expressed by those in the 300M+ who are not trapped and know no better. Its easy to like ACA when you're not in that risk pool.
I am legitimately considering ways to insure outside of this pool, paying the fine, registering late, etc, because I genuinely believe the pool is in a death spiral, not a one-time shock.
I am a healthy male, aged 58, early retired, in ACA until I am eligible for Medicare. When I was in a RATED risk pool, before ACA, my premiums were less than $400/mo and my deductible was $2500. Now, after being in the UNRATED ACA risk pool, my premiums are $750/mo and my deductible is $6000. While I'm grateful to be healthy and willing to "help" those who cannot pay, the situation feels deeply unfair. Worse is that most of the opinions about the "benefits" of ACA are expressed by those in the 300M+ who are not trapped and know no better. Its easy to like ACA when you're not in that risk pool.
I am legitimately considering ways to insure outside of this pool, paying the fine, registering late, etc, because I genuinely believe the pool is in a death spiral, not a one-time shock.
9
It seems the elephant in the room is Universal Health. If you look at those of our ally countries using universal health, you see none of these problems and a much healthier population as well.
5
We are a "fat" and lazy society
Some people here are criticizing President Obama. Others are advocating in favor of Bernie Sanders.
We should remember that NOTHING is going to change until Congress changes. President Obama didn't write the ACA program; Congress did. Sanders won't be able to do a thing if Congress doesn't change first.
We should remember that NOTHING is going to change until Congress changes. President Obama didn't write the ACA program; Congress did. Sanders won't be able to do a thing if Congress doesn't change first.
8
You can't praise Obama without allotting him some share of the blame. Pelosi and Reid didn't act in a vacuum without his buy in. Obama's fingerprints, even if only ideologically, are all over the ACA.
2
Yes Obama allowed Nancy Pelosi and Harry Reid to write the ACA. Voters should indeed remember this.
1
Costs are higher because the can was kicked down the road for decades, thereby ignoring desperately sick people. Not to worry. As soon as the election ushers in a new President, we will overturn this on day one and go back to lower premiums when the sick people are back "on their own". Safe in the knowledge they are no longer "takers" should equal out any health care concerns they experience.
As a bonus, the new President will also be able to appoint another Supreme Court justice, thereby dismantling unions entirely.
America will be great again.
As a bonus, the new President will also be able to appoint another Supreme Court justice, thereby dismantling unions entirely.
America will be great again.
6
I'm neither shocked nor surprised by these developments. It is common knowledge that many people who happen to suffer from severe illness could, for years, ill afford to go to the doctor or purchase the medication they needed. And if they did, they probably went to the doctor less often than they should have had and "economized" on the use of the medication, that is, taking their medication once a day, say, rather than three times a day. The upshot, of course, is that they only become sicker. Now there's a law that offers them the opportunity to get adequate medical care, and they are rightfully making use of it. And we are abhorred by the fact that this has caused a spike in medical care and blame that on the ACA? Really? Rather, as a nation, the US should be ashamed that it took so long take care of its less fortunate citizens who, until the enactment of the ACA, couldn't afford the healthcare that they should have gotten since the onset of their illness.
13
Hey Steffie, no one is abhorred by the fact that the sickest and most vulnerable are now being cared for appropriately. What we r abhorred by is that this care is being paid for on the backs of the middle.For many, their premiums have doubled and tripled and their co-pays r through the roof. This population group does not qualify for subsidies or tax credits. This was never discussed when the ACA act was passed. The politicians led by Obama, Reid and Pelosi were patting themselves on the back while simultaneously lying to the people about Obamacare. So Steffie, most r happy that our sickest citizens r now being cared for. However there r many more who are unhappy because they cannot afford to utilize their policy. They will stop going to physicians and health care provides as their out of pocket expenses r too high. Do you understand that? Please spare me your indignation.
9
I wonder who you think paid the bills of the uninsured before the ACA.
3
Hey Gabbyboy, there r millions of citizens who used to have policies that were affordable. With the rise ACA premiums and co-pays many middle class citizens will not go to the doctor for care as they cannot afford the co pay. We traded one problem for another. As for your ? , the govt paid for the uninsured thru Medicare/Medicaid plus ER visits of which the costs were eaten by the individual hospitals. In summary, many more of our poor r covered and that's a good thing. Many more though r insured but won't use their policy as the co pays r to expensive.
Obviously people have always needed and will continue to need healthcare. Unfortunately, the ACA has filled this need at a terribly high cost to middle class healthcare customers (yes, "customers" because our for-profit healthcare system doesn't care about conditions, it cares about profits). I am paying over 400% more and expect to continue to be bilked because, like so many people like me (over age 60, but relatively healthy), I have been phased out of anything but self-employment, so I get no premium breaks for being part of a company "pool;" and because I make earn just a bit too much to qualify for assistance. And mainly because, while insurance companies are forced to insure me, they are free to charge out the window and raise premiums and deductibles even higher than they did before on a yearly basis. All because they claim they now have to cover costlier people. It's really that they are trying to hold onto their obscene profit margins.
18
While it's easy to blame the insurance companies, or the ACA, the problem is really the entire healthcare system in the U.S., and that includes other handy "villains", like the pharma companies, but it's also the healthcare providers -- doctors, nurses, and hospitals -- and the model of care -- fee for service -- that also contribute to where we find ourselves.
While it's easy for BC/BS to come out with an analysis of their latest enrollees, giving them a tacit rationalization for their higher premiums and creating a convenient scapegoat to blame, where are the reports from BC/BS analyzing the rate of increase of pharmaceuticals, or for services charged by doctors and hospitals, or the average number of tests and procedures per patient being requested?
I agree that single-payer would remove one costly link from this chain, but it would certainly *not* address rising drug costs or increasing doctor fees or hospital charges by itself. The payer, single or otherwise, only has partial control over what healthcare costs.
While it's easy for BC/BS to come out with an analysis of their latest enrollees, giving them a tacit rationalization for their higher premiums and creating a convenient scapegoat to blame, where are the reports from BC/BS analyzing the rate of increase of pharmaceuticals, or for services charged by doctors and hospitals, or the average number of tests and procedures per patient being requested?
I agree that single-payer would remove one costly link from this chain, but it would certainly *not* address rising drug costs or increasing doctor fees or hospital charges by itself. The payer, single or otherwise, only has partial control over what healthcare costs.
3
In single payer system, the payer is like a benign dictator that decides who gets paid what for which service. A little unfair, but it controls costs. They also have caps on overall billing so that providers do not do an end-run by running up huge volume. The providers make a good living by running their business efficiently. It is uncommon to see an army of receptionists, nurses and billers sitting in a Canadian doctors office. There is usually only one other person besides the doctor who maintains office records, answers calls, does billing and provides the little nursing service required.
3
No real surprise here. These folks have been shut out of the health care system for years, sometimes because they are sick. And sometimes, being shut out leads to sickness.
The real shame of it all is that huge sums of money are still going to insurance companies like BCBS. They add nothing of value to the system, and still erect barriers to people getting necessary care. Obama and the now mostly defeated conservative Democrats who blocked a single payer solution should be ashamed. When will we realize that the only way to solve this problem is to join every single other industrialized country in the world and have a single payer system?
The real shame of it all is that huge sums of money are still going to insurance companies like BCBS. They add nothing of value to the system, and still erect barriers to people getting necessary care. Obama and the now mostly defeated conservative Democrats who blocked a single payer solution should be ashamed. When will we realize that the only way to solve this problem is to join every single other industrialized country in the world and have a single payer system?
7
Incredible that anyone would be surprised by this news unless one is politician or blindly believes in a politician.
Stop this ruse that the uninsured would ever be insured at the same rates. Younger and healthier people pay less for obvious reason....so spread the pain around equally...unless that loses votes for the politicians of course...sheesh. But stop wasting our time and money by magically thinking that older and less healthier people are ever going to cost the same as the young.
Stop this ruse that the uninsured would ever be insured at the same rates. Younger and healthier people pay less for obvious reason....so spread the pain around equally...unless that loses votes for the politicians of course...sheesh. But stop wasting our time and money by magically thinking that older and less healthier people are ever going to cost the same as the young.
1
Why should this surprise anyone? Millions of people have survived without health care for years while their health deteriorated and now they are trying to play catch up.
Our for profit health care industry has spiraled down for decades and it's going to take at least that long to reverse the slide.
I agree with Senator Sanders that we need a national health care system that begins caring for everyone before they are born and all through their lives.
Our for profit health care industry has spiraled down for decades and it's going to take at least that long to reverse the slide.
I agree with Senator Sanders that we need a national health care system that begins caring for everyone before they are born and all through their lives.
16
Universal Health Care is I believe a right consistent with the tenor of our constitution.
In addition the cost of Health care in this country is out of control compared to all other developed countries.
It is some 20 percent of our GDP , this compares with some 12 percent in Germany which has double the number of doctors and hospital beds per capita that we have.
This health care cost is covered by individuals diminishing their standard of living, corporations diminishing their ability to pay living wages and compete with other industrial nations and our Medicare , Medicaid and veterans affairs etc adding to our budget deficit and putting at risk the viability of these programs
I would like a President Sanders or a President Clinton to introduce universal health care in conjunction together with a rigorous program to reduce costs.
That means electing a Democratic House and Senate, throwing out Republican Governers across the country as State buy in is vital
Therefore Universal Health Care has to be in the Democratic agenda for all candidates wishing to represent the party and the future of the USA
In addition the cost of Health care in this country is out of control compared to all other developed countries.
It is some 20 percent of our GDP , this compares with some 12 percent in Germany which has double the number of doctors and hospital beds per capita that we have.
This health care cost is covered by individuals diminishing their standard of living, corporations diminishing their ability to pay living wages and compete with other industrial nations and our Medicare , Medicaid and veterans affairs etc adding to our budget deficit and putting at risk the viability of these programs
I would like a President Sanders or a President Clinton to introduce universal health care in conjunction together with a rigorous program to reduce costs.
That means electing a Democratic House and Senate, throwing out Republican Governers across the country as State buy in is vital
Therefore Universal Health Care has to be in the Democratic agenda for all candidates wishing to represent the party and the future of the USA
10
Universal health care is in no way guaranteed by our constitution. If you think it is, you know nothing of it.
Only because those uninsured never went to the doctor's before because they can't afford it. Now that they HAVE to pay for insurance, might as well put it to use.
3
Yet they still have to pay the co-pays and caps, so many are still not going.
1
Agree with DSS that this is not earth shattering news, if fact it was expected. Also this article talks about insurer costs, not about costs of medical care as a whole in the US. If the uninsured received care in the past it was thru emergency rooms and charity which are not born by the insurer but are born by the country as a whole.
2
Odd how none of these needy people signed up for Obamacare out of need when it first came out. They all waited until forced to sign up, so money is more important to them than their own health
2
Obamacare didn't take effect until January 1, 2014. The article covers 2014 and 2015. Hence, these people did sign up when it first came out.
I'd wager that it isn't that money is more important to people than their own health, it's that they can't afford to pay the mortgage and the insurance premium and the co-pays and deductibles and co-insurance. It's not a choice anyone in this country should have to make, but that's how it goes.
I'd wager that it isn't that money is more important to people than their own health, it's that they can't afford to pay the mortgage and the insurance premium and the co-pays and deductibles and co-insurance. It's not a choice anyone in this country should have to make, but that's how it goes.
6
Odd that people would make the silly choice of food over a doctor's visit. Strange that people would be foolish enough to buy gas to get to work over treating their health needs. Bizarre how some people would make the outlandish choice of schools supplies for their children over having that mole looked at, or going to the dentist for a cleaning.
Truly odd.
Truly odd.
4
definitely can tell you are southern us from your attitude. Whats even more interesting is how many new additions were in the southern US where diabetes is about 3x more common then the other 40 states. Most of these people who signed up were also subsidized which means that again the people with the crummiest attitude towards care of the less fortunate continue to take more from the rest of the country
5
I always find it interesting how some on the one hand state as an absolute that health care is a fundamental, basic human and civil right, and then turn right around and say that people should be forced (and penalized) if they don't take care of themselves by virtue of their diet, lack of exercise, smoking, drinking, etc. You can't have it both ways - if it is an inviolable right then you cannot take it away or limit it from people if they don't adhere to certain desired norms.
4
Norms defy Liberty. Luxury taxes fairly assess cost.
Didn't need a study. Many of us that now have insurance were denied insurance due to pre-existing conditions. Have all but reversed my diabetes, but couldn't get insurance due to this pre-existing condition. America cannot let healthcare be something only the well off can afford. We need healthier citizens to be a healthier country. I thank God for so many things Obama has done and Obamacare is among the top 5 after ending our use of torture, after saving us from financial collapse, getting out off Iraq, getting out of Afghanistan (no more boots on the ground), trying something different with Cuba.
Now, it is time to audit insurance companies & up the penalty for not having health insurance as well as demanding the states close the gap with Medicaid or nationalize all healthcare like Medicare. Many that were uninsured are now insured and, yes, many are sicker than the norm, but insurance companies are covering a lot less of uninsured in their rates from hospitals and clinics, so costs should go down starting 2017. When we make changes to systems, there's a delay in impact just like the delay in room temperature cooling when you lower the thermostat. Sometimes things look worse before they get better.
Great news for all. All these people are now paying a share for healthcare (including me), getting healthier or getting care, instead of being in the anonymous millions that go into emergency rooms and hospitals nationwide.
This is a win to build on!
Debbie Deland
Now, it is time to audit insurance companies & up the penalty for not having health insurance as well as demanding the states close the gap with Medicaid or nationalize all healthcare like Medicare. Many that were uninsured are now insured and, yes, many are sicker than the norm, but insurance companies are covering a lot less of uninsured in their rates from hospitals and clinics, so costs should go down starting 2017. When we make changes to systems, there's a delay in impact just like the delay in room temperature cooling when you lower the thermostat. Sometimes things look worse before they get better.
Great news for all. All these people are now paying a share for healthcare (including me), getting healthier or getting care, instead of being in the anonymous millions that go into emergency rooms and hospitals nationwide.
This is a win to build on!
Debbie Deland
8
The Affordable Care Act had good intentions, but is a total disaster. Lets take the profit out of medicine and insurance. My partner is over $200,000 in debt for Physician Assistant school (Weill Cornell). During the past two years she has helped make a lot of $ for people who are in medicine for profit and operate medical facilities without any medical background. At those facilities she has served numerous Medicare patients. She was paid from different payrolls and never offered health insurance. She was then replaced by a foreign educated practitioner who accepted the job for less $.
How is this a good system? Healthcare providers, who serve the under served, aren't even being given insurance.
Their should a universal plan paid for by luxury taxes on everything from weed to Doritos. If you choose, as is your personal right, to consume food and substances that have known adverse side effects, you should be taxed for it. Those who choose to live healthy lifestyles should not have to cover the premium costs and excessively high rates created by American's choice to live unhealthily. (Food for profit is also a bad thing)
It is inhumane to deny someone healthcare, and all should have it. However, the burden of cost should be placed upon people's own lifestyle choices.
“Let food be thy medicine and medicine be thy food.”
How is this a good system? Healthcare providers, who serve the under served, aren't even being given insurance.
Their should a universal plan paid for by luxury taxes on everything from weed to Doritos. If you choose, as is your personal right, to consume food and substances that have known adverse side effects, you should be taxed for it. Those who choose to live healthy lifestyles should not have to cover the premium costs and excessively high rates created by American's choice to live unhealthily. (Food for profit is also a bad thing)
It is inhumane to deny someone healthcare, and all should have it. However, the burden of cost should be placed upon people's own lifestyle choices.
“Let food be thy medicine and medicine be thy food.”
3
Should have gone to med school with that kind of debt load.
1
As everyone has said, this makes sense. Who didn't have insurance? Mostly lower income people less educated. Who tends to eat unhealthy food, not exercise, be more obese, be less of health issues, etc? Same people, and now they have signed up for ACA insurance.
This isn't some kind of discrimination or poor bashing, but just the statistical truth.
This isn't some kind of discrimination or poor bashing, but just the statistical truth.
Your knee-jerk prejudices strung together in a list with commas does not pass as "statistical proof."
5
Sickness everywhere and big Pharma, big med insurance and big hospital corps.
are ready to help - at a price! If single payer for all is too big a step to take,
why not a smaller step, 55+ Medicare will point us in the right direction and
will help an age group that got slammed in the "big recession".
are ready to help - at a price! If single payer for all is too big a step to take,
why not a smaller step, 55+ Medicare will point us in the right direction and
will help an age group that got slammed in the "big recession".
5
Health care is not a right.
Stop for a moment and think about this. "Rights" exist in the absence of anyone else's agency. Allopathic health care, on the other hand, is dependent on the efforts of others.
If you try to turn it into a right, what do you get?
You get rationed health care, which means that some who need it, won't get it, and their so-called "right to health care" is denied. You get what we see every day in the UK, or on in Canada, where those in serious need go to the US and pay out of pocket, if they can afford to do so.
Unfair? You bet. But so is life. And nature.
Stop for a moment and think about this. "Rights" exist in the absence of anyone else's agency. Allopathic health care, on the other hand, is dependent on the efforts of others.
If you try to turn it into a right, what do you get?
You get rationed health care, which means that some who need it, won't get it, and their so-called "right to health care" is denied. You get what we see every day in the UK, or on in Canada, where those in serious need go to the US and pay out of pocket, if they can afford to do so.
Unfair? You bet. But so is life. And nature.
6
Beats homeopathy.
1
Agree
1
Healthcare was rationed before the ACA was enacted. Those who could not afford it did not receive healthcare. Period.
Healthcare is a finite resource, and short of having 100 doctors for every patient, ready and willing to treat anyone for free, there's always some sort of resource management that has to occur.
You want fair? You could come up with a healthcare management system that throws everyone's name into a giant bin that spins around and the people who get picked from the pool are the lucky ones who get the care they need. Completely randomized and fair, and ability to pay would have nothing to do with it.
Healthcare is a finite resource, and short of having 100 doctors for every patient, ready and willing to treat anyone for free, there's always some sort of resource management that has to occur.
You want fair? You could come up with a healthcare management system that throws everyone's name into a giant bin that spins around and the people who get picked from the pool are the lucky ones who get the care they need. Completely randomized and fair, and ability to pay would have nothing to do with it.
3
Love that last paragraph!
Is that the 'hope' Obama promised us?
Is that the 'hope' Obama promised us?
5
Oh but if you like your doctor you can keep your doctor...
As long as your doctor doesn't opt out of AHCA and doesn't triple his or her charges for your sore throat...
It was said when this was just an idea - THE AFFORABLE HEALTH CARE ACT IS A FARSE!
And those that praise BHO for bringing it to pass should be the ones that suffer the most from this mess!
As long as your doctor doesn't opt out of AHCA and doesn't triple his or her charges for your sore throat...
It was said when this was just an idea - THE AFFORABLE HEALTH CARE ACT IS A FARSE!
And those that praise BHO for bringing it to pass should be the ones that suffer the most from this mess!
5
And you blame President Obama instead of your doctor and the insurance companies ???
(ps ... spell "farce" correctly next time.)
(ps ... spell "farce" correctly next time.)
7
Those were choices made by your doctor and yourself. What has the ACA have anything to do with it? Why don't you go to your doctor and and ask him/her exactly what line in the ACA legislation required him/her to triple his/her rates? Then let us know. We'll be waiting.
4
If the United States can refrain from listening to the stupid, venal neoconservatives and sending off tens of thousands of soldiers to get crippled and maimed in countries governed by corrupt fools who can't secure the borders of the places they ostensibly govern (e.g. Iraq) then that sure will help contain health care costs at home.
It amazes me to no end that the machinery of the U.S. government nearly or in fact did come to a screeching halt due to such fierce opposition to the ACA's passage in 2010, while the machinery of government hummed along during the Iraq debacle under Bush from 2003 to 2009.
It amazes me to no end that the machinery of the U.S. government nearly or in fact did come to a screeching halt due to such fierce opposition to the ACA's passage in 2010, while the machinery of government hummed along during the Iraq debacle under Bush from 2003 to 2009.
11
I find it interesting that people who will support going to war because nearly 3,000 people were killed on 9/11 will allow the for profit healthcare industry to continue its existence. Because, on average, 30-40,000 people a year die in the US because they can't afford healthcare. But Americans just go on taking the for profit healthcare system they've been brainwashed to accept. One would think they'd be out in the streets in anger over all those innocent deaths, all the bankruptcies...
18
You don't have to be a brain surgeon to know that those that were uninsured before Obamacare and now come from the high risk pool. You also don't have to be brilliant to know that the insurers, drug companies and many health care providers are "for profit" institutions. As with any insurance, those that don't file claims pay for those that do. Come on folks, this is not earth shattering news.
3
"You don't have to be a brain surgeon ..."
I know of a certain brain surgeon who doesn't appear to have common sense. I recall that he is now supporting Trump.
I know of a certain brain surgeon who doesn't appear to have common sense. I recall that he is now supporting Trump.
4
Should we assume that due to poor lifestyle CHOICES the folks who are then the sickest probably cannot afford coverage on their own so the taxpayer via the government is footing the bill?
Nowhere do we read that people are being told they HAVE to change poor lifestyle habits. Like stop smoking, stop drinking, stop doing drugs, stop the junk food, stop sitting on your butt so much and stop sleeping around. Just treatment treatment treatment. Which is expensive.
Bear in mind there are many healthy folks who based on government stats are at or near the poverty level who do practice a healthy lifestyle, be it proper physical exercise, plant based diet, enough sleep, drinks water not soda etc.
Nowhere do we read that people are being told they HAVE to change poor lifestyle habits. Like stop smoking, stop drinking, stop doing drugs, stop the junk food, stop sitting on your butt so much and stop sleeping around. Just treatment treatment treatment. Which is expensive.
Bear in mind there are many healthy folks who based on government stats are at or near the poverty level who do practice a healthy lifestyle, be it proper physical exercise, plant based diet, enough sleep, drinks water not soda etc.
4
First of all, why would you assume that the latest enrollees are sicker due to their "choices"? True, some may be, but there's nothing in the article to indicate that there's anything in the data to prove this.
Second, why do you assume that people's "choices" are entirely voluntary and made without any negative influences? People don't necessarily "choose" to eat less nutritious food; sometimes, it's the only food that they can afford. People don't always "choose" to not exercise; some people cannot afford the cost of a gym or the time to exercise after taking care of all of life's necessities.
Third, so is your assertion that people that harm their own health through poor life choices should be denied healthcare? Should we deny liver transplants to alcoholics? Lung cancer treatment to smokers? Or is it only the poor, who could not afford health insurance before the ACA who should be punished for their bad "choices"?
Second, why do you assume that people's "choices" are entirely voluntary and made without any negative influences? People don't necessarily "choose" to eat less nutritious food; sometimes, it's the only food that they can afford. People don't always "choose" to not exercise; some people cannot afford the cost of a gym or the time to exercise after taking care of all of life's necessities.
Third, so is your assertion that people that harm their own health through poor life choices should be denied healthcare? Should we deny liver transplants to alcoholics? Lung cancer treatment to smokers? Or is it only the poor, who could not afford health insurance before the ACA who should be punished for their bad "choices"?
6
Dear New York Times,
Would someone please forward these comments to your columnist and Nobel Prize winning economist Dr. Paul Krugman?
He seems to think there is not the political will to tackle single payer health care and has been advocating against the candidate that proposes it.
Thank You
Would someone please forward these comments to your columnist and Nobel Prize winning economist Dr. Paul Krugman?
He seems to think there is not the political will to tackle single payer health care and has been advocating against the candidate that proposes it.
Thank You
14
I lived under a single-payer system in Israel and it is incomparably better that the clunky, complicated, overpriced and inefficient system in the US. However, for those who believe that a single-payer is the cure for all the ills of the US, a word of caution. First, care WILL be rationed. It has to be. If you don't like it, get a private insurance in addition to the mandated coverage. Second, a proportionate health tax is levied on everybody, so the rich pay for the healthcare of the poor - fine with me but I assume, not with everybody. Third, lifestyle is important. The Standard American Diet (SAD) alone can undo the best health care system in the world. When I see the lumbering whales who inhabit rural America consuming ginormous burgers and fries, I don't feel like paying for their diabetes, heart disease and other obesity-related diseases. If we have a single-payer system, it'll have to have a mechanism to penalize unhealthy lifestyles.
7
I think the comment about "being sicker" is deceptive. These are people who, before they had access to any insurance, used emergency rooms as their only recourse. Sometimes the wait there is hours, so in many cases they probably tried to avoid getting medical care.
1
Long lines at the polling place = vote suppression.
Long lines at the ER = health suppression.
We could use an ACA for the former.
Long lines at the ER = health suppression.
We could use an ACA for the former.
Why is all the blame on the insurance companies, and not the individuals? As I understand the process, state insurance boards review the companies' requests for rate hikes for accuracy, and make a decision whether the rates can be imposed on the policy holders.
The diseases mentioned in the article are overwhelmingly the result of life style choices - diet, exercise, and sexual practices. And I'll bet the vast majority of these patients are receiving big ACA subsidies. When the ACA first rolled-out, I'll never forget the NYT picture of a W. Virginia man finally able to afford health insurance, and he was smoking a cigarette. So, while we make disciplined choices to keep our health care costs low, know that you are paying for people who could care less.
The diseases mentioned in the article are overwhelmingly the result of life style choices - diet, exercise, and sexual practices. And I'll bet the vast majority of these patients are receiving big ACA subsidies. When the ACA first rolled-out, I'll never forget the NYT picture of a W. Virginia man finally able to afford health insurance, and he was smoking a cigarette. So, while we make disciplined choices to keep our health care costs low, know that you are paying for people who could care less.
3
Years ago physicians were featured in ads smoking and advocating cigs. Women were targetted with Virginia Slims encouraging them to smoke to stay thin. The tobacco industry did its best to keep the serious health consequences of smoking hidden. Nicotine is one of the most addictive legal substances in existence. It' s easy to blame the victim. Less easy I guess to show compassion. You can practice all the discipline around eating exercise etc. possible& still become extremely ill & need healthcare. I say this as a nonsmoking, exercising, healthy eating person at home with a lung infection that 100 years ago might have killed me but because I have good health insurance access to good doctors affordable medication and enough financial security to be able to take a week off to recover. I would happily pay even more taxes than I do so that everyone in the US could have access to the health care I do. And don' t even get me started on kids who can't get the health care they need - you want to blame them too?
3
If others are anything like me, since I hadn't been to a doctor in more than 15 years, I had some issues the first year. Since then, I have not had any issues. Certainly, insurers expected that sort of blip.
1
aside from the morality of healthcare, it's a good investment:
healthy citizens = productive workers = better taxpayers.
but i also agree now we need single payer system for healthcare. i too am one of the healthy ones who pays A LOT more now for my coverage ($450/mo + $6000 deductible!)- and add to that the stressful and time consuming job of having to figure out which insurance company is least awful
healthy citizens = productive workers = better taxpayers.
but i also agree now we need single payer system for healthcare. i too am one of the healthy ones who pays A LOT more now for my coverage ($450/mo + $6000 deductible!)- and add to that the stressful and time consuming job of having to figure out which insurance company is least awful
6
To echo what some others have written, the biggest problem of the ACA is that it does a lot to improve access but does very little to improve quality, reduce demand for healthcare, or lower costs. This results in a financial boon for the insurance industry (and perhaps for some doctors, hospitals, and drug companies) but additional spending for the government and the insured individuals. There are only two ways to keep healthcare costs down in a sustainable fashion. One is a direct payment scheme between patients and doctors, pharma companies, and hospitals, so that laws of supply and demand can control prices, rather than a system relying on the opaque intermediate step of insurance which prevents direct interaction. As many can attest, most healthcare providers cannot even quote an out-of-pocket price for a service until insurance has finished "processing" the bill. The other option is a centralized, single-payer system that can forcibly control spending and pricing. Either one essentially forces out the insurance industry from healthcare, so both are basically political "third rails." That said, I don't think there are a lot of other good options.
4
Many GOP members, like myself(I am not Trump supporter alert) know that single-payer is the way to go for economic reasons. US companies, unlike any companies worldwide are always at a disadvantage because they cover employees' healthcare costs. And our corporate rates are not lower then theirs, but their corporate costs are much less without healthcare costs. Let's help put American business a par with the world. So for humanitarian reasons and economic reasons we need single payer.
8
I'll start by saying I think single-payer is the ultimate solution to spiraling health care costs. However, to all who are lambasting the ACA for the rising premiums and out-of-pocket expenses they're seeing compared to the employer-based insurance they (were lucky enough to have) had a few years ago, it may feel unfair/untenable, but now you see the REAL cost of the current system.
Most people on employer-based insurance still don't grasp the full cost of their insurance because their employer pays a good chunk of premiums instead of paying that equivalent in additional salary/wages. It was even more hidden before because the insurers themselves were allowed to shut out sicker/older people who would have raised premiums for all in past and the government got stuck with the bill.
And as for single-payer, it's a huge improvement because it removes most if not all out-of-pocket costs for health care that act as a continued barrier and is income-adjusted, but you better believe the citizens of countries that provide single-payer are paying higher income taxes---it's not free care. But by now they're used to the taxation and highly value what they get, hassle-free, in exchange.
The renovation of health care has begun. No one likes living in a reno, but it must be done before the ceiling falls in on us. This is the price we pay for not having started this process incrementally a long time ago.
Most people on employer-based insurance still don't grasp the full cost of their insurance because their employer pays a good chunk of premiums instead of paying that equivalent in additional salary/wages. It was even more hidden before because the insurers themselves were allowed to shut out sicker/older people who would have raised premiums for all in past and the government got stuck with the bill.
And as for single-payer, it's a huge improvement because it removes most if not all out-of-pocket costs for health care that act as a continued barrier and is income-adjusted, but you better believe the citizens of countries that provide single-payer are paying higher income taxes---it's not free care. But by now they're used to the taxation and highly value what they get, hassle-free, in exchange.
The renovation of health care has begun. No one likes living in a reno, but it must be done before the ceiling falls in on us. This is the price we pay for not having started this process incrementally a long time ago.
10
This report should provide further proof that the way healthcare in the U.S. needs a complete overhaul. Taking the profit motive out of health insurance is the only way to control healthcare costs.
Despite all the PR claims by the industry that it's populated by caring, trained professionals, American healthcare is currently run by the same incentive that drives every other U.S. industry: greed. Until we decide for-profit medicine is unethical, U.S. citizens will face the quandary of rising costs every year.
Despite all the PR claims by the industry that it's populated by caring, trained professionals, American healthcare is currently run by the same incentive that drives every other U.S. industry: greed. Until we decide for-profit medicine is unethical, U.S. citizens will face the quandary of rising costs every year.
13
No profit means no mission. There always has to be a profit.
1
Really? Sweden, Japan, Canada, Germany, Britain and dozens of other countries manage to deliver non-profit healthcare. In those countries, healthcare is considered a citizen's right. We have the most expensive healthcare in the world, with the worst result. That's the "mission" of the healthcare industry in the U.S. -- the cheapest care with the highest profit.
2
We can either pay the costs of healthcare through insurance premiums, deductibles and co-pays or we can pay it through taxes. Everyone impacted by rising premiums and high deductibles should support a single-payer health care system. Of course, that would require us to prioritize paying for health care over paying for other things, such as endless wars and other massive military spending.
15
I laugh at people who say they resent paying for health insurance because they rarely use it. In the case of DR from Colorado, he says that his sister died of colon cancer. I'm sorry for his loss, but I'll bet that her insurance came in handy. DR should ask himself: why are premiums and deductibles so high under ACA? The answer is that the cost of medical care in the U.S. is very high, and insurance premiums must be high to pay for it. Don't blame this on ACA, which in fact has kept the rate of premium increases down. The Affordable Care Act is not a disaster; it is a resounding success. I'd suggest two improvements: let ACA, Medicaid and Medicare negotiate drug prices, and add a public option for insurance coverage.
34
Jeff from Evanston
How can a program that DOES increase the cost of premiums and REMOVES ones choice of Physician from the to-be-able-to-do list a success?
It is a growing red tape nightmare to patient and Dr alike.
How can a program that DOES increase the cost of premiums and REMOVES ones choice of Physician from the to-be-able-to-do list a success?
It is a growing red tape nightmare to patient and Dr alike.
3
Republicans and insurance companies did not allow the public option because they knew it would be the eventual end of their business and their $10 million dollar paychecks. More and more people would choose the public option, no matter what its limitations, until the for-profit models collapsed.
5
I am always amazed by the capacity of politicians and Times headline writers to be amazed.
"Newest Policyholders Under Health Law Are Sicker and Costlier" ranks right up there with "Simmering for Decades, Anger About Trade Boils Over in ’16 Election"
"Newest Policyholders Under Health Law Are Sicker and Costlier" ranks right up there with "Simmering for Decades, Anger About Trade Boils Over in ’16 Election"
4
God bless President Obama, God bless the Democratic Party, God bless John Roberts and God bless the US Supreme Court. I hope Republicans will read this article. That might change theirs hearts woefully insensitive to the plight of needy Americans.
10
"People newly enrolled in individual Blue Cross health plans in 2014 and 2015 were found to have higher rates of certain diseases and conditions, including high blood pressure, diabetes, depression, coronary artery disease, H.I.V. and hepatitis C, than people who already had coverage."
Common sense would indicate that people who have never had health insurance - and most like never had a doctor's care - would be more costly and use services more. But wouldn't these costs likely decline in a few years once the initial group of uninsured has received care? People would be more healthy in general because they would be being treated for these conditions. Emergency room visits would go down and so forth. Doubtful the insurers would see a continued spike from year to year. Isn't the point of having healthcare to use it?
Common sense would indicate that people who have never had health insurance - and most like never had a doctor's care - would be more costly and use services more. But wouldn't these costs likely decline in a few years once the initial group of uninsured has received care? People would be more healthy in general because they would be being treated for these conditions. Emergency room visits would go down and so forth. Doubtful the insurers would see a continued spike from year to year. Isn't the point of having healthcare to use it?
14
Given that conventional medicine rarely cures people, mostly treats symptoms, and that around 50% of hospital visits are due to iatrogenic illnesses (i.e., caused by medical treatment), it is unlikely that these people with chronic health conditions will become less expensive to insure over time. Rather, they will get put on more and more medications, have more and more "side effects," and will require more and more care.
1
I’m turning 65 in May and will become eligible for Medicare.
I look forward to turning my back on the profit-making insurance company that increased my rates 20% this year, a Blue Cross company owned by Anthem, even though I didn’t use my insurance at all in 2015.
(Also in 2015, Anthem saw to it that my identity and that of 80 million other subscribers were hacked from its computer system:
“Protecting Yourself from the Consequences of Anthem’s Data Breach”, NYT, 2/5/15)
http://www.nytimes.com/2015/02/06/business/protecting-yourself-from-the-...®ion=top-news&WT.nav=top-news
Yet, with Medicare, you still can’t get rid of profit-making insurance. At least with prescriptions and “Medigap” policies, on top of your monthly costs to the government for “Part B” medical costs, you’re still caught in the insanity that is profit American health care.
Medicare is not truly a “one-payer” system, unless you go with a profit-making insurance company.
Additionally, I am overwhelmed with the complexity of Medicare. Medicare is designed for people going through the aging process, and losing brain cells on a daily basis, yet at 64 I am already overwhelmed by its complexity.
It is not a “health care system”; it is a game of 3-Card Monte. And you never win at 3-Card Monte.
I look forward to turning my back on the profit-making insurance company that increased my rates 20% this year, a Blue Cross company owned by Anthem, even though I didn’t use my insurance at all in 2015.
(Also in 2015, Anthem saw to it that my identity and that of 80 million other subscribers were hacked from its computer system:
“Protecting Yourself from the Consequences of Anthem’s Data Breach”, NYT, 2/5/15)
http://www.nytimes.com/2015/02/06/business/protecting-yourself-from-the-...®ion=top-news&WT.nav=top-news
Yet, with Medicare, you still can’t get rid of profit-making insurance. At least with prescriptions and “Medigap” policies, on top of your monthly costs to the government for “Part B” medical costs, you’re still caught in the insanity that is profit American health care.
Medicare is not truly a “one-payer” system, unless you go with a profit-making insurance company.
Additionally, I am overwhelmed with the complexity of Medicare. Medicare is designed for people going through the aging process, and losing brain cells on a daily basis, yet at 64 I am already overwhelmed by its complexity.
It is not a “health care system”; it is a game of 3-Card Monte. And you never win at 3-Card Monte.
11
This situation reminds me of the implementation of Medicare nearly fifty years ago. Hospitals were flooded with very sick and debilitated seniors and could not anticipate the cost. Today that population and their health status is far more predictable. It will take several years to manage untreated diseases and predict their cost.
10
The only answer in time will of course prove to be Medicare-for-all. We have an absurdly expensive and for many people discouraging private for-profit healthcare insurance system. Medicare-for-all is the answer.
17
You have to wonder if all these new to healthcare folks are:
(1) Going to a primary care physician
(2) Having a yearly physical
(3) Regularly use medicine to treat ongoing illness
(4) Exercise regularly and eat healthy foods
(5) Don't smoke and use alcohol in moderation
If we could motivate all Americans to follow these five suggestions; we would make progress to a healthier nation.
(1) Going to a primary care physician
(2) Having a yearly physical
(3) Regularly use medicine to treat ongoing illness
(4) Exercise regularly and eat healthy foods
(5) Don't smoke and use alcohol in moderation
If we could motivate all Americans to follow these five suggestions; we would make progress to a healthier nation.
7
The individual and societal value of the annual physical has been debunked in the very pages of the NYT, not too long ago. Huge cost for little ROI.
2
Conservatives in both parties have tried to deny any kind of health care reform. The idea that making health care available is socialism and dangerous intrusion of big gov't was wrong. There is still a powerful rearguard effort to limit the ACA. The fact that there would be pent up demand for health care after the passage of the ACA seems obvious. Health care is a true buyers market.
6
I think some conservatives and some non conservatives are concerned with what this article has noted has occurred.
Premiums are going UP because people who make poor lifestyle choices cost more to treat. Thus those who are responsible are paying more for their premiums because of those who have refused to be responsible.
Premiums are going UP because people who make poor lifestyle choices cost more to treat. Thus those who are responsible are paying more for their premiums because of those who have refused to be responsible.
2
Opposite problem here. This is my first year being forced by the tax penalty into the ACA, after I lost coverage when my spouse's company went out of business. I have no health problems but I have to pay $500/month for insurance with a $6300 deductible. So all the health enhancing things I did before, like osteopathic adjustments, I have to pay for myself after I hand over $500 to the insurance company. If you aren't broke and you take care of your health the ACA is a money drain.
Bernie Sanders is right about single payer healthcare. At last my money wouldn't be lining an insurer's pockets.
Bernie Sanders is right about single payer healthcare. At last my money wouldn't be lining an insurer's pockets.
16
"I have no health problems "
You think that's bad? I like in a city. I pay property taxes to support the fire department. I have NEVER "used" the fire department. Oh, the injustice!
You think that's bad? I like in a city. I pay property taxes to support the fire department. I have NEVER "used" the fire department. Oh, the injustice!
7
You may not know this but you can do a lot to preserve your health and keep your house from burning down. AND my taxes pay for the fire department and benefit everyone in the town while my payment to the insurance goes to an overpaid administrator and no one else.
Hold the presses!
You mean the people who could not even GET health insurance because they had, you know, health problems, are sicker than the healthy people who COULD get health insurance before the ACA?
Who could have expected such a thing?
You mean the people who could not even GET health insurance because they had, you know, health problems, are sicker than the healthy people who COULD get health insurance before the ACA?
Who could have expected such a thing?
27
"life, liberty, and the pursuit of happiness..." Universal healthcare is needed for all three.
15
Liberty includes freedom but also a responsibility to take care of your own. Liberty also includes my right not to have to take care of you. Why do you think you have a right to my money? Want to send me all yours?
2
As an American who voted with his feet decades ago and left for Canada, I would urge progressive citizens to educate themselves on the many different models of "single payer".
I have no expertise in this, but for starters I would recommend that you look towards a combined federal-state sharing of the payment, administration, operation and policy management for the best American single payer solution. Moreover, I would suggest the federal government "own" the establishment of common standards of health care delivery, as well as providing supporting funding for those states who are "have nots" as well as ensuring compliance, plus perhaps setting a single basis for what service providers and "big pharma" get paid.
At its core, an American single payer solution should be delivered, paid for and managed by each state, not unlike education.
Canada made the change decades ago, and for better and worse we love it, so come on! you can do it, but it will require a large core of informed, socially minded people to make it happen.
I have no expertise in this, but for starters I would recommend that you look towards a combined federal-state sharing of the payment, administration, operation and policy management for the best American single payer solution. Moreover, I would suggest the federal government "own" the establishment of common standards of health care delivery, as well as providing supporting funding for those states who are "have nots" as well as ensuring compliance, plus perhaps setting a single basis for what service providers and "big pharma" get paid.
At its core, an American single payer solution should be delivered, paid for and managed by each state, not unlike education.
Canada made the change decades ago, and for better and worse we love it, so come on! you can do it, but it will require a large core of informed, socially minded people to make it happen.
12
"I have no expertise in this, but for starters I would recommend that you look towards a combined federal-state sharing of the payment, administration, operation and policy management for the best American single payer solution.
A fed-state sharing of the payment? You do realize from whom they get their money, right? Maybe not since you opted for socialism. Hey now you can go full bore and move to Cuba or Venezuela.
A fed-state sharing of the payment? You do realize from whom they get their money, right? Maybe not since you opted for socialism. Hey now you can go full bore and move to Cuba or Venezuela.
The Republicans would not allow it.
This consequence was obvious. It will take several years for the sicker to get better (or manage their chronic illnesses) and then the health costs will even out.
7
Not so sure health costs will even out, when one considers the idea that those who are the least motivated as far as healthy lifestyle choices will also be the ones who get their coverage paid for by the taxpayer and have no incentive to change poor lifestyle habits
The reason national healthcare works well in places like Sweden is when a Swede looks around they see themselves. And seeing someone who has the same personal responsibility, moral, ethical beliefs results in a healthier populace and fewer people who need expensive medical care.
The reason national healthcare works well in places like Sweden is when a Swede looks around they see themselves. And seeing someone who has the same personal responsibility, moral, ethical beliefs results in a healthier populace and fewer people who need expensive medical care.
2
My son and daughter-in-law have a policy that they can't afford to use. The premiums doubled this year and their deductible is $13,000. Once again the millenials get hit for the benefit of us middle-agedand old people. And the reason for that is that once again the Democrats wanted to do the right thing, but not at the expense of Big Insurance or Big Pharma. Medicare for All is the only way to get reasonable health insurance for everyone. We don't need to have 10-15% of our health care dollars going to insurance company profits. At the very least we should have a public option to show what can be done.
26
What good does it do if you can wait until you're sick to sign up, get expensive treatment, and then opt out again?
17
Well, consider the alternatives:
1. They have no insurance, go to the hospital or doctor, are unable to pay the "retail" charges, and the rest of us get stuck with the bill, indirectly
2. They have no insurance and their conditions go untreated for months or years, until either it becomes critical or they die.
3. They have "faux insurance" that does not provide coverage, in which case, you're back to either options 1 or 2.
Even if temporary, they receive the care they need, are only responsible for the negotiated rates through the insurance plan, and we don't get stuck with the bills. It's not a perfect solution, but it's certainly better than what it used to be.
1. They have no insurance, go to the hospital or doctor, are unable to pay the "retail" charges, and the rest of us get stuck with the bill, indirectly
2. They have no insurance and their conditions go untreated for months or years, until either it becomes critical or they die.
3. They have "faux insurance" that does not provide coverage, in which case, you're back to either options 1 or 2.
Even if temporary, they receive the care they need, are only responsible for the negotiated rates through the insurance plan, and we don't get stuck with the bills. It's not a perfect solution, but it's certainly better than what it used to be.
1
You can only do that if you happen to get sick during the open enrollment period at the end of the year. Since most people can't predict when they're going to get sick or injured and need expensive treatment, it would be risky to try to game the system that way.
1
Exactly. It's like waiting to get car insurance until after you've had an accident and expecting the new policy to cover it.
3
Universal healthcare is a civil right for human beings because without it, all those other civil rights are secondary.
24
How did we ever get a nation without universal healthcare or insurance?
2
Yes but who pays for it? What is covered? And how can a country care for its own citizens if a large part of its population is 'undocumented' and unaccountable?
Not so simple in the real world.
Not so simple in the real world.
6
To those who opine in favor of Obamacare , you continue to ignore the facts:
1. We the people, were lied to by Obama. He said costs would go down and we could keep our current Drs if we wished.
2. Obama and his minions failed to think into the future as to what this impact was going to have to employment. My brother-in-law had to let 32 of his staff of 75 go as he could not afford to keep them on as it ate into HIS pocket as the owner of the company...I am certain that this is NOT a singular occurrence
3. With our increase in native population and illegals in this country, the costs will continue to go up impacting middle class (50-125k/yr) mightily.
I look forward to repealing this heinous law that was rammed down our throats when the GOP wins the White House in November.
Thank you
1. We the people, were lied to by Obama. He said costs would go down and we could keep our current Drs if we wished.
2. Obama and his minions failed to think into the future as to what this impact was going to have to employment. My brother-in-law had to let 32 of his staff of 75 go as he could not afford to keep them on as it ate into HIS pocket as the owner of the company...I am certain that this is NOT a singular occurrence
3. With our increase in native population and illegals in this country, the costs will continue to go up impacting middle class (50-125k/yr) mightily.
I look forward to repealing this heinous law that was rammed down our throats when the GOP wins the White House in November.
Thank you
17
"WHEN"
He said you could keep your current doctor if your current doctor was worth keeping.
You've been lied, to, all right - but be clear about who the liar is.
You've been lied, to, all right - but be clear about who the liar is.
5
Those of us who have had insurance through our employers know that we cannot choose our doctors - we have to go to doctors who have agreed to accept our insurance, so there is no free choice of doctors for anyone who has insurance. I'm sorry your brother chose to let half of his staff go because keeping them ate into his profit. But that doesn't mean that everyone shouldn't have access to affordable health care. The law FORBIDS providing insurance to people who not citizens, e.g. undocumented aliens. We would all appreciate it if you would get the facts before you adopt opinions and attitudes about public policy.
2
As a two-time voter for Obama, I now believe that the ACA will turn out to be the biggest corporate money grab ever from American families. The combination of higher premiums and sky-high deductibles have left me afraid to use the healthcare system, and unable to retire and turn my job over to a younger person. And we haven't even yet seen the impact of the 2016 requirements for small business. I consider myself to be a progressive person, but this is just a nightmare.
Bernie Sanders is 100 percent right about single payer healthcare.
Bernie Sanders is 100 percent right about single payer healthcare.
74
Obama sold out to big pharma just like Bush sold out to big oil. We as Americans need to clean house from bottom to top and start all over because the govt and system we have now is a failing and the world knows it. They are shaking their heads in disbelief is how does the the so called wealthiest nation on earth not have single payer healthcare and people not living great lives.
20
We have total wages of $7 trillion, and spend $3 trillion a year on health care. Of that, $1 trillion is paid for by Medicare and Medicaid. In order to pay for the rest, therefore, we would need a 2/7 tax on all wages. And that is 28% in additional payroll tax across the board.
Congress knows that if they imposed such a tax, the voters would string them up from lampposts. Even the legislators in Vermont blinked when they saw what the bill would be.
The correct answer is no schemes of payment, but finding ways to cut costs.
Congress knows that if they imposed such a tax, the voters would string them up from lampposts. Even the legislators in Vermont blinked when they saw what the bill would be.
The correct answer is no schemes of payment, but finding ways to cut costs.
8
Um, people?
Congress drew up the ACA, not Obama. Yes, he signed it, and yes, there are costs associated with it. But you can blame it on, primarily, conservative Democratic senators, like Joe Lieberman, that it didn't produce a single-payer, national health system.
Congress drew up the ACA, not Obama. Yes, he signed it, and yes, there are costs associated with it. But you can blame it on, primarily, conservative Democratic senators, like Joe Lieberman, that it didn't produce a single-payer, national health system.
8
It should be noted that Blue Cross Blue Shield is a non-profit that is making so much net revenue or profits and have such high reserves that some are questioning whether non-profit designation is appropriate.
34
Thirty-three people who served as the CEO of a Blues plan for some or all of 2014 collectively earned more than $26 million in salary and about $102 million in total compensation, which includes bonuses, 401(k) retirement contributions and other incentives, according to data supplied by state regulators.
The CEOs of the Big Five for-profit health insurance companies all took home at least $10 million in 2014, according to each insurers' annual filings with the Securities and Exchange Commission (SEC).
The CEOs of the Big Five for-profit health insurance companies all took home at least $10 million in 2014, according to each insurers' annual filings with the Securities and Exchange Commission (SEC).
2
Insurance companies are destroying the health of American citizens. I am sick and tired of anyone who tries to defend them. They are parasites that should be gotten rid of. Obama care has done very little for patients except force them to pay for limited services that they can pay for, out-of-pocket without having to hand out checks every month to insurance companies for nothing. The deductibles are so high, it makes no sense to have health insurance at all. The only way we can control costs and keeps citizens healthy is to implement the single-payer universal healthcare or apply Medicare for every citizen. Short of that we're back to square one.
28
Hillary says we cannot have Medicare for all, and she is winning the Democratic primaries.
2
There is no such thing as "single payer". The "payer" would be the millions who actually work and pay income taxes.
2
It would be great if a study could show if we are spending less of the GDP on healthcare now. It would be great if we knew the use of ER had decreased. It would be impossible for a program of this size not to benefit many, but at what cost? Many people have had their finances damaged by the ACA.
5
many insurers said they had been aware of a pent-up demand for health care, but had underestimated how much care their new customers would require."
Before Obamacare, insurance companies could cherry pick who they would cover and they could deny coverage for any pre-existing conditions. Therefore, sick people got sicker, because they could not get insurance coverage. Fortunately, Obamacare demands that insurance companies cover pre-existing conditions, so the insurers have to cover those patients who they denied coverage for in the past.
Obamacare also requires insurance companies to cover mental health conditions as well as physical health conditions. In the past, insurers did not cover mental health problems and acted as if mental health was not part of health care. As the years goes by, and as the Affordable Care Act, also known as Obamacare, takes hold in our nation, the people in our country will be healthier, thanks to the perseverance and courage of President Obama and his desire to do the right thing for all Americans and not just for the privileged few.
Before Obamacare, insurance companies could cherry pick who they would cover and they could deny coverage for any pre-existing conditions. Therefore, sick people got sicker, because they could not get insurance coverage. Fortunately, Obamacare demands that insurance companies cover pre-existing conditions, so the insurers have to cover those patients who they denied coverage for in the past.
Obamacare also requires insurance companies to cover mental health conditions as well as physical health conditions. In the past, insurers did not cover mental health problems and acted as if mental health was not part of health care. As the years goes by, and as the Affordable Care Act, also known as Obamacare, takes hold in our nation, the people in our country will be healthier, thanks to the perseverance and courage of President Obama and his desire to do the right thing for all Americans and not just for the privileged few.
28
As the years go by, more and more people will fail to renew their policies and pay the onerous premiums. That's what the future holds.
When "all Americans" omits 30 million people, it falls short of a home run on its best day. The other comments here illustrate why it's not working--it was a transfer of enormous and wasted funds from taxpayer and consumer to the pockets of insurance companies, plus a layer of NGOs.
Obama took single payer off the table before considering it as an option. That would have been the solution. We're now stuck in a costly quagmire that's further entrenched an entity that has nothing to do with delivering medical care--insurers--and it'll take a strong-willed, strong-minded president with a lot of support to make this right. Obama gave us an unaffordable fix.
When "all Americans" omits 30 million people, it falls short of a home run on its best day. The other comments here illustrate why it's not working--it was a transfer of enormous and wasted funds from taxpayer and consumer to the pockets of insurance companies, plus a layer of NGOs.
Obama took single payer off the table before considering it as an option. That would have been the solution. We're now stuck in a costly quagmire that's further entrenched an entity that has nothing to do with delivering medical care--insurers--and it'll take a strong-willed, strong-minded president with a lot of support to make this right. Obama gave us an unaffordable fix.
8
If you can recall how hard it was to get insurance companies to agree to cover pre-existing conditions, you may understand that it will take patience to develop a system where insurers will no longer be in control. I do believe that Obamacare is an improvement from what we had before.
1
"cherry-pick"? It's called underwriting. Someone so ignorant of how insurance works is lucky they got the letters right in all those phony degrees listed.
2
I had good Medicare coverage until my BC-BS coverage of prescription drugs. Before even deductibles and co-pays my insurance now EXCLUDES half of my prescription drugs. I have appealed, but I have been turned down. When Bc-Bs does cover medications, they even limit the dosage (to a non-clinical amount) that my doctor can prescribe for certain medications.
13
While I was and still am in favor of the ACA overall it does concern me that the costs of healthcare and annual increases in those costs were not addressed by this legislation. My wife and I get our insurance (BCBS) through her company, a small one with about 35 employees but only about half of the employees choose their company option if a spouse has a better plan. So the pool is small and the premiums are age factored; my wife who turned 65 this year pays a higher monthly premium than a younger employee. This year the new policy's premiums were about the same cost to us but the coverage was significantly lower than last year due to adjustments by the insurer to adapt to the ACA and how it effects their bottom line. Our prescriptions have all gone up in cost as has our copays for general doctors and specialists. Last year a trip to the ER copay was $150, this year it's $400! We also have to pay about 20% of any amount after the first $5000 of coverage for hospitalization or surgeries and there is now an annual cap on what they will pay out for either of us. This is very scary as a few days in a hospital for an unexpected illness can quickly go into the 10's of thousand dollars.
11
If your wife is 65, can't she get on Medicare, and if you are 65, you also?
1
This is why nationalized healthcare works. Everyone is in the pool, and everyone gets preventative care. The United States has made healthcare as difficult as possible. Wake up folks we are falling behind in the world in regards to healthcare, education and infrastructure be we sure have enough money for wars. It is like this if we have enough money for a stupid foolish war then we have enough money to help out at home.
31
Then why is Blue Shield raising rates on plans that are taking no new members?
4
Because money is fungible, and they can use the money from these plans to subsidize the plans that are bleeding money.
1
Instead of going to ER's for expensive, uncompensated charity care, the patients have insurance now. Win win.
9
Abe
Try visiting your nearest emergency room like I did 3 weeks ago when I had to take my wife in for an injury. I had not a problem as I have private insurance. All of the others appeared to have been waiting for hours....as they were uninsured. This ACA is a failure. Pure and simple
Try visiting your nearest emergency room like I did 3 weeks ago when I had to take my wife in for an injury. I had not a problem as I have private insurance. All of the others appeared to have been waiting for hours....as they were uninsured. This ACA is a failure. Pure and simple
2
I'm sorry, but you're dreaming. Yes, some who previously might have gone to the ER are insured, but they are often covered by policies with large deductibles and out of pocket costs which they cannot afford. It is not a win for them, at least in the eyes of many so affected. They still are on the hook for expenses, many (according to what one reads) still don't go to a doctor for many things because of the co-pays, and ER's are still treating uninsured or underinsured patients.
2
Ah, Chaz from London, wouldn't it be wonderful if we could all afford your private insurance?
"Pure and simple" is right. Simple for sure, but the question is, "pure what?"
"Pure and simple" is right. Simple for sure, but the question is, "pure what?"
The Affordable Care Act is a disaster. I'm a Dem and voted for Obama, but tI can't support the ACA. I've had health insurance for 30 years, rarely use it, and it now costs so much for my family of four that it is barely worth even having. My premiums have doubled and the deductible at $5,000 means that insurance is only advantageous if something serious happens. Worse, my sister died of colon cancer and I'm going in for a five-year colonoscopy (OK, you can snicker here). Because I have a family history of colon cancer, insurance won't cover the colonoscopy and I'll have $3,000 out of pocket. Meanwhile, people who haven't had insurance until now, and who through their own actions such as drug use and unhealthy diets, get affordable coverage and treatment. Where is the fairness in that?
35
There isn't any. There should be some way to cover everyone without hurting people like you and me.
1
It has in many ways been a disaster. My deductible for just me is now $6,000 and I lost the have lost the doctor visits with co-pay. My premium has soared from $335 per month to $600 per month.
I keep telling myself it did also help many previously uninsured people, but there is no question there was a better way to cover everyone. Now I fear this is all we will ever have and eventually it will self-destruct and we will be back where we started.
I keep telling myself it did also help many previously uninsured people, but there is no question there was a better way to cover everyone. Now I fear this is all we will ever have and eventually it will self-destruct and we will be back where we started.
1
"I've had health insurance for 30 years, rarely use it,"
It's insurance, dude, not a savings plan. It is there to protect you from the costs of the car wreck you didn't cause or the appendectomy you never saw coming.
Only a troll whines about his own good health. Don't be that guy, 'kay?
It's insurance, dude, not a savings plan. It is there to protect you from the costs of the car wreck you didn't cause or the appendectomy you never saw coming.
Only a troll whines about his own good health. Don't be that guy, 'kay?
5
Conflict of interest.
1
I now pay $850 monthly for my wife and I, with a $12,000 combined annual deductible, to a major carrier. Of course we never reach the deductible - and it just keeps rising! The premium meanwhile is 50% more than I paid three years ago, pre-ACA. Last year I paid $600 per month - but the policy was "non-ACA compliant" and we are looking at a 2% penalty on our gross income for 2015.
I am not wealthy, and I am not poor. But I know we have been cheated and deceived. I detest Trump - but I certainly understand the source of all his supporters' anger.
The ACA was nothing but political cronyism on a colossal scale, a momentous sop to the BlueCross/UnitedHC/Kaiser cartel that paid Washington to create this utterly corrupt arrangement - now Washington and its big-insurance cronies laugh at Americans trying to be self-reliant. Let us live our lives. Give us true options. Deregulate health care now.
I am not wealthy, and I am not poor. But I know we have been cheated and deceived. I detest Trump - but I certainly understand the source of all his supporters' anger.
The ACA was nothing but political cronyism on a colossal scale, a momentous sop to the BlueCross/UnitedHC/Kaiser cartel that paid Washington to create this utterly corrupt arrangement - now Washington and its big-insurance cronies laugh at Americans trying to be self-reliant. Let us live our lives. Give us true options. Deregulate health care now.
29
Blame goes to the corporations ... again.
The US has, by far, the most expensive health care and we use far more and more expensive prescription drugs. But up to now, we have done so in an atmosphere where only wealthier people could afford them. The model was to transfer massive amounts of money to people in the health care industry by building excessive demand for something that cost too much.
People who couldn't afford it were previously invited to die under a bridge.
Now, we are trying to adapt part of that model ... the supply part ... without changing the rest of it. It's a formula for national bankruptcy.
The US has, by far, the most expensive health care and we use far more and more expensive prescription drugs. But up to now, we have done so in an atmosphere where only wealthier people could afford them. The model was to transfer massive amounts of money to people in the health care industry by building excessive demand for something that cost too much.
People who couldn't afford it were previously invited to die under a bridge.
Now, we are trying to adapt part of that model ... the supply part ... without changing the rest of it. It's a formula for national bankruptcy.
7
Maybe it just reflects our freedom to use inequality for the benefit of the wealthy.
1
Actually, if you go back to the beginning, healthcare was provided to American workers during world war II as a way of providing additional "pay" at a time when wages were frozen. So, in the beginning the program was set up to enrich the common worker. However, since the end of the war, this program became entrenched and American corporations and the insurance industry found away to enrich themselves at the expense of the common people, en masse.
The program is now unsustainable with nearly 10,000 people per day aging into Medicare. There is no choice but to drastically cut benefits and place limitations on who gets a transplant, knee replacement, cancer therapy. In order to change to a single payer system - it will take the American people to vote in true representation. The ACA was an attempt to fit national healthcare into the existing model - but it is also unsustainable and I'm sure in 3 years time we'll hear all about it.
I wouldn't expect any changes if you continue to vote republican - with the democrats there is the possibility - with someone like Sanders it's more likely than any other candidate.
But first, the sleepy American public will have to wake up from the entertaining Cruz/Trump soap opera. Right now, our politicians are moving our cheese.
The program is now unsustainable with nearly 10,000 people per day aging into Medicare. There is no choice but to drastically cut benefits and place limitations on who gets a transplant, knee replacement, cancer therapy. In order to change to a single payer system - it will take the American people to vote in true representation. The ACA was an attempt to fit national healthcare into the existing model - but it is also unsustainable and I'm sure in 3 years time we'll hear all about it.
I wouldn't expect any changes if you continue to vote republican - with the democrats there is the possibility - with someone like Sanders it's more likely than any other candidate.
But first, the sleepy American public will have to wake up from the entertaining Cruz/Trump soap opera. Right now, our politicians are moving our cheese.
1
As a person who has been on the Affordable Care Act since it's inception, my biggest concern are the cost increases, which to date, have been completely paid by the consumer. I had a an affordable($120) Silver plan my first year that increased dramatically for year 2, so I switched to a Bronze plan that cost $146 a month. But the 3rd year, this year, 2016, the Bronze plan rose to $206. The entire increase is paid by the consumer, so for me, that was a 41% increased in payments. The government subsidy has not risen to cover ANY of the increase. As people that need care increases the rolls, the costs rise but the government subsidy does not and that is a problem. There is nothing less than Bronze, so I am stuck with a increasingly costlier plan with a $5500 deductible. It is better than no coverage but $5500 is a lot to pay first when I get sick. The subsidies must increase to offset some of the provider increases or it will no longer be affordable.
7
Obamacare did not go nearly far enough. Single payer is the only sensible way to approach this problem.
2
Welcome to the real world.
Health care costs have never been addressed. This was always going to be a problem. We need to look at health care systems in other countries which do work and modify our approach. Insurance costs will continue to rise as people utilize the insurance they are paying for, so unless and until health care costs are contained, rising premiums and increased deductibles will continue to rise. People with high insurance deductibles, essentially have catastrophic coverage.
We need some form of single-payer insurance that is reasonable for our country. It can be done. If we can spend trillions on war, we can afford health care. Other countries have accomplished the goal of providing decent health care for their citizens. We can as well.
We need some form of single-payer insurance that is reasonable for our country. It can be done. If we can spend trillions on war, we can afford health care. Other countries have accomplished the goal of providing decent health care for their citizens. We can as well.
9
Single-payer is just a scheme of payment. If nothing else changes, how would that reduce costs? The doctors and hospitals would continue to send giant bills, they'd just send them to the government instead of the insurance companies.
2
We borrowed billions for two disastrous wars and we didn't say a word. It didn't really effect our pocket book and we said it was for the common good. Now our health insurance rates go up to pay for overpriced health care and we freak out. Why, cause it is personal and it is for the common good.
2
For many in the middle class, there has been little wage growth. Much of that is caused by increasing health care costs for their employers that otherwise would go towards wages.
Now others without employer insurance must pay an increased portion of their income towards health care because of the "tax" of covering these new, expensive entrants.
Countries with universal health care such as Britain, France, and Canada have very high tobacco taxes to pay for costs. The US Federal tax of $1.01 did not increase at all. Thus, others are made to foot the bill.
We should follow the leadership of Britain, France, and Canada and increase the tobacco tax to compensate for the greater health care costs of the ACA instead of taking that money from wage earners.
Now others without employer insurance must pay an increased portion of their income towards health care because of the "tax" of covering these new, expensive entrants.
Countries with universal health care such as Britain, France, and Canada have very high tobacco taxes to pay for costs. The US Federal tax of $1.01 did not increase at all. Thus, others are made to foot the bill.
We should follow the leadership of Britain, France, and Canada and increase the tobacco tax to compensate for the greater health care costs of the ACA instead of taking that money from wage earners.
4
There is an old adage, "guns or butter." We, as a nation, have simply preferred guns. This to appease our ceaseless appetite for fuels.
Travel to other countries in Europe and Asia and it's a completely different mind-set. They aren't involved in geopolitics and nation building like we are (all euphemisms).
Travel to other countries in Europe and Asia and it's a completely different mind-set. They aren't involved in geopolitics and nation building like we are (all euphemisms).
1
The people in our country who never had access to health care are now able to go to the doctor and get healthy. And they are doing it in droves.
Although some might complain, the reality is that we have done the right thing. And too bad for Blue Cross, the most expensive health insurance out there. Maybe Blue Cross should be made to become more efficient before we agree to any rate hikes.
Finally.
Although some might complain, the reality is that we have done the right thing. And too bad for Blue Cross, the most expensive health insurance out there. Maybe Blue Cross should be made to become more efficient before we agree to any rate hikes.
Finally.
4
Of course they are sicker...they've had no or little access to health care for years thanks to republican efforts.
8
However, after having a fistula repaired and his colostomy reversed, my brother is so strong and healthy I don't have a hope of telling him what to do anymore. He worked through his illness, too, but was so miserable how could anyone tell?
"Because insurers’ premiums have to cover their medical expenses ..." Dig a little deeper, Mr. Pear.
Because insurers’ premiums have to cover their CEOs eight-figure salaries. Because those who do nothing to alleviate or treat human illness are empowered to make money ON human illness. Because America is "exceptional" in that way.
Because insurers’ premiums have to cover their CEOs eight-figure salaries. Because those who do nothing to alleviate or treat human illness are empowered to make money ON human illness. Because America is "exceptional" in that way.
25
It's called free enterprise, free to profit off the backs of the less enterprising.
How is healthcare a human right when you are asking other people to take care of you for below cost? Do you tell the restaurant owner or grocery store that you are hungry so they are obligated to feed you? Do you tell the clothing store owner that you need clothes so they are obligated to give you clothes? Why are other people obligated to take care of you?
11
According to the liberal/progressives, medical care, healthy food and affordable housing (anywhere you want to live) are all basic human rights and they have no hesitation to take money from those to have it to buy the votes of those who want more "free stuff".
5
For I was an hungred, and ye gave me meat: I was thirsty, and ye gave me drink: I was a stranger, and ye took me in. Matthew 25:35.
4
You used the term, "below cost".
The whole problem is over what should be included in the "cost" of health care.
My local hospital (which has a monopoly on the region, by the way) has a lobby that looks like a five star hotel and an electronic sign in front of their extensive garden that looks like something that belongs in Las Vegas. And that doesn't begin to cover the Mercedes, Porsches, and Hummers in the employee parking lot. And it doesn't cover the grand life style of insurance company executives who add NOTHING to the health of Americans.
The whole problem is over what should be included in the "cost" of health care.
My local hospital (which has a monopoly on the region, by the way) has a lobby that looks like a five star hotel and an electronic sign in front of their extensive garden that looks like something that belongs in Las Vegas. And that doesn't begin to cover the Mercedes, Porsches, and Hummers in the employee parking lot. And it doesn't cover the grand life style of insurance company executives who add NOTHING to the health of Americans.
6
The Young healthies are supposed to offset this according to the ACA think tankers - what happened?????? Oh yeah - they'd rather pay the penalty...
8
I think you are jumping to the conclusion this is a bad thing. People who have been marginalized are getting WELL! Imagine THAT!
3
Actually, from the looks of the report as described in the article, the information is biased and misleading. It does not quantify exactly how many new insured party's did not incur higher costs than previous insured parties. Only that the newly insured incurred higher health care costs than the previously insured. There is a difference.
No tears for BC/BS. They're telling a patient of mine that an artificial leg (she's an amputee) is COSMETIC even tho her monthly premium is $2000!
12
Now that seems rather silly; are you sure the problem is with the device and not with the supplier? Because BCBS will happily sell me hearing aids I can buy for a third of the after insurance cost at the Costco. The more you know...Costco doesn't take insurance, but their hering aids are the same I could have paid $6000 for.
Devices, this is a specialty in the insurance field, no? My hubby's audiooigist is having a cow over the new regs. Her whole profession is gonna tank because they can't overcharge us anymore!!
Devices, this is a specialty in the insurance field, no? My hubby's audiooigist is having a cow over the new regs. Her whole profession is gonna tank because they can't overcharge us anymore!!
1
Lynn, if you had all the details you might find the supplier is the issue, not the missing limb.
Last time I talked to Barbie, she was telling me the insurer would not OK her lung cancer treatment. I just picked her up because her car quit on her. No hair, so obviously someone cared.
Last time I talked to Barbie, she was telling me the insurer would not OK her lung cancer treatment. I just picked her up because her car quit on her. No hair, so obviously someone cared.
1
Lynn, if she hasn't got a hope of walking again, it is cosmetic. But I know a wealth of people who would str her up for nothing but a fitting!! Especially if she's just sitting! It is so costly it cannot be wasted on those not able to use it. I knew a man who built one for his son, and then didn't he cash in!
1
Perhaps we should look at all the "confounding" variables as we call them in public health to make these figures for health care expenses allegedly so high. You denied a large percentage of the US population health care coverage for decades if not able to be on Medicare or Medicaid - so stands to reason they will now get care for health problems they probably sought in crisis in the emergency room. It will also wash in the end. Be very careful with the political agenda on behalf of insurance industry in reporting this. After all - we still have abysmal health care outcomes in the world compared to other first world countries. Health care to survive is a human right - not a political and financial toy. I bet the executives at BC BS making 3 million a year have no health care worries. Disclaimer: I am highly educated and purchase insurance on an exchange because my teaching and research positions do not come with "benefits".
10
We, as Americans, should be ashamed of the conditions before ACA that this article reveals.
What kind of people want to remove the sick from the care they now have-while they maintain theirs? Those who call Obamacare a "scam" in paticular?
What kind of people want to remove the sick from the care they now have-while they maintain theirs? Those who call Obamacare a "scam" in paticular?
7
Are we saving money yet? I am a retired Federal employee with health insurance under Aetna. Prior to Obamacare, I paid about $300 a month. Then it starting escalating, a lot. When I complained in this forum, readers assured me it would all work out and I would see the benefit of it. Now I pay almost $1,100 a month. Explain to me again why this is good.
23
It's time for you to stop working and enjoy retirement. Then your income won't be eating you alive. But that's how much insurers say it costs to insure the employed.
1
No responsible person promised that healthcare expenses would freeze. But plenty of conservative talk-radio hosts erected that straw man.
Good thing ACA covers straw men's erectile dysfunction.
Good thing ACA covers straw men's erectile dysfunction.
2
Before Obamacare, my health insurance premiums escalated every single year ... because I got older.
I guess you retired before you qualified for Medicare. Once on Medicare my premiums (for Medicare + private insurance) went from $1800 per month to less than $200 per month.
I guess you retired before you qualified for Medicare. Once on Medicare my premiums (for Medicare + private insurance) went from $1800 per month to less than $200 per month.
1
Exactly. Those of us who could not afford health insurance or could not get it through our employers had NO way of accessing the health care we needed (I, for instance, am an adjunct professor with no benefits whatsoever). With the ACA I have been able to see doctors and lo and behold, do have medical issues that require treatment. I believe what this article demonstrates is that there are plenty of folks out there who have needed access to medical for a long, long time and have had no way to get it. Perhaps over time, as more and more people can seek preventative treatment, etc., the numbers will balance out.
6
A, it is not affordable; B, you have to wait months to see a doctor, if you can find one who is taking new patients, C, you have to pay for coverage you can't possibly need such a pregnancy care for the over menopausal woman, and D, we do not have and are not training enough doctors to take care of our population.
And that is just for starters
And that is just for starters
8
Add E. Doctors are spending more and more time on paperwork rather than treating patients.
7
C is a red herring. Your policy is priced based on actuarial data on what care is used by someone in your age bracket. If you're a woman over age 50, for instance, then the cost to you of the pregnancy coverage is basically zilch. The requirement for pregnancy coverage is to ensure that women who can have babies aren't denied the option.
1
The provocative, cutting-edge reporting and analysis in this piece is, I guess what we are paying for!
1
We are paying the CEOs to hurt us.
3
How much money was BCBS paid by the federal government to cover the premiums and treatment costs of the subsidized enrollees? It's hard to tear up for a multi-billion dollar health insurance company. Acting like the government isn't off-setting the costs and discussing the amount that is worth to the insurers is the missing half of this story.
4
"It's hard to tear up for a multi-billion dollar health insurance company."
We did it with telephones. When I was a young man, you couldn't hook ANYTHING to Ma Bell's telephone wires. You couldn't own your own phone. Innovation in telephones didn't exist.
Then we broke ol' Ma Bell into a bunch of little baby bells and before long, telephones were a whole new world.
We did it with telephones. When I was a young man, you couldn't hook ANYTHING to Ma Bell's telephone wires. You couldn't own your own phone. Innovation in telephones didn't exist.
Then we broke ol' Ma Bell into a bunch of little baby bells and before long, telephones were a whole new world.
1
When the government told employers they could bug out on their half of the payroll tax by paying us in ever increasing health insurance, our wages shrunk and as expected this incentivized skim got rolling.
7
Then the cost grew so large, even our payroll tax jilting employers got miffed and passed the costs on to us with our frozen wages. Seems some grifts outgrow their original players.
1
The way things are going with the premiums and the narrow networks we're going to be right back where we were before the ACA. We do need a single payor universal access health care system so that people can receive the care they need no matter what their employment status is, where they are when they need the care, etc. At this point in America we should not be basing the care we receive on whether or not we can afford it. I'm thinking of the care we typically need, not the extraordinary care we give when it's inappropriate: diabetes care, cancer care, vaccinations, blood tests, accidents, medication, follow up care, in other words the bread and butter of life.
6
A 26 story medical tower is being built in Tijuana, Mexico. Should be ready for patients in 2019. Their charges will be much lower than in the U.S. Lots of people already go to Mexico for treatment. Sounds pretty good to me.
4
Yeah ... this is how our automobile industry got transferred to Japan, Korea, Mexico, et. al.
Don't fix the system. Just transfer it to other countries. That'll work!!!
Don't fix the system. Just transfer it to other countries. That'll work!!!
2
The last thing Democrats want to talk about is Obamacare. Already, we heard enough defense arguments about the law by Hillary Clinton, whose running for Obama's mantle in 2016. Let's face it: ACA is a terrible joke on American consumers. Middle Class workers are going financially bankrupt because of outrageous skyrocketing premiums and copays related to their insurance coverage. All this because of a political party in congress that voted on a particular bill that was written by the Health insurance industry, which uses invasive language to force Americans to buy private health insurance exchanges or face penalties by the IRS.
It's no secret that Clinton and the Democrats who backed ACA are brought and paid for by the Health Insurance cabal. Meanwhile, Bernie Sanders talks about Universal Health Care coverage for all Americans on the campaign trail and yet, Clinton accuses him of being too radical with Pie in the Sky notions. If anyone should be making apologies to the financially unstable middle class, its Hillary Clinton and the Democrats who backed Obamacare. This law should be repeal---and yet, I agree with the GOP on that particular issue regarding Obamacare. No family in this country should be sent to the poorhouse over skyrocketing costs of health care, especially when the government is telling you to buy private health care insurance that is basically unaffordable.
It's no secret that Clinton and the Democrats who backed ACA are brought and paid for by the Health Insurance cabal. Meanwhile, Bernie Sanders talks about Universal Health Care coverage for all Americans on the campaign trail and yet, Clinton accuses him of being too radical with Pie in the Sky notions. If anyone should be making apologies to the financially unstable middle class, its Hillary Clinton and the Democrats who backed Obamacare. This law should be repeal---and yet, I agree with the GOP on that particular issue regarding Obamacare. No family in this country should be sent to the poorhouse over skyrocketing costs of health care, especially when the government is telling you to buy private health care insurance that is basically unaffordable.
11
"I agree with the GOP on that particular issue ..."
Did somebody in the GOP say that? Funny. I never heard that. My impression is that the GOP is the "let 'em die under a bridge if they can't pay" party.
Did somebody in the GOP say that? Funny. I never heard that. My impression is that the GOP is the "let 'em die under a bridge if they can't pay" party.
3
Unless and until we get rid of private insurance from health care nothing is going to change: cost, quality of care, and eventually health of people. That is why one candidate running for president is asking for a single-payer medicare-for-all plan.
Most of Europe and other nations have achieved this cutting costs and generally improving health of the population. Will anyone in US listen?
Most of Europe and other nations have achieved this cutting costs and generally improving health of the population. Will anyone in US listen?
7
For corroboration I suggest:
http://www.huffingtonpost.com/2013/03/26/charts-health-care-costs-americ...
http://www.huffingtonpost.com/2013/03/26/charts-health-care-costs-americ...
I've lived under more than one so called single payer system. The last one in England was horrible. Yes, the medical care is so called free and available. What I experienced was slow and insensitive care. Doctors were mostly interested in handing our prescriptions rather than actually diagnosing an issue. The hospitals were dirty with poor service and care. There seemed to be a lack of money to fund new and modern diagnostic equipment, i.e. ct scanning equipment was rare. Wait times for various procedures were months and sometimes years away. I hear the same issues with Canada from their citizens that live near me. I don't have a solution. I do know that anything the government runs and regulates is inefficient and fraud is prevalent. So, be careful what you wish for.
5
Shh...stop that. Everywhere else but the nasty US is butterflies and rainbows and unicorns, where health and healthcare are utopian. If we adopted single payer tomorrow we would have no more sick people, no waits, no denials or restrictions on any coverage whatsoever (for that would be "unfair"), no more greedy companies or vile corporations, all the newest drugs and procedures, and all at much, much lower costs and savings to us all. Best of all, it would be totally FREE! Yeah :)
Oh, wait, is it not that easy??
Oh, wait, is it not that easy??
5
Most of the people offering comments here already know what the problem is:
We have the most inefficient health care system in the world and therefore the most expensive.
Some people clamor for a single-payer system and mention Bernie as the solution.
That is plainly naive. A single payer system will never become law, regardless of who becomes president.
Our politicians, most of them beholden to the special interests profiting from health care, would never pass such a law.
We the people, it is not us, it is the doctors, health insurance companies, hospitals, pharmaceutical companies, medical equipment companies and others.
We the people, it is not us, it is only those that organize and hire lobbyists.
We have the most inefficient health care system in the world and therefore the most expensive.
Some people clamor for a single-payer system and mention Bernie as the solution.
That is plainly naive. A single payer system will never become law, regardless of who becomes president.
Our politicians, most of them beholden to the special interests profiting from health care, would never pass such a law.
We the people, it is not us, it is the doctors, health insurance companies, hospitals, pharmaceutical companies, medical equipment companies and others.
We the people, it is not us, it is only those that organize and hire lobbyists.
6
Most of us would have liked a "government" option plan for the marketplaces, an expansion of Medicare (see Al Gore, 2000) to age 55 and the requirement for states to cover the poorest (and sickest) under Medicaid until the pent up demand for life-saving health care was addressed. The GOP and conservative Democrats refused to accept those reasonable provisions. So we ended up with a very flawed model that would take years before the for-profits could make money off the poorest and sickest Americans and years before the state you lived in determined your access to health care and possibly whether you and your loved ones lived or died from disease.
The expectation of the legislative process is that compromise will deliver a better law than an ideological experiment (see Kansas and LA). The expectation is that our Senate and Congress will correct a law's errors. The choice of the GOP to doom millions of Americans to lives without access to health care by refusing to participate in the normal legislative process and refusing to recognize the real needs of millions has resulted in insurance companies losing money and Americans losing their lives. We deserve better.
The expectation of the legislative process is that compromise will deliver a better law than an ideological experiment (see Kansas and LA). The expectation is that our Senate and Congress will correct a law's errors. The choice of the GOP to doom millions of Americans to lives without access to health care by refusing to participate in the normal legislative process and refusing to recognize the real needs of millions has resulted in insurance companies losing money and Americans losing their lives. We deserve better.
5
We do deserve better but it is a complex mess. Yes, the GOP surely hasn't helped, but we have a president who was more concerned with power (of the "I won" form) and the modern concern about his legacy to want to in anyway, shape or form consider working with those who disagreed with him.
We also have legislators and supporters who write overly complex and poorly crafted laws and then want to sit back and allow unelected judges to interpret and divine what they "really meant" and then fix it for them to how "it should be", despite that not being their constitutional role or duty.
We also have legislators and supporters who write overly complex and poorly crafted laws and then want to sit back and allow unelected judges to interpret and divine what they "really meant" and then fix it for them to how "it should be", despite that not being their constitutional role or duty.
1
@ George S. No, I won't accept the "Big Lie" being circulated since the early days of President Obama's presidency that he is the one who refuses to work with Republicans. I do think he--and all but the most cynical of his advisors--were shocked to their cores by Sen. McConnell and his cohorts' determined effort to de-legitimize his presidency and obstinate refusal to cooperate on solving the big problems hurting Americans such as no access to life-saving health care. All of his early statements and all of his team's actual behind the scenes work seems to have been to find the point at which real progress could be made together-- not for a legacy, but for solving real problems for real people.
Have no doubt, the economic situation left by Bush II was a crisis, far more serious than has been revealed or than anyone on Mr. Obama's team expected. And the GOP obstruction in place from Day One through now with the SCOTUS nomination process took years for Mr. Obama to accept and challenge.
Our democracy needs two effective political parties to work. Due to short-term, win-at-all-cost thinking by the GOP, we only have one party functioning at the national level. As reality sets in for the current Red States, the GOP's extreme positions that don't work for most voters (Kansas?) in the real world, will cost them power because they are not working toward the US being better for everyone, the GOP is working to obstruct any policy or idea that is in conflict with their ideology.
Have no doubt, the economic situation left by Bush II was a crisis, far more serious than has been revealed or than anyone on Mr. Obama's team expected. And the GOP obstruction in place from Day One through now with the SCOTUS nomination process took years for Mr. Obama to accept and challenge.
Our democracy needs two effective political parties to work. Due to short-term, win-at-all-cost thinking by the GOP, we only have one party functioning at the national level. As reality sets in for the current Red States, the GOP's extreme positions that don't work for most voters (Kansas?) in the real world, will cost them power because they are not working toward the US being better for everyone, the GOP is working to obstruct any policy or idea that is in conflict with their ideology.
1
The underestimation of expected greater heath care needs among the newly insured is a good overall measure of resistance to doing right by the American people. It's not a flaw in the ACA. The expected greater initial costs could not be known in advance. They had to be estimated. Against political or any kind of headwinds, even "objective" estimates are more likely to be lower than higher than need. Anyone who has ever undertaken any major project, for example, refurbishing one's own home, understands how this happens and almost inevitably happens even with the best intentions to be "realistic."
The article might have more informatively distinguished between increased demand due to untreated chronic conditions and higher demand for merely delayed medical attention. Untreated chronic conditions will add long term costs after the initially higher diagnostic phase. Though proper treatment, say of diabetes, will head off even higher costs down the road, the cost of long term maintenance treatment will be baked into the system. With pent up demand for merely delayed treatment, there will be no long term cost burden. My wife is a case in point. She lived for years with a growing, disfiguring lump under her eye, periodically paying to have it tested for cancer. A preexisting condition. When we were able to obtain insurance through the ACA, we could afford to have it removed in the first year. Since then we have had no occasion to use our medical coverage. Thank you, President Obama.
The article might have more informatively distinguished between increased demand due to untreated chronic conditions and higher demand for merely delayed medical attention. Untreated chronic conditions will add long term costs after the initially higher diagnostic phase. Though proper treatment, say of diabetes, will head off even higher costs down the road, the cost of long term maintenance treatment will be baked into the system. With pent up demand for merely delayed treatment, there will be no long term cost burden. My wife is a case in point. She lived for years with a growing, disfiguring lump under her eye, periodically paying to have it tested for cancer. A preexisting condition. When we were able to obtain insurance through the ACA, we could afford to have it removed in the first year. Since then we have had no occasion to use our medical coverage. Thank you, President Obama.
6
RRI, Your statement "The expected greater initial costs could not be known in advance", is nonsense. It was and continues to obvious that the system overall would experience higher costs as poor and sick people who have not had access to medical care poured into the system. What other result could there be? Yet, Obama sold the ACA as a means of keeping costs down. Meanwhile, premiums continue to rise along with deductibles for most people. Democrats had temporary control of congress and chose to pus through a complex law that most did not even bother to read. Now that the control of congress is split is it any wonder that the Republicans are unwilling to correct what amounts to bad legislation? We have a broken system of government. Until that changes, expect a broken health care system along with many other problems.
1
My favorite part of all this.
When those of us who knew Obamacare was a scam were warning that this could happen, Obama and his supporters changed the subject every single time.
"Don't you want grandma and little babies to have insurance?"
That was the response when Obama and his supporters were called out on the ACA's scam.
Now the chickens are roosting.
When those of us who knew Obamacare was a scam were warning that this could happen, Obama and his supporters changed the subject every single time.
"Don't you want grandma and little babies to have insurance?"
That was the response when Obama and his supporters were called out on the ACA's scam.
Now the chickens are roosting.
7
ACA is not a scam. No change in discussion. Of course we had a lot of sick uninsured people til the ACA because they worked low wage jobs, or not at all because they were sick. That's the point of insurance, duh.
6
Written by someone who obviously has insurance, has no worries about his/her health or the cost of not receiving needed health care. DC Barrister, you are one of the people here who seems to delight in tearing down something that is supposed to help people. If you think you know all the answers, why not put up a suggestion, or run for office to help change things? The chickens that are coming home to roost are those associated with the GOP, the entire wealthcare industry, and the polling industry which are running things for their benefit rather than the patients who need the care. Illness is no respecter of income level. It would help this country more if we had a single payor universal access health care system rather than the unwieldy, fragmented and inadequate one we have now. And remember, it was the GOP who opposed everything that might help.
4
Well, no. Or rather so you want those that need medical attention to just not have it?? Die in the streets? Is this your idea of an "exceptional country"? Or rather do you want a country that makes exceptions for the poor?
These folks that needed to get insurance that didn't have it before: well guess what: they are WERE going to be headed to the doctor at some point - and a lot sicker and a lot more of a burden on the system - meaning emergency room visits and huge bills that they were not going to be able to pay: meaning the rest of us would have covered the costs in higher insurance premiums - and those folks on the brink would have been wiped out: meaning possibly losing their house: meaning losing financial stability: meaning needing social services.
Beginning to see how this works? There is no free lunch in a society that is interconnected on all levels. Some will be rich, some will be poor, and yet in aggregate all costs are borne by society in some manner or another (unless, of course, you really do want to step over bodies in the street).
So Obama got the toe in the door - much to every selfish republican's great distress - but he did it: he got us on the path to national health insurance. Thanks, Obama.
These folks that needed to get insurance that didn't have it before: well guess what: they are WERE going to be headed to the doctor at some point - and a lot sicker and a lot more of a burden on the system - meaning emergency room visits and huge bills that they were not going to be able to pay: meaning the rest of us would have covered the costs in higher insurance premiums - and those folks on the brink would have been wiped out: meaning possibly losing their house: meaning losing financial stability: meaning needing social services.
Beginning to see how this works? There is no free lunch in a society that is interconnected on all levels. Some will be rich, some will be poor, and yet in aggregate all costs are borne by society in some manner or another (unless, of course, you really do want to step over bodies in the street).
So Obama got the toe in the door - much to every selfish republican's great distress - but he did it: he got us on the path to national health insurance. Thanks, Obama.
4
This is a win-win. Profits and customers are up for the industry.
1
Pure ignorance ~~ that would be wrong ~~ prices are skyrocketing for everyone AND the the industry is losing money
2
Wow, strong words James. My wife and I and other members of the family work in the health care industry, as are many of our friends. Most of us are becoming wealthier, although admittedly a few unfortunates are slipping into the middle class.
What no one is pointing out, including the New York Times and the Obama administration, is that within a generation or two, no one will be coming into the healthcare system with advanced ailments that have gone untreated and are more expensive to treat than to prevent or treat early. Anyone with Obamacare will have had access to yearly checkups and screening, since birth, along with health education, that should hold in check the rising cost of insurance for this reason.
14
That would be because Obamacare will prevent people from guzzling Cokes and Twinkies ? It just treats symptoms ~~ it will actually aid and abet behavior.
3
No, that would be because people will have the ability to see a doctor much sooner.
Is the fact that the newest policy holders under the ACA sicker and more expensive to treat than normal a big surprise. Perhaps it is to Obama who promised that health care costs would decline under the Act, but that never made any sense. Insurers will have to cover these costs either by claiming money under the ACA from government or directly through increased premiums and ever high deductibles. Either way, taxpayers foot the bill.
6
The decline is over a time because people with chronic costly conditions like diabetes can get better care.
2
If memory serves, President Obama did not promise that health care costs would decline under the ACA. He promised that the rate of increase in health care costs would decline. And it has.
7
All of you single payer advocates better be voting for Sanders. Clinton won't take money away from insurance companies, and the Republicans, to a man, would rather you die (just not in the streets) and decrease the surplus population of potential Democratic voters.
8
This stupid system lacks any cost management policies at all. For instance, an angiogram costs about $10,000 at Mount Sinai in New York, but a large percentage of these tests find nothing to intervene in. Huge money could probably be saved by setting up MRI machines to image oxygen-depleted hemoglobin to screen patients for cardiac clots first.
2
Cost management is in the hands of insurance companies who pay a fraction of fair market value of health care. Look at an EOB to see the value of their market strength.
And we'd never have found out until they all paid through the same nose. NOW we can fix this. We got data.
1
“It’s no surprise that people who newly gained access to coverage under the Affordable Care Act needed health care,”
----------------
It is no surprise to me or to any of the other people who said this would be so. It, however, was a surprise to the Obama administration. Unless he was lying to us about that also.
----------------
It is no surprise to me or to any of the other people who said this would be so. It, however, was a surprise to the Obama administration. Unless he was lying to us about that also.
5
@ Michael F, I have no idea what you mean. One of the biggest points President Obama made repeatedly during 2008-09 was that our health care system desperately needed fixing because sick people -- people with "pre-existing conditions" -- couldn't get insurance. Of course he knew they needed health care, and he told us so, over and over again.
3
If my tax dollars are paying for all this- then I would like to see a team effort on behalf of all Americans and ask that people start taking better care of themselves. With small changes in diet and caloric intake and even the most simple exercise plans, anyone can begin to lose weight and lower blood pressure. You want health care? Fine- but start taking better care of yourselves!
6
How dare the government be judgmental and tell us how to live. Better to let the bureaucrats decide how much you should eat, exercise, and take care of yourself, right? And if we don't? Take away their healthcare or punish those people? Well, if healthcare is a right, then you can't do that.
4
Actually, that is not a scientifically based "theory" at all.
Renowned NYT Science write Gina Kolata has written about diet, obesity and weight loss at length -- I suggest you read her book 'Rethinking Thin". It is not true that "small dietary changes" will result in weight loss for most people -- not long term. In fact, dieting is the primary cause of obesity -- not vice versa.
Renowned NYT Science write Gina Kolata has written about diet, obesity and weight loss at length -- I suggest you read her book 'Rethinking Thin". It is not true that "small dietary changes" will result in weight loss for most people -- not long term. In fact, dieting is the primary cause of obesity -- not vice versa.
I think the first thing all Americans should do is form corporations to protect their assets like houses, then transfer their investments and retirement funds to it.
Let's all play on a level field with the big boys.
Let's all play on a level field with the big boys.
3
Please stop calling this "Rube Goldberg" contraption of medical coverage - "affordable". Like the housing bubble and the tech bubble, the escalating bubble of medical costs will soon burst and no one will be able to afford any coverage at all. Hurrah for those who are sick and now covered, condolences for those who pay full price (and rising) with no end in sight.
6
The best way to reduce health care costs is to outlaw health insurance. If people didn't get private sector socialism in the form of insurance, doctors would get a tenth of what they get now.
3
The health of a community, of a nation, is nothing less than a shared asset. Maintaining it at its optimum level is a shared moral obligation, not a profit-driven calculation.
Medicare or some equivalent from cradle to grave.
Medicare or some equivalent from cradle to grave.
13
Then how about having the smokers and overweight diabetics stop picking everyone else's pockets ~~ the moral issue please, is to stay healthy
2
Not a deal breaker, James. That would be part of the package. No objection from me.
Co-pays could be graduated according to one's adherence to accepted medical criteria for maintenance of optimum health in light of chronic or inherited disease conditions, and Part B insurers could adjust premiums accordingly.
Please re-read my first paragraph. If you have a better proposal, put it out there for all to see.
Co-pays could be graduated according to one's adherence to accepted medical criteria for maintenance of optimum health in light of chronic or inherited disease conditions, and Part B insurers could adjust premiums accordingly.
Please re-read my first paragraph. If you have a better proposal, put it out there for all to see.
3
The newly enrolled are sicker and need health care more badly. I wish they had done the study before the ACA, and decided to set up something similar to Medicare for people who were working but did not qualify for insurance due to preexisting conditions. It could have avoided the mess today, and expanded health care in a more humane manner.
1
The biggest howlers i've seen in these comments:
1. Because of Obamacare, I now have to pay over $400 for a checkup and its tests. Nope: the PPACA says that checkups and those tests must come at zero patient costs.
2. Because of O'care, my employer stopped covering me or raised my premiums. First, your boss lied to you: he just wanted to cut costs. Second, your boss is entitled to small-business subsidies of up to 50% to help his costs.
3. Because of O-care, my costs are now twenty or thirty percent of my income. Nope; they're capped at around 9%.
4. Pharmaceutical companies can just cut costs and solve the problem. Nope; those Hep C drugs cost $60-100 thousand for very good reasons: they almost always cure, and they are also cheaper than a transplant. By far. But some drug costs are in fact crazy...and patients bear some responsibility for that, as well as Big Pharma.
5. Bernie Would Fix It All. Nope. If he got full single-payer, you'd essentially lose your employer bennies, and whatever he says, your taxes would zoom up. And you need to look at Medicare: there are premiums, there are co-pays and deductibles, and unless you use a HMO, you pay 20% of costs.
But one thing, because of Obamacare: the donut hole in your pharmacy plan will be gone by 2020.
Sorry, and we badly need the public option. And we should transition to single-payer. But some of these claims are just hallucinatory.
1. Because of Obamacare, I now have to pay over $400 for a checkup and its tests. Nope: the PPACA says that checkups and those tests must come at zero patient costs.
2. Because of O'care, my employer stopped covering me or raised my premiums. First, your boss lied to you: he just wanted to cut costs. Second, your boss is entitled to small-business subsidies of up to 50% to help his costs.
3. Because of O-care, my costs are now twenty or thirty percent of my income. Nope; they're capped at around 9%.
4. Pharmaceutical companies can just cut costs and solve the problem. Nope; those Hep C drugs cost $60-100 thousand for very good reasons: they almost always cure, and they are also cheaper than a transplant. By far. But some drug costs are in fact crazy...and patients bear some responsibility for that, as well as Big Pharma.
5. Bernie Would Fix It All. Nope. If he got full single-payer, you'd essentially lose your employer bennies, and whatever he says, your taxes would zoom up. And you need to look at Medicare: there are premiums, there are co-pays and deductibles, and unless you use a HMO, you pay 20% of costs.
But one thing, because of Obamacare: the donut hole in your pharmacy plan will be gone by 2020.
Sorry, and we badly need the public option. And we should transition to single-payer. But some of these claims are just hallucinatory.
13
NYTs has run their share of The Horror stories on this subject.
First, only poor people should expect not to pay. Anyone who thinks medical care should be free is insane. That's great, because now we got them coverage, too!
I selected a silver plan which balances the co-pays with the deductibles and has a $4000 out of pocket limit. I pay $160 month because I qualify for the subsidy at the level just before qualifying for Medicare. I am happy to pay my share.
I pay for the first $750, they pay for the reaming 90%. I'm down with it and hope to beat them every year by never going over the limit. But I do have a viral infection that is slowly trying to kill me so I will not kill myself trying. Folks who select no deductible are gonna be horrified by the out of pocket limit!! Co-pays add up if you really get sick.
First, only poor people should expect not to pay. Anyone who thinks medical care should be free is insane. That's great, because now we got them coverage, too!
I selected a silver plan which balances the co-pays with the deductibles and has a $4000 out of pocket limit. I pay $160 month because I qualify for the subsidy at the level just before qualifying for Medicare. I am happy to pay my share.
I pay for the first $750, they pay for the reaming 90%. I'm down with it and hope to beat them every year by never going over the limit. But I do have a viral infection that is slowly trying to kill me so I will not kill myself trying. Folks who select no deductible are gonna be horrified by the out of pocket limit!! Co-pays add up if you really get sick.
I, too, have seen some claims in the comments that don't square with the actual law, but I also know from personal experience that the law isn't always followed. I have never had a diabetic eye exam, purportedly covered by Medicare, that is paid until it's been rejected and challenged at least twice, according to my doctors. It can take six months for them to get paid.
I'm entitled to a few so-called routine screening tests that are supposedly free that I've put off indefinitely because I don't trust the system not to hand me a big fat bill on the other side. That wasn't how the program was built, but that's how it's working out for some of us. And that's Medicare!
I'm entitled to a few so-called routine screening tests that are supposedly free that I've put off indefinitely because I don't trust the system not to hand me a big fat bill on the other side. That wasn't how the program was built, but that's how it's working out for some of us. And that's Medicare!
2
Who says they are capped at 9%? Where I live, you are not eligible for subsidy if you make more than 20k a year. Where are you getting this cap from?
2
Bro almost made it, but sadly the hospital had to pay for his emergency colosotomy and bladder repair. Only two months to go to finally be insured for a pre-existing condition that priced him out of the competition.
But now he's all better, a reversal of fortunes, but too late to save the hospital the unfortunate charges. He had to go bankrupt, too. Boo Hoo, like we care!
He's a normal functioning human again and working like a madman! How he managed to keep working under the old system is horror story.
The hospital could have offered him antibiotics for his fistula, but this was not an emergency, accordion to the amazing surgeon who OKed his colostomy. God love you, Mercy!
But now he's all better, a reversal of fortunes, but too late to save the hospital the unfortunate charges. He had to go bankrupt, too. Boo Hoo, like we care!
He's a normal functioning human again and working like a madman! How he managed to keep working under the old system is horror story.
The hospital could have offered him antibiotics for his fistula, but this was not an emergency, accordion to the amazing surgeon who OKed his colostomy. God love you, Mercy!
3
It's no surprise republicans are pushing for more competition. The Obama Administration has basically established a health insurance company cartel with Obamacare. Insurers have increased rates substantially while reducing physician and hospital networks by 30%.
3
Correct. Unlike Presidcnt Obama, I would have started the discussion with a proposal for single -payer universal health care for all, rather than a version of Romneycare (dozens of example abroad). Of course, Obama took that course on the reasonable supposition that he could get at least a few Republican votes for a Republican program. Of course, the climate of the times was not reasonable; Republicans would have said "NO" to anything Obama proposed -- in this case, even to their own program (which focused on the insurance industry).
1
'Demand?" I'd call it need.
And the ACA was written mostly by health insurers and drafted to subsidize and strengthen health insurers.
It's time to remove the extra 10-15% cost burden, as well as ending people still being sued to recover medical debt.. I see it twice a week, when I mediate small claims cases--80% of the cases are medical debt and it's post-ACA debt.
Because it was written by health insurers, payment for medication--including addictive pain medication--is favored over: physical therapy, acupuncture, massage, and MBSR programs for treatment of chronic pain. We're all seeing how well that's worked. Germany, Holland, South Korea, and other nations with universal health care are not seeing a similar "epidemic."
Maybe it's because their health care system isn't controlled by health insurers.
And the ACA was written mostly by health insurers and drafted to subsidize and strengthen health insurers.
It's time to remove the extra 10-15% cost burden, as well as ending people still being sued to recover medical debt.. I see it twice a week, when I mediate small claims cases--80% of the cases are medical debt and it's post-ACA debt.
Because it was written by health insurers, payment for medication--including addictive pain medication--is favored over: physical therapy, acupuncture, massage, and MBSR programs for treatment of chronic pain. We're all seeing how well that's worked. Germany, Holland, South Korea, and other nations with universal health care are not seeing a similar "epidemic."
Maybe it's because their health care system isn't controlled by health insurers.
1
Something like Medicare for all is the obvious answer to the healthcare/insurance problem in the US -- and it always has been a problem! The chief impediment is the Republican Party, which has opposed even the suggestion of a universal program (it didn't like Social Security either).
A two-part, semi-quick solution, at least for starters: First, vote Republicans out of power, thereby opening the gate, and, then immediately expand present Medicare to all (ignore lobbyists, and do any necessary tinkering at a later date).
A two-part, semi-quick solution, at least for starters: First, vote Republicans out of power, thereby opening the gate, and, then immediately expand present Medicare to all (ignore lobbyists, and do any necessary tinkering at a later date).
2
We do have Medicare for all - in the tax system. Everyone pays 2.8% of their wages for Medicare tax, or 3.8% if their incomes are high. Wealthy investors pay 3.8% Medicare tax on investment income. Even retirees pay between $104 and $400 a month in Medicare premiums, depending on their incomes.
But although we collect the tax from everyone, Medicare only supplies medical care to those over 65. If you wanted to extend it to everyone, where would you find the 'someone else' to pay for it?
But although we collect the tax from everyone, Medicare only supplies medical care to those over 65. If you wanted to extend it to everyone, where would you find the 'someone else' to pay for it?
1
It's an accomplishment for President Obama that sick people can now get somewhat affordable insurance. However, the public option, which would turn into one-payer, w the probable exception of boutique insurers for the rich is necessary. Blue Cross is already charging much more. Thanks to the Republicans blockage of the public option, I'm stuck w Blue Cross, which has doubled my co-pay to MDs. Also, I suspect that they've raised my deductible on Rxs. And, lastly, I just got an outrageously high bill from a lab that was in-network, but is no longer. BC came up w/ a slick new plan to divide into small companies that cover in-state only. Mine is the cutesy-sounding Magnolia something. The only thing private insurance is good for is slick advertising and profit-protection.
4
And Hillary Clinton thinks that by giving people a $5,000 tax credit toward their health costs that it will solve all the problems with the healthcare system.
People with chronic illnesses like me who paid no taxes in 2015--because they spent more than 60% percent of their gross income on medical care--need a $5,000 cash infusion--not a tax credit.
Medicare for all, and negotiated prices with pharmaceutical companies and all providers, is the only option for this country.
People with chronic illnesses like me who paid no taxes in 2015--because they spent more than 60% percent of their gross income on medical care--need a $5,000 cash infusion--not a tax credit.
Medicare for all, and negotiated prices with pharmaceutical companies and all providers, is the only option for this country.
3
She thinks this might be doable with our obstinate Congress. Not a true fix.
This analysis is limited to a study of Blue Cross/Blue Shield policyholders. It does not include those who opt for other coverage. It should come as no surprise, however, that people who previously could not afford health insurance and now can are being diagnosed with conditions that they most likely were letting linger. In health care, the best defense is a better offense, and the more people go to the doctor and seek out preventative measures, the slower the overall cost curve will rise, since they will be dealing with health issues before they become health crises and drive up the cost for the rest of us.
2
A single payer system like most of the civilized world has would stop this private profit taking by the health insurance companies. A single payer system addresses the core notion of what insurance is supposed to be "the transfer of fnancial risk from an individual to a pooled group of risks" that is shared risk based on the law of large numbers. The larger the number of insured the lower the costs, if administered on a non profit basis.
2
Instead of raising prices for insurance policies or subsidies the government should start a non profit to run all of the health insurance programs. Everyone should get excellent medical care in this country. If we retreat from having wars all over the world and stop being the worlds police force we will have plenty of money to take care of our medical needs. As it stands now the insurance companies and hospitals are making huge sums of moneys while most doctors are not. There is a shortage of doctors and young people now look to other fields as careers rather than going to medical school, building up huge debt, and getting low paying jobs when they are begin work. Of course our education system fits right into this problem because now it is also a big business.
1
Every day we read about 'non-profits' where everyone seems to be making quite a large salary. What do you think the pay would be like if the government ran one?
2
As an insurance agent, here are my observations:
1) Many newly-insured people had previously ignored their ailments because they could not afford the care they needed. Once they got decent health insurance they went out and got the care they needed.
2) When BCBS/Anthem raises their rates, their customers will move to a lower-cost company because there is no loyalty to insurance companies. Before Obamacare, people had to stay with their insurance company because they had pre-existing conditions that made it impossible to shop for lower premiums.
3) The risk corridor program was supposed to protect insurance companies from the high-cost customers over the first three years of the new rules for coverage, but Republicans seem to have killed this part of the ACA. This assures that insurance companies will lose large sums of money and will opt out of Obamacare. It also assures higher premiums from those companies that remain in the market.
1) Many newly-insured people had previously ignored their ailments because they could not afford the care they needed. Once they got decent health insurance they went out and got the care they needed.
2) When BCBS/Anthem raises their rates, their customers will move to a lower-cost company because there is no loyalty to insurance companies. Before Obamacare, people had to stay with their insurance company because they had pre-existing conditions that made it impossible to shop for lower premiums.
3) The risk corridor program was supposed to protect insurance companies from the high-cost customers over the first three years of the new rules for coverage, but Republicans seem to have killed this part of the ACA. This assures that insurance companies will lose large sums of money and will opt out of Obamacare. It also assures higher premiums from those companies that remain in the market.
3
This, of course, refutes the notion that health coverage does not affect the health of Americans. Certainly there is plenty of evidence albeit anecdotal that the lack of health coverage affects the health of those unable to afford MD visits and treatments because they lack such coverage, or what they have is so thin as to be useless (many plans before the ACA). Their conditions get worse and become far more expensive to treat once/if they do finally get insurance coverage.
Once we have near 100% coverage and everyone has access to care, over time the proportion of expensive sick needing treatment but who have put it off will diminish greatly. In that respect, the Medicaid expansion under the ACA has probably done even more good than the private insurance expansion because it helps a poorer and sicker clientele.
Once we have near 100% coverage and everyone has access to care, over time the proportion of expensive sick needing treatment but who have put it off will diminish greatly. In that respect, the Medicaid expansion under the ACA has probably done even more good than the private insurance expansion because it helps a poorer and sicker clientele.
2
I make about $1320 every two weeks, before taxes and deductions. Approximately $175 is deducted from my check for health insurance for myself, my husband and my daughter, not including dental and vision. (I cancelled those policies to offset the health insurance rate hike in the last couple of years.)
By contrast, the amount deducted for Medicare is $4.16.
So even if my Medicare deduction increased by 40 times the current amount, I'd still be paying less than I am now for health insurance.
Medicare for All.
By contrast, the amount deducted for Medicare is $4.16.
So even if my Medicare deduction increased by 40 times the current amount, I'd still be paying less than I am now for health insurance.
Medicare for All.
1
Your Medicare deduction is that low because you'll be paying for maybe forty years before you get benefits, the rest of us are picking up a lot of your tab, and if you want a scapegoat, look no further than your governor and your legislature.
They're the people who are blocking the exchange. In Mississippi.
They're the people who are blocking the exchange. In Mississippi.
2
if you "make about $1320 every two weeks, before taxes and deductions", then there is no way that Medicare deductions are only $4.16 (unless most of your income is in the form other than wages and salaries). Medicare taxes deduct 1.45 percent of wages from your paycheck and your employer pay another 1.45 percent. If your wages are $1320, that makes your Medicare deduction around $19 (and your employer pays $19) every two weeks.
For the month it would be $76 total ($19 times four). This is what you pay so that people over 65 can get Medicare. if we tried to cover everyone with Medicare, Medicare taxes will have to go up -- a LOT. And, by the way, if your were covered by Medicare as it exists today, you would be paying a monthly premium -- around $120 per person per month. So, Medicare as it exists today would cost your family of three around $360 per month in premiums only, not counting any taxes.
For the month it would be $76 total ($19 times four). This is what you pay so that people over 65 can get Medicare. if we tried to cover everyone with Medicare, Medicare taxes will have to go up -- a LOT. And, by the way, if your were covered by Medicare as it exists today, you would be paying a monthly premium -- around $120 per person per month. So, Medicare as it exists today would cost your family of three around $360 per month in premiums only, not counting any taxes.
2
Why is this a surprise to anybody that people who need to consume the most medical services will be the first ones to sign up. Obamacare from the beginning has been a device to redistribute wealth and cost.
As an affluent caring society, we should ensure that all receive decent health care and that no one is ever bankrupted by a catastrophic health issue. But the current system of using insurance to finance health care creates perverse incentives that only serve to increase overall health care costs and does not drive individual behavior to be healthier or sharper consumers of health care services. When someone pays a fixed price (insurance premiums) for unlimited consumption, the tendency is to over-consume (just go to any buffet). This is made even worse when premiums are detached from risky behavior and someone else pays or supplements the premiums. Insurance is a great device to spread the risk of catastrophe among large groups, with riskier behavior demanding higher premiums. Much of health care is a maintenance expenditure, like keeping up your car or your house. Let's put those decisions and that marketplace directly between the consumer and the provider, and be honest about redistributing wealth through taxation and supplementing some form of HSA's for everyone, and leave insurance for the catastrophic illnesses/conditions.
As an affluent caring society, we should ensure that all receive decent health care and that no one is ever bankrupted by a catastrophic health issue. But the current system of using insurance to finance health care creates perverse incentives that only serve to increase overall health care costs and does not drive individual behavior to be healthier or sharper consumers of health care services. When someone pays a fixed price (insurance premiums) for unlimited consumption, the tendency is to over-consume (just go to any buffet). This is made even worse when premiums are detached from risky behavior and someone else pays or supplements the premiums. Insurance is a great device to spread the risk of catastrophe among large groups, with riskier behavior demanding higher premiums. Much of health care is a maintenance expenditure, like keeping up your car or your house. Let's put those decisions and that marketplace directly between the consumer and the provider, and be honest about redistributing wealth through taxation and supplementing some form of HSA's for everyone, and leave insurance for the catastrophic illnesses/conditions.
1
What it shows is how second class health care is in this country. It also shows how much preventative care is needed for long term problems like diabetes. The ACA is accomplishing one of its main objectives, namely specifying a minimum level of preventative care which will reduce long term acute costs. I heard complaints early on that people's health insurance was no longer offered. Guess what folks, your previous insurance was substandard compared to the average policy and you just didn't know it.
4
How does one expect BC/BS and other private insurers to cover the increased costs of post Obamacare enrollments? Govt (our) subsidies will not cover the extra costs and more enrollment will occur as people who have zero coverage now get sick and need services.
Quite frankly the Obamacare system of insurance signup at anytime one chooses is ridiculous and non-solvent over time.
It's no different than forcing insurance companies to accept individuals buying care insurance AFTER the accident or buying homeowners insurance AFTER the fire.
Health care costs began to skyrocket back in 1965 when the federal govt opened up its (our) wallet with the signing of The Medicare Act. Remember...from 1965 to 1983 most all Medicare services paid out were "cost plus with no questions asked". In 1983 Medicare began the implementation of the Hospital Prospective Payment System. No more cost plus payments but the price structure had/has already been set.
Unbelievable !!!
Quite frankly the Obamacare system of insurance signup at anytime one chooses is ridiculous and non-solvent over time.
It's no different than forcing insurance companies to accept individuals buying care insurance AFTER the accident or buying homeowners insurance AFTER the fire.
Health care costs began to skyrocket back in 1965 when the federal govt opened up its (our) wallet with the signing of The Medicare Act. Remember...from 1965 to 1983 most all Medicare services paid out were "cost plus with no questions asked". In 1983 Medicare began the implementation of the Hospital Prospective Payment System. No more cost plus payments but the price structure had/has already been set.
Unbelievable !!!
6
Correction: you can only sign up once a year. If you don't, you are uninsured for a full year. Also, doctors and hospitals can opt out of any plan at any time, but the insured have no such rights. I can lose my doctor or hospital out of the blue but I cannot change my policy for the year.
Those are my gripes. Along with the well-known one of having a monthly premium and a high deductible before the plan kicks in at all. My adult children, insured through their jobs, have much better coverage than I do.
I see Obamacare as a deal for the insurance companies and a cost-saver only if you have catastrophic illness.
Those are my gripes. Along with the well-known one of having a monthly premium and a high deductible before the plan kicks in at all. My adult children, insured through their jobs, have much better coverage than I do.
I see Obamacare as a deal for the insurance companies and a cost-saver only if you have catastrophic illness.
1
Here's an idea, take the useless insurers out of the formulation!
OK, they are pretty good at reality checks. They nailed my Dad's death like they were the fighter pilot. Right on target, timers. They seem to realize the cost of global warming, too. Perhaps they are the best of bookies? But credit default swaps are not insurance, that's unregulated gambling, You can bet on that.
OK, they are pretty good at reality checks. They nailed my Dad's death like they were the fighter pilot. Right on target, timers. They seem to realize the cost of global warming, too. Perhaps they are the best of bookies? But credit default swaps are not insurance, that's unregulated gambling, You can bet on that.
You include misleading information. People cannot sign up "anytime one chooses". There is a specific enrollment period each year which locks people into an annual contract. And this article notes that it is no surprise that people who have gone without health care will enter the system with health issues. It is hoped that having regular access to healthcare will in time reduce the costs as people take better care of themselves by having regular checkups, and healthcare issues are caught before expensive medical procedures are required. The whole point is to bring people into the healthcare system early to keep them from using emergency room services.
3
And still nobody's talking about capping provider charges; costs just ratchet up. Much less pointing out that patients bear no responsibility and incur no penalty for not taking care of their health. Our system combines the worst of personal liberty with the least of personal responsibility - drink, have unsafe sex, overeat, take drugs, smoke; society will foot the bill to patch you up and send you out to resume the behaviour that got you sick in the first place. It's called moral hazard. At some point the 'system' will collapse under its own weight.
How many articles does the NYT have to run before it admits this law just doesn't work?
The NYT already didn't pick up an article from the other paper I read - which is editorially center-to-left, so can the 'Faux news' psuedo-witticisms - that more than half of the recipients of those vaunted subsidies will have to return some of the money. Never mind that they tend to be living on the edge, and not budgeted for a sudden expense when the government taketh away what it giveth.
If Obama and the Democrats hadn't needed an 'accomplishment' going into the 2010 midterms and the 2012 race, we might've slowed down, planned for a few years, and crafted a feasible single-payer system covering basic care and imposing cost controls. Instead we bought this lemon because we decided we needed it NOW. Haste makes waste.
How many articles does the NYT have to run before it admits this law just doesn't work?
The NYT already didn't pick up an article from the other paper I read - which is editorially center-to-left, so can the 'Faux news' psuedo-witticisms - that more than half of the recipients of those vaunted subsidies will have to return some of the money. Never mind that they tend to be living on the edge, and not budgeted for a sudden expense when the government taketh away what it giveth.
If Obama and the Democrats hadn't needed an 'accomplishment' going into the 2010 midterms and the 2012 race, we might've slowed down, planned for a few years, and crafted a feasible single-payer system covering basic care and imposing cost controls. Instead we bought this lemon because we decided we needed it NOW. Haste makes waste.
8
Sigh. Among the ways the PPACA caps provider costs is that for the first time, "overhead," is limited to 20% of premiums, that famous $700 billion in Medicare Advantage overpayments to providers got stopped...
2
ACW: By far the best comment thus far.
1
Mostly factually incorrect.
Insurance companies have already figured out that bigger deductibles are a way to compensate for the 'moral hazard'. Larger deductibles force people to reckon with taking care of themselves while properly putting in backstops to more fully cover larger health issues.
As such, where is the issue here?
Insurance companies have already figured out that bigger deductibles are a way to compensate for the 'moral hazard'. Larger deductibles force people to reckon with taking care of themselves while properly putting in backstops to more fully cover larger health issues.
As such, where is the issue here?
I just want to clear something up: "subsidies" for ACA healthcare is not free money from the government. My "subsidies" are what I would be receiving as a tax refund. In other words, it's my money.
4
Carolson: Of course it isn't free money, it's money from those who pay full price for their health insurance. Good health to you and yours.
1
Employers skip out on paying their share of payroll taxes just for paying you in ever increasing healthcare insurance. Dollar for dollar. So if you want to know why Medicare and SS funds are growing so slowly, ask you tax shifting employer.
2
I guarantee that if you qualify for subsidies for aca insurance that it is more than "your money" paying for "your" plan. And you know it. Don't try to fool us....
2
Rather than pay a fee if not signed up, high cost low profit patients should be tricked into being given a stipend to agree not to enroll or seek coverage.
The Obamacare does not address the major issue: why our health care costs so much. I am with Bernie on that. Hillary says that she wants to improve the ACA but, unless I missed it, she never said what exactly she is going to do. Without fixing the cost issue, we shall never fix the health care.
6
This is grossly untrue.
Of course any chance of changing the law for the better is lost on republicans whose only solution to anything is to do nothing. I hope people open their eyes to this mess of politicians who not only don't care about anyone but rich donors but actively pursue policies that will put people in their graves.
5
You had a chance to involve Republicans back before it was passed. It was said by many that we should not embark on something like this in a pure partisan fashion. This was written and passed completely and solely by Democrats. Own it and then take responsibility for it.
1
I'm still waiting to hear something about the GOP health plan........................
(silence)
(silence)
Several years ago I was laid off and could not afford the $1200.00 monthly COBRA payments. I shattered my knee during a fall and when the ambulance arrived they asked me if I owned my house. I did. They told me not to go tot he hospital. I did not get my leg fixed for 6 months until Obamacare kicked in and it was not a pre-existing condition. I was in excruciating pain and the leg healed badly. I got the leg fixed, sold my house and returned to Canada, where my annual premiums are less than a monthly premium in the states. The price is irrelevant, the fact is not worrying about healthcare is priceless. Canadians cannot fathom what all the fuss is about because they have never had to go without healthcare.
17
The irony is that the GOP supporters who reject universal healthcare are also the ones who make the most commotion about their patriotism.
3
The premise of this article is the very reason insurance companies would not offer policies to people with preexisting conditions.
12
And the health care law provided special payments to insurers with unexpectedly high costs.
It's nice to read that no matter how sick the people may get, the bottom line is that the Insurance Companies will always be taken care of the most. From the way it sounds, the Insurance Companies couldn't written the ACA laws better themselves.
Oh, that's right. They did.
It's nice to read that no matter how sick the people may get, the bottom line is that the Insurance Companies will always be taken care of the most. From the way it sounds, the Insurance Companies couldn't written the ACA laws better themselves.
Oh, that's right. They did.
10
companies, organizations or governments that do not cover their cost disappear! If you think the Insurance companies take care of themselves check out the behavior of government bureaucracies.
We have a "for profit" medical care system in the US. Hospital systems, clinical practices, doctors, drug companies, medical device manufacturers, and above all Insurance companies, all have to make a profit off each request for medical care.
The end result, as we know, is a national medical care cost some 30% higher than countries with national health plans, and better health outcomes.
The end result, as we know, is a national medical care cost some 30% higher than countries with national health plans, and better health outcomes.
15
Yes, we must end the monopolies doctors have which has been guaranteed by the government.
Well, it is necessary to pay skilled professionals a reasonable amount of money for their services.
However, in the US, too many doctors are highly skilled at making money. They build little empires around a physician-owned medical facility, providing end-to-end treatment for their specialty. They employ nurses, technicians, physical therapists, and take a cut of all the revenue. Doctors like this are highly skilled at maximizing their take from government programs. In New York, there have been many scandals.
However, in the US, too many doctors are highly skilled at making money. They build little empires around a physician-owned medical facility, providing end-to-end treatment for their specialty. They employ nurses, technicians, physical therapists, and take a cut of all the revenue. Doctors like this are highly skilled at maximizing their take from government programs. In New York, there have been many scandals.
1
I have read comments who are longing for their old, pre-ACA insurance policies. Nostalgia is a wonderful thing, it numbs us to the negative and allows to dream of the good times. I have been self employed for most of my adult life and I purchased private health insurance. These policies always had high deductibles ( I don't remember any policy that didn't have at least a $5,000 to $10,000 deductible), they had pre-existing condition restrictions ( I once had a small squamous cell cancer removed (benign), which then stopped us from changing insurance plans, no payment for blood testing, etc., and caps on the amount of treatment provided. Bankruptcy was always a foreseeable event. Yet, the difference in what I paid under the ACA and my private plan was not tremendously different given the additional benefits that the plan covered. Is the ACA perfect? No, it is the embodiment of privatization of healthcare, the brainchild of the GOP and the compromise they forced on the nation(single payer was DOA in 2008). Funny though, my wife is Costa Rican, and we plan to retire there soon. One of the benefits? A state run healthcare system that covers everyone and private providers, who provide excellent care at a reasonable price. Some years ago, Costa Rica made a choice they could have an army or provide healthcare and education to its citizens. They have no army and one of the healthiest and best educated societies in Latin America. We can take lessons from this tiny nation.
40
Costa Rica can get away with having no army because they can depend on ours. Aside from that ....
Nobody seems to want to ask why health care costs so much that you have to have insurance just to partake of the basics. It is generally assumed that even walking into the office costs so much you have to have insurance to cover it, and then you have to purchase additional insurance to cover the costs not paid by the primary insurance. If you think about it, this is crazy. But then, the whole economics of 'health insurance' is now unlike any other insurance. Other insurance covers only disasters, not basic upkeep and small expenses. You don't put in a claim every time you hammer a nail or paint the dining room or even replace your roof (unless a tree fell on it). You don't file a claim on your auto insurance for every fill-up and flat tire. So-called health insurance (used to be called medical insurance) is expected to cover practically every interaction with the health care 'system' - it's more like partial pre-pay. Between the amount of bureaucracy and paperwork this generates, the opportunities for padding and greed, and the sheer inefficiency, of course costs will keep ratcheting up.
Nobody seems to want to ask why health care costs so much that you have to have insurance just to partake of the basics. It is generally assumed that even walking into the office costs so much you have to have insurance to cover it, and then you have to purchase additional insurance to cover the costs not paid by the primary insurance. If you think about it, this is crazy. But then, the whole economics of 'health insurance' is now unlike any other insurance. Other insurance covers only disasters, not basic upkeep and small expenses. You don't put in a claim every time you hammer a nail or paint the dining room or even replace your roof (unless a tree fell on it). You don't file a claim on your auto insurance for every fill-up and flat tire. So-called health insurance (used to be called medical insurance) is expected to cover practically every interaction with the health care 'system' - it's more like partial pre-pay. Between the amount of bureaucracy and paperwork this generates, the opportunities for padding and greed, and the sheer inefficiency, of course costs will keep ratcheting up.
1
You offer the perfect argument for a single payer system. If people have preventative care they can avoid the costs associated with catastrophic care. A single payer system would eliminate the bureaucracy. The profit would be taken out and therefore the greed. A single payer could negotiate to keep costs down. Every other civilized country has it and most pay less than half as a percentage of GDP than the US does.
2
thewritestuff, I'm not against single-payer. On the contrary, I'm frustrated that if we had held out for a workable single-payer system instead of rushing to ram through Obamacare, we might have made progress toward it by now. But your analysis omits the problem of the American mindset, which demands maximum 'liberty' with minimum responsibility. Preventive care is the answer only for people who are careful about their health in the first place. Our mindset is predominated by people who assert their untrammeled right to smoke, drink, drug, have unsafe sex, ride motorcycles without helmets and sportscars without seatbelts, just can't drive 55, eat junk till they explode and drink Red Bull by the gallon, not vaccinate their kids, etc etc. And then stick the taxpayer with the bill for the consequences of their 'liberty'. No auto insurer is going to write an affordable policy for a driver who smashes up his car repeatedly on the assumption the insurer will keep forking out to fix it. Yet we expect to have the unrestricted right to smash up our bodies and have Uncle Sam pay to patch them up.
1
Unfortunately the US is so far behind other industrialized countries as far as providing healthcare for its population is concerned it is truly shameful. Yes, the very wealthy and upper middle class have no problem however, for the lower middle class a serious illness can result in bankruptcy and for the poor and disadvantaged it is a big problem. Prior to Obamacare the poor and disadvantaged rarely went to see a physician and very often only if serious illness struck necessitating hospitalization. Of course most of the time these poor people were not able to pay their bill. Some of the cost was absorpted by the hospital and otherwise it necessitated raising hospital fees. Once Obamacare came into effect and insurance companies became involved many of the previously uninsured with chronic illnesses like hypertension , diabetes COPD etc. went to see a physician. Once these people were in the healthcare system of course they needed more care, more tests and more visits. No wonder insurance costs had to be raised for these insurance companies are in for the money and big profit. To brake even is not one of their goals and that is why the US needs a differend payment system that is not out for making a big profit for themselves and or their shareholders. Of course big pharma shares equal blame for the rising healthcare cost. I do not know what the answer is however, I do know the present system can not endure.
6
Whatever. Health insurers note only make awesome profits, as opposed to otherworldly profits, because they are being forced to adopt the same level of social responsibility that is required across the developed world. So it's only a Benz and not a Bentley for you? Cry me a river.
5
It's a '96 Camry for me. I'd rather not pay for your bad decisions.
1
This will not work, mostly because the premiums are already at a point where working people cannot afford them and they will only get higher. I simply cannot afford to pay for insurance I barely use and to pay for others who put nothing into the kitty. It's cheaper to pay the penalty and hope for the best because I cannot afford the alternative.
11
Simply untrue. All you have to do is get what's called a "minmum value," plan, if you're income's too high for a tax credit or a subsidy--and if it's lwer than that, you're entitled to a tax credit or subsidy.
But gee, thanks for announcing that you're a deadbeat. I'm sure the rest of us applaud your happy willingness to stick us with the tab, just as we're thrilled to shell out the added costs on our car insurances to support uninsured motorists.
But gee, thanks for announcing that you're a deadbeat. I'm sure the rest of us applaud your happy willingness to stick us with the tab, just as we're thrilled to shell out the added costs on our car insurances to support uninsured motorists.
@Robert - Why do you say he's a deadbeat? He'll save so much in health insurance payments, he'll build up a substantial fortune and be able to pay cash.
1
Robert, who's paying for the tax credits now? The answer would be me and you, nothing is free. As for your second paragraph, I won't even address because it's ridiculous.
I will tell you this though, my sister lives in North Carolina on about $1,100 dollars a month as a nursing assistant with two kids. She makes too much money for medicare, Obamacare isn't available in NC because the State legislature refuses to participate, and because of the program, her monthly premiums from her employer would be $400 if she could afford it, which she can't. I guess she's another of your deadbeats, right?
I will tell you this though, my sister lives in North Carolina on about $1,100 dollars a month as a nursing assistant with two kids. She makes too much money for medicare, Obamacare isn't available in NC because the State legislature refuses to participate, and because of the program, her monthly premiums from her employer would be $400 if she could afford it, which she can't. I guess she's another of your deadbeats, right?
1
Also, the medical industry moves much faster than the government in finding ways to game the system and extract more money, even when it harms patients.
11
They are super-clever and have armies of lawyers and accountants and actuaries to game the system in their favor. They played the inexperienced Obama like a chump.
In turn, Obama played the lefty liberals -- telling them "this was a path to Single Payer" when in fact it was Big Insurance making sure we would never, ever, EVER have Single Payer in our lifetimes.
In turn, Obama played the lefty liberals -- telling them "this was a path to Single Payer" when in fact it was Big Insurance making sure we would never, ever, EVER have Single Payer in our lifetimes.
2
The reason "why" the ACA is not operating effectively, however, is because the present Administration is not aggressively compelling younger uninsured citizens to either enroll or pay the financial penalty for noncompliance.
When it became PL 111-152, everyone with half a brain realized that the ACA would never work effectively and that Insurers would use it as a vehicle to raise rates unless healthy Americans without insurance were compelled to join the program if their employer did not offer health insurance. Just like Social Security, you have to have the young and healthy, premium paying individuals defray the cost of the elderly with health issues.
In an attempt to try to win over the public to ACA, however, the Obama administration has been reluctant to press the IRS to go after millions that are ignoring their legal responsibility to participate. This foolishness is even making early supporters of this concept to shake their heads.
When it became PL 111-152, everyone with half a brain realized that the ACA would never work effectively and that Insurers would use it as a vehicle to raise rates unless healthy Americans without insurance were compelled to join the program if their employer did not offer health insurance. Just like Social Security, you have to have the young and healthy, premium paying individuals defray the cost of the elderly with health issues.
In an attempt to try to win over the public to ACA, however, the Obama administration has been reluctant to press the IRS to go after millions that are ignoring their legal responsibility to participate. This foolishness is even making early supporters of this concept to shake their heads.
5
"aggressively compelling" - like putting them in jail?
If I were still in my 20s and healthy, there is no way I'd buy an expensive Obamacare policy. The penalty for not doing so is an added tax.
The thought of people paying penalties unless they buy an insurance policy that covers OB services for men is about as anti-American as it gets.
If I were still in my 20s and healthy, there is no way I'd buy an expensive Obamacare policy. The penalty for not doing so is an added tax.
The thought of people paying penalties unless they buy an insurance policy that covers OB services for men is about as anti-American as it gets.
1
https://newrepublic.com/article/117410/obamacare-enrollment-hits-8-milli...
28% were between 18-34 in 2014. I haven't seen any numbers yet for 2015. People can stay on their parents' insurance now until age 26, and some of my friend's adult children (2 under 30, one about 30) all have employer paid for coverage. I don't know what % remain uninsured.
However, I agree that the ACA could be far better, too bad Obama gave up on single payer almost immediately--although the GOP would've scuttled any program that didn't cater to BigPharma and BigHealthInsurers. I'd far rather see the US adopt a system similar to Germany's, Holland's (the latter uses a very tightly regulated private insurer and the gov't pays premiums of those who cannot afford to pay) or Canada's.
Too bad the US has a Congress controlled by lobbyists, which has lead to a bloated DoD (no full audit for over 15 years), a pathetic, unfair system for providing health care, and failing infrastructure. But plenty of money for drones, F-35s, etc.
28% were between 18-34 in 2014. I haven't seen any numbers yet for 2015. People can stay on their parents' insurance now until age 26, and some of my friend's adult children (2 under 30, one about 30) all have employer paid for coverage. I don't know what % remain uninsured.
However, I agree that the ACA could be far better, too bad Obama gave up on single payer almost immediately--although the GOP would've scuttled any program that didn't cater to BigPharma and BigHealthInsurers. I'd far rather see the US adopt a system similar to Germany's, Holland's (the latter uses a very tightly regulated private insurer and the gov't pays premiums of those who cannot afford to pay) or Canada's.
Too bad the US has a Congress controlled by lobbyists, which has lead to a bloated DoD (no full audit for over 15 years), a pathetic, unfair system for providing health care, and failing infrastructure. But plenty of money for drones, F-35s, etc.
1
Single payer was DOA thanks to Connecticut's insurance company shill, Joe Lieberman.
The sickest were the ones that were not covered in the first instance. One of the purposes of the law was to cover everyone whether they were sick or healthy. Over time it will even out. No one said the law was to be immediately perfect. The kinks will work out if smart honest people run the programs and they are allowed to improve and do what they were intended to do.
15
People ask how can we afford universal health care.
Total health care costs in the US are about $9,000 per person.
In the rest of the industrial western countries, total health care costs are about $5,000 per person.
So we are already paying for it, we are just not getting it.
And people say they don’t want to pay for other people.
We already are paying for other people when they go to ER and don’t have insurance. That becomes part of the hospital overhead costs that goes into the price charged to their paying customers.
People say we have the best health care in the world and that people come here from other countries for health care.
I have wealthy friends in South America who go to the Mayo Clinic and pay cash.
It is true that we have the best health care that money can buy. For the rest of us, it is about average.
Look at various surveys, we do well in somethings, less well in others. And depending on what they measure we rank at the bottom such as overall health of our population.
Total health care costs in the US are about $9,000 per person.
In the rest of the industrial western countries, total health care costs are about $5,000 per person.
So we are already paying for it, we are just not getting it.
And people say they don’t want to pay for other people.
We already are paying for other people when they go to ER and don’t have insurance. That becomes part of the hospital overhead costs that goes into the price charged to their paying customers.
People say we have the best health care in the world and that people come here from other countries for health care.
I have wealthy friends in South America who go to the Mayo Clinic and pay cash.
It is true that we have the best health care that money can buy. For the rest of us, it is about average.
Look at various surveys, we do well in somethings, less well in others. And depending on what they measure we rank at the bottom such as overall health of our population.
12
"So we are already paying for it, we're just not getting it." WELL SAID!!!
1
You hit the nail on the head.
Pent up demand likely driven by the dreaded "pre-existing conditon" scam used by Insurance companies for decades prior to Health Care Reform. Yet the drum beat of "repeal" is still heard echoing from those of the right. Voters should take note of those screaming repeal the loudest and vote them out of office.
8
This article fails to document the billions in reserves that various Blue Cross plans across the US have. Also there are programs under the ACA to offset losses for the insurers. This story is reported in a way misleads unsophisticated readers and leads them to feel sympathetic towards the "non profit" insurance industry and understand why their premiums are about to skyrocket. Blue Cross and other insurers who got into this market knew exactly what they were doing. No one understands insurance risk better than they do. And where in this article are any voices of Blue Cross critics or those ensnarled in the insurance companies' attempts to limit care?
11
They are non profits with all the advantages of being this and they behave like for profit predators. The state insurance commissioners give them the rate hikes they want, public hearings are a sham, citizens have no power to stop the astronomical and unjustified rate hikes and the reserves are kept out of the math calculations. This is a sick system, Dr. Mittler and yours is a timely and great comment to expose the sleight of hand of BCBS.
The true scandal is that due to Republican intransigence the poor and indigent have been getting their health care kicked down the road for years. It's not a 'can' that's been getting 'kicked down the road' it's living people.
The working poor and the middle class slipping off the edge of self-employment, similarly have deferred doctor visits and health care. Any deferred visit that winds up as a visit to ER triggers a cascade of mandated events from CYA procedures in the ambulance that boost their separate invoices, to CAT scans of debatable necessity called for by the ER resident or intern.
The unexpectedly high costs of delivering health care comes from the human beings who the Republican have been kicking down the road and dunning through bill collectors for visits to ER that failed to even treat the underlying causes, frequently, that caused the 'emergency.'
The insurers have folded in their indirects and salaries into the costs for providing this coverage for those kicked down the road for years. Somehow the people and the president are supposed to take the blame for the health insurers decades of feasting off the deteriorating body of America's collective health?
The healthy pay for the inefficiencies high salaries and corruption of the health insurers for decades of unreimbursed coverage that is essentially protection money. When the healthy get sick, what do they become? An 'unexpected expense' of the health insurance cabal. This dialectic is sick.
The working poor and the middle class slipping off the edge of self-employment, similarly have deferred doctor visits and health care. Any deferred visit that winds up as a visit to ER triggers a cascade of mandated events from CYA procedures in the ambulance that boost their separate invoices, to CAT scans of debatable necessity called for by the ER resident or intern.
The unexpectedly high costs of delivering health care comes from the human beings who the Republican have been kicking down the road and dunning through bill collectors for visits to ER that failed to even treat the underlying causes, frequently, that caused the 'emergency.'
The insurers have folded in their indirects and salaries into the costs for providing this coverage for those kicked down the road for years. Somehow the people and the president are supposed to take the blame for the health insurers decades of feasting off the deteriorating body of America's collective health?
The healthy pay for the inefficiencies high salaries and corruption of the health insurers for decades of unreimbursed coverage that is essentially protection money. When the healthy get sick, what do they become? An 'unexpected expense' of the health insurance cabal. This dialectic is sick.
7
The complaints presented by commentators are real. The ACA is not the bill that anyone wanted. It is a way station on the journey to universal health care, and the best that could be achieved given the political realities. One can only hope that the burden of caring for our most needy will gradually drive the private insurers out, and we will over the coming years see the government assume more and more of the health care system, which ultimately is its responsibility.
5
We can't have Hillary Clinton, who is a shill for corporate health care. We must have Bernie Sanders if universal health care is to come about and the stranglehold of the wealthy and duplicitous insurance industry in America is to be broken--at the very least we must have a person who thinks it is possible to get universal health care not someone who asserts that the ACA is the pinnacle of achievement and it must be TWEAKED. O for Pete's sake spare me Senator Clinton.
I know a kindly and intelligent and decent married couple, childless and no longer young, together for forty years. One is an invalid with serious, life-threatening conditions, the other supports them both, barely, through grindingly hard work as an independent contractor. If not for the Affordable Care Act, which is the only reason that they have health insurance and pay what they can afford, the invalid spouse would in all likelihood be dead now.
As far as I'm concerned--because actions speak louder than words--the Republicans want that person dead and couldn't care less, and I hate them for that.
But that's the certain future, untreated illness and avoidable death, for millions of Americans if a Republican is elected president this year. I beg all "Berners" to remember that, if Sen. Sanders doesn't win the Democratic nomination.
As far as I'm concerned--because actions speak louder than words--the Republicans want that person dead and couldn't care less, and I hate them for that.
But that's the certain future, untreated illness and avoidable death, for millions of Americans if a Republican is elected president this year. I beg all "Berners" to remember that, if Sen. Sanders doesn't win the Democratic nomination.
11
Health care costs have been rising faster than inflation for 50 years. Even Nixon said it was a problem.
And health care inflation has been the lowest in 50 years with Obama care.
http://www.factcheck.org/2014/02/aca-impact-on-per-capita-cost-of-health...
However, if Republicans don't like Obama care they should fix health care. They have had the same 50 years and have only fought against fixing health care.
What is the Republican plan? It was Obama care before Obama put his name on it. It was Romney care that came from the right-wing Heritage Foundation think tank.
The individual mandate was the conservative value of accountability and responsibility. The exchanges were free market competition.
When Obama agreed to this Republican approach, Republicans then called it government take-over of health care and death panels.
Remember the summer of death panels? The Tea Party activists interrupting all the town hall meetings?
Where are the death panels? There aren't any and never were any.
But all those Tea Party people don't even ask themselves who told them these things and maybe they should stop listening to those people. They are just on to the next crisis - Ebola, Guatemalan kids at the border, Benghazi, and now it is the e-mail server.
And health care inflation has been the lowest in 50 years with Obama care.
http://www.factcheck.org/2014/02/aca-impact-on-per-capita-cost-of-health...
However, if Republicans don't like Obama care they should fix health care. They have had the same 50 years and have only fought against fixing health care.
What is the Republican plan? It was Obama care before Obama put his name on it. It was Romney care that came from the right-wing Heritage Foundation think tank.
The individual mandate was the conservative value of accountability and responsibility. The exchanges were free market competition.
When Obama agreed to this Republican approach, Republicans then called it government take-over of health care and death panels.
Remember the summer of death panels? The Tea Party activists interrupting all the town hall meetings?
Where are the death panels? There aren't any and never were any.
But all those Tea Party people don't even ask themselves who told them these things and maybe they should stop listening to those people. They are just on to the next crisis - Ebola, Guatemalan kids at the border, Benghazi, and now it is the e-mail server.
4
And health care inflation has been the lowest because, most cynically people are given insurance but no care--they have to beg for doctors, for hospitalizations and medicines. It is a dastardly eyewash, Independent, and it has the liberal media in thrall. Very few doctors have been asked by the media about the difficulties with the ACA--I mean doctors in the trenches--health care experts, yes, administrators yes, software vendors yes, but practicing physicians have been too lowly for the media to ask them how the ACA defeats care and how the insurers conspire everyday to make the ACA look like a banana law. And don't forget the 60,000 codes and counting on the ICD 10, its ever bountiful cornucopia, one code for being on fire while roller skating and one for problems with your mother in law--that be the end of Medicine and the start of misery for doctors. I must say, America itself under the reign and regime of the ACA looks like a banana republic, other than Trump's sincere efforts to be the worst banana in the grove.
Not sure that this is surprising. People who have not had health insurance have likely not benefited from any prevention and/or early intervention initiatives. I do think this is a front end phenomenon. It likely will even off over a period of years as more and more of the population becomes covered. It is analogous to the phenomenon noted when active addicts stop using drugs/alcohol and start accessing health care services. Their cost increases above the mean for about five years and then levels off as their bodies normalize. The addicts in that situation are typically younger than some of the people highlighted in this article, so the leveling off may take longer than five years. But what this is, in effect, is payment for years of neglect.
52
Thank you. But most people will ignore you because it's not what they want to hear. What did people think would happen when millions of previously marginalized people could go to a doctor. What would the very people who are screaming do if their coverage increased? Use it! God forbid we use the term "single payer" healthcare.
OMG, Socialism. I don't think Bernie's ideas will get him elected. The Repukes will have a field day with him.
OMG, Socialism. I don't think Bernie's ideas will get him elected. The Repukes will have a field day with him.
But unfortunately the rates the insurance companies are charging will not level off and they will not go down. It's criminal that they have come between a doctor and the care they can give a patient. Criminal.
Why did the cost per patient go UP in 2015 versus 2014? I can't figure that one out.
WR
WR
There is no doubt Blue Cross and Blue Shield's report highlights a huge potential issue with the ACA's strategy. The actual numbers, not cited in this article, underscore just home much the costs of covering the newly insured are rising - from $434 per month in the 1st quarter of 2014 to $569 per month in the 3rd quarter of 2015.
It's unsustainable because a very small group of Americans who buy insurance in the individual market and are healthy - young and older - are predominantly responsible for covering the costs of the newly insured. With each year and each premium jump and benefit decrease - many of the new heralded benefits like maternity coverage are irrelevant to policy holders because for e.g., they add nothing and simply increase costs if you are male or if you are past childbearing age - the people who have seen their premiums and deductibles often double with the ACA become angrier.
True healthcare reform required one plan for all in which all participated, all benefited, and no one "lost". That's what we were promised and that's what we did not get.
It's unsustainable because a very small group of Americans who buy insurance in the individual market and are healthy - young and older - are predominantly responsible for covering the costs of the newly insured. With each year and each premium jump and benefit decrease - many of the new heralded benefits like maternity coverage are irrelevant to policy holders because for e.g., they add nothing and simply increase costs if you are male or if you are past childbearing age - the people who have seen their premiums and deductibles often double with the ACA become angrier.
True healthcare reform required one plan for all in which all participated, all benefited, and no one "lost". That's what we were promised and that's what we did not get.
2
This was a noble but flawed system from the very beginning---mixing public and private entities in order to achieve coverage of the most people possible. Add into that mix an opposition party whose not so subtle belief in letting the poor die in the streets will stop at nothing to prevent any fixes which could make the system both noble and workable. The other reality about health care, is that any health care system that is both inclusive and cost effective will involve some form of rationing---that is inevitable. We keep up the myth that we can deliver the medical wonders we read about each day to everyone at a reasonable price. Finally, we are a public who does not really believe in living a healthy lifestyle; we are a public that believes in the finer things in life---eating, drinking, smoking, sitting, snacking,---and then asking a doctor to tune me up when, at some point in our life, all of this good living catches up to us. No medical or governmental systems can sustain a society making some very poor lifestyle choices.
32
You left out running to the doctor every time you get the sniffles. Allowing the Doctors to run your health without doing any research at all. What I resent is how much information is suppressed to make the Healthcare system MORE MONEY. They are a business you know. Name one business in America that is not trying to drum up business, cut wages, cut quality for profit, exaggerate statistics to wring out every penny from their customers. You cannot. Where is that discussion? It starts like this; "...A single payer system instead of what exists now would alleviate the need for insurance companies....." so we just don't have it.
1
If insurance offered under the ACA is too expensive, we will get into a vicious circle that may well bankrupt the system. Even with the tax penalties, young and healthier people may decide that they cannot afford insurance. Since premiums from the young and the well subsidize older, sicker populations, this will put increasing financial pressure on the system, and may jeopardize its viability.
We need to take steps to keep costs under control.
One important step would be to require that providers - hospitals and doctors - post their prices, so patients know what medical services will cost before they receive them, and can comparison shop. This won't work for truly emergent services, but it can be done for most medical care.
We may have to limit coverage of some services. For example, the contraceptive mandate, which requires unlimited coverage, with no deductible, for any and all forms of contraception approved by the FDA is probably overly generous; one gets the impression this provision was put in the ACA for political, rather than medical, reasons.
Mental health coverage may need to be restricted, and limited to those with serious conditions, rather than the unlimited coverage provided under current law. It's not always easy to identify serious conditions, but we probably need to try.
Tort reform would help greatly in avoiding unnecessary costs.
The access to medical care that is the goal of the ACA is important, we need to ensure that the system remains solvent.
We need to take steps to keep costs under control.
One important step would be to require that providers - hospitals and doctors - post their prices, so patients know what medical services will cost before they receive them, and can comparison shop. This won't work for truly emergent services, but it can be done for most medical care.
We may have to limit coverage of some services. For example, the contraceptive mandate, which requires unlimited coverage, with no deductible, for any and all forms of contraception approved by the FDA is probably overly generous; one gets the impression this provision was put in the ACA for political, rather than medical, reasons.
Mental health coverage may need to be restricted, and limited to those with serious conditions, rather than the unlimited coverage provided under current law. It's not always easy to identify serious conditions, but we probably need to try.
Tort reform would help greatly in avoiding unnecessary costs.
The access to medical care that is the goal of the ACA is important, we need to ensure that the system remains solvent.
2
The whole thing doesn't make any sense. Here are poor people who can barely afford clothes and a place to live. Under the ACA, they can gain access to health care. Their diseases are treated by doctors who make hundreds of thousands a year, and they are admitted to hospitals full of high-paid administrators, doctors, and technicians. The insurance companies fork out huge sums of money for this. The poor patient gets the care, but the money goes to very well-to-do medical professionals. They get their care, and limp off to their 1990 Nissan Sentra and drive back to the trailer park. Meanwhile, the endocrinologist hops into his silver Porsche and drives to his McMansion on the rich side of town.
Doctors will complain this is unfair, but IRS statistics show it is true. The average AGI of even GPs shows that their income alone puts their households in the top 5% of household incomes. Specialists are way up there. Of the top 1% in income, 27% are doctors.
Sure, these doctors work hard and are highly educated. But we have to start asking, how can a country where the average salary is $35K afford to hire these amazingly skilled, dedicated professionals at such a high cost. If you add up the health care that the average person requires over his lifetime, you can see it is equal to about half his total earnings. This is not sustainable.
Doctors will complain this is unfair, but IRS statistics show it is true. The average AGI of even GPs shows that their income alone puts their households in the top 5% of household incomes. Specialists are way up there. Of the top 1% in income, 27% are doctors.
Sure, these doctors work hard and are highly educated. But we have to start asking, how can a country where the average salary is $35K afford to hire these amazingly skilled, dedicated professionals at such a high cost. If you add up the health care that the average person requires over his lifetime, you can see it is equal to about half his total earnings. This is not sustainable.
10
The whole economy is rigged starting with the costs charged to people at college which end up lasting close to their full lifetime.
It is time to regulate prices and have open books accounting where the true cost of materiel can be calculated and limits on how much profit is reasonable set.
It is time to regulate prices and have open books accounting where the true cost of materiel can be calculated and limits on how much profit is reasonable set.
The cost of physicians salaries is a miniscule portion of the cost of healthcare. Canadian physicians are paid just as well and their single payer healthcare system costs a fraction of ours. The high costs come from health insurance companies extracting a rent without any added value. Obama's ACA just baked this into law instead of removing it, and insurance company shareholders (mainly the 1%) enjoyed a large increase in their stock values as a result.
The other large cost is for pharmaceuticals. Again, Obama's Justice Department could have used the existing anti trust laws to break up a wave of conglomeration that pushed prices higher than ever even for generics. Hospitals are faced with frequent deliberately induced shortages of basic supplies like saline iv bags and must charge enormous sums. Likewise they face a conglomeration wave that has pushed out of business many needed local hospitals and the remainder have financed their mergers with debt and inflated prices to patients.
None of this will stop until we get a single payer system in place and institute some price controls. But blaming hard working doctors is not going to solve anything. The suicide rate for GPs is already the highest ever. A medical school class worth of physicians commits suicide every year. Do you think they want to work in this for profit system where they see their patients suffering not only from illness but from subsequent financial pains from their treatments?
The other large cost is for pharmaceuticals. Again, Obama's Justice Department could have used the existing anti trust laws to break up a wave of conglomeration that pushed prices higher than ever even for generics. Hospitals are faced with frequent deliberately induced shortages of basic supplies like saline iv bags and must charge enormous sums. Likewise they face a conglomeration wave that has pushed out of business many needed local hospitals and the remainder have financed their mergers with debt and inflated prices to patients.
None of this will stop until we get a single payer system in place and institute some price controls. But blaming hard working doctors is not going to solve anything. The suicide rate for GPs is already the highest ever. A medical school class worth of physicians commits suicide every year. Do you think they want to work in this for profit system where they see their patients suffering not only from illness but from subsequent financial pains from their treatments?
2
As a respiratory therapist, I can tell you that the big moneymakers in the healthcare system are not the techs or caregivers like nurses or CNA's. Those jobs are middle-class wages. And I wouldn't point my finger at the doctors either. Most of them work very long hours with each patient presenting a risk of a lawsuit should the doctor make a mistake due to those hours. And BTW, the average student graduates from med. school with $166K in student loan debt. The newer doctors are living a decent lifestyle, but certainly are not driving home to a McMansion on the nice side of town in their Porsche. Medicare and insurance reimbursements are getting lower all the time, so the pie is getting smaller.
Lastly, the elephant in the room is that many patients, particularly in the case of those who are now accessing Obamacare have a lifetime of bad choices that led to their bad health. They may live in a trailer park, but they are still coming up with $7 a day to support their cigarette smoking. They're broke, but somehow manage to be very overweight. I often see patients who have expensive prescriptions (paid for by insurance), but don't take them because they forget, or "I want to be natural."
I'm a bleeding heart liberal, but pointing the finger at medical staff, and not taking into account the actions of patients, the decrease in reimbursements, and the high cost of administrators to navigate the dysfunctional healthcare system is misguided.
Lastly, the elephant in the room is that many patients, particularly in the case of those who are now accessing Obamacare have a lifetime of bad choices that led to their bad health. They may live in a trailer park, but they are still coming up with $7 a day to support their cigarette smoking. They're broke, but somehow manage to be very overweight. I often see patients who have expensive prescriptions (paid for by insurance), but don't take them because they forget, or "I want to be natural."
I'm a bleeding heart liberal, but pointing the finger at medical staff, and not taking into account the actions of patients, the decrease in reimbursements, and the high cost of administrators to navigate the dysfunctional healthcare system is misguided.
3
This was a good article. Costs have risen because people with greater needs are now being taken care of. This reflects that there was a great need for the ACA and that need is not going away. There are several things we could do to bring costs down.
We could recognize our need to have fitness become a priority among our citizens. How many billions of dollars in health care costs could be saved if we reduced obesity? Somewhere around $170 billion dollars. That is a lot of money, and a lot of healthier lives.
We could gradually reduce the age limit for Medicare starting with dropping it to 62 and then lower over time. This would pull more of the costlier care out of the private market place.
Third we could negotiate with pharmaceuticals and reduce the cost of medicine in our country, we should be paying the lowest world wide price, not the highest. This may require changes in laws and regulations of generic drugs.
We can do better, and we should pick a President who can continue to move us toward that better place.
We could recognize our need to have fitness become a priority among our citizens. How many billions of dollars in health care costs could be saved if we reduced obesity? Somewhere around $170 billion dollars. That is a lot of money, and a lot of healthier lives.
We could gradually reduce the age limit for Medicare starting with dropping it to 62 and then lower over time. This would pull more of the costlier care out of the private market place.
Third we could negotiate with pharmaceuticals and reduce the cost of medicine in our country, we should be paying the lowest world wide price, not the highest. This may require changes in laws and regulations of generic drugs.
We can do better, and we should pick a President who can continue to move us toward that better place.
92
Since you can start getting SS at 62, starting Medicare at 62 makes sense and I'm sure a Democratic congress would make this change as a start. If there was a Democratic congress.
Maybe a Trump or even Cruz candidacy will help elect more Democrats to congress. Here's hoping.
Maybe a Trump or even Cruz candidacy will help elect more Democrats to congress. Here's hoping.
You are on smart dude and I agree with you all the way. Let's add to the list " DO NOT GO TO THE DOCTOR every time they get a virus....they just cannot do anything for them. Has anyone said anything about that? How much money can be saved by NOT living in a world where people need a pill to feel better about things. Save the Doctors for sick people.
1
One of the things that I think could easily be reined in is over-billing and fraudulent billing under Medicare.
http://www.usatoday.com/story/news/nation/2015/06/18/largest-medicare-fr...
[[Federal officials charged 243 people with Medicare fraud Thursday, the most defendants representing the largest financial losses ever to the program.
A "strike force" including the Justice Department, FBI and Department of Health and Human Services and local officials brought cases in 17 districts, including the fraud hot spots of Miami and New York City. The cases include 46 doctors, nurses and other licensed medical professionals such as physical and occupational therapists. The schemes involved more than $700 million in false billings.]]
If we moved to single payer tomorrow, but you had doctors and clinics ripping off the system left and right, how is that better for the customer or the taxpayer?
http://www.usatoday.com/story/news/nation/2015/06/18/largest-medicare-fr...
[[Federal officials charged 243 people with Medicare fraud Thursday, the most defendants representing the largest financial losses ever to the program.
A "strike force" including the Justice Department, FBI and Department of Health and Human Services and local officials brought cases in 17 districts, including the fraud hot spots of Miami and New York City. The cases include 46 doctors, nurses and other licensed medical professionals such as physical and occupational therapists. The schemes involved more than $700 million in false billings.]]
If we moved to single payer tomorrow, but you had doctors and clinics ripping off the system left and right, how is that better for the customer or the taxpayer?
4
None of this is sustainable until there is real reform in terms of provider payments. Insurance companies will go on gaming the system by increasing Premiums, Deductibles and Co-pays. The basic truism is that nothing can grow faster than the economy forever. US health care is twice as expensive as a proportion of the economy as the next costliest healthcare system in the world with one of the worst patient outcomes in the developed world. Like the Bush senior prescription benefit before this, Obamacare is just another cynical attempt by the providers to enrich themselves on the backs of the public at large. Healthcare mirrors what happened to the housing market. Every president in the last 50 years used policy to to push home ownership which ended in disaster in 2008. In 2016 healthcare growth is poised to overtake new home construction as the biggest contributor to GDP growth. The country ran out of new people willing to slave for their mortgages so the people slaving to pay their health premium and student loan have replaced them. It does not matter their degree did not get them a job and they still cannot afford to see their doctor despite their health policy. What is important is their doctor drives a Mercedes and their college Dean vacations in France. Long live capitalism, god bless America!
1
It should be made clear that ACA was not passed as designed and that the main factor behind its purpose was to get care to these people whom are temporarily overwhelming the system. That Achilles heel is what the GOP went after when they acted to make sure we did not get full participation by all.
ACA was built as it is now in the process of getting it passed. The changes have caused a lot of problems. Another set of problems increasing costs have been caused by the States whose Governor’s refused to participate and the incompetence of the States who participated in rolling it out and in Oregon, where out right fraud by the companies hired to do the work and State employees meant to ensure it worked was perpetrated.
If anything this should make clear the need for single payer health care and the fact that everyone should be required to pay for it.
Maybe we should talk about the character of people who complain about medical insurance for all? Maybe we should speak of the character of people who think its ok to let people suffer just because they are less able to handle the deceitful manipulative nature of the American Economy? Maybe we should talk about the character of people who think that deceitful manipulative economy is normal or something to be proud of?
I know the same people who think that economy is great describe something very different than the economy I have to live in when they describe what they seem to be imagining exists.
ACA was built as it is now in the process of getting it passed. The changes have caused a lot of problems. Another set of problems increasing costs have been caused by the States whose Governor’s refused to participate and the incompetence of the States who participated in rolling it out and in Oregon, where out right fraud by the companies hired to do the work and State employees meant to ensure it worked was perpetrated.
If anything this should make clear the need for single payer health care and the fact that everyone should be required to pay for it.
Maybe we should talk about the character of people who complain about medical insurance for all? Maybe we should speak of the character of people who think its ok to let people suffer just because they are less able to handle the deceitful manipulative nature of the American Economy? Maybe we should talk about the character of people who think that deceitful manipulative economy is normal or something to be proud of?
I know the same people who think that economy is great describe something very different than the economy I have to live in when they describe what they seem to be imagining exists.
2
It seems there’s no shortage of money when it comes to funding illegal invasions of sovereign nations or saving the obscene bonuses of greedy crooks running the too big to fail institutions that destroyed the lives of millions. But in our insane society, saving lives and providing health care to citizens is considered an unnecessary extravagance.
7
Don't forget the invasion of our own country by illegal immigrants. There's no shortage of money when it comes to providing municipal services (and then some) to those who illegally enter our country.
3
We really need to stop calling this "insurance." I think that insurance is protection for an event that we don't expect to or hope that we will not need. But healthcare "insurance" is not that - it is actually joining a combined benefit / payment membership pool - against which members feel that they will most likely lay a claim for payment of medical expense. Changing the description could help turn peoples focus towards wondering why it is that costs are just crazy, and then focus on the even harder questions of utilization.
5
You know what costs even more than providing healthcare to poor people who have been deprived of it for years or decades?
Insurance companies.
In any system that guarantees health care as a right, the insurance companies would have no reason to exist. Only in a market-based system in which our health risks are a commodity can insurance companies claim to fulfill any function. And let's be clear that that function is keeping costs down and profits up by squeezing people for the highest possible premiums and denying them the most care.
Health insurance companies are essentially parasitical and the sooner we replace them with a single-payer Medicare-for-all system like the rest of the civilized world, the better off we will be.
Hillary Clinton, who has received millions in campaign donations, speaking fees, and contributions to her family foundation warns us that we don't want to have that fight. I'll be voting April 19 for the guy who says we need to have that fight.
Insurance companies.
In any system that guarantees health care as a right, the insurance companies would have no reason to exist. Only in a market-based system in which our health risks are a commodity can insurance companies claim to fulfill any function. And let's be clear that that function is keeping costs down and profits up by squeezing people for the highest possible premiums and denying them the most care.
Health insurance companies are essentially parasitical and the sooner we replace them with a single-payer Medicare-for-all system like the rest of the civilized world, the better off we will be.
Hillary Clinton, who has received millions in campaign donations, speaking fees, and contributions to her family foundation warns us that we don't want to have that fight. I'll be voting April 19 for the guy who says we need to have that fight.
25
A 51 YO man came to the office on the first day he was eligible for healthcare under the ACA, with a hole in his foot for months. He had undiagnosed diabetes and after a lengthy hospitalization, 6 drugs and a partial amputation, we were able to save his foot. The scope of unmet healthcare needs in America was staggering and a national disgrace.
243
Absolutely. I'd add that what the Right has been doing--as with coal, global warming, Iraq, and a thousand other things--is shoving those costs under various rugs.
They get pushed off on small cites, on families, on small businesses, on hospitals and schools, just like in Texas and Ohio.
While single-payer would not be the happyhappybunnyland that Sanders' supporters pretend, one of its strongest arguments is: you get the real costs put right up front, right where you can see them, rather than the Republican squirreling this bitty bit and that bitty bit into various cubbyholes.
They get pushed off on small cites, on families, on small businesses, on hospitals and schools, just like in Texas and Ohio.
While single-payer would not be the happyhappybunnyland that Sanders' supporters pretend, one of its strongest arguments is: you get the real costs put right up front, right where you can see them, rather than the Republican squirreling this bitty bit and that bitty bit into various cubbyholes.
2
"Pent Up Demand" is a very neutral term that distances itself from real human suffering. The fact that so many Americans with chronic conditions are finally receiving care- to the apparent alarm of the insurance companies- illuminates how inhumane and stingy our "healthcare" system is.
I am certain that these individuals suffering from diabetes, or HIV, or Hepatitis were not delaying care and treatment due to negligence. Most likely they either could not afford the ludicrous cost of treatment, or if they once had insurance, they were probably booted off of coverage by these same insurance companies under their previous "pre-existing condition" clauses.
If we want a healthy, productive society we need to cover and treat ALL Americans. A Medicare for all program will be cheaper over the long term, more accessible for the American people, and will lead to a healthier nation and society in every facet.
I could care less about the profits of insurance companies- who do nothing to improve advances in scientific or medical knowledge, nor expedite my care, nor ease my access to physicians. They are nothing more than middlemen and shakedown artists. Healthcare is a human right, and we are the richest nation on the planet. It's time for Medicare for all.
I am certain that these individuals suffering from diabetes, or HIV, or Hepatitis were not delaying care and treatment due to negligence. Most likely they either could not afford the ludicrous cost of treatment, or if they once had insurance, they were probably booted off of coverage by these same insurance companies under their previous "pre-existing condition" clauses.
If we want a healthy, productive society we need to cover and treat ALL Americans. A Medicare for all program will be cheaper over the long term, more accessible for the American people, and will lead to a healthier nation and society in every facet.
I could care less about the profits of insurance companies- who do nothing to improve advances in scientific or medical knowledge, nor expedite my care, nor ease my access to physicians. They are nothing more than middlemen and shakedown artists. Healthcare is a human right, and we are the richest nation on the planet. It's time for Medicare for all.
18
Those "shakedown artists" have many times prevented the healthcare provider establishment from shaking me and my family down. Don't get me wrong, I appreciate the hard work and advanced education of medical workers, but I don't think they deserve the amounts that appear on my insurer's explanation of benefits statements, corroborated by those appearing on the providers' bills, as the gross billed amount. (Neither do I believe, by the way, that they deserve the paltry rewards doled out through healthcare systems like the British NHS, whose some of whose doctors have threatened to strike over long hours and low pay.) Private insurance allows me to moderate my costs by giving my insurer the authority to negotiate on my behalf.
Medicare for all will not compare to Medicare is we know it today, because the privately insured currently subsidize Medicare. If everyone had Medicare, there would be no one to whom to shift those costs except through much higher taxes for most households.
Medicare for all will not compare to Medicare is we know it today, because the privately insured currently subsidize Medicare. If everyone had Medicare, there would be no one to whom to shift those costs except through much higher taxes for most households.
1
When will we come to our senses and implement Medicare for All?
7
We, the people, have come to our senses. The oligarchs are the problem. They, too, have come to their senses-- but their senses are very different from ours.
Do you think that the because cattle scream as they scent the smell of blood as they approach the slaughter house that their screams hve any affect on the meat barons' behavior?
We are the equivalent of feed-lot animals.
Do you think that the because cattle scream as they scent the smell of blood as they approach the slaughter house that their screams hve any affect on the meat barons' behavior?
We are the equivalent of feed-lot animals.
Concentrating higher cost patients in the Obamacare exchange plans (adverse selection) increases premiums. But who pays those higher premiums? Individuals who have just enough income to disqualify them from receiving the federal subsidies.
It is the hard working middle-income individuals and families who are suffering most from increased health care costs, higher premiums, higher deductibles, and less choice through narrower provider networks.
We can still fix this problem by improving Medicare and expanding it to cover everyone. The taxes to pay for the program would be assessed equitably so that everyone would pay only their fair share.
It is the hard working middle-income individuals and families who are suffering most from increased health care costs, higher premiums, higher deductibles, and less choice through narrower provider networks.
We can still fix this problem by improving Medicare and expanding it to cover everyone. The taxes to pay for the program would be assessed equitably so that everyone would pay only their fair share.
11
hmmm...no prior existing condition exclusions, could we be looking to insure those that use a lot of medical care and have a lot of problems...i think so...the insurers will go broke insuring this population.
3
".the insurers will go broke insuring this population."
And that will be a blessing! We will be freed from their vampiric, pernicious activities.
And that will be a blessing! We will be freed from their vampiric, pernicious activities.
So what's YOUR plan to handle them?
All this pent up demand for healthcare from sick people. Sick people who had been locked out of healthcare who have finally gotten care because of the Affordable Care Act. Yet the republican congress have voted 60 times to repeal the ACA. They have voted 60 times to throw those sick people back out on to the street without medical care. They don't seem to know who they work for. This sort of politics is unconscionable and deeply shameful.
11
I think they know very well for whom they work. It's not for the people.
You missed the point. For too many, the ACA is not affordable.
Its obvious that we need Medicare for all. We keep playing around the edges because there is no way Republicans would vote for it. Every 1st world country in the world with the exception of the U.S. has healthcare for all. Its not free in those countries. People pay taxes and in many cases pay co-pays and premiums. Yes, our taxes will go up, so what.
If everyone would be on Medicare, that would include younger, healthier people, ergo today's Medicare would be saved. Its a program that works. Probably better in many cases than private insurance. People could purchase a supplemental just like is done now with Medicare recipients.
To think that the greatest country on the planet (or we used to be) would deny health care coverage to many of its citizens because the donors and Koch brothers and ALEC don't like it.
I'm not a Socialist, I'm actually very moderate. My brother who is a conservative agrees with me. He used to work in the insurance industry and thinks that coverage for all makes the most sense economically.
If everyone would be on Medicare, that would include younger, healthier people, ergo today's Medicare would be saved. Its a program that works. Probably better in many cases than private insurance. People could purchase a supplemental just like is done now with Medicare recipients.
To think that the greatest country on the planet (or we used to be) would deny health care coverage to many of its citizens because the donors and Koch brothers and ALEC don't like it.
I'm not a Socialist, I'm actually very moderate. My brother who is a conservative agrees with me. He used to work in the insurance industry and thinks that coverage for all makes the most sense economically.
18
Based on current spending, everyone would have to pay 22% of income in additional tax. Are you in?
5
"If everyone would be on Medicare, that would include younger, healthier people, ergo today's Medicare would be saved. "
Everyone is ALREADY paying for Medicare, including the younger and healthier people. They pay Medicare taxes, just like everyone else. It's just that under the current rules of Medicare the younger people are not eligible to receive any Medicare benefits. If we allow them to receive the benefits (i.e. create Medicare for all), it won't save Medicare, it will kill it. To have Medicare for all, the taxes will have to rise a lot.
Right now, just to pay for Medicare for those 65 and older, everyone in the country pays Medicare taxes -- and even that is not enough and we transfer almost as much out of the general tax revenue to finance Medicare, plus Medicare recipients pay around $110 per person per month in premiums -- and then there are deductibles and co-pays.
Everyone is ALREADY paying for Medicare, including the younger and healthier people. They pay Medicare taxes, just like everyone else. It's just that under the current rules of Medicare the younger people are not eligible to receive any Medicare benefits. If we allow them to receive the benefits (i.e. create Medicare for all), it won't save Medicare, it will kill it. To have Medicare for all, the taxes will have to rise a lot.
Right now, just to pay for Medicare for those 65 and older, everyone in the country pays Medicare taxes -- and even that is not enough and we transfer almost as much out of the general tax revenue to finance Medicare, plus Medicare recipients pay around $110 per person per month in premiums -- and then there are deductibles and co-pays.
1
Hence the reason for the conservative-conceived and designed mandate.
5
Unfortunately the new system takes from some in order to give to others. We need a system where everyone pays in and benefits are uniformly awarded.
I know several self employed people who deliberately keep their income, on paper, low enough to be eligible for the subsidies. I don't blame them; it's not hard to do. But it feels like the system behaves like a bad parent - giving to one but not the other. The government gives our self employed friend several thousand dollars a year in subsidies while ignoring the fact that our contribution rises every year as does our deductible. We have to work for our insurance, which comes as part of our pay, but our friends receive theirs as a gift from the taxpayers. It's not a good system. I'd much rather we all pay a percentage of our income and receive the same plan in return. It's poor policy to give to some and penalize others by forcing them to pay full freight AND raising their taxes. It just breeds resentment. One more argument for a uniform single payer system that is not coupled with employment.
I know several self employed people who deliberately keep their income, on paper, low enough to be eligible for the subsidies. I don't blame them; it's not hard to do. But it feels like the system behaves like a bad parent - giving to one but not the other. The government gives our self employed friend several thousand dollars a year in subsidies while ignoring the fact that our contribution rises every year as does our deductible. We have to work for our insurance, which comes as part of our pay, but our friends receive theirs as a gift from the taxpayers. It's not a good system. I'd much rather we all pay a percentage of our income and receive the same plan in return. It's poor policy to give to some and penalize others by forcing them to pay full freight AND raising their taxes. It just breeds resentment. One more argument for a uniform single payer system that is not coupled with employment.
74
It sounds as though you favor a Medicare type plan for all -- where participants with higher incomes pay more for the plan, just as they do now for Medicare.
Something about covetousness comes to mind.
A uniform aingle payer system would mean MUCH higher taxes, and plans that required more from those who currently have employer-based plans.
2
Obamacare? All I know is thanks to the Affordable Care Act, I basically lost my health coverage for the the first time in my life. My employer shifted us to a plan with deductibles so high (and a monthly premium to boot), that there's no way I can use my insurance unless it's an emergency. And the readers out there can shift blame to my employer all they want; I blame the government for allowing this to happen with a poorly devised plan and a poorly written law that "wasn't better than nothing." Except for the insurance companies. Thanks, Mr. Empty Suit President. It's one thing to be devoid of Foreign Policy Chops, quiet another thing to be a Domestic Policy push over: Single Payer? Thanks for nothing.
16
This is simply untrue, not least because "Obamacare," covers your routine checkups and tests at zero cost to you.
Also--you actually believed your boss when he switched your program to cut HIS costs, and blamed it on the President?
Good grief.
Also--you actually believed your boss when he switched your program to cut HIS costs, and blamed it on the President?
Good grief.
2
''New insurance policies are often more generous and comprehensive than individual policies sold before the health care law. The new policies must, for example, cover maternity care and mental health and substance abuse services.''
Ask the people who actually pay for policies (yes NYT there are people who actually pay their own bills in America.) how generous these plans are.You know,the middle age couples forced to pay for maternity care and other peoples drug and mental health issues.How much longer are the NYT and it's lib/prog brethren going to continue to perform cpr on the corpse of Obamacare.
Ask the people who actually pay for policies (yes NYT there are people who actually pay their own bills in America.) how generous these plans are.You know,the middle age couples forced to pay for maternity care and other peoples drug and mental health issues.How much longer are the NYT and it's lib/prog brethren going to continue to perform cpr on the corpse of Obamacare.
6
Blue Cross Blue Shield should be talking. They kept millions out with their preexisting conditions policy. And now they and all the other insurers are increasing premiums, while simultaneously cutting cost and practicing brutal rationing. I am at the front lines of care and I know that my patients cannot get most medicines available for diabetes except the cheapest, generic ones. If patients need a combination of drugs to deal with terribly out of control diabetes, if patients need a thorough work up for coronary artery disease that accompanies diabetes, if they need work up and medications for other coexisting conditions, it is a struggle for me, their endocrinologist, to get them what they need. God forbid, they have side effects to the statin that they're on or to their anti hypertensive, it would cost me hours in time to convince the insurer that my patient needs to be excepted from their stringent rules because I am the one following the patient. The insurers have taken to not only controlling what medication a patient will receive but also what dose and how many pills. I won't name insurers, but some will tell you through their mail order pharmacies, that you're duplicating therapy, when you're not, that the patient can have only 2 times a day of a medicine, when they need that medicine three times a day, that you must try another medicine that has already been tried and hasn't worked or prove to them this is so. It is hell for patients and doctors.
66
I am not a provider but I too work directly with patients. I think it is absolutely unconscionable (and should be illegal) that some stranger in an office cubicle in Omaha or wherever can dictate your treatment plan for your patient.
2
Thank you bluedot.
I realize that I am perhaps a bit idealistic but universal healthcare should be an entitlement that we as Americans all support. I agree with others here that the ACA is just the first step towards this. Having healthcare that doesn't bankrupt us should be a right and not a privilege. The taxes that we would pay for it would be returned to us all in fewer lost work days, higher productivity, and relief from the fear that we are one paycheck away from financial destruction should we experience a health crisis that requires expensive care. Achieving universal healthcare seems daunting to achieve. However, we will never achieve it if we vote for local, state, and federal representatives who do not also support it.
18
The problem: With a few unavoidable exceptions - for example, children, animals, who have a right to be free of mistreatment - there cannot feasibly be rights without responsibilities. If citizens are to rely on the body of society to pay for their health care, it necessarily implies some restraints on personal freedom and some definition of what comes under the rubric of 'entitlement' and what should be the cost of the individual to bear. Get into details and it gets messy. Cosmetic surgery? We all agree, I think, a horrible disfigurement should be fixed. But I could posit a dozen hypotheticals that would have you tearing your hair. And that's just one aspect of details that have to be thrashed out. Except that as a people we are prone to sweeping declarations and not inclined to bother our pretty heads with thought. especially when reality doesn't live up to our ideals. We love 'should'; we hate 'is' and avoid it until it whacks us in the face, as it is doing repeatedly with Obamacare.
3
Wah, wah....Of course this is the initial press release from the insurance companies. Next they will demand rate increases. Young healthy people will play Russian roulette until the penalty becomes to high to skip out on the health insurance mandate. Then costs will equalize. I know of of one Health care giant who did so well last year that they bought all employees a health fitness tracker. Who is telling the whole truth?
8
They have been getting rate increases since this law went into effect.
1
Health insurance does not work if only the sick are willing to pay for coverage. That's why we need Medicare for all Americans. Unfortunately, Hillary tells us that cannot happen, and we need to spend even more money on ObamaCare.
5
You are so right. Health Insurance as it stands is just "profiteering"/ private insurance company "socialism" in the sense that it is a pooling of all premiums contributed to by everybody, sick or well, and then participants using the services only when we need them. All members--both the healthy and sick subscribers pay in premiums, and those who need it when they need it, get their needed health care.
Meanwhile ALL members subscribers are supporting the outrageous pay of CEO's an high officers of the company. Single payer/Medicare for All medical care would eliminate the bankrolling of Insurance, medical corporations, and big pharma private vulture profiteering.
Meanwhile ALL members subscribers are supporting the outrageous pay of CEO's an high officers of the company. Single payer/Medicare for All medical care would eliminate the bankrolling of Insurance, medical corporations, and big pharma private vulture profiteering.
2
/Tony - Lots of clumsy attempts to blame the solution - which means expanding the portions of health care that bring down the cost to the consumer. This translates into:
capping drug company profits which have spun out of control.
capping CEO and fundraising salaries for health delivery companies who are passing these costs to the patients.
expanding the market across state lines for health providers to open up price competition.
expanding the window of eligibility for medicare downward for certain conditions that are chronic, thereby removing them from the ACA pool. Type 2 diabetes post age 50 would be a classic example. Certain hypertension and heart conditions would be another. HIV and other disabilities another.
Gosh - all that sounds so much more complicated than electing Bernie and having a Revolution!!! Yes. It sounds like it might actually be something we can accomplish in the real world - at the expense of big pharma and overcompensated CEOs.
capping drug company profits which have spun out of control.
capping CEO and fundraising salaries for health delivery companies who are passing these costs to the patients.
expanding the market across state lines for health providers to open up price competition.
expanding the window of eligibility for medicare downward for certain conditions that are chronic, thereby removing them from the ACA pool. Type 2 diabetes post age 50 would be a classic example. Certain hypertension and heart conditions would be another. HIV and other disabilities another.
Gosh - all that sounds so much more complicated than electing Bernie and having a Revolution!!! Yes. It sounds like it might actually be something we can accomplish in the real world - at the expense of big pharma and overcompensated CEOs.
2
You can keep your plan.
You can keep you doctor.
$2500 annual savings.
Not one dime in middle class tax increases.
NOT.
You can keep you doctor.
$2500 annual savings.
Not one dime in middle class tax increases.
NOT.
16
Again it is clear the "Affordable" in the Affordable Health Care Act is a totally misleading euphemism. The ACA increased access at increased cost and did nothing to make health care more affordable.
The next decision that our Nation will face would to1) reduce quality and cost by adopting one payer (Nationalized) health care and be like the VA or 2) to make actual reforms that will reduce cost but be highly lobbied against (introduce market competition, tort reform, insurance reform).
The next decision that our Nation will face would to1) reduce quality and cost by adopting one payer (Nationalized) health care and be like the VA or 2) to make actual reforms that will reduce cost but be highly lobbied against (introduce market competition, tort reform, insurance reform).
9
qcell,
In your first paragraph you fail to take notice of the fact that ACA was designed to take this influx into account and that the GOP acted to make sure this temporary increase in demand cost more by discouraging people from signing up for insurance.
It isn't a government program it is a set of rules for private insurance. Hence all the GOP folderol about government health care is a lie they know its a lie and now their actions have let the Insurance Co.'s increase premiums which is what GOP wanted all along. Plus they get to make hay of the fact that all the people they convinced not to sign up didn't sign up.
We pay way more for health care and the products and services involved than we should due to those prices being artificially inflated as is much of our economy.
True pricing (cost + <15%) would solve a lot of our economic issues but that would cut profit margins down to reasonable levels and we can't have that now can we?
In your first paragraph you fail to take notice of the fact that ACA was designed to take this influx into account and that the GOP acted to make sure this temporary increase in demand cost more by discouraging people from signing up for insurance.
It isn't a government program it is a set of rules for private insurance. Hence all the GOP folderol about government health care is a lie they know its a lie and now their actions have let the Insurance Co.'s increase premiums which is what GOP wanted all along. Plus they get to make hay of the fact that all the people they convinced not to sign up didn't sign up.
We pay way more for health care and the products and services involved than we should due to those prices being artificially inflated as is much of our economy.
True pricing (cost + <15%) would solve a lot of our economic issues but that would cut profit margins down to reasonable levels and we can't have that now can we?
1
Single payer would be tort reform because it remove the economic incentive Americans patients have to sue doctors. I bet Canadian doctors are sued far less often than American doctors.
1
Here is the root of the problem. Ask anyone how much they want to pay
for health insurance. "As little as possible". Ask how much
in resources should they get if they are sick."Whatever it
takes".
Healthcare is expensive. Period. And until people aspire to great health care
just like they aspire to housing, education or the latest car we can not start
a discussion of what we all want and how much we are willing to pay for it.
for health insurance. "As little as possible". Ask how much
in resources should they get if they are sick."Whatever it
takes".
Healthcare is expensive. Period. And until people aspire to great health care
just like they aspire to housing, education or the latest car we can not start
a discussion of what we all want and how much we are willing to pay for it.
16
The problem is that we do not have easily accessible universal health care.
The root of that problem is the GOP.
The root of that problem is the GOP.
Let's be clear, we (the USA) is going to pay for it (health care). The only question is "When and where"? In the ER or with Medicare and SS disability, or with health insurance, The latter is cheaper, but a great pseudo issue for elections.
2
Health care costs too much because it amplifies its delivery costs through the salaries and perks it delivers to its CEO's and investors. Health care and prisons should be public services, not ghoulishly calculated events that degrade human beings into 'profit centers.'
The health insurers and private health care institutions should be faced with deciding between controlling their perks and costs and being replaced by competitors including an expanding medicare mandate.
Why doesn't this article focus on the compensation margins being paid to CEOs, shareholders, independent contractors, public relations and fund raising consultants and other super-numeraries of the health delivery industry?
The health insurers and private health care institutions should be faced with deciding between controlling their perks and costs and being replaced by competitors including an expanding medicare mandate.
Why doesn't this article focus on the compensation margins being paid to CEOs, shareholders, independent contractors, public relations and fund raising consultants and other super-numeraries of the health delivery industry?
3
The ACA has been disastrous for my family. I used to be covered by my employer but because there are only two full-time staff, once the ACA was enacted my employer could no longer provide coverage. So now I'm stuck with a plan in which I pay $1900/mo (up $300/mo from last year) for my husband, son and myself, with a $6000 (!!!) deductible, and no coverage outside my home state except for dire emergencies. Financially we are just above the limit for any type of assistance with our premium payments. I am truly glad for the expansion that provides insurance for people who were not able to get it previously, but the insurance companies should NOT be able to increase rates on the middle class to pay for those with the most financial and medical need. WE MUST HAVE SINGLE-PAYER NATIONAL HEALTH CARE!
203
I am very sorry for your situation, which I predicted when the ACA was passed (without reading it first, thanks Nancy Pelosi!).
I hope you will post regularly in these forums, because I see ALL THE TIME proponents of the ACA and fans of Mr. Obama, who swear on a stack of bibles that the ACA is the greatest thing ever, and everyone has lower costs & better care! I know this is not true, but they get away with these lies and deceptions because people are who actively being hurt by the ACA (like your family) are not speaking up enough.
I am therefore very sorry to tell you that passage of the ACA was pretty much a coup by Big Insurance -- to ensure that we never, ever, ever have single payer (at least, in our lifetimes). It was a "deal" between them and the Obama Administration. In exchange for NOT having single payer nor a public option, they would agree to cover "pre-existing conditions" and a few popular (but inexpensive) things like covering 22-26 year olds on their parent's policy (note that this group is likely to be VERY healthy and need almost no care!).
Vote Democrat, and the ACA will be written in stone for your lifetime or longer -- and you will pay more and more and more every year. The insurance companies must be celebrating with cake and ice cream every day, for this amazing and stunning absolutely GIVEAWAY of tax dollars and FORCED purchases by ordinary people terrified of IRS penalties if they do not an overpriced, useless policy. Good times!
I hope you will post regularly in these forums, because I see ALL THE TIME proponents of the ACA and fans of Mr. Obama, who swear on a stack of bibles that the ACA is the greatest thing ever, and everyone has lower costs & better care! I know this is not true, but they get away with these lies and deceptions because people are who actively being hurt by the ACA (like your family) are not speaking up enough.
I am therefore very sorry to tell you that passage of the ACA was pretty much a coup by Big Insurance -- to ensure that we never, ever, ever have single payer (at least, in our lifetimes). It was a "deal" between them and the Obama Administration. In exchange for NOT having single payer nor a public option, they would agree to cover "pre-existing conditions" and a few popular (but inexpensive) things like covering 22-26 year olds on their parent's policy (note that this group is likely to be VERY healthy and need almost no care!).
Vote Democrat, and the ACA will be written in stone for your lifetime or longer -- and you will pay more and more and more every year. The insurance companies must be celebrating with cake and ice cream every day, for this amazing and stunning absolutely GIVEAWAY of tax dollars and FORCED purchases by ordinary people terrified of IRS penalties if they do not an overpriced, useless policy. Good times!
6
Moving from a health care plan chosen by your employer--and paid for tax-free for you and your employer--to a competitive marketplace which gives you "choice" and which requires significant research before locking yourself and your family for a year into a policy from a for-profit insurance company apparently did not pay off for you. Other than removing the lifetime cap on insurance coverage, removing the "prior condition restriction for coverage and allowing your children to be covered under your policy until age 26 as well as many other ACA reforms, you didn't improve your insurance access to health care much at all, right?
1
You are not "stuck" with the plan. But ACA requires you to shop for a better plan in order to get a better plan. That is not good. The answer is either single payer or tighter regulations on insurers. The latter is far more likely in this country.
Of course the ACA is seeing those who need the most help..Employer-based insurance -- and by extension private insurance - where plans can enter and leave markets (and members) at will - is filled with perverse disincentives.
For years the private insurance industry has worked actively to either avoid patients with pre-existing conditions or doing the least care possible (sometimes under the moniker of "step therapy") because insurers know full well that under employment-based insurance - there is a very high possibility that if they can delay expensive care for a year it will be "someone else's problem."
For years the private insurance industry has worked actively to either avoid patients with pre-existing conditions or doing the least care possible (sometimes under the moniker of "step therapy") because insurers know full well that under employment-based insurance - there is a very high possibility that if they can delay expensive care for a year it will be "someone else's problem."
16
The choice of the photo accompanying the article, with nothing but Spanish-language words on the back of the guy's T-Shirt and the sign in the background (it looks like they're in a mobile phone store) plays upon the Trump-ian fear-mongering about Latino immigrants swamping our country. For shame.
9
Except it is true, so at least there is that. It is poor minorities who are "winners" in this system because the ACA gives them the biggest prize of all -- 100% FREE Medicaid welfare, with no premiums, no deductibles, no copays of any kind (plus vision & dental care!).
Try getting anything remotely like that, at ANY price, if you are a middle class American. You will quickly find it doesn't even exist, and if it did, it would cost more than your entire income.
There is no point in denying that Latino immigrants -- legal and illegal -- have swamped our nation, to the point they are now the majority in California, our largest state.
Try getting anything remotely like that, at ANY price, if you are a middle class American. You will quickly find it doesn't even exist, and if it did, it would cost more than your entire income.
There is no point in denying that Latino immigrants -- legal and illegal -- have swamped our nation, to the point they are now the majority in California, our largest state.
7
Um, you can't avoid the politically incorrect fact that a lot of Latinos are lower-income (including illegal immigrants) and that lower-income individuals and families, who are more likely to be in the part-time or 'gig' economies and not offered employer-based health benefits, will be the ones patronizing these storefront sign-ups like the ones shown in the picture. Especially in places like Miami, with a large Hispanic population.
When Adam Savage on Mythbusters said 'I reject your reality and substitute my own,' at least he was making a joke.
When Adam Savage on Mythbusters said 'I reject your reality and substitute my own,' at least he was making a joke.
2
Maybe that's the reality?
ACA is the most inefficient method of insurance in relation to all our peer countries.
Having said that it is light yrs better than the de facto criminal republican system we had before that....be rich and/or don't get sick or have a bad life event.
Now let's join the rest of our peer countries and get a system similar to Canada or most other peer countries.
Having said that it is light yrs better than the de facto criminal republican system we had before that....be rich and/or don't get sick or have a bad life event.
Now let's join the rest of our peer countries and get a system similar to Canada or most other peer countries.
52
As President of the United States of America, Bernie Sanders will support the fight for a sensible, cost-effective program of medical care for all. Republicans? Ha Ha Ha - -
That opportunity came and went. It is now too late.
The very existence of the ACA locks in forever the power and wealth of the Big Insurance Industry -- who WROTE THE ACA. Do you even realize that? To get them "on board", Obama gave away the store. He had Big Insurance write the absolutely most self-serving legislation of their DREAMS -- and got it passed (*without one single Republican vote!) -- and it gave them unlimited power, fueled by MANDATORY insurance with HUGE HUGE fines for ordinary Americans.
Now you HAVE TO buy an overpriced policy or face the wrath of the IRS. Pretty sweet! What other industry has the FEDERAL GOVERNMENT force you to buy their product? A product which is known to be lousy, unfair, grossly overpriced, restrictive and often useless?
The alternative would have been to fight the insurance industry tooth and nail, and everyone remembers 1993 and the very effective "Harry & Louise" ads that Big Insurance ran. So Obama caved before there was even a fight.
The very existence of the ACA locks in forever the power and wealth of the Big Insurance Industry -- who WROTE THE ACA. Do you even realize that? To get them "on board", Obama gave away the store. He had Big Insurance write the absolutely most self-serving legislation of their DREAMS -- and got it passed (*without one single Republican vote!) -- and it gave them unlimited power, fueled by MANDATORY insurance with HUGE HUGE fines for ordinary Americans.
Now you HAVE TO buy an overpriced policy or face the wrath of the IRS. Pretty sweet! What other industry has the FEDERAL GOVERNMENT force you to buy their product? A product which is known to be lousy, unfair, grossly overpriced, restrictive and often useless?
The alternative would have been to fight the insurance industry tooth and nail, and everyone remembers 1993 and the very effective "Harry & Louise" ads that Big Insurance ran. So Obama caved before there was even a fight.
6
It is not light years better. It has ruined coverage that the majority of Americans enjoyed, lost cost and what they wanted, to fill both the dems and the insurance companies coffers. They could have started with little changes on the way to single payer, but instead decided, without half the country, to cram something down our throats. If you think we will ever have single payer as good as Germany (run by insurance companies) or Australia, think about the VA. Anything touched by this government and civil service turns into a disaster, except for the military because they have standards. This was just another venue for graft and corruption, did anyone ever lose their job over anything? And you kool-aid drinkers still going on about how much better it is!
3
Deciding to provide affordable healthcare with braod coverage cost to all was/is based first on values. If it is important enough, we will find ways to do it.
Selling healthcare by arguing that that it would be cheaper, money-wise, than not providing healthcare to more people, never made sense.
The ACA brought millions more under its umbrella - but was a bad compromise, which elevated the cost of care for many if not most who had already had some coverage- and took employers off the hook. I sometimes think that GOP pols refuse to see those who are in need and deny the lack of medical care -- and the Dems deny that there is a price tag. The lack of collaboration - which HAS been Republican-instigated - and the nfluence of the health care industry mean we ended up with a mash-up of private insurance which is incredibly hard to navigate and doesn't present appetizing options. I support the ACA as better than nothing, i but I also hear of a lot of young or single workers who have decided to bet that they can delay insurance, and just pay the penalty. The costs of insurance for many who work and are not subsidized is above their ability to pay, when you look at diminishing wages, relative to other costs.
To have sensible compromise - there has to be compromise - even in Europe there are personal costs for coverage - is to have a Congress which stops trying to destroy the ACA as an end in itself - and accepts universal coverage as a goal.
Selling healthcare by arguing that that it would be cheaper, money-wise, than not providing healthcare to more people, never made sense.
The ACA brought millions more under its umbrella - but was a bad compromise, which elevated the cost of care for many if not most who had already had some coverage- and took employers off the hook. I sometimes think that GOP pols refuse to see those who are in need and deny the lack of medical care -- and the Dems deny that there is a price tag. The lack of collaboration - which HAS been Republican-instigated - and the nfluence of the health care industry mean we ended up with a mash-up of private insurance which is incredibly hard to navigate and doesn't present appetizing options. I support the ACA as better than nothing, i but I also hear of a lot of young or single workers who have decided to bet that they can delay insurance, and just pay the penalty. The costs of insurance for many who work and are not subsidized is above their ability to pay, when you look at diminishing wages, relative to other costs.
To have sensible compromise - there has to be compromise - even in Europe there are personal costs for coverage - is to have a Congress which stops trying to destroy the ACA as an end in itself - and accepts universal coverage as a goal.
13
" - even in Europe there are personal costs for coverage -"
Since Europe depends on the US for its military protection it can probably afford to subsidize health insurance.
Since Europe depends on the US for its military protection it can probably afford to subsidize health insurance.
5
Values? In what world is taking my money by force to pay for people who failed to plan a value or not take care of themselves? A value of liberalism I suppose.
5
A real liberal/progressive value, making those who can pay for those who won't.
5
These people needed health care, yes, but what they might have needed even more was the mandate forcing them to purchase it.
5
it does show that the claim that insurance costs would come down was bogus and anyone with common sense would have known that
10
No surprise here.Price something below cost and lots of people want it. Charge way above value and people reject it. Thats how the ACA premiums work and why the sick sign up and the young and healthy don't. Those who couldn't afford insurance before probably can't afford the deductibles either so physicians (mostly) and hospitals get stiffed for that portion. Hardly a viable long term solution. Out here BC/BS products have very narrow networks with few hospitals or providers (no big teaching hospitals for example) and very blowout of network benefits. And they call it insurance.
9
None of this is going to work until we control the costs of health care.
Too many peopel are getting rich off the medical industry.
As a nation we simply cannot afford the current, out of control, cost structure that we allow in our hospitals and doctor's offices.
"We the people" need to take charge of costs.
Too many peopel are getting rich off the medical industry.
As a nation we simply cannot afford the current, out of control, cost structure that we allow in our hospitals and doctor's offices.
"We the people" need to take charge of costs.
16
I agree, but I don't see how adding yet another layer of bureaucrats to a system already overloaded with non-care-providing overhead costs can help.
Costs are up, care is harder to arrange, and fewer are covered.
At some point, folks might wish to revisit the wisdom of this scheme.
Costs are up, care is harder to arrange, and fewer are covered.
At some point, folks might wish to revisit the wisdom of this scheme.
3
Except we the people want Cadillac coverage on a Chevy budget. Also, we have a civil service corps that is definitely not up to the job.
1
You forgot the legions of insurance industry meddlers.
1
Didn't the Republican-controlled Congress just repeal a portion of Obamacare that helped insurance companies make up the difference caused by sicker patients? Or am I mistaken? I'm sure I read that somewhere. Can someone help me out here?
1
The Republican-controlled Congress cannot repeal anything without the President's signature. The Republicans do not have the votes to override a presidential veto.
2
No, the Republican Congress repealed the portion of Obamacare in which the US Government (i.e., the taxpayers) provide a blank check to cover insurance companies' excess costs, which are indeed excessive given the uneconomic incentives of the law.
3
Of course I was using the term "repeal" inexactly. My bad. I would love to have Medicare for all or at least a robust public option. But since we're stuck with the insurance companies, they should be helped, yes, through our taxes equitably applied, to meet the expense of covering a sicker population.
1
Today is National Doctors Day and I'm a physician so I won't hold back (but I will keep it brief.)
We caused this. We gave up our right to quality affordable healthcare the moment any third party (insurance companies, government, pharma, etc) come between the patient and the physician. This article proves that as long as that third party can dictate what happens during a private personal interaction, we're screwed.
No govt official has a viable plan because they all include a fatal flaw: they enshrine a third party in between the patient and physician.
So how do we create an affordable system that removes 3rd party influence and eliminates govt involvement? I've already done it and am sharing the idea with everyone I know. It's time for a paradigm shift in healthcare. That time is now.
We caused this. We gave up our right to quality affordable healthcare the moment any third party (insurance companies, government, pharma, etc) come between the patient and the physician. This article proves that as long as that third party can dictate what happens during a private personal interaction, we're screwed.
No govt official has a viable plan because they all include a fatal flaw: they enshrine a third party in between the patient and physician.
So how do we create an affordable system that removes 3rd party influence and eliminates govt involvement? I've already done it and am sharing the idea with everyone I know. It's time for a paradigm shift in healthcare. That time is now.
122
Well, I remember when doctors could charge whatever they wanted, and they charged exorbitant rates. It's no surprise someone stepped in to stop that practice.
4
Well, tell us how. And if you have some secret, please let the Europeans know - they already have better health outcomes than we do and at only about 70% of the cost when figured on GDP.
Better health care at less cost is a challenge that was solved in multiple countries decades ago. It's not difficult to understand, but it's difficult to implement here ecause there's a lot of money to be made from the present system and a lot of that money goes to politicians who are willing to obstruct health care reform.
Better health care at less cost is a challenge that was solved in multiple countries decades ago. It's not difficult to understand, but it's difficult to implement here ecause there's a lot of money to be made from the present system and a lot of that money goes to politicians who are willing to obstruct health care reform.
3
We also need to get "third party" players out of the electoral process…all the tv networks with their shiny stages and shiny presenters and canned questions. The pre-selected studio audiences that cheer on cue as the candidates unleash their sound bites.
For example, get rid of the crowds and say to the Republican candidates "Let's stipulate that you would get rid of Obamacare "on Day One" of your presidency. What would you put in its place? You have five minutes to outline your plan."
For example, get rid of the crowds and say to the Republican candidates "Let's stipulate that you would get rid of Obamacare "on Day One" of your presidency. What would you put in its place? You have five minutes to outline your plan."
2
Well, lets face facts: the alledged greatest nation can not keep up with Canada, most of Europeor Australia in caring for its citizens.
64
But Europe, Australia and Canada do not have to pay the full costs of their military defense which are provided by the US.
4
Or Cuba. We fall behind Cuba in caring for our citizens ...
Charles:What has that to do with anything except to point out once again that the U.S. gov't puts the welfare of it's people at the bottom of the barrel?
Everyone expected the first people to sign up were going to be those that were denied insurance b/c of pre-existing conditions. These are people who were literally dying for lack of insurance.
However, as more younger and healthier people sign up in later years (26 year old aging out of their family plans, for example), the costs will decline.
I think we need to review data for 5-6 years before making any judgement on the program.
However, as more younger and healthier people sign up in later years (26 year old aging out of their family plans, for example), the costs will decline.
I think we need to review data for 5-6 years before making any judgement on the program.
8
Remember Obama told us we could keep our doctor,keep our plan,and each family would save $2500 a year in premiums.Now we see Blue Cross angling for higher premiums due to the high medical costs of insuring Obamacare patients.Another series of lies by Obama.
18
Exactly. If experts had predicted higher medical costs due to those "newly entering the insurance market" how come insurance premiums are just now going up? Why weren't premiums set from the beginning to cover these expected costs? If the point of ACA was to get insurance for the previously uninsurable, how could the experts not understand the implications and plan for them? Better to know from the beginning that your premiums are high than to have the family budget shredded the second year.
The answer to those questions is quite simple. One: elected officials openly said that had not read the bill and made flippant comments about finding out how it would work by passing it. Two: the true cost would have prevented ACA from passing.
This another example of government slight of hand - something ALL parties are well practiced at. They fudge the facts one year and pass a law, then act surprised when it doesn't go as promised. Oops sorry, have a nice day.
The answer to those questions is quite simple. One: elected officials openly said that had not read the bill and made flippant comments about finding out how it would work by passing it. Two: the true cost would have prevented ACA from passing.
This another example of government slight of hand - something ALL parties are well practiced at. They fudge the facts one year and pass a law, then act surprised when it doesn't go as promised. Oops sorry, have a nice day.
3
I am fortunate enough to a) be over 65 and b) a state retiree. Those who are not so fortunate, my children included, cannot afford those absurdly high premiums and deductibles. The enrollment of the previously uninsured and very sick should have been calculated into the equation before this law was implemented. Have our lawmakers not heard of computer modeling? I am truly astonished at the lack of foresight. And I voted for Obama.
2
B Dawson:
The telltale sign should have been the big increase in insurers' stock.
The telltale sign should have been the big increase in insurers' stock.
3
The ACA may be good for some but it has been awful for others. Now if you don't do anything you can get coverage. If you are solidly middle class you simply cannot afford it. Yes the costs have shifted to those of us who work 50+ hour weeks and are trying to keep our heads above water. Retirement????? Not in my lifetime, I can't afford it.
13
Personable personal experiences with the aca .
1 - wealthy friends of mine qualify and are covered under obamacare and their premiums are subsidized. Turns out the aca only uses income as a criteria . My friends are in their fifties and retired living on savings therefor have no income.
2- I employ young people and do not offer them health care coverage. All of them pay the penalty for not having insurance rather than pay the premium.
3- my wife and I both lost our doctors and our insurance under the aca. We have had to pay higher premiums and higher deductibles for insurance under the act.
Just my experience under the law. I'm sure many have had positive experiences.
1 - wealthy friends of mine qualify and are covered under obamacare and their premiums are subsidized. Turns out the aca only uses income as a criteria . My friends are in their fifties and retired living on savings therefor have no income.
2- I employ young people and do not offer them health care coverage. All of them pay the penalty for not having insurance rather than pay the premium.
3- my wife and I both lost our doctors and our insurance under the aca. We have had to pay higher premiums and higher deductibles for insurance under the act.
Just my experience under the law. I'm sure many have had positive experiences.
8
Lost several long-time doctors and all out-of-network benefits, which in New York matters. Premium went down slightly; however, given the higher out-of-pockets, net effect is $10,000+ more per year in costs.
4
I'm shocked, absolutely shocked that people who have not been able to access healthcare, most likely their entire lives, have expensive medical conditions. Who would have guessed!!??
89
Under the ACA our premiums have risen and our deductibles are higher. But, our premiums kept rising before the ACA. We have more comprehensive coverage, for sure. But, the 10k a year in premiums and $5500 family (of two) deductibles to get to 75% coverage is steep, to say the least. Just one of the reasons I support Bernie Sanders.
15
Wait until you're a bit older. The premiums rise with age.
6
Bernie Sanders' grand scheme for health care couldn't even fly in his own state. It was too expensive.
5
Of course the newly insured are hugely expensive: these are the people who were formerly uninsured because their policies were guaranteed money - losers for the insurance companies. Now that insurance can't be denied for pre - existing conditions, a powerful adverse selection has been put into place. It's only a matter of time until soaring premiums drive more healthy people to drop out of the insurance pool and pay the fine and the insurance death spiral begins in earnest.
13
"Researchers and health policy experts had predicted that people with higher medical costs would enter the market in the first few years of the public insurance exchanges."
The pre-existing conditions clause must have a grandfather period, and then stop for good. If after years of opting-out and paying the penalty (lower than the cost of health insurance I don't yet need), I can sign up once I get sick by simply moving states or getting married, that is a loophole so big every young person would be insane not to take for self-interest. Assuming people will act financially in the best interest of others is asking far too much. This isn't helping your local community by paying property taxes for good schools. This is state-wide at the minimum, and when the distance gets that far, people just stop caring.
The pre-existing conditions clause must have a grandfather period, and then stop for good. If after years of opting-out and paying the penalty (lower than the cost of health insurance I don't yet need), I can sign up once I get sick by simply moving states or getting married, that is a loophole so big every young person would be insane not to take for self-interest. Assuming people will act financially in the best interest of others is asking far too much. This isn't helping your local community by paying property taxes for good schools. This is state-wide at the minimum, and when the distance gets that far, people just stop caring.
3
For people who are sick and have a chronic illness, cancer, heart disease a health plan is a bargain with or without a subsidy. Blue Cross and Blue Shield have a national network of providers. While many of them have a terrible in State network which keeps those with low incomes relegated to second rate health providers, those with the money to go out of State can get their sick family members into quality facilities because of the Blues national network. Blue Cross Blue Shield providers around the country are starting to limit their out of state networks or get rid of them outright along with raising their premium. It's not just premiums going up good providers are being severely limited.
The ACA, which opened the floodgates for the sick to get insurance is opening the flood gates to restricted networks which will kill the sick in poor facilities that are overwhelmed with more patients then they can provide for.
The sad secret is even if your well off, if you don't get insurance through your job, you no longer can buy any health plan that has high quality providers in it. You're at the mercy of the lowest cost providers regardless of condition.
My provider dropped out of the health care insurance business at the end of 2015. I completely understand why. The $24,000 a year to insure my wife and I didn't begin to cover cancer care at the Mayo clinic who was a contracted in network provider. If you get a rare cancer good luck at the CVS mini-clinic.
The ACA, which opened the floodgates for the sick to get insurance is opening the flood gates to restricted networks which will kill the sick in poor facilities that are overwhelmed with more patients then they can provide for.
The sad secret is even if your well off, if you don't get insurance through your job, you no longer can buy any health plan that has high quality providers in it. You're at the mercy of the lowest cost providers regardless of condition.
My provider dropped out of the health care insurance business at the end of 2015. I completely understand why. The $24,000 a year to insure my wife and I didn't begin to cover cancer care at the Mayo clinic who was a contracted in network provider. If you get a rare cancer good luck at the CVS mini-clinic.
17
Yes, restricted networks are the price some pay for others to receive care. This and other restrictions, like sky-high out-of-pockets, are the "fine print" that were never publicly discussed by the champions of the ACA.
Sebelius and Obama must have figured Americans wouldn't mind having fewer options and paying more because they would be receiving all those mandated benefits. They figured wrong.
What's puzzling is that for all their talk of "access", they never realized that they were creating access barriers for millions with those high out-of-pockets. Now they simply won't acknowledge it, instead touting all the Medicaid enrollees as "newly insured."
Sebelius and Obama must have figured Americans wouldn't mind having fewer options and paying more because they would be receiving all those mandated benefits. They figured wrong.
What's puzzling is that for all their talk of "access", they never realized that they were creating access barriers for millions with those high out-of-pockets. Now they simply won't acknowledge it, instead touting all the Medicaid enrollees as "newly insured."
8
For profit healthcare should be anathema to any developed society. I've been on the ACA for 2 years. It costs me WAY more than my old insurance. With a deduction for income, the premium is about $30 less than my premium was before, but the deductible is what's higher. I have a $600 deductible on medications—my old insurance had a $150 deductible. And I'm on the "Gold" plan! I went for a physical exam and will have to pay $225 for the routine lab work. It was $30 on my old insurance just 2 years ago, at the same lab, same tests. I just got a bill for the Dr. I saw for the exam—so I paid a $25 copay AND now I'll have to pay about 1/2 the cost of the visit: $180.
I can't afford this. I also have no trust that my healthcare plan is any good to me at all if I get seriously ill. And my old health insurance company has jacked up the premiums and also their deductibles.
The ACA is a patent, disgusting fraud. It is a bailout for the insurance industry. It's ruined getting insured for everyone but the people with pre-existing conditions. The goal is to have people on company plans in the "marketplace," saving corporations on benefit costs.
30-40,000 people die every year in America because they can't afford healthcare. In two years, that's more killed by our healthcare system than American soldiers killed in the 10-year Vietnam war. This barbarity has got to stop and people need to demand what every other industrialized nation in the world has: a national healthcare program.
I can't afford this. I also have no trust that my healthcare plan is any good to me at all if I get seriously ill. And my old health insurance company has jacked up the premiums and also their deductibles.
The ACA is a patent, disgusting fraud. It is a bailout for the insurance industry. It's ruined getting insured for everyone but the people with pre-existing conditions. The goal is to have people on company plans in the "marketplace," saving corporations on benefit costs.
30-40,000 people die every year in America because they can't afford healthcare. In two years, that's more killed by our healthcare system than American soldiers killed in the 10-year Vietnam war. This barbarity has got to stop and people need to demand what every other industrialized nation in the world has: a national healthcare program.
134
I sympathize with you, but we Americans clutch to the fantasy of Capitalism,private rights and free markets as the hallmarks of a freed society.
And this healthcare discussion is exposing the downsides of these free market fantasies I hope we stop drinking that nonesense.
And this healthcare discussion is exposing the downsides of these free market fantasies I hope we stop drinking that nonesense.
15
Well, talk to Republicans then. I agree with you that we need a national healthcare program. I'd give up my employer-based insurance in a heartbeat for that, not because I would expect better care or access to care (if your employer has a group plan, it's usually a pretty sweet deal) but because it's the right thing to do for the country.
The ACA is better than what existed before, but it has a huge number of flaws because it still relies on for-profit insurers and because, yes, some people like you still lose. It's not a good situation, it's just a huge step forward from where we were. Hopefully we can push for national healthcare under a President Clinton or Sanders, but more likely the president after that.
The ACA is better than what existed before, but it has a huge number of flaws because it still relies on for-profit insurers and because, yes, some people like you still lose. It's not a good situation, it's just a huge step forward from where we were. Hopefully we can push for national healthcare under a President Clinton or Sanders, but more likely the president after that.
6
Agree in general, but why do you think there are so many Indian doctors and health care professionals? In my area, affluent Bergen County, they're thick on the ground. They're not here because there are no sick people in Mumbai. They're not even here because we have high-tech First World practice opportunities; Canada, Australia, and the UK offer the same. OTOH Paul Theroux notes in his recent book 'Deep South,' a travelogue of that region, that the poorest of the poor are often served, if at all, by Indian doctors who come here on a program that involves an agreement to work in desperately poor areas for two years. Once their term is up, they light out for where the money is. (Some don't even fulfill their contract, but skip out early.) They're here for the same reason Willie Sutton robbed banks: it's where the money is. (Don't even get me started on 'nonprofit' hospitals; that's an ongoing story in NJ, after a court ruled they're not true to the original intent of the 'nonprofit' exemption from property taxes, which is true: 'nonprofit' hospitals are not charities, and everyone working in them is very much for-profit. The NYT hasn't bothered to cover the story, though our NJ media are hot on the story.) Obamacare is an ATM for them.
4
Every American man, woman, and child needs timely access to appropriate modern healthcare. Medical conditions untreated or undertreated because of economic barriers cause unnecessary disability and death.
We still have 30 million Americans who do not have access to this basic human right.
We still have 30 million Americans who do not have access to this basic human right.
73
I thought the ACA was supposed to solve all that.
2
Then we are doing the right thing, and that's the most important choice we can make in his world. Helping people who need help the most with care. Contrast the plans to PRIVATIZE and downgrade Medicare, Medicaid and perhaps even Social Security by Paul Ryan and all the new Republicans with Donald Trump's genuine statement of authenticity as a person with a heart that if Republicans believe they can both privatize and downgrade these programs and also win elections and the White House, they are wrong. As but one example, I believe there are less than 30 people in the United Stated with the brutal, life long, POEMS virus from Asia. I doubt 99 plus of Americans have even heard of it, not to mention a lot of other unnamed viruses Americans can and do contract in the course of professional and personal travel abroad, or they can just be high probability unlucky here in the homeland. Americans are caring people, and some are not fortunate in life with health issues. Healthcare reform remains a work in progress. Health reform under President Obama and Vice President Biden is an important step forward for the country. It would be acceptable to God if Americans who profess their faith in God, Christianity, the Bible, Constitution and the Republican Party put a little more of their heart into the needs of those Americans who need help the most. Stop voting the other way around.
28
Charity comes from personal initiative to help those less well off. There is no virtue in mandated alms.
9
Let's get charity out of it. I want something that is going to work and be fair. I want to make sure it is not used as a venue for corruption and graft as this one already has (opening website). We are going to have to cut available things, like sex-change operations, until we get our costs under control. We are going to have to decide who we want to get the organ transplants, i.e. alcoholics and drug abusers, people that do not follow their drug regimens as directed? We are going to have to get the tort system in line, drastically lowering the costs there (check out what Germany does). We are going to have to get a lot more efficient and I don't see that happening, ever. Check out the VA. People that work there actively embezzled from it and were given their jobs back. One person was sent to jail and was not only given his job back, but got back pay. Until the civil service is efficient and not a political patronage outfit I can guarantee anything you want will end up in disaster. I am tired of hearing arguments for morality or charity. Keep your religious beliefs to yourself. I would be more than happy to do this if we could do this without graft, fraud, and millions of illegal aliens getting free healthcare on our tab. When you can do this, get back to me.
1
The American dream is alive and well in Canada. Bernie Sanders is a New Deal Democrat who supports Medicare for all because he believes that health care is a right, not a privilege.
Canadian Medicare for all: better prevention -- better outcomes -- no bills -- no co pays or deductibles -- no lifetime caps -- no bankruptcies -- no insurance middlemen to override doctors -- the vast majority of Canadians like their system
Real Canadians Talking Real Healthcare
https://m.youtube.com/watch?feature=youtu.be&v=VQFX32Ed7ZQ
"As a Canadian who's always had health care I just don't get it. Every westernized country in the world has it, but the U.S. doesn't. It's always just seemed remarkable to me. How can you not have it? Your health is everything."
"We have enough worries when your child gets sick, but imagine a financial burden. We don't have that. We never even heard of that."
"It's like your living in a third world country. You have nowhere to go. Where's the safety net?"
"We just go and and your taken care of, and everybody is treated the same. That's what a democratic society is, isn't it?"
Canadian Medicare for all: better prevention -- better outcomes -- no bills -- no co pays or deductibles -- no lifetime caps -- no bankruptcies -- no insurance middlemen to override doctors -- the vast majority of Canadians like their system
Real Canadians Talking Real Healthcare
https://m.youtube.com/watch?feature=youtu.be&v=VQFX32Ed7ZQ
"As a Canadian who's always had health care I just don't get it. Every westernized country in the world has it, but the U.S. doesn't. It's always just seemed remarkable to me. How can you not have it? Your health is everything."
"We have enough worries when your child gets sick, but imagine a financial burden. We don't have that. We never even heard of that."
"It's like your living in a third world country. You have nowhere to go. Where's the safety net?"
"We just go and and your taken care of, and everybody is treated the same. That's what a democratic society is, isn't it?"
177
Correct me if I'm wrong but my reading of your comment is that we should move substantially left to impress our northern neighbors.
3
I live in Arizona and have many Canadian citizens who winter here. They are routinely getting service at the Mayo Clinic. In fact many of them don't get treated at all in Canada. I just can't figure out why?
6
Americans seem to think that everything is "free." They want what you have in Canada but expect someone else to pay for it. I was in Canada last month for about ten days. Everything is much more expensive than in the US - gas, food (double in many cases), hotels, restaurants, etc. I don't think Americans are willing to really pay for the healthcare costs. That's my read.
6
This thing is spiraling out of control. I can barely afford my premiums of $526/month. My insurance pays for nothing until I hit my deductible of $6450.
Remember real insurance? I used to have an affordable premium, less than $400. I could go to any doctor with a $30 copay. I could go to the ER with $100 copay. I had a $1000 deductible. I was fully covered, felt safe and secure.
To get coverage like that now, I would have to buy a gold plated plan that costs over $800/month. Impossible.
So what do I do now? I don't go the the doctor. If I complain about anything, liability kicks in and the doctor will order a bunch of outpatient tests. As soon as you walk through the front door of a hospital, you spent $5000. As soon as you fill out the release forms, you spent $5000.
Billing rates have not dropped. Providers have not reduced their fees. Cost keep going up. Profits keep going up. There is no check on costs. They just get passed through to the consumer.
There is no significant competition between insurance companies. They all have similar overhead. They all have the same cost structure. Consequently, the costs between similar plans only vary about $10-$15 per month. Big deal when you are paying $600. Big deal when the deductible is over $6000.
I can order a standard blood work up on the internet for $59. It will tell me if something is way off. If so, I will take the results to a doctor. DIY medicine has arrived.
Remember real insurance? I used to have an affordable premium, less than $400. I could go to any doctor with a $30 copay. I could go to the ER with $100 copay. I had a $1000 deductible. I was fully covered, felt safe and secure.
To get coverage like that now, I would have to buy a gold plated plan that costs over $800/month. Impossible.
So what do I do now? I don't go the the doctor. If I complain about anything, liability kicks in and the doctor will order a bunch of outpatient tests. As soon as you walk through the front door of a hospital, you spent $5000. As soon as you fill out the release forms, you spent $5000.
Billing rates have not dropped. Providers have not reduced their fees. Cost keep going up. Profits keep going up. There is no check on costs. They just get passed through to the consumer.
There is no significant competition between insurance companies. They all have similar overhead. They all have the same cost structure. Consequently, the costs between similar plans only vary about $10-$15 per month. Big deal when you are paying $600. Big deal when the deductible is over $6000.
I can order a standard blood work up on the internet for $59. It will tell me if something is way off. If so, I will take the results to a doctor. DIY medicine has arrived.
109
I have had a very similar experience. A few years ago, we had a fair degree of security that costs would be manageable in case of illness. Now, a serious illness (or even a not-so-serious illness) would cripple us financially. How is this an improvement? And I say this as a solid Democrat. Something is not working with ACA.
5
Health care insurance is now like car insurance. Car insurance doesn't cover oil changes and tire rotations, it just covers essentially catastrophes.
We need single payer. We deserve single payer and by god, and against the insurance industry, we are going to get single payer. Vote Sanders, for your health and that of your family.
We need single payer. We deserve single payer and by god, and against the insurance industry, we are going to get single payer. Vote Sanders, for your health and that of your family.
2
My own experience was similar. The main difference was that I would have had to pay well over $1000 for a good ACA plan - what I actually got for the $750/month that I was forced to pay (it's the law!) was a plan like the one that you now have.
Fortunately, when the ACA "hit" in January 2014 I was only 16 months away from my 65th birthday. Since then I have been paying about $250 for a "suite" of Medicare policies which provide coverage which is at least as good as I had back when, before the ACA took effect, I had a policy which was very similar to the one which you used to have.
Fortunately, when the ACA "hit" in January 2014 I was only 16 months away from my 65th birthday. Since then I have been paying about $250 for a "suite" of Medicare policies which provide coverage which is at least as good as I had back when, before the ACA took effect, I had a policy which was very similar to the one which you used to have.
1
I think this is to be expected. Folks put off going to the doctor, even though they knew they needed care. They stopped taking prescriptions because they could not afford it. These are the people who were just waiting for the enrollment period so that they could finally see a doctor regularly and afford their meds again. People without a pressing reason will be slower to enroll. We are just getting to the part where there will be a consequence for not enrolling. It will take about 4 years to trail off.
8
What is missing from the data in this story are the outcomes of the people who could not get insurance prior to ACA and now have it as compared to the outcomes--morbidity and mortality from a whole variety of diseases including HIV, diabetes, hepatitis C-- of uninsured people before ACA. That is where the significant impact of ACA is to be found. And that is where its true value lies.
53
Beautiful Mr.Levitt. But the simple fact is this: people are going without care despite what the insurers say. Denial of care is very common with insurers. Expanded Medicaid for my patients has meant more agony. I am an endocrinologist. I had a patient with an overactive thyroid--hyperthyroidism. I had to get prior authorization from her Medicaid HMO for a simple ultrasound of the thyroid. With that it was established she had a thyroid nodule. The next step in the work up was to get a radioiodine uptake and a thyroid scan looking to see if the nodule was hyperactive. I had to go through hell, as did her primary care to get permission for that. It took 4 refusals from the insurer and a final yes. After the patient got that test and it was established that the patient had a hot--overactive--thyroid nodule responsible for her hyperthyroidism, the therapeutic decision was to give her radioiodine treatment to ablate the nodule. Back to the insurer it was to beg again and the patient got fed up and vanished. With patients who don't understand the gravity of their conditions doctors must strike iron when the iron is hot. with patients who have unstable lives and financial situations the doctors must do the same--treat them when they are available and willing, not drag out the arrival at the therapeutic destination by months, until the patient tires or the patient's circumstances change or the patient doesn't care anymore. That's what insurers want.
11
These figures cannot be a surprise to anyone. I wonder also just how many of the first time insured gave up trying to get through these insurance companies horrible phone system to sign up or just to talk to someone about signing up. Companies do not voluntarily cover public goods market share that can't meet the company's preferred pricing. They have no reason to bond with these newly insured to keep them happy in the long run unless government continues to rubber stamp their rate increases. It is called the Profit game. Single payer has always been the way to get this done so there is truly equity in the system. Insurance companies design a second tier service level for the poor even while receiving their funding increases. The same thing happens in utilities, banking, and education. The watch dog on these companies has to be strong and it cannot be loaded with insiders.
21
It's not surprising that many new subscribers for health insurance are sicker and so costlier for insurance companies, but that is only half the story. What we also need to know is the experience of healthcare providers now that more people are covered with insurance. In the past, many of the new health insurance subscribers still used healthcare but could not afford to pay for it. Providers would bill for services and then have to embark on expensive debt collection activities and sometimes writing off debt. Have hospitals experienced a decrease in unpaid receivables?
11
Sarah B you hit the nail on the head with that one. Yes, we're going broke. I am an endocrinologist. Insurers will deny payment for nothing. We are doing more and more gate keeping, paper work and documentation with repeated calls from insurers for random audits for free. Prior authorization for drugs is common place. Can't treat diabetes, HIV, Hep C or any of the various types of arthritis without prior authorization. While waiting for treatments patients worsen. The desperation doctors and patients feel is palpable and frustrating, deteriorating the health of both. If hours are spent on paperwork and unnecessary audits to judge competency of care--the competency and efficiency measures themselves being in question--there is no time for patient care, patient education or compassion, the last being the backbone of medicine. I myself feel it is immoral not to spend adequate time with each and every patient who comes to me but when insurers keep increasing administrative demands without commensurate payments, then more patients have to be seen to stem losses. Medicare doesn't allow balanced billing and increasingly we are seeing patients who have Medicare but no secondary or supplemental insurance. They are too poor to pay and too old to burden and we, the caregivers, have to take the losses. I recently had a patient whose office copay was 90 dollars. She absolutely needed an endocrinologist and we agreed I'll do a lot of my care via phone to save her money.
5
Those things were reasonably supposed to be a result of the ACA. But maybe there is not enough pressure on providers and hospitals to not pocket the money they are also saving instead of lowering rates.
There's no money to pocket, buddy.
1
This is because we need ONE pool. The practice of insurance companies has always been to select the healthy, be it by "pre existing conditions" or by insuring employees, who by definition can work a 40 hour week.
Single payer also means ONE pool, for all of us, not tranches of relative health, with the government getting the unprofitable (older folks and the disabled) and private industry getting "the well".
In NY, finding a doc who takes ACA plans can be rough as well-the reimbursement to medical professionals is less than the same company's non ACA plans.
Single payer, one pool, with negotiation for drug pricing. How is this so difficult ?
Single payer also means ONE pool, for all of us, not tranches of relative health, with the government getting the unprofitable (older folks and the disabled) and private industry getting "the well".
In NY, finding a doc who takes ACA plans can be rough as well-the reimbursement to medical professionals is less than the same company's non ACA plans.
Single payer, one pool, with negotiation for drug pricing. How is this so difficult ?
249
Insurance companies rate risk. They can insure anyone with any condition for a price. The fact is treating chronic, deadly diseases cost a huge amount of money. There's a reason Sloan Kettering, the Mayo Clinic, Cleveland Clinic and Cancer Centers of America, all none profits advertise Cancer care on prime time TV.
We are grossly overpaying for health care in this country and no insurance scheme that Congress, funded by health care and insurance, is going to change the cost of delivery. Until that happens all health care schemes are going to be unaffordable. Single payer doesn't address it. That's why most Seniors carry additional private coverage over and above what Medicare provides.
We are grossly overpaying for health care in this country and no insurance scheme that Congress, funded by health care and insurance, is going to change the cost of delivery. Until that happens all health care schemes are going to be unaffordable. Single payer doesn't address it. That's why most Seniors carry additional private coverage over and above what Medicare provides.
7
"This is because we need ONE pool."
Why? There seems to be some strong unspoken assumption behind your comment. If I had to guess, that assumption sounds something like this -- "everyone should pay the same amount of money (i.e. insurance premiums) for healthcare no matter how much or how little of it they use". Why? We do not make the same assumption for any of the other essentials in life, like food or housing. People who consume more food pay more for it than those who consume less. People who consume more housing (live in larger houses) spend more on housing than people who consume less housing. Why is healthcare different? Is it because you are assuming that people have no control over how much healthcare they consume? Is this assumption correct?
Why? There seems to be some strong unspoken assumption behind your comment. If I had to guess, that assumption sounds something like this -- "everyone should pay the same amount of money (i.e. insurance premiums) for healthcare no matter how much or how little of it they use". Why? We do not make the same assumption for any of the other essentials in life, like food or housing. People who consume more food pay more for it than those who consume less. People who consume more housing (live in larger houses) spend more on housing than people who consume less housing. Why is healthcare different? Is it because you are assuming that people have no control over how much healthcare they consume? Is this assumption correct?
2
It's difficult because our government is addicted to the money insurance, medical and pharmaceutical industries supply to vote their rather than our interest.
But more fundamentally, it's difficult because however hard it is for you and me to pay these insurance and medical costs, every dollar the industry receives is income for someone else. Reduce doctors' fees by 50%? Tell that to someone with huge medical school loans and a mortgage larger than yours and mine together. Replace the inefficient insurance industry with single payer? Tell that to the hundreds of thousands of claims adjusters who will be out of work. Complete overhaul is the rational way to organize this sector of the economy, but getting there from where we are won't be easy, will take at least a generation and will require special support for all those in the industry displaced by radical change. I'm not optimistic that we're up for this.
But more fundamentally, it's difficult because however hard it is for you and me to pay these insurance and medical costs, every dollar the industry receives is income for someone else. Reduce doctors' fees by 50%? Tell that to someone with huge medical school loans and a mortgage larger than yours and mine together. Replace the inefficient insurance industry with single payer? Tell that to the hundreds of thousands of claims adjusters who will be out of work. Complete overhaul is the rational way to organize this sector of the economy, but getting there from where we are won't be easy, will take at least a generation and will require special support for all those in the industry displaced by radical change. I'm not optimistic that we're up for this.
8
It is hardly surprising that the newly insured "were sicker, used more medical care and had higher medical costs than those who already had coverage." The reason they did not buy healthcare, in large part, was because they could either not afford it or were shut out by pre-existing conditions. But since Obamacare was enacted into law they can now enter the marketplace.
I fully understand that my annual cost may have gone up as a result of that and may continue to go up even further. But I view that as my civic duty to help others so that everyone can gain access to healthcare. Besides, those who were earlier shut out of the healthcare market would have gone to emergency care raising our collective cost in a different manner. I'd like to know if that has decreased. And if so, the increased cost has to be seen as an offset as a decrease in the cost of providing emergency care.
I fully understand that my annual cost may have gone up as a result of that and may continue to go up even further. But I view that as my civic duty to help others so that everyone can gain access to healthcare. Besides, those who were earlier shut out of the healthcare market would have gone to emergency care raising our collective cost in a different manner. I'd like to know if that has decreased. And if so, the increased cost has to be seen as an offset as a decrease in the cost of providing emergency care.
58
These newly insured patients are those I used to take care of on Med Service C during residency. Med C patients had no insurance, could not dream of paying inpatient bills, and had outrageous health problems. By law (and by common decency) the hospital admitted them and gave them treatment. Med C was a bookkeeping distinction--the care administered was virtually the same as paying/insured patients. Because of the outrageous health problems, though, Med C patients required a lot of care.
Previously, the costs accrued by the uninsured were covered through government easements (your taxes) and higher inpatient costs for insured patients (your premiums). Before the ACA, Med C costs were defrayed from other revenue streams by hospital accountants in small offices. After ACA, there is a clear accounting of who is paying the bill, because the uninsured are now insured. The ACA just brought these charges into the light.
Hopefully, with insurance, previously uninsured patients can now get preventative and early care instead of suffering in silence and turning up for ultra-expensive care once they are nearly broken. This early care should help contain overall costs for everyone.
Make no mistake, however, you were paying for Med C patients before the ACA, too. You probably just didn't know it.
Previously, the costs accrued by the uninsured were covered through government easements (your taxes) and higher inpatient costs for insured patients (your premiums). Before the ACA, Med C costs were defrayed from other revenue streams by hospital accountants in small offices. After ACA, there is a clear accounting of who is paying the bill, because the uninsured are now insured. The ACA just brought these charges into the light.
Hopefully, with insurance, previously uninsured patients can now get preventative and early care instead of suffering in silence and turning up for ultra-expensive care once they are nearly broken. This early care should help contain overall costs for everyone.
Make no mistake, however, you were paying for Med C patients before the ACA, too. You probably just didn't know it.
339
"...and turning up for ultra-expensive care once they are nearly broken. This early care should help contain overall costs for everyone."
Unfortunately, there is NO evidence that this is happening. In fact, E.R. visits have RISEN, despite the promises of the President. The cases you describe are the result of lifestyle problems, not insurance problems. No one can argue that universal health care doesn't improve the health of the overall population, in the same way that free transportation would improve people's ability to get to work. So why not buy everyone a car? The word "cost" never appears in NY Times commenters' remarks. The ACA will crush our economy - don't bother with my opinion, look at the Europeans, whose economies are still on the canvas after the recession, largely because their governments already spend so much on social programs, there's no money left to juice their economies with spending on job-creation.
Sorry, Michael, I've seen the future and it looks like it costs too much.
Unfortunately, there is NO evidence that this is happening. In fact, E.R. visits have RISEN, despite the promises of the President. The cases you describe are the result of lifestyle problems, not insurance problems. No one can argue that universal health care doesn't improve the health of the overall population, in the same way that free transportation would improve people's ability to get to work. So why not buy everyone a car? The word "cost" never appears in NY Times commenters' remarks. The ACA will crush our economy - don't bother with my opinion, look at the Europeans, whose economies are still on the canvas after the recession, largely because their governments already spend so much on social programs, there's no money left to juice their economies with spending on job-creation.
Sorry, Michael, I've seen the future and it looks like it costs too much.
3
Connecticut Yankee:
"In fact, E.R. visits have RISEN, despite the promises of the President"
***
President Obama pretty much got it wrong about almost everything.
BTW, one reason given for the stubbornly high use of the ER is its convenience. People seek health care when they are not working.
Now imagine an entire population of Americans, used to receiving services on demand, bumping up against a system that relies on rationing to keep costs low.
Anyone who believes Americans will go for long wait times -- once they believe they are paying for something and/or entitled to it -- is dreaming. They are probably the same ones who believed people would love all the new benefits in Obamacare and wouldn't mind paying more for them.
"In fact, E.R. visits have RISEN, despite the promises of the President"
***
President Obama pretty much got it wrong about almost everything.
BTW, one reason given for the stubbornly high use of the ER is its convenience. People seek health care when they are not working.
Now imagine an entire population of Americans, used to receiving services on demand, bumping up against a system that relies on rationing to keep costs low.
Anyone who believes Americans will go for long wait times -- once they believe they are paying for something and/or entitled to it -- is dreaming. They are probably the same ones who believed people would love all the new benefits in Obamacare and wouldn't mind paying more for them.
I am middle class who always had health insurance but privately paid for by our own business. It was expensive but now astronomical due to Obamacare. With a $5,000 deductible, a premium of $16,000 and then we still would have copays if we were to be hospitalized, not to mention my son's $2000 college health plan, I foresee my health deteriorating because I am paying for those who didn't have. Don't get me wrong, I don't want to see others hurting, but not at my own expense. I am a cancer survivor myself. Obamacare is destroying the efforts of hard-working middle class people who work for themselves and consequently destroying future entrepreneurship. Seems like there is no point anymore trying to get ahead.
58
Obamacare did not cause you premiums to go up. Premiums are a function of the underling costs of the health care delivery system since 85% of the costs are the claims. THAT is what costs so much. The fact is that the uninsured were paid for by everybody but now people pay for some of their care and, better, it is now managed within the delivery system and not waiting until things are so bad as to cause patients to get their care in the ER. Plus it is the right thing to do. Kudos to the Blue Cross Association for releasing the data.
6
Your son does not need his own health insurance, if he is under 26. So, most all college students are covered under their parent's plans.
I do agree that health care is not terribly affordable, but at least now, I can buy insurance! I pay $7200 a year but have a platinum plan with no deductibles,
I do agree that health care is not terribly affordable, but at least now, I can buy insurance! I pay $7200 a year but have a platinum plan with no deductibles,
6
Didn't you worry that your individual insurance would be rescinded when you were diagnosed ? Didn't you notice your premiums going up every year PRIOR to Obamacare ? Did you have the same benefits prior to Obamacare? There is evidence that you would actually be paying more for your previous plan because of inflation and the fact that more & more people were becoming uninsured because of that inflation.
8
My personal anecdote. I recently had appendicitis which required a CAT scan, a 90 minute laparoscopic surgery, and 36 hours in a hospital bed on pain and antibioic medications. The hospital billed my insurer $23k, of which I was on the hook for about $5k. That's on top of the $6k I pay annually for my premiums.
This entire medical industry (Obamacare and all), can't come crashing down fast enough in my opinion. We need single payer with aggressive cost controls.
This entire medical industry (Obamacare and all), can't come crashing down fast enough in my opinion. We need single payer with aggressive cost controls.
332
RP Smith, My husband had the same, uninsured because he has cancer , in 2010.
Hospital billed $60,000. Because of our income , we have to pay $23,000. We will be paying monthly on that for about 10 years.
Now we have a policy under Obamacare. He had a triple bypass. Hospital billed insurer $160,000. Insurer discounts brought it down to $60,000. We were on the hook for only $10,000. Delighted !
The cancer that caused him to be uninsured only requires yearly blood tests while we watch & wait to see if he'll need treatment. It meant that he was also uninsured for everything else - Isn't it better to have people insured ?
Hospital billed $60,000. Because of our income , we have to pay $23,000. We will be paying monthly on that for about 10 years.
Now we have a policy under Obamacare. He had a triple bypass. Hospital billed insurer $160,000. Insurer discounts brought it down to $60,000. We were on the hook for only $10,000. Delighted !
The cancer that caused him to be uninsured only requires yearly blood tests while we watch & wait to see if he'll need treatment. It meant that he was also uninsured for everything else - Isn't it better to have people insured ?
18
10 years ago I had to appendicitis ( burst appendix). I had a CAT Scan, laproscopic surgery that DIDN't clear all the massive infection, 16 days in th hospital, 12 days before the infectious disease head was allowed to see . The surgeon kept saying it was my fault I was getting sicker and sicker. He First sent a psychiatris (who I didn't allow in my room), then a pastor, even though my paperwork said I am an agnostic!
Infectious disease Dr. determined I had MRS and CDIF and I required Invasive radiology treatment.
All the above was covered by Insurance and Hospital costs were $40,000, surgeon $5000.
Compare to RP above as see ohw exorbitantly hospital bills have increased.
Infectious disease Dr. determined I had MRS and CDIF and I required Invasive radiology treatment.
All the above was covered by Insurance and Hospital costs were $40,000, surgeon $5000.
Compare to RP above as see ohw exorbitantly hospital bills have increased.
5
I agree with you. The problem isn't entirely with The Affordable Care Act or even the insurance companies, its the out of control costs from the providers.
We as consumers have zero ability to influence competitive market forces on them.
We as consumers have zero ability to influence competitive market forces on them.
6
It is no surprise that socio-economically challenged people are more complexly ill with or without health insurance. We are all patients someday and will succumb to either heart disease or cancer, spending the most healthcare dollars as we spiral towards the end.
Without access to primary care, there is no choice but over-utilize emergency rooms as the front door to healthcare as an inappropriate, fragmented solution.
We will all pay either upstream or down, it is just a matter of when and where.
Without access to primary care, there is no choice but over-utilize emergency rooms as the front door to healthcare as an inappropriate, fragmented solution.
We will all pay either upstream or down, it is just a matter of when and where.
36
Everyone must practice preventive medicine and the food industry, the soda industry and all the other industries that keep us fat, slothful and unhealthy with the aid of our politicians must back off.
2
We have to decide what aspect of the ACA was the priority. Was it getting access to healthcare that a huge swath of our population - maybe 50 million people - were denied, or was it making health care cheaper?
Both can be accomplished, but not simultaneously. Frankly, extending care is the easy part. Trying to reduce cost means reducing someone's revenue and reducing revenue is reducing income. That will not happen overnight - whether we stick with the ACA, repeal and "replace," or go to the golden land of universal care. Cutting cost requires grown up decision making and a level of acceptance that we cannot have everything we want, for free, right now.
If we could get the Party of No to stop trying to kill its constituents long enough to work the problem, we might have a chance to make headway. But I am not optimistic.
Both can be accomplished, but not simultaneously. Frankly, extending care is the easy part. Trying to reduce cost means reducing someone's revenue and reducing revenue is reducing income. That will not happen overnight - whether we stick with the ACA, repeal and "replace," or go to the golden land of universal care. Cutting cost requires grown up decision making and a level of acceptance that we cannot have everything we want, for free, right now.
If we could get the Party of No to stop trying to kill its constituents long enough to work the problem, we might have a chance to make headway. But I am not optimistic.
14
Making health care cheaper may well be more difficult than expanding access to health care, especially when the hospital industry, which appears to have benefited enormously from the ACA, continues to be as powerful as it was when the ACA was drafted and passed. However, what made extending care relatively easy was the way that its essentially redistributive nature, with the cost of extending care being borne disproportionately by people whose income is just a little too high for them to qualify for subsidies, was hidden, in some cases so well that some of the legislators who voted for it didn't appreciate the extent to which their middle class constituents were going to be stuck with most of the bill.
1
This gives me an idea. Since a single payer system is not politically possible at present, what about having the government pay for treatment and prescriptions relating to a few specified diseases–e.g. diabetes, hepatitis C, HIV–which are particularly responsible for high insurance premiums? The gov't could set reasonable prices to make sure it wasn't overcharged; millions who suffer from these conditions would be guaranteed the treatment they need and have no anxiety on that score; and the insurance premiums for everyone else would go down substantially.
2
And who will be paying for the cost of "having the government pay for treatment and prescriptions relating to a few specified diseases–e.g. diabetes, hepatitis C, HIV–which are particularly responsible for high insurance premiums"?
4
Looks like Obamacare is going to cost more than predicted, kind of like "if you like you doctor, you can keep you doctor". Oops...better call spin control at the NYT.
24
This should come as no surprise. The design of Obamacare was uniquely crafted to encourage adverse selection - only those in need of expensive care signed up. The healthy have done so in far fewer numbers and the penalties (taxes) are not onerous enough to force the healthy to enroll and drive down costs. Our government at work.
13
Even the government worshiping NYTs has said on many occasions that "government is always inefficient and often corrupt" so this is just another example to prove it.
5
what about the healthy who need an appendectomy and can't pay for it ?
5
Oh where to start?
Access, quality and cost are the three pillars cited by most when it comes to describing a health case system. It is a reasonable starting point for discussion. The ACA, like some state driven initiative started with Access, get people more actively engaged in the health care system, usually promising that then challenges with Quality and Cost could be address. Whether knowingly or not, it has been a lie. Dealing with Quality and Costs are harder to do and our political leadership lacks either the insight and/or the spine to do the harder efforts.
And this affects out broader wellbeing. When Germany provides its citizens health care acceptable to them for 11% of their GNP, but it is closer to 18% in the US, that makes it equivalent to a 6-7% extra tax on every other job to fund a disappointing system. No wonder jobs go overseas. Who benefits? Well all over the people working in the Health care delivery system seem to be surplus funded, and the political leaders we continue to reelect disputed their spineless feckless behavior
Access, quality and cost are the three pillars cited by most when it comes to describing a health case system. It is a reasonable starting point for discussion. The ACA, like some state driven initiative started with Access, get people more actively engaged in the health care system, usually promising that then challenges with Quality and Cost could be address. Whether knowingly or not, it has been a lie. Dealing with Quality and Costs are harder to do and our political leadership lacks either the insight and/or the spine to do the harder efforts.
And this affects out broader wellbeing. When Germany provides its citizens health care acceptable to them for 11% of their GNP, but it is closer to 18% in the US, that makes it equivalent to a 6-7% extra tax on every other job to fund a disappointing system. No wonder jobs go overseas. Who benefits? Well all over the people working in the Health care delivery system seem to be surplus funded, and the political leaders we continue to reelect disputed their spineless feckless behavior
12
If a 6-7% cost is driving jobs overseas, then let's remove Social Security taxes (6.2%) from the employees ledgers and bring those jobs back.
2
And pay for Social Security how?
2
The ACA is a rare bird -- it's a long-term government investment intended to reduce healthcare costs over coming decades. It has already helped slow the rate of annual increases in healthcare coverage. But its real aim is to inculcate the idea of preventive health in generations to come by getting them to doctors and professionals earlier in life and more often, before their conditions become chronic, severe, and exorbitant. Many of us would have preferred single-payer, but the theory behind the ACA is sound: keep people out of emergency departments, diagnose them before they need major surgery, and cut back on obesity, heart disease, diabetes, mental health issues, etc. It will be interesting to see whether Americans will vote to continue down that wise road, or pull the plug out of a more typical impatience with any effort that requires a generation to show real results.
44
have annual increases slowed?
after paying middle class level premiums (I'm self employed) our family rations "health care" big time because nothing left for deductible and copay. Pre ACA was unacceptable, ACA era still insufferable
Regarding "real aim is to inculcate the idea of preventive health in generations to come by getting them to doctors and professionals earlier in life and more often, before their conditions become chronic, severe, and exorbitant" - unfortunately part of life is to develop chronic, severe and exorbitant conditions beyond what preventative care can prevent
after paying middle class level premiums (I'm self employed) our family rations "health care" big time because nothing left for deductible and copay. Pre ACA was unacceptable, ACA era still insufferable
Regarding "real aim is to inculcate the idea of preventive health in generations to come by getting them to doctors and professionals earlier in life and more often, before their conditions become chronic, severe, and exorbitant" - unfortunately part of life is to develop chronic, severe and exorbitant conditions beyond what preventative care can prevent
4
How can ACA cut back on obesity?
3
The problem is that preventive health generally does not lead to decreased health care costs. If preventive measures are very successful, you will in fact have a large cohort with very high costs - for instance people who live to old age and develop dementia.
The real cost saving measures of the ACA were not preventive care - it was passing more costs on to the consumer, such as through higher deductibles and premiums. This was proudly discussed by one of the ACA architects, until negative public response caused him to hedge a bit. (Notably, academics at Harvard were in favor of such proposals - until it was applied to their own policies and caused tremendous outrage.)
The real cost saving measures of the ACA were not preventive care - it was passing more costs on to the consumer, such as through higher deductibles and premiums. This was proudly discussed by one of the ACA architects, until negative public response caused him to hedge a bit. (Notably, academics at Harvard were in favor of such proposals - until it was applied to their own policies and caused tremendous outrage.)
6
The predictable outcome of this study is that Republicans will say we can't afford to provide health care to "these people" because they are too sick and the cost are high. Hopefully, voters can be convinced that condemning their fellow citizens to a life of illness and suffering is not the best course of action for the richest country in the world. I would imagine that providing health care to the sick and making them well would have many secondary benefits to society and the economy.
39
"I would imagine that providing health care to the sick and making them well would have many secondary benefits to society and the economy."
I agree. Also, maybe many of these sick people would be healthier if they could afford to eat healthier food and made enough money to lessen their financial stress. There are reasons why these people are so sick and as a society we can work on the causes as well as treat the symptoms if we find the will to do so.
I agree. Also, maybe many of these sick people would be healthier if they could afford to eat healthier food and made enough money to lessen their financial stress. There are reasons why these people are so sick and as a society we can work on the causes as well as treat the symptoms if we find the will to do so.
5
Sicker and costlier? Excellent! That shows the ACA is working. Without it these people would be sicker and sicker. The moral cost of allowing that is incalculable. Need more dollars to pay the fiscal costs? I'll kick in if those far wealthier than I am join me--as the Congress clamps down on overcharging for health care. We can do this.
132
Feel free to donate to the charity of your choice but don't rope me and my wallet into your scheme with forced charity in the guise of tax dollars. I don't expect anyone to pay for me so I shouldn't have to pay for anyone else.
4
It does seem to be true that the ACA is working in precisely the way that its proponents hoped it would. Unfortunately, the political forces which powerfully influenced the law's rather devilish details resulted in the financial burden being distributed in such a way that the "far wealthier" aren't being required to bear any more of it than individuals whose gross annual income can be as low as $47,000.
3
@Leave Capitalism Alone - I surely would never want to hang out at your party.
2
We need a shift in values away from becoming rich off one or another subset of the medicine industry. In other countries, people become doctors because medicine interests them and they care for people's welfare. Generic drugs are easily and quickly available. Excedrin and Ibuprofen are in push through pill packets that discourage abuse, not jars of 300.
If mega rich specialty physicians wouldn't choose to do what they're doing if they couldn't be that wealthy, (medical school loans is a straw dog), then they should be doing something else outside the human care domain.
The ACA is inadequate because it never could be adequate as long as it resides in a for-profit medical system.